'Opt-out' Organ Donation plans for UK and other issues...

Great Debates
1

The PM has show his support today for a radical change in the organ donation system in the UK. Under the current system, you are only a donor if you opt-in by carrying a donor card and even then family consent is necessary for organs to be used. So if someone had intentions to be a donor, carried the card and was suitable for donation in the event of their death, their next of kin can refuse consent for whatever reasons they see fit. (Mourning is not the best time to make life-changing decisions, IMHO).

The proposed new system would be similar to that in other European countries (see Spain’s system). Doctors would automatically have the right to take organs from patients unless the patient had officially stated their refusal during their lifetime, and as long as the family were in agreement. This system just seems to make more sense; more people live through transplants and people that die are still dead (if slightly lighter) except for the part of them that will go on and bring life to someone else.

I can never really understand why some people have so many problems with organ donation. If I’m going to die, I’m going to die. The only way that any good can come from my death is if I can help somoone else live. I can see how initially it’s strange as a concept, and why many people would like to be left alone when they die. But surely the good to come from it outweighs any hang-ups that you can have. Is it simply that to think about donation you have to think about the possibility (more the certainty) that you will one day be dead, and people dont like that, so say no to donation?

So in my mind, that’s it. But I’d like to hear anyone else’s take on the matter, especially if you don’t want to donate and can explain why soundly. Additionally, it’d be good to hear US dopers’ views and whether they would like to see a similar system in place.

It does, however, raise other issues about our contributions to organ/tissue banks. Should someone who is an organ donor be treated preferentially to a non-donor in an organ waiting list? Should someone who opts-out of the new system be treated at all in the event that they need a transplant?

I do not carry a donor card, but simply because of the way the system works. I am fully confident that if die, my parents or whoever the decision goes to will give their consent to take what is useful from me. Also, I am on the Anthony Nolan register for bone marrow donation, and would be happy to donate if contacted. Apparently it’s quite painful, but I dont really see myself as having a choice when it comes down to it. The same goes for blood donation. Once again, if it came down to a choice of who to help, a donor or a non-donor, is there an argument that one is worth saving/one is worth effectively sentencing to die?

2

Sounds good to me.

I would say no and yes, respectively. It’s in the best interests of the system to technically kill off any future donors, and the enticement of being kept alive longer yourself might work as an inducement to get people to sign up to the current system. But if we do switch to an opt-out system, it’s less important to provide inducements, and I don’t think the betrayal of the only-medical-history-matters approach is enough to change it. As for people opting out getting organs, some of them I imagine may choose to not get donated to for the same reason that they won’t themselves donate. But while I would consider it potentially selfish, I don’t think choosing to opt out yourself should mean you yourself won’t get anything.

And huge kudos to you for being on the Anthony Nolan register.

3

Is there something similar to the Anthony Nolan register here in the U.S.?

4

http://www.marrow.org/ - Is that what you’re looking for?

Admittedly, I only vaguely knew what I was signing up for when I did during freshers week a few years ago. When they wanted to take blood, I had a proper look and realised what it’s all about.

5

I’m all in favor of organ donation, but I don’t think society is entitled to my organs after I die. So I do have that issue with the opt-out program.

6

Thank you very much. I think I’ll be dropping by the National Marrow Donor Program at Oregon/SW Washington, here in Portland, as soon as possible this week.

7

Then opt out? Well, you don’t actually need to, but you get my point.

8

So opt out…

9

After hearing other people’s similar responses, I’ve been trying to think of an analogy. I don’t think it’s a case that the state is ‘entitled’ to your organs when yo die, it’s just that the it’s assumed you’re a good person and would make the right decision if you’ve not stated otherwise.

Would you have issue with your old clothes getting taken automatically to a charity shop when you throw them out? I know it’s a weak parallel, but essentially it’s the same issue. It’s not a case of someone snatching your parts when you die because you didn’t tell them not, simply that by when it comes to donating your insides, you’ll be either dealing with many greater things or unable to consider it at all depending on your beliefs.

10

If it was instituted here, I don’t think I would opt out. I’m not opposed to organ donation for any reason. As I said, I just don’t like the presumption that society is entitled to my organs, because I don’t think it is. If people want to donate their organs, they can already opt in, so it seems to me that a program like this would be relying on apathy or ignorance to get people’s organs. It leaves a bad taste in my mouth despite the importance of the issue.

11

I’ve been saying for years we should be opt out. Those who have strong feelings against can make their intentions known, and everyone else can be recycled.

12

And to take it one step further, if you opt out and you’re over 18, you are at the back of the list if you require opting in to obtain an organ.

13

not worth it. You could opt in, get your new kidney or whatever, and then opt out. I do not believe people should be coerced anyway. I would want them to choose to opt in, but it is just that, a choise, and it should be a free one.

14

I don’t think it’s fair to give them worse care because they don’t want to donate their own organs. Hell, would we confine blood transplants to those who have already donated blood? Or close up free clinics because poor people aren’t financially supporting the healthcare system they use?

15

That’s a guilt trip. :wink:

If my clothes had the same, er, sentimental value to my family that my body does, this would be an apt comparison. Maybe somebody with firsthand knowledge can correct me, but I thought that typically, everything that can be harvested in organ donation is taken and the body is then cremated. Perhaps I’m thinking of what happens when a body is donated to science.

Nothing personal, but that’s just spin. It doesn’t actually deal with the issue, it just rephrases it. I’m all for organ donation, but this is a powerful sentimental issue for some people and I don’t think this is the way it should be decided.

16

I’m all for the opt-out. I find it rather distasteful that at present, the decision is made by a third party, who may or may not make it according to their knowledge of the dead person’s wishes, a knowledge which may or may not be correct.

I don’t think there should be a direct connection to priority for organ transplants, though. Meddling with a medical decision for non-medical reasons is very dangerous territory.

17

If you have clear knowledge that your family will indeed attach such value to your corpse, then you opt out. If you don’t know whether they will do so, then maybe you need to have that discussion, because even at the moment they’ll be the ones making the decision.

18

It seems to me that the only actual difference in an opt-out system is that the doctors wouldn’t have to consult my family. If that’s the case, I’m not sure I see this change as a necessity.

19

I don’t quite follow what you mean. If you mean this in response to my comment you quote, then I think you missed my point, that irrespective of the system being opt-in (where the next-of-kin do the opting) or opt-out, making your family aware of your wishes is a pretty important thing.

With the current system there’s also the huge problem that in the case of an unexpected death, the next-of-kin need to be contacted, fully informed of the situation, and reach a decision within hours. Often not possible. Especially when you consider the added complications of divorced parents etc. - it cannot be one parent making the decision, it has to be a mutual one.

20

I can completely understand that the opt-out system makes practical sense, but I do think it’s a bit like siezure of property upon death - granted, it’s property that is otherwise useless, and you’re done with it, but still, I don’t like the principle (when I consider it in complete detachment from the issue of pressing need for donated organs).

In what other situation would it be appropriate to assume that it’s OK to institutionally appropriate things? - it just feels like it’s a violation of principles.