Final copy
Health is a vital component in ensuring better living standards, mutual development and progress of the community, and the general welfare of the community. As such, the government’s health department is responsible for the establishment and promotion of good health in its country. Health and general welfare promotion are chiefly attained through health-related preventive and intervention methods. Organ transplant is one of the key technological advancements of preventive and intervention approaches to establishing and promoting health. It has become a common and highly reliable means of improving health and saving lives. However, organ donation is not optimal due to organ shortage that is evident in the United States. The number of donors is considerably lower than the number of people in line waiting to benefit from the organs. This deficiency is highlighted by the statistics collected from surveys and researches across the country. According to the HRSA (2020), more than 112,000 Americans required life-saving organ transplants in the United States as of May 5, 2020, with the number increasing by one person every 10 minutes. These people appear as potential organ recipients on a very long waiting list. Most of these people do not get an organ, and some die before they can obtain a transplant to prolong or sustain their lives. At least, America approximately loses 20 patients each day due to organ shortage (Ladin, 2016). Others may not die but lead miserable, tedious, and depressing lives. For instance, patients with kidney failure make numerous, regular trips to the hospital for dialysis, which has financial, social, and health ramifications to the person, family, community, and public health department. If these patients had access to a ready stock of organs, the ramifications could reduce significantly. As such, this policy proposal calls for the review of the current organ donation legislature to change it from an opt-in to an opt-out organ donation system, still managed by the current Uniform Commissioners to ensure more organs are donated to curb the shortage.
The proposal is to overhaul the U.S. organ donation policy and change it from an opt-in to an opt-out donation system. The opt-in system means that harvesting or donation of organs is only allowed legally if the person, or his or her next-of-kin, approves it (Ahmad & Iftikhar, 2016). This establishes that taking organs from the deceased is universally illegal unless the person indicated formal approval before death, or the next-of-kin indicates it. This means that the government approaches the issue of organ donation from two angles. It seeks organs from the person while he or she is still alive and from the same person when he or she is dead through that person’s family members. Notably, this approach is not sufficient as the shortage persists in an era marked by rising morbidities. As HRSA (2020) observes, over 60 percent of the adults register for organ donation, but only about three people in every 1,000 die through circumstances and conditions that allow for the donation of the organs. On the other hand, the opt-out system describes a governmental law stating that the medical harvesting of organs for transplant is legal universally unless the person indicates formally before death that he or she does not wish to donate her organs (Ahmad & Iftikhar, 2016). The opt-out system has two main types, the “soft” opt-out, and the “hard” opt-out. Soft opt-out refers to a policy that allows the next-of-kin or family members to make the formal refusal to donate the organs on behalf of the person after he or she has died (Ahmad & Iftikhar, 2016, p. 26). The family members can refuse even if the deceased did not make the formal refusal when alive. The hard opt-out system establishes that only the person can make the formal refusal, and the next-of-kin or family members cannot deter it if the person did not make it when alive (Ahmad & Iftikhar, 2016, p. 26). This means the decision to refuse is personal and cannot be influenced by any other subjects in the environment. The “Soft Opt-Out” donation system is the proposed policy.
The monitoring and implementation of the policy should retain the same structure it currently has. The policy should change, but the administrative structure of establishing, monitoring, and enforcing the new donation system in the U.S. should remain the same. Currently, Uniform Commissioners is responsible for the modeling and drafting of UAGA (Uniform Anatomical Gift Act), which is a collection of the laws and regulations governing organ donation in the U.S. (Glazier, 2018). Uniform Commissioners comprises representatives selected by the U.S. governors, who meet and set uniform laws at the national level but whose jurisdiction falls under the respective states because the nature of the field does not allow federal regulation (Uniform Law Commission, 2020). This governing and monitoring structure should remain. The Uniform Commissioners should develop a Soft Opt-Out donation system, just as they designed the current opt-in policy. Then, each state should adopt and implement the new laws accordingly.
