Presumed consent for organ retrieval

Improving organ retrieval rates: various proposals and their ethical validity

The current global shortage of organs has prompted a series of proposals for improving organ retrieval rates. They include preferred recipient status for registered organ donors, payment for organs, presumed consent and required response. This paper examines the tenability of these proposals and points out their shortcomings. Taking the Canadian situation as an example, it argues further that the shortage is exacerbated by unethical and essentially illegal retrieval protocols that flout the law of informed consent. It is suggested that before any redrafting of laws and regulations is undertaken, these protocols should be revised.

Kidney procurement policies in the Eurotransplant region. 'Opting in' versus 'opting out'

A shortage of kidneys has been part of kidney transplantation ever since it evolved from its experimental stage and became a therapeutic possibility. However, at present this shortage is more acute than ever before. Post mortem kidney procurement policies can be distinguished into 'opting in' and 'opting out' systems. In the five countries cooperating in Eurotransplant, systems of both kind have been implemented. In this paper the relation between these procurement policies and kidney availability in the Eurotransplant region is examined. The opting out system turns out to be more favourable to kidney procurement than the opting in system. The approach of the next of kin with the donation question happens to be an important barrier for kidney procurement in the opting in system, but fails to appear under opting out. In the epilogue some remarks are made on the possibilities of introduction of the opting out system in countries now applying opting in.