Every day, 17 Americans die while waiting for an organ transplant. Opt-out organ donation policies, which enroll everyone into post-mortem donation programs by default unless people choose to opt out, have been touted as a way to increase the supply of desperately needed organs. But opt-out organ donation policies may reduce living organ donations, leaving systems no better supplied with lifesaving organs.<\/p>\n
Pascal G\u00fcnt\u00fcrk\u00fcn and colleagues analyzed epidemiological data from 24 countries between 2000\u20132023 and conducted four experimental studies with over 5,000 participants to examine how switching from opt-in to opt-out organ donation policies affects both deceased and living donor rates. The authors found that while opt-out policies led to a non-significant increase in deceased donors of 1.21 people per million population, the policies significantly decreased living donors by 4.59 people per million population-a 29% reduction.<\/p>\n
Through experimental and comparisons between Germany (opt-in) and Austria (opt-out), the authors demonstrated that this crowding-out effect primarily affects so-called “altruistic donations” to acquaintances and strangers, rather than donations to family members. People living in countries with opt-out systems perceive organ supply as sufficient, and are consequently less willing to become living donors. According to the authors, the findings reveal the unintended consequences of a public policy nudge and suggest that policymakers should consider potential crowding-out effects when implementing opt-out organ donation systems.<\/p>\n
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