(Discussion) Organ Donation: Should it be Mandatory?

[LadyTevar]

British Govt. Considers New Organ Donor System

Government advisers have recommended a radical overhaul of the UK organ donor network in a bid to double the number of organs available for transplant.

By recruiting twice as many transplant co-ordinators and creating 24-hour organ retrieval teams they hope to emulate Spain's successful model.

A system of "presumed consent" in which everyone is a potential donor unless they opt out is also being considered.

Gordon Brown has backed the opt-out idea, which is still under discussion.

InnerBrat pointed this little article out on her LiveJournal, and that the bolded part in particular seems to be causing a fuss over in Britain. At the moment, like America, Britain has the 'opt-in' donor system, where a person may check a box or sign a paper stating that they wish to have their organs donated after their death.

The new system would assume that the deceased's organs are up for donation. The person would have to Opt-Out by clicking a box or signing a waiver to prevent this. In short, the opposite of how it is now.

This has caused a lot of commentary and outrage. Comments have ranged from "It's taking away our options", "It's Ignoring Patient Rights", "I don't want the Government to make my choices for me!", to "It'll turn doctors into vultures!"

Now, I've been opting-in for donation since my first Driver's License, and all of my family knows that I would like my usable organs given to those who could use them. After reading this article, I started talking about it with Keevan, DS, and B4, who are also donors. The comments and views they had on the subject were interesting, so I wanted to see what others think about it.

SO, please.. discuss.

[Dark Silver]

Presumed consent is wrong - it takes the decision out of the individuals hands. Personally, I've no problem with donating my organs should I pass on (I seriously doubt any of them will be found viable upon screening post mortem though).

The system of presumed consent should be removed, there's to often that people will not even know of it, and thus they are agreeing to something not out of their own validity, but out of ignorance.

I know stateside, they ask you when you get your DL, if you wish to be a Organ Donor. If it's suddenly presumed you wanted to, what's to ensure that the people are asked "do you want to be a organ donor should you pass on?"

It's.....to easy to take advantage of, the way I see it.

[LadyTevar]

I would like to think that the Opt-Out Option would be mentioned and would be passed along to those people who don't wish to donate for religious reasons or otherwise.

[Comrade Tortoise]

Presumed consent is wrong - it takes the decision out of the individuals hands. Personally, I've no problem with donating my organs should I pass on (I seriously doubt any of them will be found viable upon screening post mortem though).

The system of presumed consent should be removed, there's to often that people will not even know of it, and thus they are agreeing to something not out of their own validity, but out of ignorance.

I know stateside, they ask you when you get your DL, if you wish to be a Organ Donor. If it's suddenly presumed you wanted to, what's to ensure that the people are asked "do you want to be a organ donor should you pass on?"

It's.....to easy to take advantage of, the way I see it.

Take advantage of what? They're dead, what will they care? Legislate it so that when they fill out the box on their drivers license they HAVE to see the box, make it in big bold print.

As it stands now countless people, who are alive and do care, die agonizing deaths on transplant lists. While perfectly good organs are tossed because people cant be arsed to donate them. Fuck that.

[Cynical Cat]

There's nothing wrong with presumed consent. People who don't like the idea of organ doning can opt out. There is no removal of choice. It simply changes the default from "no instructions about the body, let it rot and don't try to save any lives to "no instructions about the body, lets save some lives with the parts."

[Dark Silver]

It's also a false positive.

There is something fundamentally wrong by assuming everyone wants to do it.

But that's my opinion on the matter, if a person dies in a hospital, with the family present, they can STILL decide if the body can be donated for the organs or not.

Besides, this won't change much in the way of organ donations, it's not that there's to few donors, it's that the majority of donors cannot pass post mortem screening for their organs (the rules, at least in the US are inordinately strict for such things).

At any rate, as I said, this is my opinion, it won't be changed easily.

[Comrade Tortoise]

There is something fundamentally wrong by assuming everyone wants to do it.

Why? Present reasoning.

Besides, this won't change much in the way of organ donations, it's not that there's to few donors

I call BS

While less than 50 percent of eligible families donate now, and while 20 percent of families will never donate for a variety of reasons, Siminoff believes the number of families who would donate can increase dramatically if improvements were made in the public's education of the donation process and the method in which requests are made.

http://www.case.edu/pubs/cnews/2001/7-19/organstudy.htm

[Hotfoot]

So long as you make it easy to opt out, I don't see what the problem is. Nobody's rights are "trampled", because all it takes is a simple "No thanks" during some paperwork.

Hell, I wouldn't even feel that bad if it WAS mandatory and there was no way around it, at least on a personal level. I wouldn't push for this, because I know there are groups of people who feel very strongly against this sort of thing, but I personally am of the opinion that once you're dead you shouldn't give a shit what happens to the flesh that you were using, and if can save the life of someone else or improve their quality of life, hey great.

