PDF(Pubmed)
Abstract：
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.
摘要：
英格兰在2020年转向了选择退出同意制度，旨在增加可用器官的数量。西班牙也实行退出制度，但与英格兰相比，每百万人口的器官捐赠几乎是英格兰的两倍。我们旨在确定同意政策的差异和相似之处，两国死者捐赠的文件和程序采用比较定性的内容和语篇分析。西班牙更简单，本地定制的文件，家庭审查和处理信息的时间可能会更短，在西班牙有更多的途径导致器官捐献，以及对个人在生活中做出的决定提供更强有力的法律保护。西班牙文件中的语言是支持和保证之一。相比之下，英国的文件显得令人困惑，因为增加的目的是保护NHS免受风险，并对以前的文件版本进行修改，以反映法律的变化，而不是完全重铸。如果英格兰的目标是达到类似西班牙的同意率，那么这项分析就突出了可以加强英国系统的机会——通过给予个人在器官捐献者登记簿上记录的决定合法权重，同时统一和简化同意政策和程序，以支持家庭和医疗保健专业人员。
