Impact of presumed consent for organ donation on donation rates: a systematic review
Rithalia and colleagues conducted a systematic review of what presumed consent does to organ donation rates, covering five before-and-after studies of countries that changed their law, eight comparisons between countries with and without presumed consent, and thirteen surveys of public and professional attitudes. All five before-and-after studies reported an increase, with little investigation of what else was changing at the same time. In the four best between-country comparisons, presumed consent was associated with higher donation, including increases of roughly a quarter in two of them. The review then lists the other factors that mattered in at least one study: deaths from road traffic accidents and cerebrovascular causes, transplant capacity, national income, health spending, religion, education, public access to information and the legal system. The authors conclude that presumed consent alone is unlikely to explain the variation between countries.
Rithalia and colleagues conducted a systematic review of what presumed consent does to organ donation rates, covering five before-and-after studies of countries that changed their law, eight comparisons between countries with and without presumed consent, and thirteen surveys of public and professional attitudes. All five before-and-after studies reported an increase, with little investigation of what else was changing at the same time. In the four best between-country comparisons, presumed consent was associated with higher donation, including increases of roughly a quarter in two of them. The review then lists the other factors that mattered in at least one study: deaths from road traffic accidents and cerebrovascular causes, transplant capacity, national income, health spending, religion, education, public access to information and the legal system. The authors conclude that presumed consent alone is unlikely to explain the variation between countries.
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338, a3162. Presumed consent associated with higher deceased donation rates, with increases of roughly a quarter in two between-country studies, alongside a list of confounds including road traffic deaths, transplant capacity, health spending, income, religion and education. doi:10.1136/bmj.a3162
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https://doi.org/10.1136/bmj.a3162
DOI: 10.1136/bmj.a3162