Presumed consent organ donation

[elmarko]

If we assume that Liberty is less important than any potential risk to another's Life in all cases then we are potentially on a very dangerous line of reasoning....

We already make these assumptions in a vast amount of different areas.

Why do you have to own a licence to drive almost any vehicle? - you must conform to certain government regulations & laws because you are put into a situation in which you could harm or injure another person.

We sometimes completely remove another persons liberty if they injure other people deliberately through our criminal justice system, as they represent a risk to another's life.

We must pay taxes to ensure our infrastructure can be maintained & continued, we are expected to respect laws on property ownership (such as freedom of movement around the country in certain private locations).

All of these are clear infringements on personal liberty, which we must ad-hear to due to the impact on another or their property.

I don't see organ donation as any different really personally, I'm not saying I'd enforce that view on others - just how I see the matter.

I also don't believe a corpse has any liberty to be infringed on either.

 

[elmarko]

And if that rare material was inherent in the individual themselves and removing it would save a thousand, but destroy the very essence of the person to which it is inherent?....does the potentially greater human impact outweigh that individuals right to choose what happens to his/her own body?

"Destroy the very essence of the person" doesn't really apply in this case, they are dead - they have no essence of the person.

If it was a case of removing organs from alive people I'd agree - but that's not what's being suggested.

Should society assume the choices of its members, is this a Brave New World, or a society based on fundamental principles of freedom and the right to self determination without that determination being assumed?

So society, through the mechanism of the State should determine the rights of the individual as it sees fit?

Everything determined by the collective right, not the individual right....

Do you think the individual has the right to make a choice (which comes into effect after they are dead) or action which indirectly results in the death of another human being?.

Freedom currently does & should have it's limits, where those limits are drawn is key - to choices which cause needed objective human suffering or death then I'd argue they don't

 

[Castiel]

We already make these assumptions in a vast amount of different areas.

Why do you have to own a licence to drive almost any vehicle? - you must conform to certain government regulations & laws because you are put into a situation in which you could harm or injure another person.

We sometimes completely remove another persons liberty if they injure other people deliberately through our criminal justice system, as they represent a risk to another's life.

We must pay taxes to ensure our infrastructure can be maintained & continued, we are expected to respect laws on property ownership (such as freedom of movement around the country in certain private locations).

All of these are clear infringements on personal liberty, which we must ad-hear to due to the impact on another or their property.

I don't see organ donation as any different really personally, I'm not saying I'd enforce that view on others - just how I see the matter.

I also don't believe a corpse has any liberty to be infringed on either.

You see a persons body as the property of the State....I do not..I see that as an infringement on individual liberty that goes to the very core of what it means to be an individual.

As others have said, where does this line of reasoning end? It is a dangerous assumption to make, particularly when other, less invasive ways are available to us.

 

[Xordium]

Not really, if you actually read the post a question mark was at the end of the sentence.

This indicates it was a question, giving him the opportunity to correct that if it wasn't accurate.

Strange. Poor reading comprehension.

The point is, we all make concessions on liberty for perceived benefit (which in most cases isn't even real) - this would be a minor concession & has a measurable benefit.

It's related to the subject matter at hand.

A bit slow this morning guys?.

No, you made a misleading and deliberate attempt there. There is a difference between asking a question for the purposes of extracting information and doing what you were doing there.

Minor concession lol and you say we're slow - maybe we are going slow because you are not looking at things in such a superficial fashion.

Measurable benefit? Really, any evidence to support this? Do you have any evidence to show the current ratio of actual potential donors to accepted for this country? I am guessing you don't. How do you know there is a capacity there to be improved?

 

[elmarko]

You see a persons body as the property of the State....I do not..

I do not personally, I see a persons body as biological matter which has the potential to be recycled.

The state doesn't own or use it - neither does it benefit from the arrangement, it get's reused & put into the bodies of other individuals.

You could have this system in a stateless society, so any state related arguments hold no water.

I see that as an infringement on individual liberty that goes to the very core of what it means to be an individual.

Once the individual ceases to exist & only biological matter remains, I don't think there is anything for it to go against.

As others have said, where does this line of reasoning end? It is a dangerous assumption to make, particularly when other, less invasive ways are available to us.

