I wrote about the U.S.’s lack of organ donors back in June, but while listening to Marketplace yesterday I heard a really interesting factoid (God, I can’t believe I just used the word “factoid”. I suck). Apparently Europe is having similar problems finding willing donors. Except Spain. (Requires login. You can see Google’s cached version here)

In several well-cited studies, researchers in the United States attempted to predict organ donation potential by using medical capacity, mortality, economic, and sociodemographic variables. Unfortunately, the external validity, or generalizability of their findings, may be problematic when applied to Europe, especially because the United States has no presumed consent (opting-out) policy “on the books” or in practice.

Within Europe, much attention relating to improving organ donation has focused on the activities of 2 programs: the Spanish donation and transplantation program and the Donor Action Foundation.

Spain leads the world in rates of organ donation per million population. Academics and professionals study the Spanish model for donation and transplantation in an attempt to determine if some of its attributes might be replicated globally. Spain, to acquire global leadership, opted to focus legislative, economic, and media resources on a hospital-based team approach to donation and transplantation.

The Donor Action Foundation has focused its energy on educating professionals and standardizing the request process within critical care units of hospitals and medical centers throughout Europe and the world. With other variables held constant, their program had the causal effect of improving a given country’s organ donation by 70% to 160% within a 3-year period after implementation.

Public policy response to the shortage of organs available for transplantation has varied from country to country. Perhaps the most controversial response from ethical, religious, and individual rights perspectives has been the presumed consent policy for organ donation. Although national programs vary widely in the process for “opting out,” the role of family members in the donation decision and in the potential implementation of such a policy varies from country to country. Regardless of implementation details, studies have suggested that countries with presumed consent laws, on average, have higher rates of organ donation than do countries that do not have a presumed consent law.

Which pretty much brings me back to what I was talking about in June. I can’t understand what (other than religious beliefs) would make somebody be so damn selfish that they’d be unwilling to give up their organs after they die and, in the process, save someone’s life. You can’t take it with you, folks.

So I ask again, why should our organ donor system be one in which a prospective donor needs to “opt-in” rather than selfish people being forced to “opt-out”? It’s not like organ donors are waking up in a bathtub full of ice and their kidneys gone. People who are so pigheaded that they want their organs to rot with them in the grave should be the ones who are forced to jump through hoops, not those who to save lives.

Of course, people opposed to an “opt-out” organ donor program would probably just bring up Baby Lazarus, as if somehow the United States has a high population of miracle babies who would be threatened by a presumed consent law.