Why Organ Donation should be Compulsory?

Imagine this: you are diagnosed with severe heart failure and your only chance of survival is to receive a heart transplant. Although your loved ones would desperately like to help, they are unable to. Unlike a set of lungs or a pair of kidneys, you only have one heart, thus making it impossible to consider the idea of utilizing a living donor. You now are faced with the fact that in order to live, you need to rely on an organ from a deceased donor and are placed on a waiting list of over 114,000 names.

You hope and pray that even though the list seems never ending, you somehow will be bumped up in line by proving to be the best match for an available heart before it is too late. After months of waiting, the organ never comes, and you have succumbed to your disease, leaving your friends and family behind to mourn your loss. While that story seems chilling, it is a reality for thousands of individuals every year. If implemented by the United States government, an opt-out organ donation system has the potential to save countless lives that would have otherwise been lost.

Compulsory organ donation is a system of presumed consent, meaning that upon an individual's death, their organs will automatically be considered for transplant unless that person had made the decision to opt-out before their passing. Of the 114,000 people currently listed on the transplant waiting list, twenty a day will die while waiting for a transplant. Additionally, a new name will be added to the list every ten minutes, and only three in every one-thousand individuals will die in a way that allows for their organs to be donated ("Organ Donation Statistics").

These facts show that the United States is both in dire need of more registered donors, as well as a larger pool of viable organs available to be transplanted. While many individuals see organ donation as selfless, extremely important, and entirely necessary and have no issue with the government implementing a law of presumed consent, others are opposed to the idea entirely.

Those who are against the idea of compulsory organ donation more often than not tend to bring up the same few reasons for their oppositional views. One of the most significant concerns with implementing this system is that many individuals believe that to do so would go against their religious beliefs. This, however, is far from the truth. In fact, almost every major religion in the United States is in support of organ donation. The Lutheran Church, for example, believes that donating one's organs is "an expression of sacrificial love for a neighbor in need[,]" and the Presbyterian Church has stated that they "[recognize] the life-giving benefits of organ and tissue donation, and thereby encourages all Christians to become organ and tissue donors as a part of their ministry to others..." ("Organ Donation and Religion").

Consequently, followers of these religions are not only told that organ donation is perfectly acceptable to take part in, but that they are encouraged to do so. Aside from the fact that nearly everyone who is concerned with their religion disapproving of organ donation being wrong, the compulsory system still leaves the option to opt-out at any time. Therefore, if an individual follows a very specific religion that happens to not believe in or support organ donation, those individuals can simply choose to not participate in the program.

Another reason that some are opposed to the opt-out organ donation system is because they think that it would encourage doctors to not work as hard to save their lives if they were dying and believe that the doctors would be more concerned with how useful their organs are than their life itself. This belief is entirely false, as the only priority that medical personnel have when one is emergently admitted to the hospital is to save their life. Until each and every lifesaving method has failed and each and every option has been exhausted, organ donation doesn't even begin to become a possibility ("Organ Donation Myths and Facts").

Something else to consider when discrediting this oppositional belief, is that every single doctor has had to take a Hippocratic Oath before they begin to practice medicine, which specifically states to "first, do no harm", and encourages placing the good of the patient before the good of themselves. ("Philosophy of organ donation: Review of ethical facets"). For a doctor to choose to not provide adequate care to a patient that is a known organ donor in an attempt to utilize their organs would be to go against everything they swore to do.

The idea of being "too sick" or "too old" is another common reason for opposition to the opt-out system. Some people are so greatly misinformed on who can and cannot donate, that they completely disregard the idea of organ donation becoming compulsory because they believe that there would be no point in them being automatically registered as donors since their organs would not be useful to anyone based on their age or poor medical history.

While there are some cases where organs can be deemed not viable due to illness, that is completely up to the transplant team to decide. As far as the concern with age being a hurdle in organ donation, the idea of being too old to donate could not be further from the truth, as the oldest organ donor to date in the United States was ninety-three years old ("Organ Donation Myths and Facts"). This alone means that there is absolutely no age limit to organ donation, and that the only thing that matters is the health of your organs when you die.

Fear of one's family members having to pay for their organs to be donated is one other significant reason that some people are opposed to the compulsory organ donation system. This myth, though widely believed, is simply that: a myth. Families never have to pay for their loved one's organs or tissues to be donated ("Organ Donation Myths and Facts"). While a lot of false information in regard to organ donation tends to be passed around and accepted as fact, if one just does a little bit of research, they will learn that almost everything negative that they have believed about organ donation is completely untrue.

Contrary to popular belief, a compulsory organ donation system is not a system of hypotheticals, as it has been proven to work in other countries. Spain, a country that has adopted the opt-out system is not only the world leader in organ transplants and has been for the past twenty-five years, but in 2016, it broke its own record for the number of transplants that were carried out that year ("How Spain became the world leader in organ transplants").

With the number of patients on the transplant waiting list in Spain consistently being lower than the number of patients on the transplant waiting list in a country with an opt-in system, such as the United States, one could easily conclude that the opt-out system is a much more effective model. Along with Spain, Belgium also follows the presumed consent system of organ donation. According to an article published in The Lancet, a weekly peer-reviewed general medical journal, "Belgium [has] well documented and convincing evidence that a change in the law from contracting in to contracting out in 1986 led to an increase in organ supply" ("The Case for "Presumed Consent" in Organ Donation").

