An Honest Fear

Last month my family had to remind me to renew my drivers licence. I will not be living with them for much longer and my name is changing in the fall but better to be safe than pulled over for an easy fix. So I went to the State website, logged in and inserted the number on my licence. Normal questions popped up, check if all of the information is correct and so on. Then a page that really made me nervous when I went into the DMV;

Would you like to sign up to be an organ donor? 

Now, the DMV isn't the first place I think of when it comes to trying to decide a philosophical quandary about ones own potential demise, but it was a heavy weight on me when I was asked for the first time. I was in high school, I really did not want to drive, and it was easier to take the bus and walk. With all of the anxiety I told the clerk no, walking away feeling guilty and arguing with myself. The second time was a renewal and I said no again, still fighting with myself. What would change if I had said yes? Was I being selfish? Ignorantly fearful? Was I alone?

It was last week I heard of a study published by the US National Library of Medicine National Institutes of Health, a case study on the very quandary I had been having with myself for years. The concern of the researchers was how to increase organ donation based on the policies of other countries, the best way to test it would be to quantify the data through rounds of testing. They made an almost Oregon Trail text adventure out of it, and yes, the pun by me was intended. In short, the longer your imaginary person survived with a "A organ" and "at least one B organ" working in the simulation, the more the participant would get paid. A crude facsimile for the stress and worry of someone's life but better that than a biased participant. There were plenty of rules about what one could donate and when organs failed but the major test was about the opt-in versus the opt-out, or, does donation increase if the population is told they need to remove themselves from the list or put themselves on the list to become a organ donor. They found that opting out, with the default of everyone being a donor, increased donor rates compared to the opting in. The participants knew the potential risks, and so do we right? Should irrational fear change my position?

According to the U.S. Government Information on Organ Donation and Transplantation that many concerns I had about what would happen to me if I was hurt and unable to communicate, the hospital's priority is to save my life. And this continued to be true in other organisations information sources as well, such as the United Network for Organ Sharing and American Transplant Foundation. These advocates know the policies and fears better than anyone, but they also know the benefits for those that are on the list, a fluctuating list that as of writing this is around the 113,000 mark but feel free to check how that number has changed since then.

I am not here to change your mind. What I can tell you is that I opted in, after spending several hours mulling in my dorm room, researching and really thinking about what I wanted. I was not worried about what people would think about me in a public space. Only the people who look at my ID would even know, I don't get brownie points with my fiance or parents. Just solace that all that time spent staring at a screen fretting was not wasted. But if I have changed your mind, feel free to sign up. Some food for thought: is Opt-out fair? Should there be more forceful education be taken to increase registration? What about the policies of ranking someone for the list? Any concerns I did not touch on? Questions about the study?