Presumed Consent - Wales & Organ Donation

The Welsh government has adopted a system of presumed consent for donating organs after death.  (Independent / Guardian)  The opt-out system, which will be introduced in 2015, means that everyone is regarded as a willing donor when they die unless they state otherwise.




U.S. policymakers really need to follow this model and focus more on flipping the defaults with respects to many aspects of end-of-life care.  Since most people fail to opt out of the default, the default rule should maximize benefit.  But currently, our defaults (e.g. aggressive curative focused treatment) are not what most people want.  Therefore, we have a high error rate in that many people do not get the treatment they want.  



Following Wales, we would do better to make the default what most people want and/or what maximizes social welfare.  Yes, that might produce some false negatives (inferring no desire for life-sustaining treatment from the patient's failure to opt out).  But it would eliminate far, far more false positives (assuming the patient's desire for life-sustaining treatment when there really is no such desire).