[dogma1138]

Some countries have it opt-out on gaining a driver’s license. The family however can always override it.

There is another factor and is cause of death and age which directly is tied to doner suitability as well as if there is infrastructure to support organ donation across the nation and other process related issues.

I would strongly suspect that Spain managed to solve the infrastructure and process related problems rather than it simply being a cultural factor or that Spain has somewhat more non-toxicity, cancer/congenital or massive trauma deaths of otherwise healthy people between the age of and 20-45.

[severine]

edit: sorry, I hadn't read the article, I see it says more or less the same than my link

> Spain managed to solve the infrastructure and process related problems

That's correct, the Organizacion Nacional de Transplantes is the main culprit.

You can read about it here: http://www.newsweek.com/2015/02/20/spain-has-become-world-le...

> Dr Matesanz rejects the idea of a Spanish miracle or a unique store of generosity in the hearts of his compatriots: “We have asked the same question in various surveys over the years and every time 56% or 57% say they would donate their organs after dying; roughly the EU average.” On the role of Spain’s transplant law, which presumes consent unless otherwise stated, Matesanz is also dismissive, pointing out that families always have the final say and that the only country in the world to enforce such a rule is Singapore. “Spain has not been a leader in surgery or research; we have hardly chalked up any firsts in transplant operations. What we have brought to this area is organisation. Following a philosophy that states that donors do not simply fall from the heavens, we have provided organisation and professionalisation.”

[baud147258]

> transplant law, which presumes consent unless otherwise stated

The same law is being applied in France, you have to be registered as not a donor in a national database. But, as the doctor said, the problem is with the available organisation, not the laws that are applied.

[dogma1138]

Exactly there might be a lot of other factors.

For example is familial consent is required and the answer is usually yes even in Spain AFAIK.

But that doesn’t mean they are all equal the time that it takes to contact a family and get consent plays a critical role so is who contacts them as in a professional that can explain to them the process and increase the likelihood of consent being given to some busy administrator asking them that as btw....

Also are all hospitals equipped for organ harvesting? Do they have free surgeons and free surgical staff and rooms for that? Can all hospitals handle transport and distribution of organs? How fast is donor decision can be made after harvesting?

These are all critical factors for organ donation in cases that do not involve a vegetable state patient where organ donation can be planned.

I don’t know about the UK but I have knowledge of another opt-out system in a different country and in the case if the family couldn’t be contacted in time for the organs to be harvested the reason for why not would be recorded as the same as the family refused and that is “consent was not given”.

So to me the % difference can be just that Spain is quicker at contacting the family and is more prepared for organ harvesting and distribution for ad-hoc cases in which time is critical.