Presumed consent organ donation

[elmarko]

Yes...my opposition is one of conscience not whether organ donorship is worthwhile. The state should not be in a position to determine ownership of the person as a default position.

I guess we will have to agree to disagree on this point.

I don't believe ownership is a relevant term to use, as the state won't own anything - certain parts are given to individuals.

The only change is the assumption of the views of the individual, from an expressed "no" to an expressed "yes" - with the opting system reversed.

While it's not ideal, the benefits out-weight the non-existent consequences.

It's just biologic-recycling to be honest.

 

[krooton]

Don't like the idea hope it doesn't come to England.

I would assume other religious people would feel the same, and both you and them have the right to opt out if you wish.

 

[Spook187]

+1.

Part of me thinks if you opt out (when if you are able medically to donate, also an adult) then you should be at the bottom of the transplant list if you should ever need one.

Might discourage people from opting out.

Talk about blackmail.

 

[elmarko]

Talk about blackmail.

How is it blackmail?, why should opting out only relate to the donation aspect?.

Nobody is forcing you to have organs or not to donate, it's simply treating people by the same standard they treat others.

"Do unto others as you would have them do unto you"

I would assume other religious people would feel the same, and both you and them have the right to opt out if you wish.

To be fair, at least some of the people who do it for religious reasons also refuse to accept donations, they are not adding to the problem of an organ deficit.

 

[Spook187]

So your saying people should be at the bottom of the transplant list if they opt out, what is this world coming to.

 

[RDM]

While it's not ideal, the benefits out-weight the non-existent consequences.

I thought the evidence was mixed on this and that some countries had seen a fall in donations when moving to an opt out system?

Like Castiel I am a long term donor card carrier but I am not entirely comfortable moving from an organ donation system to an organ harvesting system.

 

[elmarko]

I thought the evidence was mixed on this and that some countries had seen a fall in donations when moving to an opt out system?

Like Castiel I am a long term donor card carrier but I am not entirely comfortable moving from an organ donation system to an organ harvesting system.

The evidence doesn't seem to support that conclusion, but I'd be interested to see some if you have it.

"Since 2008, signing an organ donor card in Israel has provided a potential medical benefit to the signer. If two patients require an organ donation and have the same medical need, preference will be given to the one that had signed an organ donation card. Organ donation in Israel increased after 2008."

"For example, Germany, which uses an opt-in system, has an organ donation consent rate of 12% among its population, while Austria, a country with a very similar culture and economic development, but which uses an opt-out system, has a consent rate of 99.98%"

"In the four best quality between country comparisons, presumed consent law or practice was associated with increased organ donation—increases of 25-30%, 21-26%, 2.7 more donors per million population, and 6.14 more donors per million population in the four studies."

http://www.bmj.com/content/338/bmj.a3162
https://en.wikipedia.org/wiki/Organ_donation
http://en.wikipedia.org/wiki/International_organ_donor_rates

 

[Xordium]

This is not a good decision at all. It is something that has been mentioned for a long time and that way it is politically represented is wholly inaccurate both from a comparative view with other countries, the ethical and legal framework and justification along with strong evidence against this.

This is a decision that whilst may be applauded by associated invested concerns is actually quite disputed with the transplant community and not really something we ever wanted.

What we need to do is to stop comparing ourselves to countries ad comparing their rates with ours. Take the often presented example of Spain in the donation rate. Spain doesn't have the seat-belt laws we do therefore they will get more closed head injuries - therefore they will get more people suffering brain stem death who are therefore eligible for donation.

What we need to do is to address the donation problem across ethnic groups. For example, say in kidney transplant the highest demand will be in groups of Asian descent however traditionally they are the least likely to donate.

Transplantation is not the definitive end goal of treatment. The immunosuppressive regimes for cadaveric transplantation (en masse) are aggressive and not without profound side-effects. Therefore, the goal should not be for cadaveric transplantation but for a co-ordinated attempt to instigate live donated transplantation.

tldr - a poor idea with no real benefit and a whole lot of bad consequences towards a goal that is neither best practice or that desirable.