Three critical factors justify why the chosen system is better than the current one. The first factor revolves around the benefits of the proposed legislation. According to Ahmad & Iftikhar (2016), the overall objective of any organ donation system is to ensure optimal and effective organ donation. This means the volumes of the organs donated should be high to meet organ demand of the population. The current policy is not resolving the shortage adequately, whereas the opt-out option remains unexploited. As Ahmad & Iftikhar (2016) explain further, the opt-out system allows the public health to obtain organs from the large portion of citizens who would otherwise, have consented to organ donation but did not due to the hindrances of time, resources, and preoccupation needed to make a formal consent before one dies (Ahmad & Iftikhar, 2016). Apparently, the current 60 percent subscription rate to organ donation would increase to almost 100 percent. Every citizen would be a potential donor until stated otherwise. This would increase the organ supply and reduce the health, social, and economic consequences of organ shortage.
The second supporting factor is the attitude of Americans concerning organ donation. Studies indicate that almost all Americans would readily donate their organ upon death. This finding has been consistent over the years. According to Ladin (2016), surveys conducted since 1993 and 2016 indicate that more than 90 percent of Americans are willing to donate their organs for medical purposes. A survey in 1993 indicated that 93.5 percent would readily donate, while others conducted in 2005 and 2016 indicated 92.9 percent and 94.9 percent, respectively (Ladin, 2016, p. 157). Apart from the positive public attitude, a phenomenon called Default Effect further influences the community into accepting social changes made by the government. According to Ahmad & Iftikhar (2016), a Default Effect means that people view certain positions taken by the government on social issues as the most favorable for them and the community. As such, they refrain from challenging them. Besides, opting for the alternative of filing a refusal under the opt-out system would be time-consuming and stressful, making the person opt for the default state (Ahmad & Iftikhar, 2016). It means that once the government implements this policy, the public will endorse and accept it with minimal objections and noncompliance.
Thirdly, apart from the encouraging attitude of the public, the public health body has the responsibility and authority to implement social policies that mandate public participation in collective action to resolve a social issue, especially in serious matters such as health and safety (Ladin, 2016). This implies that the body has the responsibility and mandate to force collective action, if necessary, to safeguard the community’s health and welfare. Failure to institute social policies to address social problems indicates the ineffectiveness and unreliability of the presiding public health authorities. As such, reviewing the existing policy to enhance organ donation and simultaneously facilitate organ transplantation is a key function of the United States public health authority. Its responsibility for changing the policy would be greatly supported by the positive attitude of the public and the Default Effect phenomenon.
Some critics may object to this proposal claiming that it is radical and extensive and instead propose minor changes that entail commercializing organ donation for profit. A trend is emerging in which some scholars, bureaucrats, and commercial entities are campaigning to modify the current policy from being a “free organ donation” system to a “paid organ donation system.” Supporters of this system argue that compensation for organ donation would encourage more people to donate, which would minimize the shortage (Adair & Wigmore, 2011). However, this optimist projection is misguided. As studies have indicated, the paid donation system would lead to greater adverse effects. According to Adair & Wigmore (2011), this approach would increase illegal black market trade of organs, make it difficult for the poorer members to access organs for transplant due to high competition and low purchasing power, and motivate the poor to sell their organs. Therefore, organs should not be sold. Another way should be sought to ensure their abundance in matching the demand. This other better way presents in the form of an opt-out organ donation system.
Conclusion
In conclusion, the United States currently uses the opt-in organ donation system, which is marred by organ shortage and the resultant health burden on the community and health sector. This system allows harvesting of donated organs from people who give consent during their lifetime or whose next-of-keen make the offer to donate. This system is ineffective. The Opt-out system would be more appropriate of several critical factors. First, it allows for harvesting of organs from all deceased citizens with an exception of those who make it formally clear that they do not wish to donate their body organs. Also, organs would not be collected from those whose next-of-keen refuse on their behalf. This means that more people will donate organs than they are currently. Secondly, the public largely supports the notion of donating organs at approval rates that are consistently above 90 percent. This means that they would not feel gravely violated by the proposed legislature. Thirdly, the government has an innate responsibility of instituting social policies that promote health and safety. Therefore, it has the mandate to make the proposed changes. Implementing the opt-out donation system will increase the number of donated organs in the country and resolve the shortage problem leading to better public health outcomes and lifestyles.