Not the most popular opinion, but that's how I see things. I can't get overly enraged about someone's belief that if their body doesn't get buried whole they won't go to the afterlife, because I personally don't have that view, and I have a very hard time seeing what harm is done to the corpse or the survivors by harvesting the useful organs just after death.

I would like to reiterate that I can see why people would get upset, and I support their right to BE upset and oppose this if they so choose, but I don't have to agree with them or be righteous on their behalf. I think it's wrong to condemn someone to death because of faith in the afterlife or that you're squeamish about how the organs are removed, and let's be blunt, those are the issues at hand here.

[Cynical Cat]

It's also a false positive.

As is assuming they don't want it done.

There is something fundamentally wrong by assuming everyone wants to do it.

Its not an assumption, its a default. It is morally superior to default to donation because organ donation saves lives. The way it stands now, there is default against organ donation. We have the option of defaulting to one or the other. One results in lives being saved and is thus the superior choice.

Besides, this won't change much in the way of organ donations, it's not that there's to few donors, it's that the majority of donors cannot pass post mortem screening for their organs (the rules, at least in the US are inordinately strict for such things).

Incorrect, as Tortoise has pointed out.

As long as it is relatively easy to change to a non-donation option, there is no good reason not to default to organ donation. That way people can continue to callously put their cultural/religious practices ahead of human life and suffering if they want to.

[LadyTevar]

In Spain, which is the model the Brits are following, the Catholic Church, the Jewish establishment, and the Muslim establishment have all come forth to say that saving another's life in this way is a good and just act for the faithful.

In America, I believe the main opponents religiously would be the Jehovah's Witnesses, and the Christian Scientists with their idea of 'the body is a temple' and faith healing. Both are known for their refusals of modern medical procedures.

[Hotfoot]

In Spain, which is the model the Brits are following, the Catholic Church, the Jewish establishment, and the Muslim establishment have all come forth to say that saving another's life in this way is a good and just act for the faithful.

In America, I believe the main opponents religiously would be the Jehovah's Witnesses, and the Christian Scientists with their idea of 'the body is a temple' and faith healing. Both are known for their refusals of modern medical procedures.

I don't remember the exact groups, I'm sure I could ask my sister, as she would know. However, the other problem is squeamishness. The movie that came out recently, "Awake" or something, was a "cautionary tale" about the dangers of organ harvesting. Or something. I couldn't stand to even watch the trailer for it. Anyway, short version, squeamishness plays a big role too. If it's less or more than specific religious beliefs, I couldn't say though, as I do not have access to that data.

[Dark Silver]

There is something fundamentally wrong by assuming everyone wants to do it.

Why? Present reasoning.

Easy enough, it's wrong to assume everyone will want to donate their orgins, because...and wait for it... not everyone will want to donate their organs. I know of several people in my own life, who despite understanding the nature of organ donation, and how it may very well help others, refuse to let their organs be donated post mortem. Now they maybe selfish assholes for it, but they refuse, and thus wouldn't mark it on their ID or license.

Makes sense? No, but that's how they fell. I can't project my morals on them for not wanting to donate.

Besides, this won't change much in the way of organ donations, it's not that there's to few donors

I call BS

While less than 50 percent of eligible families donate now, and while 20 percent of families will never donate for a variety of reasons, Siminoff believes the number of families who would donate can increase dramatically if improvements were made in the public's education of the donation process and the method in which requests are made.

http://www.case.edu/pubs/cnews/2001/7-19/organstudy.htm

Ok, so I'm wrong, it happens, I never claim omnipotence in these matters, but at least challenge the entire sentence CT, instead of chosing half of it.

Still, even if they do increase the amount of organ donors - it should be through better education in the process to those who are being asked - not by automatically assuming everyone wants to do it, they just don't understand it.

And still, despite a increase in donors by this method, we still come to the problem that a good majority of the organs donated, just don't pass screening for use. And it may not even be directly proportional that the significant increase in donors will lead to a significant increase in viable organs. Hell, I'll have to drop next time I renew my license if only for the fact I have a family history of heart disease and high blood pressure - both things which will disqualify my heart from being donated, and my liver and kidneys due to a period of heavy drinking some years back.


Am I against donation? No, as Tev stated in the OP, I'm a organ donor. Do I think everyone should be a organ donor? No....because honestly, there's some people out there who really shouldn't be wanting to pass their organs on - drug addicts in example and people with a history of heart disease or kidney problems - because they would be wasting the screeners time because all organs which are marked as donated, have a very small window of time before they become useless.


