This article argues about increasing organ donation by presumed consent and allocation priority:

To promote organ donation, legislating the principle of priority provides a strong incentive by signalling to people that registering as a non-donor decreases their chance of receiving a donated organ when needed. Such legislation is in place in Israel and Singapore. Singapore has experienced an increase in the number of donors after introducing a priority system, although the effect of the priority system is unclear because a presumed consent system was implemented at the same time. Preliminary results in Israel, which does not have a concomitant policy of presumed consent, are promising, showing a significant increase in both deceased and living organ donation.

So, both Israel and Singapore show that a priority system (that favors those who explicitly registered as donors) tends to increase organ donation.

I am wondering why this principle is apply in so few countries considering its benefits.

Question: Why is the principle of priority so rarely used in relation with organ donation?

  • The article implies the introduction in Singapore was coupled to a change to an opt-out donor system, so that would be disfavouring those who register as non-donors. – origimbo Dec 3 '18 at 8:37
  • @origimbo - yes. However, for Israel results seem good in spite of not using the same opt-out donor system. Such a system should provide an additional incentive for people to register as donors, so one should expect an improvement in donation volume. – Alexei Dec 3 '18 at 8:40

According to this article (only header visible without subscription) on the BMJ and this one in the Telegraph, priority on the transplant list for registered donors has been considered in the UK around 2012. However, I've been unable to find any further information on the outcome of these consultations. The most closely related "results" information I could find was this one, which was published in 2018 and relates almost entirely to the changes to presumed donation consent and Opt-out policies.

The NHS Organ Donation Mythbusting page does not mention priority for donors at all, which suggests it never became a wide ranging discussion in the UK, although there might be something in the video on that page which I haven't viewed.

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