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Opt-out not the answer for organ donation

  • 21 March 2019


In 2018 in an effort to stamp out illegal trade practices and raise organ donation rates, a parliamentary committee recommended Australia take an opt-out approach to organ donation. An opt-out system would presume everybody is an organ donor unless they have taken preventative measures and officially registered to opt-out.

In 2011 I was one of 1001 Australians who benefited from the generosity of 337 deceased organ donors. At the time, it was Australia's highest recorded number of organ donations. Last year Australia recorded 554 deceased organ donors — an increase of 64.3 per cent.

DonateLife, the peak body responsible for organ donation in Australia, maintains the position that adopting an opt-out policy has the potential to decrease donation rates. According to DonateLife, growing education and awareness have been the catalysts that have seen organ donation rates increase in Australia. So why change a system that is working?

Many in favour of adopting an opt-out system believe it will override family consent, and organ donation will become automatic for those who have not opted out via the registration system. Transplant wait lists will subsequently decrease — it seems like a win for everyone.

However, the idea that opt-out will override family consent is false. The key deciding factor for both opt-in and opt-out systems requires that next-of-kin provide consent. Without this consent, organ donation will not proceed under either model.

Of those who die in the circumstances compatible with organ donation, 59 per cent of families consent. A closer look at the statistics reveals 90 per cent of families say yes to organ donation when their loved one has registered, and 73 per cent of families say yes if they've had a conversation and know their loved one's wishes, even if they never registered.

In comparison, only 44 per cent of families consent when they do not know their loved one wishes. Without the clear indication of intent provided to next-of-kin by registering to be an organ donor, changing the organ donation register to opt-out runs a real risk that organ donation rates will lower.


"As guardian to gifted lungs, I am now responsible for taking care of a part of someone else, and I take great comfort form the knowledge that these lungs were given willingly."


Why worry about a little thing like consent then? Why not let opt-out go a little further and override next-of-kin consent? The obvious argument is that the first headline shouting 'Government stole