A question that's been plaguing me recently is that of organ donation, and why the rate of donation is so low. I have a family member on a waiting list for a kidney (he has long suffered from a genetic kidney disease) and the medical community can not guarantee that he will ever receive a kidney.
There are a number of factors that contribute to the situation but overall Australians seem to be averse to donating their organs.
In my opinion the major contributor to donor refusal is that the final decision of organ donation is left up to the grieving relatives. The decision to donate needs to be made relatively quickly and the family members are generally not in a state where they are thinking clearly. This leads to situations where the family goes against the patient's wishes and refuses to donate.
An exception to this national trend is South Australia. The national donor rate in 2002 was 10.2 donors per million of population (dpmp) whereas in SA the rate was 20.7dpmp. The increase is contributed to the SA government's adoption of the "Spanish Model" of donation. The Spanish Model places an independent donation team in each hospital to be responsible for raising the number of donations. (Spain adopted this method in 1997 and has raised the donation rate from 13 dpmp nationally to 33.5 dpmp by 2001)
By increasing the number of donation nationally to the same level as SA the number of Australians on waiting lists could be dramatically reduced.
As a personal choice I am an organ donor. My thoughts on the matter are that once I die, I won't need then so who am I to deny someone else my kidney or my heart or my lung, especially if it allows them to continue living.
If I was to be in a position where I was placed on a waiting list of decades for a new organ - say a kidney I know I would expect there to be a kidney available for me - and I don't think I'd be the only one
One dramatic way to solve this problem is to make organ donation a default - and then give people the option to opt out if they do not wish to donate. This "opting out" would have to occur while the individual they were still alive and could not be decided by the family after death. This would remove the decision from the family and place it back onto the individual.
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Just a point of wonder: Why is organ donorssip measured in terms of donors per million people? Wouldn't a more comparable measure be donors-to-deaths? Since the death rate would (more or less) directly have an impact upon the donorship, it makes more sense that the statistic be quoted as donors-to-deaths.
To use the countries you've used:
Australia's death rate: 7.51 deaths/1,000 population
Spain's death rate: 9.72 deaths/1,000 population
Since Spain's death rate is 29% higher than Australia's, you would expect them to have a higher rate of donorship.