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'Opt-out' system needed for organ donation: ethicist

24 February, 2014

More Australians could, and should, donate organs when they die, says Charles Sturt University (CSU) ethicist Dr Alberto Giubilini, who has called for the introduction of an 'opt-out' system.

Dr Giubilini, from CSU's Centre for Applied Philosophy and Public Ethics, said DonateLife Week was an opportunity for people to think more carefully about becoming organ donors.

"Last year there were only 391 deceased donors in Australia, or about 17 donors for every million Australians. Clearly, Australians are not doing enough," he said.

"With the current system, the problem is not so much that people decide not to sign-up but that they don't decide anything at all. They simply don't think about the possibility because they are never asked."

Dr Giubilini said awareness campaigns were just one way of encouraging people to consider organ donation, but it would be more effective to introduce an opt-out system.

"In countries such as Austria, Belgium, and Singapore people will become deceased donors unless they declare otherwise," he said.

"This approach would guarantee Australians who would opt to become donors if they only considered the option could easily do so. In fact, it would be so easy they wouldn't have to do anything at all.

"Deceased donations in Singapore increased nearly eight times over three years after an opt-out system was introduced, and Austria and Belgium have more than twice as many donors per million head of population than Australia."

Dr Giubilini said another option was to follow Israel's example by encouraging people to become donors by being given priority status on transplant waiting lists in the event they needed an organ themselves.

"This is a basic ethical principle," he said. "I am entitled to receive something that others donate provided that, if I were in someone else's shoes, I would be ready to donate the same thing."

Although donation rates in each country can be affected by other factors, including the way people die, Dr Giubilini said Australia's annual spending on renal replacement therapy alone (expected to be $1.1 billion by 2020) meant there were financial as well as ethical reasons to find new solutions.

"There is no guarantee that any of these policies would work equally well in Australia, but it is important to test ideas like these," he said.

"Australia has already committed $1.2 million to a trial policy on living organ donation, so why not implement a trial scheme on other organ-related policies such as an opt-out system and the reciprocity policy?"

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Veronica Dix | Thursday, February 27, 2014, 10:01 AM
I dont agree with this. I think there is enough media advertising to encourage donation. A blanket "opt out" approach, does NOT take into account a persons religious, moral or personal views about having their body desecrated. We MUST allow every individual to have a choice
archibald | Thursday, February 27, 2014, 11:31 AM
Thankyou Veronica you have said it better than I could have. 100% agree. A person's own conscience should not be overridden by some opt out system.
mmcc | Thursday, February 27, 2014, 1:01 PM
Like the infant vaccination program, a conscientious objector form could be filled in, allowing those with personal views against organ donation to have a choice, and to opt-out. The individual is still choosing in this situation, Veronica. What Dr Giubilini is suggesting is not forcing anyone to donate their organs, nor is their conscience being overridden.
Malarchie | Thursday, February 27, 2014, 1:53 PM
The author's words do not appear to be based on 'ethics' but an op ed. This is an expression of personal opinion and the information therein is biased. The systems and causes of death amongst deceased donors in other countries are not easily comparable. Once someone has a 'should', implied or otherwise, in their statement they appear to be taking the 'moral high ground'. The Israel example is like saying "unless you are prepared to relinquish a baby you shouldn't be able to adopt. Just a tad punitive me thinks. As for the infant vaccination, parents do not have to give notice of their decision in advance .. or else.
Veronica Dix | Thursday, February 27, 2014, 4:56 PM
I dont agree with you mmcc that an "opt out" policy is actually choosing. People already have that choice as things stand, by NOT having to submit paperwork to explain WHY they think their body is sacred and do not wish to have it carved up. The fact is that it is human nature to NOT have to think about death until we have some reason to be confronted with it. Dont get me wrong, I FULLY support organ donation and in fact would encourage it, however the individual should NOT need to have to justify their reasons why they choose not to donate.