New Approach Could Produce 80 More Organ Donors a Year

Sweden could gain 80 additional organ donors a year by improving how people make and communicate decisions about donation. Many people never register, not necessarily because they oppose donation, but because they avoid making the choice.

Only 1.9 million Swedes are registered in the donation register, and 80% of those registered support donating their organs after death. Pia Löwhagen Hendén, a donation physician at Regionalt Donationscentrum Väst, said simple reluctance or inconvenience often explains why people do not register. She compared it to putting off exercise and noted that registration is now easy through the 1177 health service and BankID.

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It is roughly like not getting around to exercising. You think it is a hassle and you are not really sure how to do it. But it is extremely easy now through 1177 and BankID.

Anna Forsberg, a nurse and professor of caring science at Lund University and Skåne University Hospital, said psychological barriers also play a role. People often avoid talking about death, and some fear that their bodies will not be treated respectfully. She said several people had changed their minds after she explained that the operation is carried out with great respect.

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It is very much about psychology and our society. We do not want to talk about death.

The number of organ donors fell slightly last year, although Forsberg said it remained high by the standards of the past decade. By Aug. 10 this year, 144 people had become donors. Improvements in healthcare have also reduced some of the conditions that commonly lead to donation, including major brain hemorrhages, traumatic head injuries, and cardiac arrest.

Sweden applies presumed consent. If a person has not registered a refusal or expressly told relatives that they oppose donation, healthcare providers and the law assume the person wanted to donate. When the deceased is not registered, medical staff must ask relatives to help determine the person’s wishes. Löwhagen Hendén said that conversation can take anywhere from a minute to several days because relatives may be devastated or may not yet understand that the person has died or is expected to die.

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The most common reasons a person becomes a potential organ donor, major brain hemorrhages, traumatic head injuries, or cardiac arrest, are decreasing as treatment methods and preventive healthcare improve, which is fantastic in itself.

Healthcare providers have seen a threefold increase since 2020 in cases where relatives interpret the deceased person’s wishes as negative. Löwhagen Hendén called the trend worrying.

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It can take anywhere from a minute to many days.