It's pretty easy, you weight up freedoms against the harm they cause.

You want to drink while drinking, tough - as you might kill somebody else.

You want to assault people with deadly weapons, tough - as you might kill somebody else.

You want to destroy organs valid for donation upon death, tough - as you might kill somebody else.

You want to smoke in an enclosed public space, tough - you have no right to give others lung cancer.

And the list goes on for all subjects which cause measurable human harm.

As I've said plenty of times, other solutions which don't cause this perceived impact would be fine - just I'm curious as to how many lives people think this kind of liberty is worth.

No, you made a misleading and deliberate attempt there.

Now who's building a straw-man.

I'm not going to debate the meaning of my question to another person with you, if they didn't feel my interpretation of what they said was accurate they are free to challenge it.

There is a difference between asking a question for the purposes of extracting information and doing what you were doing there.

Minor concession lol and you say we're slow - maybe we are going slow because you are not looking at things in such a superficial fashion.

Measurable benefit? Really, any evidence to support this? Do you have any evidence to show the current ratio of actual potential donors to accepted for this country? I am guessing you don't. How do you know there is a capacity there to be improved?

Are you suggesting that the national organ donor registers attempts to get more people onto the register are contrary to what they actually need?.

Why exactly are they actively attempting to get more people to sign up if it isn't a desirable outcome?.

"Would you take an organ if you needed one? Nearly everyone would. But only 31% of us have joined the Organ Donor Register.

More than 10,000 people in the UK currently need a transplant. Of these, 1000 each year - that's three a day - will die because there are not enough organs available.

Please help us to turn people’s good intentions about organ donation into action by registering on the NHS Organ Donor Register."

 

[sports_brah]

Elmarko, for someone who claimed they were not authoritarian in another thread, you really don't give that impression off.

We must pay taxes to ensure our infrastructure can be maintained & continued, we are expected to respect laws on property ownership (such as freedom of movement around the country in certain private locations)"

I put food and water into my body for hopefully a huge number of years. This was an investment on my behalf, my body is mine. Just because I have perished doesn't just remove my rights. Or do you believe that personal property should also be removed?

The fact is that organs have a "value" to them, and it is absolutely ridiculous in the extreme to allow the state default access to your property.

Not to mention the flagrant level of abuse that will follow it.


Educate people if you must to help improve rates, don't slyly attempt to steal stuff,

 

[sports_brah]

I do not personally, I see a persons body as biological matter which has the potential to be recycled.

The state doesn't own or use it - neither does it benefit from the arrangement, it get's reused & put into the bodies of other individuals.

You could have this system in a stateless society, so any state related arguments hold no water.

Once the individual ceases to exist & only biological matter remains, I don't think there is anything for it to go against.

It's pretty easy, you weight up freedoms against the harm they cause.

You want to drink while drinking, tough - as you might kill somebody else.

You want to assault people with deadly weapons, tough - as you might kill somebody else.

You want to destroy organs valid for donation upon death, tough - as you might kill somebody else.

You want to smoke in an enclosed public space, tough - you have no right to give others lung cancer.

And the list goes on for all subjects which cause measurable human harm.

As I've said plenty of times, other solutions which don't cause this perceived impact would be fine - just I'm curious as to how many lives people think this kind of liberty is worth.

How you are relating an aggressive action (drink driving, assaulting people with deadly weapons (lol??)) against an act of omission (not giving organs) I do not know. You are placing responsibility upon people based upon what authority? Certainly not a moral one, nor religious.

People make choices. You're welcome for your organs to be harvested as you see fit, but stop being so intolerant as to force it upon everyone else.

 

[Castiel]

"Destroy the very essence of the person" doesn't really apply in this case, they are dead - they have no essence of the person.

If it was a case of removing organs from alive people I'd agree - but that's not what's being suggested.

That is not what you said however, your example was trying to create a scenario that devalues how an individual may feel about themselves and their worldview may predispose that death is not the end of their essence, as might their family. This is what you are attempting to do, perhaps unwittingly...your examples for comparison are implying that the State has the right to assume its preferred position over the individual unless that individual explicitly takes ownership themselves....I feel that such fundamental assumptions should always lie with the individual, not the State. Death doesn't change that.

