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Organ donation: rule change in France highlights issues in Swiss system

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Organ donation: rule change in France highlights issues in Swiss system
Photo: Swiss transplant

Should Switzerland follow France’s lead and change its organ donation system to ‘presumed consent’?

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On January 1st the French health system changed its rules on organ donation from opt-in to opt-out, meaning every citizen is automatically made a potential donor unless they opt out by signing a national register.
 
In Switzerland some 1,500 people are currently on a waiting list for a transplant and that is only increasing, according to organ donation foundation Swisstransplant. 
 
The number of donors fell in 2016, and each week two people die waiting for a new organ.
 
Speaking to daily Le Matin, Franz Immer, head of Swisstransplant, said due to Switzerland’s opt-in system, in 60 percent of cases families refuse organ donation upon their loved one’s death as they do not know their wishes.
 
That's higher than in 2013 when a study from the University of Bern found that nearly 53 percent of potential organ donors either failed to register their consent during their lifetime or had consent refused by relatives after their death. That figure was higher than in 2008 (42 percent) and far greater than the European average of 30 percent.
 
“Apart from Germany and Switzerland, all our neighbours operate with the presumed consent of the patient, which makes dialogue and acceptance a lot easier for families,” said Immer.
 
However in Switzerland many families refuse if they don’t know their family member’s thoughts on organ donation, he added.
 
In September Swisstransplant launched a government-backed campaign to raise awareness of donation. 
 
According to figures from the federal health office over 80 percent of Swiss people are in favour of organ donation and yet the number of donors is still falling, Swisstransplant said in a press release at the time.
 
The Swiss parliament has in the past discussed changing the system to opt-out, but the idea has twice been dismissed. 
 
Swisstransplant is aiming to raise the number of donors to 20 per million inhabitants by 2018. 
 
That figure fell to 11.7 per million in 2016, Immer told the paper.
 
“The figures are so bad that the consent method will certainly return as a topic of political debate before 2018,” he said. 

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