AMA debates how to get more donor organs

[PfcHammer]

http://interestalert.com/brand/siteia.shtml?Story=st/sn/06140000aaa06f47.upi&Sys=siteia&Fid=LATEBRKN&Type=News&Filter=Late%20Breaking

AMA debates how to get more donor organs
By ED SUSMAN, UPI Science News

CHICAGO, June 14 (UPI) -- Doctors suggested Monday that one way to obtain more donor organs to save the lives of thousands of people waiting for kidneys and livers and hearts would be to adopt policies in Europe -- assume people are truly good at heart and would want their organs to be used by someone else.

"We have to do something to change the system," said Dr. Stephen Schwartz, a psychiatrist in Huntington Valley, Pa. "We are standing by idly while people are dying. We can't stand by and let them die."

According to statistics from the United Network for Organ Sharing, about 6,000 people in the United States -- 17 people every day -- die because they cannot get an organ that could keep them alive.

Schwartz, at the annual meeting of the American Medical Association's House of Delegates, proposed that the United States use the organ donor system in effect in Belgium, Spain and other countries and assume a person who has died would have donated his or her organs so others could live.

[THUNDER HANDS]

1. I have no idea why this isn't the policy already

Dead folks don't need their organs, why do people have to conscent to this?

It makes no logical sense to let someone die just because someone failed to sign a donor card and their grieving wife or husband doesn't want their body cut open and their organs removed.

[NashVegas]

3. So Now, People Who Are Philisophically Opposed would Have No Say

Over their bodies, and the remains of them, against those who refuse to accept mortality?

Do you believe a woman has the right to decide whether or not to have an abortion? And if so, how is that not comparable?

[THUNDER HANDS]

4. is the woman having the abortion dead?

If so, then she no longer has a right to choose.

Same thing with a potential organ donor. The good of the living outweighs the wants of the dead and the dead's family.

I'm sorry, but if it helps save lives - screw the dead.

[Heddi]

6. Sorry, but that's just wrong

Jehovah's Witnesses, for example, are against organ donation and blood donations/transfusions.

Yes, the patient is dead, but their family isn't, and what right do Dr's have to say "oh yeah, by the way, we took your dad's heart and liver, and who cares if, in your religions' views, that means he's going to hell..."

In many places there is a shortage of cadavers for med schools, and bodies are needed for experimental treatment. Should we just trump the views of the family---who says dad HAS to be burried? Who cares what the family wants......:eyes:

There needs to be more EDUCATION about organ donation, imo. People are under the false assumption that if you donate organs, your body can't be burried, or cremated, or that you'll be too disfigured to have an open-casket funeral. Or that you'll HAVE to be cremated, or that you'll HAVE to be burried.

If people have moral or ethical or religious reasons against donating organs, those wishes should be upheld throughout life AND death. I, while alive, have JUST as much say over my life as I do my death. If I want to be cremated, I should have the right to make that decision, even if it goes against what my family wishes. If I want to donate organs, I should be able to even if it too goes against my family's wishes.

Equally, if I *DON'T* want to donate my organs, neither myself nor my family should have that decision trumped by a doctor.

My BODY, My CHOICE---in life and in death.

[THUNDER HANDS]

10. nope, sorry I disagree

Once you die, you lose all your personal rights and the good of the state comes first.

[Heddi]

13. So the family should have NO say?

You do understand that death itself is very traumatic for the family to begin with----add to that the stress of not knowing what's going to happen to your family member's body--even if it violates the very core of your belief system or family wishes?

The poster who made the above analogy between this issue and abortion is right on the money. Why should one have choice in one issue but not in another?

At what point does the 'personal good of the state' coming first encroach more and more upon life than death? Forcing someone to have a child so that child can provide bone marrow transplant for a sick sibling? Forcing a child to be an organ donor for a sibling?

No---I disagree with you (which isn't to say either of us is more right or wrong than the other), but I feel that any decisions I've made about my death, while living, should trump the 'good of the state'

[THUNDER HANDS]

19. yes, the family should have no say

I'm sorry if it sounds cruel. But at least its less cruel than a family just saying 'no thanks, let that little girl who needs a kidney die - my religion tells me it's wrong to cut my husband open.'

Dead people are.....wait for it......DEAD!!!!

DEAD

DEAD

They don't need those organs anymore. And we're not talking about harvesting human beings just for that purpose. We're talking about people giving a small part of themselves after their life has ended, for the greater good of mankind.

