GESTIÓN EN SALUD PÚBLICA: BioEdge: Will Britain’s new opt-out organ donation system work?

domingo, 19 de agosto de 2018

BioEdge: Will Britain’s new opt-out organ donation system work?

BioEdge: Will Britain’s new opt-out organ donation system work?

Bioedge

Will Britain’s new opt-out organ donation system work?

by Michael Cook | 17 Aug 2018 | 1 comment

Britain will change to an opt-out organ donation system by 2020 under proposed new legislation. “We believe that by making these changes, we can save as many as 700 more lives every year,” Jackie Doyle-Price, parliamentary undersecretary of state for mental health and inequalities, said in a statement.

However, the opt-out system is unlikely to increase the number of donations, according to a new study in the Journal of Experimental Psychology by psychologists from Queen Mary University of London.

Most organ donation legislative systems, whether opt-in or opt-out, include a clause that allows the final decision to donate to be made by family members. The National Health Service reported in 2016 that more than 500 families had vetoed organ donations since April 2010 even though they had been informed that their relative was on the opt-in NHS Organ Donation Register. This translated into an estimated 1,200 people missing out on potential life-saving transplants.

Lead author Dr Magda Osman explained: "We show it's harder to judge the underlying wishes of the deceased if they were on an opt-out and mandatory donation register. Why? Because making a free choice indicates what your preference is. If you don't actively choose and you are listed as a donor on the register, then it isn't clear if you really wanted to donate your organs. This matters because if in the event of death your relatives have to decide what to do, they may veto the organ donation if they can't tell for sure what your underlying wishes were."

To address problems like these, behavioural interventions, such as nudges, have been used to provide practical solutions that are based on psychological and behavioural economic research.

An example of a nudge is an automatic default, such as the ones often used in organ donation legislative system. The rationale behind an automatic default is that it can bridge the gap between a good intention and the effort needed to implement that intention into practice.

Dr Osman said: "Our findings are important because they challenge the efforts of many nudge enthusiasts to promote the use of opt-out defaults in organ donation."

She added: "To help increase actual rates of organ donation, we need more transplant coordinators working with families to help them understand the issues before being faced with a monumental and distressing decision.”

Saturday, August 18, 2018

It’s not an original thought, but with every amazing technological advance comes an unheard-of and very dangerous drawback. Smashing the atom gave us nuclear power and the atom bomb. The automobile gave us hitherto unimaginable mobility and tens of thousands of deaths on the road. The Pill gave women control over their fertility and led to birth rates so low that some countries are in danger of disappearing.

And the mobile phone? Where do we start? This week, with selfies. They give Millennials a buzz, but according to cosmetic surgeons, they also can lead to a psychological disorder which has been dubbed “Snapchat Dysmorphia”. Young women (mostly) are so used to altering their images with apps that they demand the same service from cosmetic surgeons.

“This is an alarming trend because those filtered selfies often present an unattainable look and are blurring the line of reality and fantasy for these patients,” report the authors of an article in JAMA Facial Plastic Surgery.

It would take a sharper mind than mine to define the problem, but our relationship with technology is problematic. We don’t foresee the problems and we can’t control our dependence. Since so much of contemporary bioethics revolves around the proper use of technology, this is something we always have to bear in mind.