If my son died in an accident and he was dismembered after death without the explicit permission of himself prior to his death or from those who would have reasonable cause to determine that explicit decision, I would see that as a fundamental infringement of human dignity and the rights if the individual.

I don't find that acceptable in a free society, particularly when it is avoidable.

Do you think the individual has the right to make a choice (which comes into effect after they are dead) or action which indirectly results in the death of another human being?.

I do not think that the State has the right to assume it knows what an individuals wishes are. I do not feel that a persons right to determine the disposition of their own person is a decision that should be removed simply because another human being is ill.....what if that illness that requires a transplant was self induced...smoking, drinking, poor lifestyle, etc. what then?...whose rights should take precedence?

Do you not see the moral questions that are raised by assumption?

Do you not see that other equally viable solutions would largely negate such moral questions with the same (or improved) outcomes?

You are on a very dodgy ledge if you are going down the route of determining which decisions people make that may potentially and indirectly lead to another's death should be taken from them or which they should be held responsible for.

 

[elmarko]

How you are relating an aggressive action (drink driving, assaulting people with deadly weapons (lol??)) against an act of omission (not giving organs) I do not know. You are placing responsibility upon people based upon what authority? Certainly not a moral one, nor religious.

People make choices. You're welcome for your organs to be harvested as you see fit, but stop being so intolerant as to force it upon everyone else.

I don't recall saying I would force anything, try reading the thread.

I'm arguing that the that's the reality of the situation, we already make concession (not all of which I agree with or that have a measurable benefit) - but I don't believe freedom to cause objective harm should be included.

It's already illegal to leave a person in the street who needs medical treatment, we already have a law against omission which causes another harm.

Elmarko, for someone who claimed they were not authoritarian in another thread, you really don't give that impression off.

We must pay taxes to ensure our infrastructure can be maintained & continued, we are expected to respect laws on property ownership (such as freedom of movement around the country in certain private locations)"

I'm stating how our current system is currently structured - not that I really agree with all of the elements.

Just that similar forms of liberty reduction already exist & are widely accepted in society.

 

[elmarko]

If my son died in an accident and he was dismembered after death without the explicit permission of himself prior to his death or from those who would have reasonable cause to determine that explicit decision, I would see that as a fundamental infringement of human dignity and the rights if the individual.

Or alternatively,

If your son almost died in an accident & needed a couple of transplants, after being crashed into by another driver (who died but wanted to destroy his perfectly good organs) - who's rights should be respected?.

The wishes of the person who is already dead?, or the wishes of a person who wants to remain alive?.

Should the liberty of the dead over-ride the right to life of the living?.

 

[Xordium]

Being as I've bothered to look at the figures I can tell you what is currently occurring (I've hidden the actual data numbers for obvious reasons):

Around 30,000 deaths per year are assessed for potential donation.
Of these only 1700 met the neurological criteria and 8500 the circulatory criteria (this would dictate what could be transplanted).
After ruling out contra-indications only 1200/1700 and 3000/8500 met the criteria.
Families approached 1100/1200 and 1600/3000 for a variety of reasons.
Conversion to 1000/1100 and 1500/3000 respectively.

So the conversion rate for neurological (this is the one we want ideally) is: 90%
So the conversion rate for circulatory (this is not so useful) is: 65%

Of the refusal to convert from the families then 35% was down to patient's expressed wishes, 35% shared family value structures with all other factors consistent but a feeling around 15% in the circulatory death that the process was too long. The ones where the family were in disagreement and were overriding the wishes were < 8%.

So how many more are you going to get for this massive structure - is this a cost effective solution - no.

So in the ideal situation at best we could up it by 9% on what we currently have however optout would cause the 70% refusal that still occurs and therefore we are left with all this for a 3% improvement.

What was it Blair called it The New NHS: Efficient and Effective ... hardly if this occurs.

 

[Castiel]

I do not personally, I see a persons body as biological matter which has the potential to be recycled.

Then we have our fundamental difference in how we perceive the situation...I see a persons body as inherent to them, not merely as biological matter to be disposed of or recycled as the State sees fit. I see the individual, not the collective. (The collective is for the benefit of the individual, not the individual as a benefit of the collective)

The state doesn't own or use it - neither does it benefit from the arrangement, it get's reused & put into the bodies of other individuals.

