How to Increase the Rate of Organ Donation in Australia - Management Assignment Help

Assignment Task:

Task:

How to increase the rate of organ donation in Australia?
Artin Tebyanyan – teby0002@flinders.edu.au
Introduction:
Organ donation is the practice of removing a person’s organs and subsequent transplantation into another host for therapeutic purposes. In 2019 Australian donation rates where 21.6 and 10.9 donors per million population (dpmp) in deceased and living populations respectively. A study by S.E. Morgan et al, investigated the factors influencing the decisions, of a sample population, regarding organ donation. The study found that the choice to donate was prompted by religious beliefs and altruistic intentions. Alternatively, the choice against was due to a lack of trust in medical professionals, and education surrounding the organ donation process and the inability to set conditions regarding who receives their organs. 3
In 2019, 221,641 Australian donors registered, yet, donations (from deceased individuals) are limited by the circumstances of death, hence only 1-2% of deaths were allowed. Donation numbers have steadily increased, 554 donations in 2018 to 558 in 2019; the demand however is still not met with 1,600 Australians currently waitlisted. Meeting this ever-increasing demand calls for changes in public policy. Adjustments include adopting an opt-out from an opt-in system, removing of the power of veto and introducing incentivises.
Opt-out system:
Australia currently practices an opt-in system, requiring individuals to provide informed consent expressing the desire for organ donation through the Australian Organ Donation Registry (AODR). Comparatively, the opt-out system has been adopted by Spain. It presumes that all individuals wish to donate, requiring individuals opt-out from the registry if they wish. If individuals have not specified their decision, the opt-in system assumes that he/she did not wish to donate. 2
Currently, 33.3% Australians are registered donors, albeit statistics from DonateLife indicate 69% of individuals wish to be donors. The opt-out system will therefore accommodate for the remaining 36% of unregistered potential donors. This system, amongst other factors, has enabled Spain to achieve the highest number of deceased donors globally, 48.9 dpmp. 4 B. Firat identified 18% higher donation rates in countries adopting the opt-out system as compared to opt-in. 1 Furthermore, as statistical review has found that leverage/value of altruistic motives correlate to higher donation rates. 4
The opt-out system respects the wishes of the deceased. Simultaneously it encourages donation and conscious decision making regarding their organs. This system comes under scrutiny, however, if individuals are registered as donors when they have not expressed their views (false positives). Therefore, the opt-out process challenges the law of informed consent as it is not necessary given.
Power of veto:
Under the Australian Organ and Tissue Donation and Transplantation Act 2008, following the death of a donor power of veto is endowed upon the next of kin. This power enables the next of kin to revoke the donor’s decision. Largely in Australia, the wishes of the donor have been upheld despite this power, however, in 2019 it was found that 38% of all potential Australian donations were revoked despite the wishes of the deceased. Moreover, statistics have shown that people are more willing to donate their organs rather than make the same call for another, supporting the above statistic. 2
The power of veto, furthermore, opposes the ideology of informed consent. Informed consent is a prerequisite for medical treatment, which must be satisfied prior to action, and can only be given when the individual is fully aware of the implications of the proceeding action. When given, informed consent is binding and the power of veto is not endowed upon the next of kin, respecting the individual’s autonomy. This standard, uniquely, is not upheld in situations pertaining to organ donation. Therefore, next of kin should only be permitted to provide or withhold consent when the donor is unable to provide consent, similar to providing consent for medical treatment.
Organ donations are restricted by the conditions of death; hence, only 1-2% of donors can successfully donate. Therefore, after removing 38% (veto), only 0.62-1.24% donations are executed. Comparatively Austria (23.8 dpmp) having externalized the practice of veto, has higher rates of deceased organ donation than Australia and can carry out all valid donations. 1 Furthermore, removing the power of veto upholds the wishes of the deceased without conflict. Excluding of the next of kin can be the cause of emotional distress as the wish of the deceased may oppose their own. Therefore, it is important to note that responsibility is put onto the donor to communicate their wishes to their family.
Incentive’s:
Property law indicates that the body, and body parts, are not considered property of the individual, and therefore, cannot be sold. The individual is however authorized to donate/give organs by free will. The term donation implies that monetary compensation is not given, however, monetary incentives may influence poorer individuals to register. Yet, unless paid for by the state monetary incentives introduce in-equality, as some individuals are unable to pay. Thus, leading to the poor being exploited and the wealthy favoured. Alternatively, the state could pay a portion of the funeral and post-death expenses, again prompting registration of those in lower socio-economic brackets. Incentives, however, are not limited by monetary confines. Donors could be prioritized on transplant waitlists, as was introduced in Israel and has contributed to increased donation numbers. 5 This may, however, undermine the organ allocation system which is built around urgency.
Incentivising organ donation downplays the altruistic intentions of the donation yet acts as a strong stimulus for registration. Incentives yield themselves to ethical concern, as incentivizing donation can be exploited, introducing in-justice and in-equality; undermining the ideology of organ donation.
Conclusion:
In 2019, 558 donations were received from deceased Australian donors, yet over 1,600 individuals are still on transplant waitlists. Therefore, the Australian organ donation rate must increase through changes to public policy. While all changes may cause a degree of hardship, the following would yield the best outcomes; adopting an opt-out system and removing the power of veto. Additionally, incentivising organ donation should only be implemented as a last measure. Incentives stands to increase donation rates in poorer individuals; but will concurrently introduce ethical concerns such as exploitation and injustice.
 

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