Typically in the United States, the idea of organ donation occurs at some point when you interact with your state’s Department of Licensing. If you agree (opt in) to organ donation, you have a little red heart on your driver’s license.

Unfortunately, there appears to be a long-standing problem of too few organ donations for the people who need them. Recently, one count estimated the number of people in the US waiting for organ transplants at over 115,000. Regularly, such people waiting for a life saving transplant die before getting one.

Although some folks have argued for allowing for the buying and selling of organs, it is expressly against the law in the US – you can get 5 years in jail for doing so. So without a market place for organ procurement, and without enough donors to meet supply (and with the number of available donors likely to shrink in the coming decades after driverless car technology is perfected, and there are far fewer vehicular fatalities to produce viable organ donations), some countries have decided to change “opt in” systems to “opt out” systems.

Simply put, with “opt in” systems the default is that you are not an organ donor – you must affirmatively decide to be a donor. But with “opt out” systems, the default is you are an organ donor, and you must affirmatively opt out.

Currently there are over two dozen European countries with some form of an “opt out” system. Recently a couple of states introduced such legislation, but neither became law.

The system – particularly in a country such as the United States which very much values a person’s autonomy and freedom (“Don’t Tread On Me”) – many can be persuaded by the argument that an “opt out” system is allowing the government too much control over a person’s body.

But in the context of so many people dying waiting for transplants, perhaps it is time to consider a new strategy.