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Opt-out legislations: the mysterious viability of the false. It is frequently assumed that opt-out legislations set down a more favorable scenario to organ donation than do opt-in legislations. However, there are no clear examples of countries with a real sustained increase in organ donation after modifying the law. Arshad et al. performed a comparison that shows no significant differences between countries with these 2 legal systems. Health care providers must focus on actual barriers to increasing organ donation rather than on presumed consent alone.