Donating an organ after one dies is not an easy thing. First, the person needs to die in a certain way, called brain death, which leaves the organs undamaged. It also helps if the person is otherwise healthy. And it usually requires the person to already be in an intensive care unit of a hospital to save time.
Paul Beerkens, Netherlands Kidney Foundation
Added to this is the need for consent - either being a registered donor, or at least having made one's preference clear to loved ones. That means people have to ‘opt in' But some countries have flipped the requirement on its head.
'Presumed consent'
France, Spain and Belgium all have laws that presume that an individual wants his or her organs to be donated, unless they ‘opted out' while they were alive.
But is this an intrusion on a persons rights, for the government to declare that the default stance is in favour of donation? Paul Beerkens, of the Netherlands Kidney Foundation, disagrees.
"There's a huge misunderstanding here. It's the person that decides. Even if the government changes the law, it's you that decides if you want to be a donor or not - and you can change that every day. At the end of the day, it's you that decides, or your family that decides. Not the government."
David Nix, Donor Family Network
Risk of bad press
But for other campaigners on the side of organ donation, presumed consent is a nightmare waiting to happen. David Nix is Chairman of the Donor Family Network in the United Kingdom. He thinks organ donation needs to be promoted better so people elect to become donors.
Under a presumed consent scenario, mistakes can happen. He imagines an instance where a person dies while the opt-out form is in the mail, or family members are abroad, and his or her organs are taken against the deceased's wishes.
"Unfortunately, the press and media would have an absolute birthday and it would certainly encourage people not to donate. Exactly that happened in France in the early ‘90s. They took the corneas from two patients without the families' consent and the legal ramifications thereafter and the furore that followed, organ donations went down for years."
Indian donation crisis
Other countries are facing a different problem with getting people to donate organs. In India, an illegal trade in organs has tainted the idea of organ donation and made it even more difficult to get a transplant.
Desperate people even sell their own kidneys while they are still alive, according to Dr. Amitabh Parti, a cardiologist in Delhi. He says the black market has made it even harder to get people to donate organs.
"It deters the rate of donations, because if I can buy a kidney off a lower-income group individual, I will hardly make any effort to motivate a family member or anyone else to donate a kidney for a friend or loved one."
There is also a social stigma against organ donation. While Dr. Parti supports the idea of ‘presumed consent' for India, he says social traditions need to change. For instance, Indians need to be educated through national campaigns that donating a kidney at the time of death does not mean something illegal or forbidden by religious laws.
Dave McGuire and Hermione Gee
Radio Netherlands