The organ donor iphone app is here – and it’s free

A few weeks ago Richard Thaler wrote this in his Economic View column about organ donation:

The key, however, is to make signup easy, and requiring people to make a choice is just one way to accomplish it. The private sector could help create other simple methods. Here is a challenge to Mr. (Steve) Jobs: Why not create a Web site — and a free app for the iPhone — that lets people sign up as organ donors in their home states?

Steve Jobs didn’t meet Thaler’s challenge, but Raymond Cheung of Serenity Integration did. “Basically, I was inspired after reading Dr. Thaler’s column,” he tells the Nudge blog. So he directed his team of developers to create an iPhone app called Donate Lives that lets users identify where they live, and then takes them directly to the state web site where they can sign-up to become an organ donor

The app was pretty simple to make, Cheung says. It took a couple days to build. Getting the free app approved on iTunes took a couple weeks. It’s available for download now, so head over to iTunes if you own an iPhone. “Even if a small fraction of those download the app and register, I’d consider it successful especially if it leads to even one more life saved,” says Cheung.

Richard Thaler on organ donation

Richard Thaler writes about opt-in vs. opt-out vs. mandated choice organ donation policies in this week’s Economic View column. Illinois follows a mandated choice policy.

Here is how it works: When you go to renew your driver’s license and update your photograph, you are required to answer this question: “Do you wish to be an organ donor?” The state now has a 60 percent donor signup rate, according to Donate Life Illinois, a coalition of agencies. That is much higher than the national rate of 38 percent reported by Donate Life America

The Illinois system has another advantage. There can be legal conflicts over whether registering intent is enough to qualify you as an organ donor or whether a doctor must still ask your family’s permission. In France, for example, although there is technically a presumed-consent law, in practice doctors still seek relatives’ approval. In Illinois, the First-Person Consent Law, which created this system, makes one’s wishes to be a donor legally binding. Thus, mandated choice may achieve a higher rate of donations than presumed consent, and avoid upsetting those who object to presumed consent for whatever reasons. This is a winning combination.

Conflicting opinions on presumed consent for organ donation in the U.K.

The public says yes. The British Medical Association and the Royal College of Nursing say yes. British doctors say maybe. Those are the results of a recent poll in the U.K. on organ donation.

Two thirds of the public now supports the idea. Intensive care doctors are split, with half saying a move could damage the trust between patients, their families and doctors. (The sample size for the doctors was only 125.) The concerns are similar to the ones David Orentlicher raised in his working paper.

Some doctors are concerned presumed consent might instill doubts in patients and relatives about a potential conflict of interest.

Mr Gunning said: “In intensive care patients are often admitted suddenly and the families have to comes to terms very quickly with the fact that someone may not survive. It is very important in this situation that we have their trust, that we are doing is going to be in the best interests of that patient.”

While he strongly supports the principle of organ donation, he believes any consideration of presumed consent is premature.

“The trouble is we live in a society where people are very much worried about the interference of the state. I think you would find that families would view this as taking the organs – and that would create a tension.”

Hat tip: Jeffrey Sybesma

Here’s what happened the first time the United States assumed people wanted to be organ donors

Indiana law professor David Orentlicher has a working paper (forthcoming in the Rutgers Law Review) about the potential pitfalls of implementing a presumed consent organ donation policy in the United States. Part history, part policy advisory, Orentlicher points out that presumed consent laws for body parts like corneas and pituitary glands were adopted in a number of states in the second half of the twentieth century – reaching a peak in 1980s – with underwhelming success. Their failure, he says, was due to family member remonstrations at the actual moment of organ removal on religious, medical, and ethical grounds. The result was either fewer organs donated than originally presumed, and in some circumstances a public backlash.

Continue reading the post here.

Delaware proposal for presumed consent in organ donations

Where presumed consent is trumped in one situation:

If designated donors have a “living will” or advance medical directive that prohibits the use of a ventilator or other devices to keep them alive — which sometimes is needed to keep organs viable until a transplant can take place — the living will would trump the donor designation.

Read the proposed bill here, or the news article about it here.