This paper looks at the ethics of opt-in vs. opt-out of organ donation as Scotland has transitioned its systems to promote greater organ availability. We first analyse studies that compare the donation rates in other regions due to such a system switch and find that organ increase is inconclusive and modest at best. This is due to a lack of explicit opt-out choices resulting in greater resistance and family override unless there are infrastructures and greater awareness to support such change. The paper then looks at the difference between informed consent of the opt-in vs. presumed consent in the opt-out approaches. Patient autonomy and dignity are better reflected with informed consent. Eighteen months have passed since the new organ donation policy has come into effect, this paper recommends more research into organ donors’ psychological motivations to help governments and the healthcare profession obtain more organs for transplantation.

本文着眼于选择加入与选择退出器官捐赠的伦理，因为苏格兰已经转变其系统以促进更大的器官可用性。我们首先分析比较其他地区由于这种系统转换而导致的捐赠率的研究，发现器官增加充其量是不确定的和适度的。这是由于缺乏明确的退出选择导致更大的阻力和家庭凌驾，除非有基础设施和更高的意识来支持这种变化。然后，本文研究了选择加入的知情同意与选择退出方法中的假定同意之间的区别。知情同意能更好地体现患者的自主权和尊严。器官捐献新政实施至今十八个月，