If my wife or kid needed an organ, and the only way they could be saved was to harvest your grandma's kidney, I'd rip her open myself to save my child.

I'd imagine millions of other families of people who died while waiting for an organ donation would feel the same way.

Its about saving lives...you know, of people who are still breathing.

[NashVegas]

20. Dead People Are Dead - And We Will Be, Too

No one should be forced to have their beliefs over-ridden by those who demand (which organ donation is becoming, as evidenced in this thread) assistance in buying some time.

[HuckleB]

21. Huh?

I don't think presumed consent is the way to go, as I do see it as unethical. However, your statement that organ donation is merely "buying some time" does not match up with reality.

[daleo]

25. Unfortunately it is just "buying time"

Nobody lives forever, at least in their current corporeal body, so any medical procedure is just buying time, from an existential point of view. I believe this is the crux of what the poster meant by "refusing to accept mortality" as well.

[HuckleB]

26. Five, ten, 20, 30 years is a lot of time.

By your "definition," taking antibiotics for a severe bacterial infection is just "buying time." Why have healthcare at all?

[NashVegas]

30. The Difference

Is that in taking anti-biotics, you aren't forcing anyone else to give up final say over what becomes of their remains.

[HuckleB]

31. Read my posts.

I'm not asking anyone to give up final say over their "remains." You seem to be spinning in circles rather than addressing my actual posts.

[daleo]

46. I was just pointing out the facts

All medical interventions are just buying time, at least in our current incarnations - what may happen after that is a matter of great interest and speculation, but not germane to our current bodies. That doesn't mean I don't want to buy more time, and I expect most people are the same.

Some people just believe getting extra time at someone else's expense is wrong - I am not one of those, but someone I know very well who is. She says she wouldn't want an organ transplant, should the situation ever come up, for this very reason. I don't really understand the reasons, but I respect them. She has a pretty firm conviction that there is life after death (although she doesn't follow any of the mainline religious traditions exactly), so that may be part of it.

Anyway, the point is simply that people should have a right to their convictions on this very fundamental subject, whether they make sense to others or not.

[Name removed]

47. Deleted message

Message removed by moderator. Click here to review the message board rules.

[Gemini Cat]

52. I'm really really glad my SO was able to "buy" some time!!

It's one thing to want to live forever when you're 93, and it's a completely different thing to want some life at 30!
Thank G-d someone thought the same thing and signed their donour card.
And thank G-d that someone's family honoured their wishes.

[daleo]

56. I am glad for you

Somebody gave you a wonderful gift.

[NashVegas]

59. I'm Very Happy for You and Your SO

It's a wonderful thing for you. Now, imagine the scenario if the donation was forced against a person's wishes, as some would have it.

[notadmblnd]

33. Well if dead people have no rights and become property for the

state. the the state should become responsible for burial/cremation expenses.

[FlaGranny]

86. Heddi,

I have lost my father (age 89), mother (age 94), and daughter (age 21). I was devastated that I could not donate any of their organs and have their deaths create happiness and life for someone else. I also lost my first husband (age 30), but that was BEFORE much organ donation, except for eyes, but no one asked me for them and I didn't think about it at the time.

How wonderful for the death of a love one to actually save the life of someone else. I can tell you, that it has been a major disappointment to me that none of my family members could donate. My husband and I have signed up for organ donation, as have our sons.

When we are dead, we no longer have any use for our bodies. If someone else can benefit, that is good. I have told my husband he has permission to donate my body to a medical school and when they are done with it, they can cremate the remains. I certainly won't need it any more.

[Heddi]

90. But what if your family members had reasons to object

and I personally can't think of any reasons other than religious reasons, but I really feel that it's THEIR decision as to whether or not to have their organs donated after death.

You say: have told my husband he has permission to donate my body to a medical school and when they are done with it, they can cremate the remains --- those are YOUR wishes. If YOU want your body donated, then that's great. I personally am an organ donor, as is my husband, both our mothers, grandmothers, etc.

However, if for whatever reason my husband DIDN'T want to be a donor, even though I'm his wife and am his next of kin, etc---I could NEVER live with myself if I did something against his wishes "just because he's dead".

Why do we honour the wishes of loved ones with regards to burrial? My mom wants to be creamated. Cool. But I shouldn't be able to say after she dies, "Well, mom wanted to be creamated, but screw that. *I* want her to be burried, so she will be".