You could have this system in a stateless society, so any state related arguments hold no water.

In a stateless society....hmmm. In a stateless society there is still authority...and it is that authority that I am disputing has the right to assume consent if the individual over the disposition of their body. The State is inherent in our society, therefore it is disingenuous to say it hold no water based on such a semantic obfuscation.

Once the individual ceases to exist & only biological matter remains, I don't think there is anything for it to go against.

Which is a fundamental disagreement in our relative positions.

As I've said plenty of times, other solutions which don't cause this perceived impact would be fine - just I'm curious as to how many lives people think this kind of liberty is worth.

I don't accept that retaining such liberty needs to cost lives....other solutions have been proposed, yet you have not commented on them or accepted or opposed their potential validity...you appear to be set in your opinion that this is the only route and that others objections are invalid.

 

[stoofa]

You know what - It makes me so happy that the 80%+ of the people who were involved with the vote in Wales voted to pass this new Bill.
It also brings a smile to my face when I browse through this thread and see that if right now if the decision to introduce this bill in England was based purely on the people in this thread it would also pass.

What makes me livid inside is this general "up the state" attitude that some people seem to carry around. At all costs the state must be challenged even when its for the good of the masses.
Lines such as " the state has no rights to my organs" honestly makes me mad. How you can sit back and tell us you'd fight any proposal and actively opt-out of a scheme that could potentially save numerous lives every year - it just amazes me.

This bill doesn't set anything dangerous, it wouldn't suddenly mean people "on the edge" would get any less treatment.
It simply means that those people who hadn't gotten around to getting on to the donor register would now automatically be placed there.
It will be a very simply matter of getting yourself removed from that list.

If somebody feels that strongly about donating organs then they can easily get themselves removed - simply put, no harm done.
But those people looking to get themselves removed "simply because" and back to the "up the state" idea just make my blood boil. How can anyone explain it better.
You will be dead. Your organs, despite what others have said, have no monetary value in the UK (to you or your family). You are left with two choices:

1. Potentially save the life of another. Your death means life to others.
or
2. Your death doesn't potentially save a life, your don't give somebody else that amazing gift.

How the government decide to get to those two choices really shouldn't matter to you.
If your choice is number 1 then you'd need to do nothing in the world and when the unexpected death arrives you might just save someone else.
If your choice is number 2 (and yes, you still have this choice) then one simple signature and your decision is made.

I started this thread and this is going to be my last contribution to it. The small minded few have just made me so angry I don't think I can constructively contribute anything else here.
Numerous people have said that I'm sure everybody in this thread would accept an organ if they needed one yet some of those same people are not willing to do the same for someone else.
The 95%+ of people in this thread that will never be directly affected by organ failure are blessed and they come into this whole discussion with eyes only half open - I only hope that you remain in the dark on the agony & pain that comes with organ issues.

I personally now hold out more hope than ever before of the same system coming to England. I know some people will want to opt-out of this for real reasons and fine - that is how the system is designed to work.
However I also know some people will opt-out for no-existent reasons - and you guys.....I'm just lost for words.

 

[skippy2421]

Or alternatively,

If your son almost died in an accident & needed a couple of transplants, after being crashed into by another driver (who died but wanted to destroy his perfectly good organs) - who's rights should be respected?.

The wishes of the person who is already dead?, or the wishes of a person who wants to remain alive?.

Should the liberty of the dead over-ride the right to life of the living?.

In short I'd say it's the rights of the dead person to do as they pleased with their body even if at thedetriment of my son. Completely agree with Castiel's view that there are much better way to increase donation than this.

Personally I don't give a toss about this really. But I'd definitely argue against a system that would undermine the impartiality of the NHS (your prioritisation scheme). In fact I know a lot of staff would be against this. I suppose you support denying treatment to fat people and smokers as well due to their decisions in life? don't use the organs are limited argument either as doctors time, drugs, money and theatre time are also limited too. If people can be refused drugs to save them as they're too expensive or people die due to be at the bottom of waiting lists for ops then people can wait for organs too.

