Golsteyn Bart H H, Verhagen Annelore M C
Department of Economics, Maastricht University, Maastricht, The Netherlands.
PLoS One. 2021 Mar 17;16(3):e0247719. doi: 10.1371/journal.pone.0247719. eCollection 2021.
Previous research shows that countries with opt-out consent systems for organ donation conduct significantly more deceased-donor organ transplantations than those with opt-in systems. This paper investigates whether the higher transplantation rates in opt-out systems translate into equally lower death rates among organ patients registered on a waiting list (i.e., organ-patient mortality rates). We show that the difference between consent systems regarding kidney- and liver-patient mortality rates is significantly smaller than the difference in deceased-donor transplantation rates. This is likely due to different incentives between the consent systems. We find empirical evidence that opt-out systems reduce incentives for living donations, which explains our findings for kidneys. The results imply that focusing on deceased-donor transplantation rates alone paints an incomplete picture of opt-out systems' benefits, and that there are important differences between organs in this respect.
先前的研究表明，在器官捐赠方面采用“默认同意”系统的国家，其进行的已故捐赠者器官移植手术显著多于采用“明确同意”系统的国家。本文研究了“默认同意”系统中较高的移植率是否会转化为在等待名单上登记的器官患者（即器官患者死亡率）同样较低的死亡率。我们发现，在肾脏和肝脏患者死亡率方面，两种同意系统之间的差异明显小于已故捐赠者移植率的差异。这可能是由于同意系统之间存在不同的激励因素。我们发现实证证据表明，“默认同意”系统降低了活体捐赠的激励因素，这解释了我们关于肾脏的研究结果。结果表明，仅关注已故捐赠者移植率并不能完整地体现“默认同意”系统的益处，而且在这方面不同器官之间存在重要差异。
