TY - JOUR

T1 - Qualitative Content and Discourse Analysis Comparing the Current Consent Systems for Deceased Organ Donation in Spain and England

AU - Rees, Kate

AU - Mclaughlin, Leah

AU - Paredes-Zapata, David

AU - Miller, Cathy

AU - Mays, Nicholas

AU - Noyes, Jane

N1 - Copyright © 2024 Rees, Mclaughlin, Paredes-Zapata, Miller, Mays and Noyes.

PY - 2024/7/4

Y1 - 2024/7/4

N2 - England switched to an opt-out system of consent in 2020 aiming to increase the number of organs available. Spain also operates an opt-out system yet has almost twice the organ donations per million population compared with England. We aimed to identify both differences and similarities in the consent policies, documents and procedures in deceased donation between the two countries using comparative qualitative content and discourse analysis. Spain had simpler, locally tailored documents, the time taken for families to review and process information may be shorter, there were more pathways leading to organ donation in Spain, and more robust legal protections for the decisions individuals made in life. The language in the Spanish documents was one of support and reassurance. Documents in England by comparison appeared confusing, since additions were designed to protect the NHS against risk and made to previous document versions to reflect the law change rather than being entirely recast. If England's ambition is to achieve consent rates similar to Spain this analysis has highlighted opportunities that could strengthen the English system-by giving individuals' decisions recorded on the organ donor register legal weight, alongside unifying and simplifying consent policies and procedures to support families and healthcare professionals.

AB - England switched to an opt-out system of consent in 2020 aiming to increase the number of organs available. Spain also operates an opt-out system yet has almost twice the organ donations per million population compared with England. We aimed to identify both differences and similarities in the consent policies, documents and procedures in deceased donation between the two countries using comparative qualitative content and discourse analysis. Spain had simpler, locally tailored documents, the time taken for families to review and process information may be shorter, there were more pathways leading to organ donation in Spain, and more robust legal protections for the decisions individuals made in life. The language in the Spanish documents was one of support and reassurance. Documents in England by comparison appeared confusing, since additions were designed to protect the NHS against risk and made to previous document versions to reflect the law change rather than being entirely recast. If England's ambition is to achieve consent rates similar to Spain this analysis has highlighted opportunities that could strengthen the English system-by giving individuals' decisions recorded on the organ donor register legal weight, alongside unifying and simplifying consent policies and procedures to support families and healthcare professionals.

KW - Humans

KW - Tissue and Organ Procurement/legislation & jurisprudence

KW - Spain

KW - England

KW - Informed Consent/legislation & jurisprudence

KW - Tissue Donors/legislation & jurisprudence

KW - Decision Making

U2 - 10.3389/ti.2024.12533

DO - 10.3389/ti.2024.12533

M3 - Article

C2 - 39027155

VL - 37

SP - 12533

JO - Transplant international : official journal of the European Society for Organ Transplantation

JF - Transplant international : official journal of the European Society for Organ Transplantation

SN - 0934-0874

ER -