We leave wills for a reason, and even at my (supposedly) young age, both my husband and I have advance directives should we be injured or in a coma. I have written and notarized what body parts i want donated. However, my body isn't going to be donated to science--that's just my personal preference. I will be cremated--again, a personal choice.

Yes, it would be wonderful if everyone who passed on left their organs for donation. But it's called organ DONATION for a reason---because it's not forced.

it's a deeply personal decision, imo, and a decision that shouldn't be made by next of kin, or doctors, or well-meaning funeral directors. It should be made by the person whose organs they are, while they are living.

If no directive is given, then the default should be "no, do not donate".

I just can't agree that Dead=organs without the express consent of the departed. I think it's a violation of their body and their wishes, and yes, just because we're dead and we don't need our bodies anymore doesn't mean that we can't make decisions about our deaths while we're still alive.

I'm sorry--I'm just not going to change my mind on this subject :)

[mulethree]

22. but is it the good of the state?

A 67 year old woman given a heart lung transplant, because she smoked for 45 years and ruined her own. Estimated life expectancy after transplant - less than 4 years, expected quality of life - low, estimated cost to taxpayers - $350,000 - worth it? Is it for the good of the state to do this operation?

Meanwhile a 50 year old man who needs a transplant due to asbestos exposure but does not have good private health insurance. He would have longer life expectancy, better quality of life, and his condition isn't the result of self-destruction. As the state goes, this case makes more sense, but would the state pay for it?

Dick Cheney could use a new heart, would you want him to have yours?

Would you want your liver to go to an accident victim? or an alcoholic who ruined his own liver? or a kid with a hereditary condition who will marry and have 4 kids of which 2 will be dependent on transplanted livers?

If a rich kid and a poor kid both need a kidney do they have an equal chance of getting yours when you die?

Do you want your scalp used to give someone a cosmetic hair transplant? Do you want it removed and used for development of the next generation of Rogaine?

No I don't trust the state to decide on collective best interests, to be pragmatic instead of sentimental. I don't trust the medical community to apply my standards of morality in their choice of beneficiaries. I leave the decision to my wife and brother who know my feelings on this. They each feel differently and if they die then I will respect their wishes when making the decision.

The fate of my bank accounts and properties will likewise be determined in accordance with my wishes. Not given to the state or to an unspecified doctor to decide.

[Virginian]

37. It's not a matter of money.

"If a rich kid and a poor kid both need a kidney do they have an equal chance of getting yours when you die? "

YES!

Both the rich and poor kids are listed on the waitlist by their doctors. The computer determins who is the best match, second best match etc. The computer does not know who has money, private health insurance or anything like that. Organ allocation is equitable.

Check out www.unos.org for the FACTS.

[Mokito]

54. I'm sorry, but that's bullsh*t!

At least in a society structured to the likeness of the USA. Sad to say, but even doctors choose profit above people. If you want this to be a given, then a social safety-net is absolutely indispensable.

[HuckleB]

60. Why? Just because you say so.

Sorry, but you need to offer more than that.

[Mokito]

67. To answer your argument (or to attempt so)

The United States: Organ contracts? In the United States, the American Medical Association (AMA) is trying to start a project for selling human organs. The AMA believes that most Americans will not donate their organs (except, perhaps, to people in their family) unless they are paid. The AMA's idea is that people can sign a contract while they are alive, promising that their organs can be transplanted when they die. In exchange, the donor names another person who will receive money if the organs are used. The AMA hopes that it will be able to try the project in 1998, even though many American doctors are not comfortable with the idea

Buying and selling organs: is it right or wrong? Are parts of our body really just things that can be bought and sold? Or are they somehow different and special? One Japanese sociologist, T. Awaya, warns that we are beginning to look at each others' bodies greedily, as a way of getting new parts to make our own lives longer. He calls it "social or 'friendly' cannibalism." Awaya does not say transplants are wrong, but he would like people to think about this subject very carefully.

http://www2.gol.com/users/bobkeim/orgsale.html

I'm not really familiar with the policies of the United States about Organ-donors, but the mention of 'donating' organs in exchange for cash, tells me somehow this simply can't evolve to an equal division of organs to the most urgent cases. Before you know it 'donors' are deciding to which financial brackets they will 'donate' their organs.

Human Organs and eBay: A Combination that Could Save Lives

by J. H. Huebert

A few weeks ago, on line auction site eBay decided to block an auction for "one fully functional human kidney," for sale by the kidney’s original owner. By the time eBay cancelled the auction, the high bid was already $5.7 million.

...

