Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY, USA.
The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA.
J Med Ethics. 2022 Aug;48(8):522-529. doi: 10.1136/medethics-2020-107053. Epub 2021 Jun 8.
Changes to deceased organ donation policy in the USA, including opt-out and priority systems, have been proposed to increase registration and donation rates. To study attitudes towards such policies, we surveyed healthcare students to assess support for opt-out and priority systems and reasons for support or opposition.
We investigated associations with supporting opt-out, including organ donation knowledge, altruism, trust in the healthcare system, prioritising autonomy and participants' evaluation of the moral severity of incorrectly assuming consent in opt-in systems ('opt-in error') or opt-out systems ('opt-out error'), by conducting an online survey among healthcare students at a large academic institution.
Of 523 respondents, 86% supported opt-out, including 53% who strongly supported the policy. The most popular reason for supporting opt-out was the potential for increased donation rates, followed by convenience for those not registered but willing to donate. The most popular reason for opposing opt-out was the belief that presuming consent is morally wrong. Those strongly supporting opt-out viewed the opt-in error as more morally unacceptable, and had higher knowledge and altruism scores. Those opposing opt-out viewed the opt-out error as more unacceptable, and had higher autonomy scores. 48% of respondents supported priority within opt-in systems; 31% supported priority in opt-out.
There is strong support for opt-out organ donation among healthcare students, influenced by both practical and moral considerations.
美国提出改变已故器官捐赠政策,包括选择退出和优先制度,以提高登记和捐赠率。为了研究人们对这些政策的态度,我们调查了医疗保健专业的学生,以评估他们对选择退出和优先制度的支持程度,并了解他们支持或反对这些制度的原因。
我们通过在一所大型学术机构的医疗保健专业学生中进行在线调查,研究了支持选择退出的关联因素,包括器官捐赠知识、利他主义、对医疗保健系统的信任、对自主权的重视以及参与者对在选择加入系统中错误假定同意(“选择加入错误”)或选择退出系统中错误假定同意(“选择退出错误”)的道德严重性的评估。
在 523 名受访者中,有 86%支持选择退出,其中 53%强烈支持该政策。支持选择退出的最常见原因是潜在的捐赠率提高,其次是对未登记但愿意捐赠的人的方便性。反对选择退出的最常见原因是认为假定同意在道德上是错误的。强烈支持选择退出的人认为选择加入错误在道德上更不可接受,并且他们的知识和利他主义得分更高。反对选择退出的人认为选择退出错误更不可接受,并且他们的自主权得分更高。48%的受访者支持选择加入系统中的优先级;31%支持选择退出系统中的优先级。
医疗保健专业的学生强烈支持选择退出器官捐赠,这受到实际和道德考虑的影响。