Explaining Failure Through Success: A critical analysis of reduction in road and stroke deaths as an explanation for Australia’s low deceased organ donation rates.

Abstract

ABSTRACT: During the past 20 years Australian federal and state governments have funded many initiatives to bolster organ donation. Despite large investments of time, effort and money, Australia’s deceased donation rate is amongst the world’s lowest and has only slightly increased from 11.9 donors per million people (pmp) in 1990 to 13·8 donors pmp in 2010. An often-cited explanation for this situation is that Australia’s success in increasing levels of public health and safety has reduced the number of potential deceased organ donors. We refer to this as the “Failure Because of Success” hypothesis. Although commonly accepted, this hypothesis is largely untested. Analysis of health data on road trauma and stroke deaths from Australia and other OECD countries reveals that improvements in public health and safety do not provide an adequate explanation for Australia’s low organ donor rates. Keywords: Organ donation, Public safety, Brain death, Traffic fatalities, Stroke