Yet eBay blocked the auction. Why? Because eBay understandably likes to conform with federal laws, including those prohibiting the sale of human organs, so that they can stay in business. But, beyond this, eBay vice president of marketing Steve Westly says that it just isn’t right to treat the problem of a kidney shortage so lightly as to allow people to sell them online: "There are transplant patients waiting years for a kidney. To them, this is not a joking matter."

http://www.jhhuebert.com/articles/organs.html

Organs for Sale

Last week, baseball hall of famer Mickey Mantle, waiting just one day, moving ahead of others on the waiting list, received a liver transplant. As a result ethical hand wringing began as to whether celebrity status played a role and whether he really deserved a liver after destroying his own through alcohol abuse. Should these be issues? Since organs are scarce, not all who want one can be served. But is there a better way of deciding who gets them? Or shall we leave the decision up to the arbitrary capriciousness of the medical profession? I say no! How about deciding the same way we decide who gets what house, car, food or clothing - the market. The ought to be a market for buying and selling of organs. Let's look at it.

...

"Okay, Williams, you say, "so far so good, but with a market only rich people would get organs." That makes as much sense as saying with the market only rich people will get cars, houses and food which we all know is nonsense. I'd much rather compete with the likes of Mickey Mantle or Pennsylvania's ex-governor, Bob Casey, who got a heart and a lung just waiting one day, in the market than through favoritism and the medical profession's who-needs-it-the-most method.

http://www.gmu.edu/departments/economics/wew/articles/95/Organs.htm

These opinions are obviously pro-selling of organs. Do you really think that when a market for organs becomes reality, poor people, however needy of an organ, have any chance of obtaining one?
I personally am especially disgusted by the second opinion, which equates the 'commerce' of organs to the 'commerce' of cars, food, houses, etc. This opinion omits one specific point; the production of cars, food, houses, etc., does not require one to die first to make the 'product' available.

And last: When death-row prisoners become a production-plant, wrongful executions of innocent suspects become rampant, IMHO.

ARIZONA WANTS TO HARVEST DEATH ROW INMATES ORGANS - Richard Rossi

It seemed like a natural progression when recently legislators proposed
a bill in the state house that would allow the harvesting of organs from
death row inmates after they were executed. After all, a bountiful
harvest is a thing of beauty. Why let these organs go to waste when they
are there for the picking? Think about it - fresh vital organs are
going to waste by just burying them! Considering the vast growth of the
death row population in the American prison gulag, why not recycle what
can be salvaged?

http://www.ccadp.org/rossipage5.htm

[HuckleB]

68. Anecdotes unrelated to the question at hand.

First, the AMA, as well as the other proposals, have been lamblasted by medical ethicists across this nation for these proposals. They are not taken seriously by most people, as they are faulty in logic, regardless of the ethics. No one is going to make money off organs, unless we allow them to sell to the highest bidder, which even the AMA is against. The money options the AMA came up with would only increase insurance costs, which would be passed down to the insured and more, meaning that anyone who "sells" an organ will have paid more for the "right" to sell it, in the first place. Thus, the whole proposal makes no sense, regardless of ethics. Though, again, the ethics have been brought to bear on these "proposals" and more so.

The bottome line is that the system needs to figure out how it can procure more donations, if that's possible. However, the system isn't, by and large, unfair. It's far more fair than most systems the world has known.

[Virginian]

72. You really should check your "facts" with www.UNOS.org.

The Casey transplant was illegal. He was not at the top of the list for the heart or the lung from that donor. Oddly enough, that donor had been in the hospital shortly before he was murdered. I remember reading a news clipping about that one. The donor was shot as he opened his front door. The gunmen were careful not to hit the heart or lungs. The hospital and surgeon had sanctions imposed. Then the hospital probably built a new Casey memorial wing.

I also remember reading about the Micky Mantle transplant. His doctor determined that he should be on the list and his was a legit match. Unfortunately, he had undetected cancer and the imunosuppression drugs he took for the liver caused the cancer to progress.

You wrote: "I'm not really familiar with the policies of the United States about Organ-donors, but the mention of 'donating' organs in exchange for cash, tells me somehow this simply can't evolve to an equal division of organs to the most urgent cases. Before you know it 'donors' are deciding to which financial brackets they will 'donate' their organs."

If you are curious, Check the facts at www.UNOS.org.

