We don’t always do what we think we should do.

To be an organ donor in Canada, you have to register (“opt-in”), otherwise your organs will not be harvested to save another life. The participation rate is low in our country and yet it has been reported that many Canadians support organ donation. In fact there are more people who support organ donation than there are actual registered donors. Why is that?

Many other countries, including Austria, Belgium and France, presume consent. Their residents are potential organ donors by default. Those who do not want to be organ donors must make the effort to remove themselves (“opt-out”) from the donor list.

Countries with a presumed consent policy have many more potential organ donors than countries with “opt-in” policies.   Organ donation consent statistics indicate most people accept the default position made for them. Making decisions, especially the significant ones, is difficult. Should I be an organ donor or not? How do I feel about donating my organs? What are the consequences? Not easy questions, so many people decide not to decide and accept the status quo. Thus opt-in nations have fewer people in their donor registries than those in countries with presumed consent. The state makes the decision for them.

Difficult decisions involve sacrifice. We all have limited resources. Only so much time, energy, and money. Use your resources for one priority can mean forsaking another. Not easy, not fun, and sometimes painful.

But it is more than that. Many people are unhappy with certain aspects of their lives and yet they do nothing to change their circumstances. There are consequences to making changes. Hopefully intended consequences, but we fear the unintended, undesirable, unforeseeable consequences. Fear of the unknown and the devil you know is better than the devil you don’t, or so it goes.

Understandably, decisions are made when the status quo is unacceptable. If a person`s current situation is not tolerable, they are apt to make decisions to change it, even if the results of those decisions are fraught with risk or inevitable negative consequences. Syrians fleeing their country are risking their lives as they head towards countries that are less than hospitable. Why take the risk unless accepting their current situation is unacceptable?

My clients are parents of children with developmental disabilities. Most often, these parents don`t seek my help until their children are in their 20s and 30s. 56% of the families I work with have a child with a disability between the ages of 20 and 35. Only 5% of the families I work with have a child under the age of 10.

When you have a child with a developmental disability who is nearing the end of high school or has finished high school, needs change. The parents are in their late 40s and 50s. They are thinking about retirement and worrying about what will be for their children after they (the parents) die. To top it all off, government supports and services are very limited for adults with developmental disabilities, which easily increases the financial burden for the family. How do these parents make sure they are able to retire, continue to support their adult children and ensure they leave enough money behind after they have died?

I don’t think parents in their 20s and 30s who have a young child with a significant disability have their heads in the sand, exactly. They know they have to save for retirement and make sure they leave enough behind for after they are gone, but those issues are more abstract and less pressing. They are focused on present day issues. The idea of shifting resources from present day challenges to feed long-term future plans is stressful.

When you have a child with a developmental disability, deciding to set aside money for long-term savings and insurance can be stressful, especially if current day expenses are steep. There are parents of children with autism spending $5,000 or more a month on therapies. Everything is focused on the here and now, leaving no money for the future. Sometimes there are circumstances when you really can`t put any money aside for the future.

But there are families, even those with a person with a disability, who simply decide not to decide. People are afraid of the unintended consequences, the “what ifs.” Significant decisions should offer benefits, but they also come with risks. Accepting the status quo typically delivers its own consequences and also presents its own risks. Accepting the status quo for too long and those consequences can be severe, if not devastating.

Opt in. Soon.