It boils down to this - if it's marked as a positive already on the sheet, I don't trust people enough that they'll always ask the question "Do you want to be a organ donor" if the person requesting the ID/License looks healthy and doesn't turn it down on their own violation.

Like I said before, it's personal opinion, not fact on that end. And as such, I'll concede the argument instead of wasting the space here.

[Cynical Cat]

There is something fundamentally wrong by assuming everyone wants to do it.

Why? Present reasoning.

Easy enough, it's wrong to assume everyone will want to donate their orgins, because...and wait for it... not everyone will want to donate their organs.
.

Assuming they do want to donate their organs is no different from assuming people don't want to donate their organs. It's just the default position. I posted this previously. It does not stand.

[Batman]

Ok, so I'm wrong, it happens, I never claim omnipotence in these matters,

That'd be omniscience, not omnipotence.

Still, even if they do increase the amount of organ donors - it should be through better education in the process to those who are being asked - not by automatically assuming everyone wants to do it, they just don't understand it.

It wouldn't. As has been pointed out by several people in this thread AS LONG AS IT IS EASY TO OPT OUT OF IT there's nothing wrong with assuming anybody NOT opting out out if being in agreement.

And still, despite a increase in donors by this method, we still come to the problem that a good majority of the organs donated, just don't pass screening for use.

And the minority that ARE (even if your assumption that the majority ISN'T is correct, which is base on what, exactly?) would not have been available otherwise so we still get more transplants. The downside of this is?

And it may not even be directly proportional that the significant increase in donors will lead to a significant increase in viable organs.

And then again, it may? Again, the downside of this is?

Am I against donation? No, as Tev stated in the OP, I'm a organ donor. Do I think everyone should be a organ donor? No....because honestly, there's some people out there who really shouldn't be wanting to pass their organs on - drug addicts in example and people with a history of heart disease or kidney problems - because they would be wasting the screeners time because all organs which are marked as donated, have a very small window of time before they become useless.

So how exactly does a heart disease affect a kidney, a ruined liver affect a heart? As long as SOME of their organs are OK, they're valuable donors.
As for there being people who shouldn't pass their organs on-that's what the opting out process is for.

It boils down to this - if it's marked as a positive already on the sheet,

Excuse me, if it's marked as positive on the sheet, doesn't that mean they already WERE asked the question on a previous occasion?

I don't trust people enough that they'll always ask the question "Do you want to be a organ donor" if the person requesting the ID/License looks healthy and doesn't turn it down on their own violation.

If they're looking healthy they're well enough to ask the question again. If they're NOT you're relying on your paperwork being in order EITHER way.

[LadyTevar]

As Batman says, just because the heart isn't working right, doesn't mean that the cornias of the eye aren't viable transplants, or cadaver skin for use in burn treatments.

[frigidmagi]

Is it easy to opt out?

[SirNitram]

Is it easy to opt out?

It'd probably be as easy to opt out as it is to opt in now; present proof of ID, tick a box.

I have no doubt opponents of this measure will seek to make this a grueling opt-out, for the simple reason it will stir public sentiment against it.

[Marcao]

I am not a big fan of this particular stance. I think the current system works, if you are inclined to be a donor you go somewhere and say so. Putting the system in reverse is not morally objectionable to me, since I am relatively thorough about shit that I sign. However, I can't help but feel that this little law would be put in place to catch the people that are less thorough than myself in such matters.

There are certain religious groups which would have to opt out by default, there would be lawsuits as people have their loved ones "organs" harvested because they missed the "opt out" clause or whatever. In short, I feel more comfortable with how the system is now. It assumes that we do not want to be "touched" or have our stuff "taken" by default. Some people can call it being selfish, but in this case I would support taking that stance.

As for me personally? I am not a donor and likely will not be in the short term. While I can intellectually admit that after I am dead, I won't need my organs and I am not encumbered by any religious dogma that would prevent me from doing it. I have an irrational fear that being organ donor means that a doctor can afford to let me die, so they can take my organs. The little voice in the back of my mind has always whispered to me that being organ donor means taking that chance, that a doctor will not go all out to save my life. I have been unable to silence that voice.

[frigidmagi]

It doesn't help that there have been accusations to that effect in certain cases. From what I've read over the years at least one doctor in the last 5 years was successfully sued for malpractice and disbarred because he whipped out the saw and started harvesting to early. As in the girl stopped breathing only after he sawed through her diaphragm(man I hope I didn't misspell that).

Things like that are very rare however, at least 90% of the docs will try to keep you alive instead of looking at you as a walking cart of spare parts.

[B4UTRUST]

It's just that other 10% you gotta worry about. I share Marcao's paranoia about that. I'm an organ donor. But as I told Tev the other night, I always wonder when it's going to come down to the situation that even if I might live an otherwise healthy normal(more or less) life after the procedure, the doc won't try as hard, or offer me every avenue of treatment because my death can save 3 other lives. Yes, I could live, but my life costs 3 others theirs. When does it stop being moral choices and ethics and start getting to simple numbers.

