MultiplicateX7: A Comparison of the Organ Donation and Transplantation Systems and Attitudes in Argentina and the United States

Abstract

In 2018, a law was passed in Argentina that changed the organ donation model from an opt-in to an opt-out model: all Argentinian citizens over the age of 18 are automatically organ donors by default unless they place their names on a register of non-donors. This new law gained support following the organ donation awareness campaign led by a young girl in need of a heart transplant and her family. The campaign used the hashtag #MultiplicateX7, which indicates that one deceased donor can help save 7 lives. The law is colloquially called the Justina Law in her memory. Although the presumed consent model for organ donation has been successful in increasing the number of donors in Argentina, this model is not necessarily the optimal system for every nation. Public attitudes toward organ donation and transplantation are highly dependent on cultural beliefs and trust in the medical establishment. Organ donation policies and practices in each nation must be compatible with the national cultural values in order to be effective and appropriate for that nation. Despite the fact that the United States has one of the highest organ donation rates in the world, there remains an organ shortage, and many people die on the transplant waiting lists every year. However, adopting an opt-out policy for organ donation in the U.S. instead of the current opt-in policy is not likely to create a positive impact on the organ shortage because of the importance of the American cultural values of autonomy and individual rights as well as the engrained trust issues among many minority groups in American society that would make it difficult to accept a presumed consent policy. Efforts in the United States should instead focus on culturally specific outreach programs to improve opt-in rates and optimizing organ allocation to ensure fairness and that no organs are wasted.