The Formation of Organ Donation Policy in Germany: Evidence, Politics and Public Opinion

摘要

The gap between the demand and supply of organs for transplantation is a worldwide phenomenon that continues to tax policy-makers. We consider recent policy reforms in Germany, drawing on evidence from Spain and Austria for comparison. Our analysis adopts Kingdon’s multiple streams model which suggests that windows of opportunity for policy change open when an issue of public concern combines with a plausible solution and favorable political circumstances. Evidence is central to this process, but the type of evidence and the ways it is used, differ from technocratic formulations of evidence based policy-making. Scientific evidence may contribute to the rational appraisal of options, but this and other forms of evidence are also used rhetorically to generate political will and public support for change. We conclude by considering what the formation of organ donation policy in Germany reveals about the processes of policy-making under the competing imperatives of rationalism and democracy.