 

[elmarko]

Being as I've bothered to look at the figures I can tell you what is currently occurring (I've hidden the actual data numbers for obvious reasons):

Around 30,000 deaths per year are assessed for potential donation.
Of these only 1700 met the neurological criteria and 8500 the circulatory criteria (this would dictate what could be transplanted).
After ruling out contra-indications only 1200/1700 and 3000/8500 met the criteria.
Families approached 1100/1200 and 1600/3000 for a variety of reasons.
Conversion to 1000/1100 and 1500/3000 respectively.

So the conversion rate for neurological (this is the one we want ideally) is: 90%
So the conversion rate for circulatory (this is not so useful) is: 65%

Of the refusal to convert from the families then 35% was down to patient's expressed wishes, 35% shared family value structures with all other factors consistent but a feeling around 15% in the circulatory death that the process was too long. The ones where the family were in disagreement and were overriding the wishes were < 8%.

So how many more are you going to get for this massive structure - is this a cost effective solution - no.

So in the ideal situation at best we could up it by 11% on what we currently have however optout would cause the 70% refusal that still occurs and therefore we are left with all this for a 3% improvement.

What was it Blair called it The New NHS: Efficient and Effective ... hardly if this occurs.

Is that just specific organ donation, or does that include all forms of donation (such as tissue donation?)

If there is no real benefit, why is the NHS trying to increase the amount of donors?.

"3. Why are even more donors needed?

Every day three people die while waiting for an organ transplant and many others lose their lives before they even get on to the transplant list. There is a serious shortage of organs and the gap between the number of organs donated and the number of people waiting for a transplant is increasing.

Transplants are very successful and the number of people needing a transplant is expected to rise steeply due to an ageing population, an increase in kidney failure and scientific advances which mean that more people are now able to benefit from a transplant.

However, the number of organs available for transplant has remained static over the past five years. Only a very small number of people die in circumstances where they are able to donate their organs. Because organs have to be transplanted very soon after someone has died they can only be donated by someone who has died in hospital. Usually organs come from people who are certified dead while on a ventilator in a hospital intensive care unit, generally as a result of a brain haemorrhage, major accident like a car crash, or stroke.
The numbers of people, particularly younger people, dying in these circumstances is falling, mainly because of welcome improvements in road safety, medical advances in the treatment of patients and the prevention of strokes in younger people.

Another major reason for the shortage of organs is that many people have not recorded their wishes about donation or discussed it with their families. Too few people have joined the NHS Organ Donor Register and made sure that their families know their wishes.

While only a very few people die in circumstances which would enable their organs to be donated, many people can donate tissue after their death. Scientific and medical advances in the treatments that are available for patients has led to an increased need for donated tissue."

 

[Castiel]

Or alternatively,

If your son almost died in an accident & needed a couple of transplants, after being crashed into by another driver (who died but wanted to destroy his perfectly good organs) - who's rights should be respected?.

The wishes of the person who is already dead?, or the wishes of a person who wants to remain alive?.

Should the liberty of the dead over-ride the right to life of the living?.

Objectively I would not presume to decide for another, be it my son or the man who died, lets me put it this way, If it was me who needed the organs I would not feel comfortable taking them from someone who expressed a desire not to donate...if it resulted in my death then so be it....I feel some principles of individual rights are that important to me.

In the case of my son, I would not be so objective and would, in all likelihood compromise any and all principles to save his life, I would potentially take another's life to ensure his own, I am not as morally strong as some people when it comes to the protection of my family over the rights of others...which therefore Elmarko, I feel the question is unfair to be honest, and I am disappointed you felt you need to ask it in order to forward your agenda.

 

[elmarko]

In short I'd say it's the rights of the dead person to do as they pleased with their body even if at thedetriment of my son. Completely agree with Castiel's view that there are much better way to increase donation than this.

Personally I don't give a toss about this really. But I'd definitely argue against a system that would undermine the impartiality of the NHS (your prioritisation scheme).

As I've said about 50 times if you read the thread, I was saying "If I was harsher I'd support this".

