The system is an opt-out program.
Photograph by CBS Photo Archive/CBS—via Getty Images
By Sy Mukherjee
January 4, 2017

A major public health change swept France on New Year’s as new regulations making citizens automatic organ donors unless they specifically choose to opt out through a national database took effect.

The new “opt-out” system is aimed at combating widespread organ shortages and long wait lists for transplants. Previously, French citizens who hadn’t specified whether or not they wanted donate after dying could have their organs’ fate left up to relatives. Now, the responsibility will fall on individuals, and next-of-kin will no longer have carte blanche veto power.

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Those who object to donating their organs will have to sign up with a National Register of Refusal or make their intents known through written documents they leave with their families. They can also tell their relatives that they’ve chosen to opt out, and these family members would then have to provide signed documentations to that effect to doctors. About 150,000 people have already signed up for the refusal register, according to The Guardian.

Opt-out donation systems already exist in a number of places in Europe, including Spain, Austria, and Wales. While they can be controversial, there’s at least some research suggesting that they improve donation rates in countries that adopt them.

For instance, a 2014 review by U.K. researchers examining 48 countries with opt-in or opt-out systems found that donor rates were significantly higher in countries using opt-out regimens. (Interestingly, living donor rates were actually higher in the opt-in systems, although overall transplants for sought-after organs like livers and kidneys were higher in the opt-out systems.)

The U.S. government (which has an opt-in system) estimates that a patient is added to the national transplant waiting list every ten minutes, and that 22 people die every day while waiting for a transplant.

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