 

[realBabelfish]

Yes...my opposition is one of conscience not whether organ donorship is worthwhile. The state should not be in a position to determine ownership of the person as a default position.

it is just a dead body though. its not a person any more, just a collection of cells. might as well put it to good use i say.

i guess its a moral dilemma, who 'owns' a body after you die? if you have no finances and no relatives, who would be expected to bury/cremate the body? i guess that is the gov, they wouldnt just chuck you in a skip would they?

as said, its fine if people dont want to donate but then they shouldnt be allowed any transplanted organs. dont want to be a hypocrites do we?

 

[realBabelfish]

Talk about blackmail.

no it isnt. it might be anti-hypocritical though.

if you dont believe in donating organs why should you be allowed to get donated organs? if you believe in sky fairies and dont want to donate then surely you dont need donated organs as your sky fairy will look after you when your organs fail.

 

[realBabelfish]

So your saying people should be at the bottom of the transplant list if they opt out, what is this world coming to.

a more fair one? why should they get preference over someone who is prepared to think of others after they die? i see opting out as being selfish and selfish people can go to the bottom of the list (or not at all as far as im concerned)

 

[elmarko]

What we need to do is to address the donation problem across ethnic groups. For example, say in kidney transplant the highest demand will be in groups of Asian descent however traditionally they are the least likely to donate.

Genuine question, would not increasing the overall donation rate for the entire population also include Asians (via an opt out system)?.

It's not like 100% of them are going to opt out, as not all Asians are religious or dissimilar from the native population on social & political issues - just like us many too lazy to sign up.

You are pointing out medical problems in donation, not problems related to an opt out system.

What would be worse with an opt out system compared to an opt in system, what evidence suggests more lives would be saved by keeping to our current system compared to changing?.

While I was half-joking with a mutual opt out system, how is it any different to a social insurance policy - as in a group of people joining a collective with the understanding that anybody on that list covers each other in the event of death, providing for each other the organs they need?.

(such as http://www.lifesharers.org/ )

Pretty much the same as life insurance, but with organs - I'm not saying this is an ideal policy by any stretch of the imagination (I'd much prefer a civilised society with a social concious, but hey we don't have one) - just a method to decreasing the amount of people who die waiting for organs.

 

[Xordium]

if you dont believe in donating organs why should you be allowed to get donated organs? if you believe in sky fairies and dont want to donate then surely you dont need donated organs as your sky fairy will look after you when your organs fail.

I suspect most on here won't have contributed as much tax as me - does that mean I should warrant special treatment over them. Of course not - everyone gets the same standard of care it's one of the basic ethical principles the whole framework is built upon.

You do not have a say who your organs go to.
You do not have a say where your organs come from.

The organs get matched - the national transplant team runs the match against the list - the consultant gets offered the organ/s - the consultant accepts or declines.

I don't believe in the sky fairy and I wouldn't donate - I've been in the room when it happens - not pretty.

 

[RDM]

The evidence doesn't seem to support that conclusion, but I'd be interested to see some if you have it.

Brazil is the oft quoted example, they had to withdraw their opt out system.

"Since 2008, signing an organ donor card in Israel has provided a potential medical benefit to the signer. If two patients require an organ donation and have the same medical need, preference will be given to the one that had signed an organ donation card. Organ donation in Israel increased after 2008."

Israel doesn't have an opt out system, instead they give priority to cases where you have opted in.

"For example, Germany, which uses an opt-in system, has an organ donation consent rate of 12% among its population, while Austria, a country with a very similar culture and economic development, but which uses an opt-out system, has a consent rate of 99.98%"

Except Austria doesn't have a consent rate of 99.98%, it is an opt out rate of 0.02%.

Obviously you are going to have more organs to harvest if you assume consent but it is a fundamental change moving from donation to harvesting.

 

[Marky]

The way it should - I hope the UK get this soon

 

[Xordium]

Genuine question, would not increasing the overall donation rate for the entire population also include Asians (via an opt out system)?.

It's not like 100% of them are going to opt out, as not all Asians are religious or dissimilar from the native population on social & political issues - just like us many too lazy to sign up.

You are pointing out medical problems in donation, not problems related to an opt out system.

What would be worse with an opt out system compared to an opt in system, what evidence suggests more lives would be saved by keeping to our current system compared to changing?.

Well for a start is not a religious thing before anyone jumps in there. None of the major religions prohibit the use of organ donation and their stances are all that it is down to personal choice and preference.

