CONSENT FOR ORGAN DONATION - TIME FOR A CHANGE

The present worldwide shortage of organs is not due simply to a lack o f potential donors, but also to a failure to turn many potential donor s into actual donors. At least part of this failure can be traced to p roblems with the two major systems presently used for obtaining consen t for cadaveric organ donation: ''opting-in'' and ''opting-out''. Mand ated choice has been proposed as an alternative system for obtaining c onsent designed to combine the benefits of its predecessors while avoi ding their shortcomings. Under this proposal, all adults would be requ ired to decide for themselves whether or not they wish to become organ donors upon their deaths and their decisions would be controlling. Th is approach would preserve altruism and voluntarism while eliminating the need to obtain family consent, which is a major barrier to organ r etrieval. To see if the public would support mandated choice, I contra cted the Gallup Organization to poll 1000 randomly selected U.S. adult s regarding this proposal. Nearly two-thirds of respondents said they would support such a system and three-quarters believe that the family should not be able to override their loved one's wishes. Mandated cho ice appears to be an acceptable method for obtaining consent for donat ion which, by eliminating the family consent barrier, might well incre ase the supply of organs available for transplantation.