A British Medical Journal (BMJ) article titled Will an opt-out organ transplant law save lives? referred to the English legal initiatives explains in few words the state of the art in Spain (read the entire article HERE).

The authors affirmed, Spain is often cited as having the world’s highest nationwide transplant rates and they have an opt-out law. But, upon careful examination, their success is based on other factors.

Opt out law organ donation efficiency myth

Spain’s law was enacted in 1979, but there was no measurable impact on transplant rates until after 1989, when a strong national organization was established, and significant resources were committed to provide support for highly trained intensive care physicians and nurses in transplant centers. Rafael Matesanz, the director of the Spanish programme since 1989, attributes Spain’s higher organ donation rate to the practice of these highly qualified physicians and nurses who always have a conversation with donors’ families to secure their approval before proceeding with organ removal. While Spain has a legal opt-out system, it functions as an opt-in system, because the family is routinely asked for permission. Wales shifted to an opt-out law in 2015, but the number of organ donations has not increased, over the past two years.

In this sense an English newspapaer published the statement of Estebanez, physician from Malaga, that has been working as a transplant coordinator for nearly four years, that affirmed “Despite Spain having a nominal presumed consent system, in practice coordinators do all they can to find out whether a patient is happy to donate before they die, and also whether their relatives or loved ones are comfortable with this (see HERE).”