Organ Donation

Let us discuss a controversial issue that, in some extent, I believe should not be classified as such (controversial that is) – organ donations in Europe with more focus on the Netherlands. One could expect that the Netherlands would be in favor of organ donation, being a liberal and progressive country. However, the current status is far from that.

To begin with, two main reasons that could cause this lack of organ donation could be either ignorance or personal choice. On the one hand, ignorance would be associated with a not-necessarily malevolent attitude, but rather due to lack of important information and awareness. On the other hand, one should also take into account personal beliefs and attitudes towards “desecrating” the body after death.

In support of the first statement, approximately 7 million people in the Netherlands (over the legal age consent of 18) have not yet submitted their preferences as far as organ donation is concerned [1]. That is a crucial fact, since many people might be willing to donate organs but perhaps are “too lazy” to register and to take some action. “Is it possible for someone to be willing to donate but too bored to actually do so?” The answer is a simple yes. The format of how the question of donating your organ is presented matters. Sounds strange, doesn’t it? Probably you think it does sound strange, but it has been proven that making decisions seems rather “boring” to many people and most prefer maintaining the status quot. One paper that explored in depth this phenomenon is the article written by E. Johnson & D.Goldstein, “Do defaults save lives?”. In this article, they show how a simple change in the formation of the question asked, can make a difference.  The above chart represents the percentage of people willing to sign up for organ donation after death. As you can see, the difference is quite significant. As far as the first group (gold bars) is concerned, the question asked was “Opt-in (check the box) if you want to be an organ donor”, whereas in the second group (blue bars) the question asked was “Opt-out (check the box) if you DO NOT want to be an organ donor”. Peculiar as it may be, a minor detail can have a major impact on a decision about organ donation.

The consequences can be fatal to those in need. According to, (Central Bereau of Statistics Netherlands) in general more people are willing to be a recipient of an organ than donating one. Almost 80% in 2011 compared to roughly 70% respectively in 2010. However in 2011, out of families that had a deceased relative whose organs could be harvested, only 33% gave their consent to actually do so. This percentage is relatively small.

How can this situation change? An ideal solution would be to increase awareness about organ donation and put emphasis on informing people of how their decision can influence someone else’s well-being. One possible solution for that was the airing of “De Grote Donorshow”, a highly controversial reality show, in which a terminally-ill patient would donate a kidney to the winner of the show. Although the terminally-ill patient was an actress, it was successful in creating awareness and having people at least notice the importance of the situation regarding organ donation. I believe that having an opinion is far more acceptable than simply staying on the sidelines and not caring about organ donation.

As you may have noticed, I have placed more emphasis on the aforementioned “ignorance” factor, rather than personal choice and beliefs. My opinion in that is very simple, and in some extent cynical as well. Ignorance and misinformation regarding organ donation can relatively easily be tackled, whereas personal choice and beliefs is a more challenging section. It is a matter of having as much information as possible for someone to make a concrete decision on organ donation. Various explanations for personal reasons can be noted that will not be further elaborated as the topic is controversial enough on its own. However, as you may recall, a couple of paragraphs above I mentioned the willingness to receive an organ and to donate one (80% vs. 70%). It is ludicrous that people want to have something, but should they pass away, they are unwilling to have their organs harvested. I believe that those two questions should be expressed as one. When you want to be the recipient of a transplant, you should also be willing to donate your own (should the circumstances be as such). In any case, you can’t be on both sides simultaneously so, in the end you can benefit by being a recipient and when the unfortunate moment comes, you can help someone else in need by means of organ donation.

Further reading:

Johnson, E., & Goldstein, D. 2003. “Do defaults save lives?” Science, 302 (5649), 1338-133






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