Yes, I expect you would get more. I would wager you'd get the same amount with a co-ordinated health promotion campaign that would most likely cost less than the botched and abortive IT system the government will contract out to keep track of this (with the high likely cockups that will occur and the subsequent law suits).

I pointed out the medical issues to make one thing quite clear - in the lions share of transplantation - organ donation from dead people is not something we should be investing in - we should be investing money in organ donation from living people - why pay money and create all this kerfuffle over a second and possibly third choice treatment for a large proportion of the people needing a donation (obvious exceptions included).

The fact of the matter is not many deaths are suitable for donation - people don't really understand this. Any death that is suitable then the relevant people will be approached anyways.

Lives would be saved by spending the money people are going to waste on this to:

a) Targeted poorly represented communities
b) Facilitating live related programs where possible
c) Increasing the staffing for the dedicated team for families of the deceased.

 

[elmarko]

Well for a start is not a religious thing before anyone jumps in there. None of the major religions prohibit the use of organ donation and their stances are all that it is down to personal choice and preference.

Yes, I expect you would get more. I would wager you'd get the same amount with a co-ordinated health promotion campaign that would most likely cost less than the botched and abortive IT system the government will contract out to keep track of this (with the high likely cockups that will occur and the subsequent law suits).

I pointed out the medical issues to make one thing quite clear - in the lions share of transplantation - organ donation from dead people is not something we should be investing in - we should be investing money in organ donation from living people - why pay money and create all this kerfuffle over a second and possibly third choice treatment for a large proportion of the people needing a donation (obvious exceptions included).

The fact of the matter is not many deaths are suitable for donation - people don't really understand this. Any death that is suitable then the relevant people will be approached anyways.

Lives would be saved by spending the money people are going to waste on this to:

a) Targeted poorly represented communities
b) Facilitating live related programs where possible
c) Increasing the staffing for the dedicated team for families of the deceased.

Out of curiosity, do you know how much is spent currently (in time & effort) in getting people onto the register - encouraging donation?.

Is it more than would be spent dealing with the other side of the coin (essentially leaving more money/time free for the A,B,C things you mentioned?).

 

[Westyfield2]

I massively disagree with this. Organ donation is great, but a default consent unless you opt-out is bad. IMHO everything in society should be presumed no unless you manually opt-in... but I guess that's just because I'm libertarian,.

Unless of-course we were to make everything in this country default consent unless opt-out? Automatically signed up to Telephone Preference Service, automatically get a passport, presumed consent to sex, etc etc... in which case it's fine to do organ donation as-well as everything else.

 

[Bear]

How would you be forced into it?.

Encouraged by saying "Ok, if you don't want to sign up-to donation you are also on the bottom of the receivers list" isn't forcing.

You are fully free to refuse to sign up-to donation & then die if you need one (in my system), that's freedom at it's best!.

I personally think presumed consent is wrong, it should always be IMO be an opt in system. Depnding on how it is done, people that don't want to donate may be put in the uncomfortable position of having inform their doctor or may have to justify it to someone when asked why not.

The whole debate for me isn't about the people that don't donate but the lazy morons that want to but never get round to doing so. Presumed consent is for the lazy ***** that can't be bothered to get off their backsides to do something which they seemingly feel passionate about, so its those people and the ones that choose not to donate that should go at the back of the list. In fact I would put the lazy morons right at the end of the list.

 

[Woden]

If they bring in an opt out then I will opt out..I carry a card now, but that is my choice. .if the default positive position becomes the choice of the state then I will no longer carry one.

That is incredibly childish at best. By stopping your organs being donated because the government says you should, you are still letting the government make your decisions for you. Most people grow out of that in their teens.

Or, even worse, you are some sort of extremist hipster? If organ donation becomes to mainstream you will stop? Even if it costs lives?

The default position should always be in favour of the individual, not the State.

You are almost right on that one. The default position should always be in favour of the living individual. The state doesn't benefit here, people on transplant lists do.

I don't care what happens to my body when I die, and the people that might be asked about it when I do finally pop my clogs know this. They can take anything that could be useful for transplant, research or education, cremate the rest. Not exactly using it am I? In my mind, it is no different to me giving away my blueray player when I got my PS3.

It will save lives. It's that simple. Anyone that wants to keep their body intact for whatever reason (I know Muslims believe their body should be buried whole for example) will have the ability to opt-out. Anyone that doesn't care enough to opt out would likely be okay with it anyway.