I suppose you support denying treatment to fat people and smokers as well due to their decisions in life? don't use the organs are limited argument either as doctors time, drugs, money and theatre time are also limited too. If people can be refused drugs to save them as they're too expensive or people die due to be at the bottom of waiting lists for ops then people can wait for organs too.

I'm sorry you think a hard limitation is the same as a soft limitation (funding can be reallocated, increased new organs can't yet be fabricated.) - but it doesn't make it so.

But if you read above, you would see I don't support that system either - just that it's what some of this stupid population deserve (not that I'd inflict that on them).

 

[estebanrey]

I put food and water into my body for hopefully a huge number of years. This was an investment on my behalf, my body is mine. Just because I have perished doesn't just remove my rights. Or do you believe that personal property should also be removed?

Eh? It is.

When someone dies, we don't just board up their house and leave it to rot because it is "theirs" and still belongs to them. It gets given to someone else, normally a family member via a will but if none was made and no family members make a claim then it goes to the government.

Property ceases to be yours both practically and legally when you die, that is the complete opposite to what you are suggesting should happen with body parts.

 

[elmarko]

Objectively I would not presume to decide for another, be it my son or the man who died, lets me put it this way, If it was me who needed the organs I would not feel comfortable taking them from someone who expressed a desire not to donate...if it resulted in my death then so be it....I feel some principles of individual rights are that important to me.

In the case of my son, I would not be so objective and would, in all likelihood compromise any and all principles to save his life, I would potentially take another's life to ensure his own...which therefore Elmarko, I feel the question is unfair to be honest, and I am disappointed you felt you need to ask it in order to forward your agenda.

To be fair, I didn't bring up your son in this debate, you have one side of the coin related to a personal situation.

I simply gave an account of the other side to the situation you proposed, I would not have bought it up without it being done by yourself first (apologies if it caused offence).

It's easier to die personally for a moral or ethical stance, I'd do similar for certain principles myself (that I can understand) - but letting another person die (be that a total stranger, or a family member) for personal ethical stances is another thing (which is what this relates to).

While personal liberty is great & many of us may be willing to die for it - it's not the same to let other people die for it.

Personally, if I'd sacrifice certain ethical principles to save the life of one of my closest family members (within reason) & regarding a subject which doesn't result in the death of another (quite the opposite, they are already dead) - I feel I'd be a hypocrite if I thought liberty should be sacred above all.

As if I had that view the reality would be "Liberty is sacred, as long as it's other people who pay the price & die to maintain it - if it's a case of my loved ones - liberty can go-to hell" which for me isn't a fair compromise.

 

[Castiel]

To be fair, I didn't bring up your son in this debate, you have one side of the coin related to a personal situation.

I simply gave an account of the other side to the situation you proposed, I would not have bought it up without it being done by yourself first (apologies if it caused offence).

It's easier to die personally for a moral or ethical stance, I'd do similar for certain principles myself (that I can understand) - but letting another person die (be that a total stranger, or a family member) for personal ethical stances is another thing (which is what this relates to).

While personal liberty is great & many of us may be willing to die for it - it's not the same to let other people die for it.

I'm not offended, just disappointed that you would take advantage of my example in such a way, that you think it is acceptable to undermine my objectivity to try to gain advantage in a debate then I underestimated you (I'm am not sure that was your intention however, i hope it wasn't) As I said, in such an example I would not act in a rational or objective way, so any reply I would give would be an emotional one, not an objective one and therefore would be pretty useless in this debate...I perhaps should have made my example more generic, but I was trying to convey the personal way in which people see theirs and their close ones death...rather than the distant, externalised way in which you see death. As I said it is a fundamental difference in how we approach the validity of the position on Assumed Consent.

You seem intent on the assumption that opting out and not opting in are the same thing, when they are not....no one is killing anyone by excising their choice to have their body buried intact for example.....those people would have died if that person had not died anyway, it is disingenuous to make that connection.

I am, neither is anyone else that I can see, opposed to organ donation...they are opposed to the concept of assumed consent...which is totally different to the way you are framing your argument in favour of assumed consent.

I think that is where this debate is getting skewed...some of us are arguing against the concept of Assumed Consent, others are arguing for Organ Donation....and this is creating a disparity in what people are assuming our respective positions are.

Even the OP has made this assumption.