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Healthcare students support opt-out organ donation for practical and moral reasons
  1. Long Qian1,2,
  2. Miah T Li1,2,
  3. Kristen L King1,2,3,
  4. Syed Ali Husain1,2,
  5. David J Cohen1,
  6. Sumit Mohan1,2,3
  1. 1 Department of Medicine, Division of Nephrology, Columbia University Irving Medical Center, New York, NY, USA
  2. 2 The Columbia University Renal Epidemiology (CURE) Group, New York, NY, USA
  3. 3 Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
  1. Correspondence to Dr Sumit Mohan, Division of Nephrology, Department of Medicine, Columbia University Irving Medical Center, 622 W 168th St, PH4-124, New York, NY 10032, NY, USA; sm2206{at}


Background and purpose Changes to deceased organ donation policy in the USA, including opt-out and priority systems, have been proposed to increase registration and donation rates. To study attitudes towards such policies, we surveyed healthcare students to assess support for opt-out and priority systems and reasons for support or opposition.

Methods We investigated associations with supporting opt-out, including organ donation knowledge, altruism, trust in the healthcare system, prioritising autonomy and participants’ evaluation of the moral severity of incorrectly assuming consent in opt-in systems (‘opt-in error’) or opt-out systems (‘opt-out error’), by conducting an online survey among healthcare students at a large academic institution.

Results Of 523 respondents, 86% supported opt-out, including 53% who strongly supported the policy. The most popular reason for supporting opt-out was the potential for increased donation rates, followed by convenience for those not registered but willing to donate. The most popular reason for opposing opt-out was the belief that presuming consent is morally wrong. Those strongly supporting opt-out viewed the opt-in error as more morally unacceptable, and had higher knowledge and altruism scores. Those opposing opt-out viewed the opt-out error as more unacceptable, and had higher autonomy scores. 48% of respondents supported priority within opt-in systems; 31% supported priority in opt-out.

Conclusions There is strong support for opt-out organ donation among healthcare students, influenced by both practical and moral considerations.

  • transplantation
  • donation/procurement of organs/tissues
  • public policy
  • ethics

Data availability statement

Data are available upon request.

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Data availability statement

Data are available upon request.

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  • Contributors LQ, MTL, KLK, SAH, DJC and SM worked collaboratively to conceive the project, design the survey, recruit participants, analyse the data and write the manuscript.

  • Funding This work was supported by the Columbia University Vagelos College of Physicians and Surgeons Scholarly Projects Fund; the National Center for Advancing Translational Sciences (grant KL2 TR001874); and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (grants R01-MD014161 and U01-DK116066).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.