In its recent reversal of its organ donation policy, France is now automatically assigning all its citizens as donors upon their death, unless they join an official register for opting out.

The new law, which took effect Jan. 1, presumes consent for organ removal and donation, although the family refuses or wishes otherwise. Prior to this measure, a person had to have a clear intent to donate or doctors must consult the family, who refused in nearly one-third of cases.

How The Opt-Out System Works

The Guardian reported, however, that French citizens can still join a so-called “refusal register,” which has been signed up by at least 150,000 individuals last Jan. 2 at the time of the report. Those who refuse can do so by doing the action online rather than by post.

In addition, people who oppose having their organs used can leave a signed document in the case of their next-of-kin or orally express their choice to relatives, who will then produce a written declaration of non-consent to doctors during the time of death.

Read the process on the agency’s official Facebook page.

Organ Donation Systems Around the World

The updated “opt-out” system is targeted at preventing widespread organ shortages and long transplant wait lists. Similar measures are already in place in certain European countries, including Austria, Spain, and Wales – generally controversial laws but also backed by research of improved donation rates.

In the United Kingdom, for instance, healthcare providers lament that they have one of the lowest consent rates in the region and a general lack of black or Asian donors. While a record number of organ donations and transplants were made in the country from 2015 to 2016, the rate falls short of the 80 percent target by year 2020.

The same problem with lengthening patient waiting lists has been highlighted in the European Union.

Deemed as the largest hurdle is the opposition of relatives, often vetoing transplants even from registered donors.

In a 2014 review by British researchers that involved 48 countries with opt-in or opt-out donation systems, donor rates were notably higher in nations with opt-out systems, compared with living donor rates being higher in opt-in systems. However, overall transplants for in-demand organs such as kidneys and livers were higher in opt-out regimens.

The United States still follows an opt-in system. Here, a patient joins the waiting list for transplant every 10 minutes, while 22 every day die waiting for their transplant.

French Legislation

The major public health change is not the only French law to recently make headlines.

On New Year’s Day, France legislated its workers’ "right to disconnect" from their work email during off-hours. The new employment law obliges companies with more than 50 workers to start negotiations with employees about their right to ignore their phones and avoid compulsive after-hours email checking.

The legislation aims to address the scourge of “info-obesity” in workplaces and the “always-on” work culture, which has been blamed for such health issues as burnout and has paved way for rising rates of unpaid overtime.

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