I'm not a doctor so I can't state how they view or think of a situation. But having to watch someone die because someone else didn't die every day and dealing with people to that degree can't be mentally healthy. I know they numb themselves and remove themselves and distance themselves etc. But it wouldn't shock me to learn that they get to the point where they no longer see their patients as people, but as a number. And if they got to that point, wouldn't the next step be, whether it's a concious or unconcious decision, to stop trying as hard for one patient when they could save two. Or three. Or more.

Yes, 90% of doctors aren't like that. Hell 95% of doctors probably aren't like that. But it's always that small percent who are that gives me paranoia.

And as Frigid knows, I'm one paranoid mother fucker.

[Cynical Cat]

There's a shortage of organs. You're much more likely to suffer and die because an organ you need won't be available than some boogie man organ harvester will get you.

[Mayabird]

I would like to reiterate that I can see why people would get upset, and I support their right to BE upset and oppose this if they so choose, but I don't have to agree with them or be righteous on their behalf. I think it's wrong to condemn someone to death because of faith in the afterlife or that you're squeamish about how the organs are removed, and let's be blunt, those are the issues at hand here.

There's the biggest problem, I think, for the vast majority of people (there really aren't that many Christian Scientists or the like). I posted an article here before about how many people don't make decisions about morality based on actual ethics or thinking, but because something makes them feel icky, and they won't discuss it further, again because it makes them feel icky.

And squeamishness is not a valid position. It's a completely irrational emotional response that inhibits rational thought on the matter. It might've worked back when everyone lived in little tribes hunting and gathering, and that dead deer carcass over there is kinda gross and maybe we shouldn't eat it or drink the water around it, but we're not in that kind of situation anymore.

Also, people seriously, massively overblow the proportion of doctors who might actually not care and let you die to harvest the organs. Humans are BAD at statistics. We naturally do things on an intuitive basis, based on experience and what we hear. When you're a hunter-gatherer and all you have is what you do and what others tell you, and things really aren't that complicated, it's fine. When you have the media publishing stories of the one bad apple for days on end and never mentioning the ten thousand times it didn't happen, people draw false conclusions for it.

Another example of the above: I was actually talking with a friend the other day about how bad we humans are at statistics, and she mentioned how a woman hiking on the Appalachian trail was murdered. She was just supremely unlucky. Of all the thousands of people who walk the trail every day, she just so happened to run into a serial killer who was hiding near the trail. It sucked, but it was a freak event. Meanwhile, the newspapers are all blasting away about how dangerous hiking is, and how women should only go hiking with a man, and how much crime goes on along the trail, all over one freak event. Most people will react to this not with, "This is totally overblown" but "I'm scared to go hiking."

B4, I seriously doubt the number of bad doctors would even be 10%. Much, much lower, but the reporting on them will be way out of proportion.

So yeah, have your ID and check the box to opt-out. There'd probably also be an additional opt-out if the family doesn't want them to donate the organs if they become a vegetable in the hospital.

[Bloody Good]

As usual, I have difficulty making any decision because I can see both sides of the debate. But I would like to point out for B4's benefit that he will likely need a liver transplant before he's 40.

Yeah, okay, uncalled-for joking aside. I am hesitant to let the government say that we will donate all the important squishy bits of our bodies unless we check box 334F on page 1,807 of form 77P, section Q933 (not to be confused with box 334E, which says you would the clerk to administer a vigorous wedgie to you). Yes, hyperbole, I know. I do, however, like the idea of giving some kind of incentive for being an organ donor. I dunno, maybe a small yearly tax credit? Like those places that pay people to donate blood or plasma or whatever bodily fluid it is that they're sucking out of you through a tube.

[Devonie]

I don't see that a "small yearly tax credit" is that much of an incentive. For myself, I don't file taxes (disabled, they'd end up paying ME), and I'm an organ donor anyway. (Not that they can actually USE my organs, but that's another story)

D

[B4UTRUST]

@Cyn, Maya:

I know it's an irrational fear of doctors being like that. Hence the word(which I used to describe my self and my own fear o this) PARANOIA. I realize it's mostly unfounded and unjustified but it's there anyway. Yeesh.

Oh, and Maya, I said it's probably less then 10% I think I said it's probably less then 5% of doctors who are like that. It's in realty probably only 1 or 2% max. But again, there is still the fear there behind it.

And Bloodygood, that was my newyears resolution. Not to stop drinking, but to find a viable liver donar, kidnap them, keep them locked up and healthy so that when mine fails I have a standby ready. Hmmm, wonder if yours is a match...