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Opt-in? Or Opt-out? SOCHUM Chooses

By Cheryl Chin, Channel NewsAsia

Published: 20 Mar 2019 - 08:09 AM

The National Donor Monument in the Netherlands

The National Donor Monument in the Netherlands

The Social, Humanitarian and Cultural Committee (SOCHUM) had a debate on whether an opt-in or opt-out organ donation system is more viable as a solution to the illegal organ trade. With an opt-in system, people will have to sign papers to have their organs donated after death. As for an opt-out system, people will have to sign papers to be exempted from donating their organs after death.

Minutes into the discussion, there was a clash between 2 sides - one in favour of the opt-in system and the other which preferred the opt-out system.

Delegates from countries like China, Croatia, Pakistan, and the United Kingdom stood for the opt-in system, seeing it as a choice that respects human rights more than the opt-out system. The delegate of Croatia exclaimed that the opt-out system is ‘state-fascism’ and worries that people’s organs will be harvested ‘just because they forgot about signing paperwork’. The Chinese delegate stressed the importance of ‘clear moral boundaries’ as well as ‘free will and own choice’, saying that allowing people to sign up for organ donation is more ethical than being signed up at birth and having to opt out if they are against it.

On the other side of the spectrum, delegates of France, the Netherlands, Uruguay, and other nations supported the opt-out system. The delegate of France spoke of the ‘empowerment’ for people, knowing that they can ‘help someone even when they are deceased’. She mentions that it would be a ‘waste of organs’ if they were ‘left out to rot’, highlighting the fact that those organs could have saved someone’s life. The delegate of Uruguay suggested for countries to ‘push for more education’ so that people ‘fully understand what they are consenting to’ in the opt-out system.

However, a number of delegates wanted a system which is structured around both the opt-out and the opt-in system, namely the delegate of the United States. Although the opt-out system is in place in the United States, the delegate believes that applying for organ donation is a ‘mandated choice’ and that ‘many opportunities to opt out’ should be given, aligning to his opinion that ‘everyone has control over their own bodies’. For example, authorities can put questions asking for one’s preference about their organs being donated into papers like ‘driving license applications’. The delegate of Iran also warned less developed countries to avoid using the opt-out system in fear of the poor and illiterate not understanding the terms of such a system.

Eventually, delegates of SOCHUM decided that there was no ‘one-size-fits-all’ solution. Thus, the delegates chose to understand that different countries require different organ donation systems. The more developed countries were certain that many of their citizens can understand the terms of organ donation after death, due to their higher literacy rates. Hence, implementing an opt-out system would not cause much harm to a more developed nation. However, less developed countries have more people of lower socio-economic status and more illiterate individuals so an opt-in system was recommended in the debate for such countries to avoid exploiting these vulnerable people without them knowing it. The committee then changed the subject to something that was agreed to be ‘necessary for both the opt-in and opt-out system’ - education to raise awareness of organ donation. Education would improve the opt-in system by spreading awareness to get more people to donate their organs upon death so that the supply of organ transplants would increase. The opt-out system would benefit from education on organ donation because people will understand the terms of the system and make an informed choice on whether to opt out or remain in the system.