Korean J Transplant 2020; 34(1): 2-7
Published online March 31, 2020
© The Korean Society for Transplantation
1Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
2 Division of Transplantation and Vascular Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
Correspondence to: Young-Nam Roh
Division of Transplantation and Vascular Surgery, Department of Surgery, Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The “mandatory choice” system is an organ donation system that forces individuals to clearly express their choice about organ donation. Although this system is widely practiced in western countries, it has not yet been implemented in many Asian countries. This study aimed to compare the possible outcomes of a mandatory choice system and the current system in Korea.
Methods: A mathematical model was used to predict outcomes under each system. A structured questionnaire assuming two systems (current opt-in and mandatory choice) was developed to investigate participants’ decisions on organ donation and the family’s consent after brain death in each system. Participants who enrolled in this survey were 100 couples (200 people).
Results: The total number of donors decreased slightly from 102 (51.0%) in the current opt-in system to 93 (46.5%) in the mandatory choice system. The rate of achieving autonomy was increased from 62.5% (125/200) in the current system to 68.0% (136/200) in the mandatory choice system. The achievement of negative autonomy was relatively higher in the mandatory choice system (73.6% [67/91] vs. 63.2% [55/87]).
Conclusions: The mandatory choice system can supplement the weak ethical point of the current system by increasing the achievement of autonomy.
Keywords: Organ donation, Mandatory choice system, Autonomy
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