Though it seems like common sense that making organ donation compulsory unless one chooses to opt-out will lead to an increase in available organs, the fact that other countries who have adopted this idea have been successful with it speaks octaves louder than common sense ever could.

Though organs are a vital part of the compulsory donation system, bodily tissue donation will also be essential in the process to positively impact lives. While one organ donor can save up to eight lives, that same organ donor can enhance up to seventy-five more with their tissue. Tissue includes body parts such as skin, heart valves, ligaments, bones, veins, and corneas, and can be used to treat birth defects, injuries, and more.

With an opt-out system, the roughly one in twenty Americans who will require some sort of tissue donation in their lifetime will be much more likely to receive the body parts they need, whether that be bones for a patient in need of undergoing a reconstructive procedure, skin for a burn victim, a heart valve for an individual with a defect, or a cornea for someone with visual impairments ("10 Things You Need to Know About Tissue Donation"). The many uses for donated tissue is nearly endless, and since tissues can be stored for longer periods of time than organs can, their versatility is invaluable in regard to the lives that they can vastly improve.

Many in support of a compulsory organ donation system believe that donating your organs and tissues is not only the right thing to do, but that it would be selfish not to. In an article published in the World Journal of Transplantation that was written by Aparna R Danal, an assistant professor in anesthesiology at the Icahn School of Medicine at Mount Sinai, Danal states that "[o]rgan donation is founded on the pillars of altruism.

When the moral value of an individual's actions are focused mainly on the beneficial impact to other individuals, without regard to the consequences on the individual herself, the individual's actions are regarded as []Altruistic.[']" ("Philosophy of organ donation: Review of ethical facets") This ideology goes hand-in-hand with compulsory organ donation as donating your organs or tissues to someone in need is a tremendously selfless act. Danal goes on to note that studies have been done by neurologists that prove that when someone commits an act of charity, the subgenual cortex/septal region of the brain, which is linked to social attachment or pair bonding, is triggered.

Therefore, when one participates in organ or tissue donation, they are not only benefiting others, but they are benefiting themselves by having a positive neurological response to the act itself. Of course, this would only apply to living donors since when you die, your brain will clearly not have this response. For deceased donors, however, there are still thought to be personal benefits to gain from donation, albeit slightly more ego-driven ones than altruistic ones.

In fact, many donors believe that by committing a selfless act, they will leave behind a legacy of being highly respected and gain a positive reputation when they die, or for those who are religious, they believe that donation will lead them to being rewarded for their sacrifice in whatever life after death situation they personally believe in ("Philosophy of organ donation: Review of ethical facets"). Though there are varied reasons, selfish and unselfish, for one to believe in the idea of an opt-out model in regard to organ donation, they all have one desire in common: to save more lives.

Use of a presumed consent type system will obviously make it much easier for those who want to be organ donors to become one because they would never have to sign up to begin with ("Organ Donation Statistics"). Never again would one have to check a box at the DMV or sift through various "sign-up" websites to express their desire to become a donor. Modern Americans are notorious for being drawn to quick fixes, whether that be due to laziness or an extremely busy lifestyle.

The idea of not having to stress about trying to make time to register as a donor would surely be appealing to many Americans. Aside from the convenience aspect of being listed as a donor automatically, supporters of a compulsory organ donation system have often come to that conclusion due to personal experiences related to themselves or a loved one receiving an organ, or even knowing or being someone who gave their organ(s) to someone in need. In an article written by Kenneth Moritsugu that was published by Public Health Reports in 2013, Moritsugu gives the reader an intimate, firsthand look into his own positive experiences with organ donation.

After losing his wife and daughter within four years of each other in motor vehicle related accidents, Moritsugu found comfort and solace in the fact that his wife and daughter saved and improved multiple lives by donating their organs. Even after experiencing such devastating losses, Moritsugu still preaches the importance of organ donation and recognizes the need for more donors by stating that "[o]rgan donation provides a life-giving, life-enhancing opportunity to those who are at the end of the line for hope[, a]nd the need for organ donors is growing."

Moritsugu somehow had managed to find a way to see past his grief when thinking back to his wife and daughter's deaths and instead chose to focus his attention on spreading awareness of the importance of addressing the growing need for organs, since in the four years between his wife and then his daughter's death, the number of names on the transplant waiting list had nearly doubled, proving that the lack of organs is becoming an epidemic in the United States.

After all the facts have been considered, compulsory organ donation is imperative in the quest to save the lives of those who suffer from organ failure. It would greatly decrease the number of individuals on the transplant waiting list, assure that new names will be added to the list in larger time intervals than every ten minutes, and will cause the statistic of twenty people dying a day while waiting for a transplant to decline.

Furthermore, use of this system allows the earlier mentioned 95% of all American adults who believe in organ donation to automatically be listed as donors, therefore one can conclude that approximately 95% of the country will be organ donors, since there would be no need for one who believes in donation to opt-out. This being said, presumed consent would effectively fix the problem of the large disparity between adults in agreement with donation and adults who are actually registered as donors. Thus, the gap between the 95% and the 54% will be closed, and thousands of more lives will be saved through the use of organ transplantation each year.

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