You may have come across the term ‘presumed consent’ or ‘opt out’ in conversations about organ and tissue donation policies around the world. Countries like the United Kingdom have adopted this approach, where individuals are considered potential donors unless they explicitly opt out. In contrast, the United States follows an opt-in, first-person authorization system. This means individuals must actively register their decision to become organ, eye, and tissue donors. Once the decision is legally documented, typically through a state registry or driver’s license, no further approval is needed at the time of death.
The Opt-in System is Preferred and Works for Americans
A presumed consent system may seem like a logical way to address the organ shortage, but before supporting it, consider these key facts about how it works and why it may not be the best fit for the United States.
No Systems Operate as True Presumed Consent Models
While presumed consent has been enacted in several Western European countries, in practice, most of these systems are implemented as family authorization, with families effectively able to override the presumption of consent.
Presumed Consent Removes the Opportunity for Discussion with the Family
With the current opt-in system, organ procurement organizations can talk directly with the families of potential donors. This gives families a chance to ask questions and make informed decisions. Switching to an opt-out system would take away that important opportunity for family conversations about donation.
Understanding Public Attitudes Toward Presumed Consent
The most recent national study on presumed consent was commissioned by the Department of Health and Human Services in 2019. It found that 34% of people would choose to opt out if the U.S. adopted a presumed consent system. This data offers important insight into how many Americans feel about organ donation policies.
Many people view presumed consent as a decision imposed by the government rather than a personal choice. This perception could lead some to opt out, not because they oppose organ donation, but because they do not want to be automatically enrolled.
The latest global research from the Max Planck Institute in 2024 also found that switching to an opt-out system does not increase organ donation rates. Their study of five countries showed no significant rise in donations after adopting presumed consent policies.
Presumed Consent is Not in Alignment with American Legal Principles
Laws in the U.S. focus strongly on individual rights and freedoms. Presumed consent may conflict with these principles. While it might seem promising, such a big change could impact public trust in organ donation. Still, ongoing conversations about it are important.
Opt-out or Presumed Consent Would Not Make More Organs Available for Transplant
Finally, data suggests moving to an opt-out system would not make more organs available for transplant in the U.S. Under our current opt-in system, 48,149 organ transplants were performed in 2024, according to data from the Organ Procurement and Transplantation Network (OPTN). That was made possible by the generous contributions of 16,988 deceased donors and 7,030 living donors in the United States. These numbers show the U.S. opt-in system works well. People have to voluntarily decide to register, but many do, which leads to relatively high donation rates.
Join the 5th annual Concert for Hope presented by the Orr’s Hope Foundation
Come at 5 for local vendor fair including education and games from Donate Life Wyoming. Stay for performances by Rising Star Tumbling and Dance, line dance lessons by Country Kickup, and end the night with a performance by the one and only Chancey Williams with opening guest Jarrod Morris.
For Aris, a longtime DMV employee, asking people if they want to register as donors is part of his everyday work. But one day, a man walked up to him with a red rose and changed everything. The man told Aris that years ago, he was on a transplant waitlist and that because Aris asked someone to check the box, he got the kidney he needed to survive. That gift meant he’d be spending Christmas with his granddaughter.
That moment stuck with Aris. It reminded him that what might feel like a small interaction could actually mean the world to someone else.
“Not just because of the job I do, but as a human, that moment motivated me to be better, to be kinder, and to think about others,” said Aris. ” I can have the greatest gift, even though I don’t have all the riches I want, but I have time with my son and things I love within my reach.”
Aris and his son Dominic are both registered donors. They’ve talked about what it means to give someone more time with family, time to heal, time to live.
“When my son got his permit, beforehand we talked about it and I explained to him how important it is to be an organ donor,” said Aris.
That conversation left an impact, and Dominic took it to heart.
“To a person that might need a transplant, it’s everything, it’s whether you get to continue living and having experiences, to have time with loved ones and that’s really powerful,” said Dominic.
Stories like Aris’s are a reminder that donation is about more than checking a box, it’s about creating memories with loved ones that last a lifetime.
It’s National Nurses Week!
National Nurses Week, observed each year from May 6 to May 12, honors the vital contributions nurses make to the health and well-being of our communities. In time of uncertainty, nurses have shown to be unwavering beacons of compassion. They’re often the solitary faces of comfort in hospitals when we need it most. Their dedication knows no bounds, working 12-hour shifts and shouldering tasks that may seem insurmountable to many. From the frontlines of patient care in hospitals to the vital role they play in preventive healthcare within doctors’ offices, nurses epitomize the essence of selflessness and care.
Showing Support for Transplant Nurses & Donor Caregivers
Nurses play a big role in the organ and tissue donation process. From providing support to helping families navigate the complexities of organ and tissue donation, their expertise helps Donor Alliance honor a person’s decision to give the gift of life.
Nurses’ tireless efforts also help Donor Alliance ensure a person’s lifesaving and healing gifts are received by transplant centers and tissue processors in a safe and timely manner.
Donor Alliance thanks all nurses for honoring the gift of life each day. Their partnership makes organ and tissue donation possible across Colorado and most of Wyoming.
There are also other unsung heroes: the caregivers. They provide steadfast support to transplant recipients and living donors. They offer solace, advocacy, and love throughout the journey of donation and transplantation. Their strength shows the power of compassion and care.
How You Can Give the Gift of Life
In honor of National Nurses Week, there are ways you can provide support to those waiting for a lifesaving transplant. Currently, there are nearly 1,300 people in Colorado and Wyoming on the waitlist and more than 100,000 people nationally. Say “yes” to registering as an organ, eye and tissue donor the next time you obtain your driver license or state ID. You can also register today at DonateLifeColorado.org or DonateLifeWyoming.org. Once you register, you will receive the little heart with the Y on your license. That little heart has a big impact – one person can save up to eight lives through organ donation and save and heal up to 75 lives through tissue donation.
As we celebrate and express gratitude for nurses and caregivers, let’s remember the essence of their work lies in caring for life. It’s a gift that transcends boundaries and transforms futures for those waiting for a lifesaving and healing transplant.
