Is opt-in or opt-out the best way to address our organ donor shortage?




It used to be a yes or no question when you renewed your licence but since this was scrapped, we now we have an opt-in method to become an organ donor that we must actively seek out – but is it the best option?

Opting out means that everyone can potentially donate their organs when they die, and only if they do not choose to, then they can remove themselves from the register. Opting in is when you can choose to become a donor, otherwise your family will make the final decision when you pass away. One question has been the source of much debate around the world: is opt-in or opt-out best?

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To answer the question scientifically, researchers from the University of Nottingham, the University of Stirling and Northumbria University analysed the legislation of 48 countries. 23 countries in their study were on the opt-in system, and 25 on the opt-out. Over 13 years, they found that countries with an opt-out system had a higher total number of kidneys transplanted, which the majority of people on transplant lists are waiting for.

And even though opt-in kidney donations can be slightly higher if the donors are still living, the opt-out system still has a greater overall quantity of organ transplants in all the countries studied.

Those of us who have donated to a family member or stranger, or have had an organ donated to us, know how crucial becoming a donor is. Living donors can make a choice to save a life even if they aren’t a registered donor, no matter what system their country is using. Donors that are still alive have a higher rate of donation than if you were passed away as your family can ultimately decide on donation options.

In Australia, we have a waiting list of over 1,500 at any given time and only 1,760,000 Australians are registered organ donors…the demand is much greater than the supply.

In an article published in The Conversation last year, it was proven that default systems do make a big difference. A study by Eric J. Johnson and Daniel G. Goldstein involved asking different people in an online survey whether they would be willing to be donors in several different hypothetical scenarios.

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In the first scenario, participants were told that the default was not to be an organ donor (but they had the option to consent-in). In the second, participants were told that the default was to be an organ donor (but had the option to opt-out).

Not surprisingly, this made a big difference. When participants had to consent-in, only 42% chose to do so. If they had to opt-out, 82% agreed to donate.


Registration is easy, voluntary and allows you to choose which organs and tissue you are willing to donate. To register, you can:

– Download a registration form

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– Visit your local Medicare office, where you can pick up a Donor Register brochure and registration form

– Telephone 1800 777 203

– Request a registration form to be mailed to you by emailing your full name and postal address to [email protected]

– Register online


So, the question is, would an opt-out system work for Australia? Are you a registered organ donor? Have you or someone you know needed an organ transplant? Tell us your thoughts below.