[Virginian]

71. You may call it Bullsh*t, but It is the law.

You can check for yourself at www.unos.org.
This is the official website for the organization that matches organ donors with organ recipients.
If you have questions, you can address them to a person who knows the laws and regulations.
I worked for this organization several years ago. I may not know what has changed recently, but I do know what will never change.

[Romulus]

50. "Good of the State Comes First"??!!!???

:wtf:

Sure, whatever the state wants, the state gets . . .:eyes:

[NashVegas]

57. "The Good of the State"

Well if you want it that way, let's just cancel the program altogether. Less impact on health insurance rates, thanks to a few less $200k procedues. Less impact on Medicare/Medicaid, so we won't have to fund the operations for the poor. Less strain on the medical system in general.

[Virginian]

36. good post

more facts at www.unos.org

[calimary]

80. Well, gotta say the "My Body My Choice" argument is compelling.

My one hangup about this (probably silly, but it has kept me from filling out a donor card) is that it always feels to me as though there's this circle of vultures overhead, waiting and hoping for their victim below to die so they can dig in and start picking through the carcass. "Harvesting" is the verb that's used. And I am also afraid that, in the rush to harvest transplantable organs, what's to keep some doctor from - um - shall we say - "rushing things"?

I know, doesn't make much sense. Probably quite uncompassionate and hypocritical of me. But I am hugely conflicted about this issue, for the above reasons.

[Heddi]

92. Working in HEalth Care, I've never seen things like that happen

granted, i'm not around all doctors in all situations, but the way I understand it, most places aren't even aware of your donor status until the end is pretty much emminently near.

There's plenty of people who are organ donors who are in basically permanent vegatative states (read: permanent comas) and have been for many many years. Their deaths would be easy enough to...hurry along....but honestly, I don't see Dr's and Nurses walking the wards, checking their watches to hope that a donor's life is snuffed before the end of their shift...

And from what I understand, once a donor is identified, and that donor dies, the process of removing the organs (I *HATE* the term harvesting---it really removes the person from the whole process and makes the body seem like nothing more than a commodity, instead of realizing that a selfless human has given the ultimate gift to a perfect stranger) is actually quite a pain in the ass---you have to get everything out within a certain amount of time, coordinate with the people who work with the Organ Donor program, get the organs packed in ice, and onto a helicopter/plane so that they can be transplanted within X amount of time (usually a few hours at the absolute MAX).

From what I understand, most Dr's look at this as more of a pain in the ass than some great experience. Of course, they're not jaded about it, but they've no incentive (financial, or otherwise) to speed-up the death of a donor, or potential donor. They see it as they see all deaths---people die in hospitals. In some instances, the bodies are claimed, in others, the bodies are never claimed. In some instances, people donate organs, in others, they don't. It's just what happens.

There's another poster here who's posted links to the ORgan Donation site. It's a great resource, and has quelled the fears that a number of my family members had about organ donation.

I am an organ donor---but don't want my body donated to science----when you donate an organ, they take what is needed (and what you give them permission to take---it's not "all or nothing"---you can specify organs/organ systems and exclude others if you want) and then your body is prepared for burial/cremation/whatever.

When you donate to science, they take your body to a med school or something of that nature and the body is either used as a cadaver, or for medical research of tissues etc. In science donation, your family doesn't get the body back. There's no cremation, no burial. Most teaching hospitals that take the bodies have a yearly "rememberance ceremony" for friends and family---my Great-Grandmother donated her body to Medical University of South Carolina upon her death----but that's not what I wish to have done.

Check out the website. See what they say. It may parlay your fears and apprehension.

And if not---that's okay. No one is forced to donate. It's a great thing, and I wish more people did it, but it should never be forced, or against the will of ANYONE---whether they're alive (gasp!) or dead!

[LeighAnn]

78. They're not really dead: Nasty Side of Organ Transplanting

Maybe you should know a few things about the "potential donor"...

The organs are harvested while the "deceased" is still alive, generally without anesthesia.

It's been speculated that the "brain death test" itself actually causes brain death.

Things to consider ... you speak of the organ donors as if they're actually dead.

http://www.geocities.com/organdonate/index.html

[Virginian]

15. I'm confused by your post?

Who are "those who refuse to accept mortality?"

Are they the healthy who may become injured and brain dead,
the relatives of the brain dead who would have to sign the consent forms or are they
the ill who will probably die without a transplant?

[LuminousX]

35. It is my body, assume nothing.

I also believe that we use medicine to extend people's lives too much. I can't force my beliefs on other people, but I can say that my organs will not go to anyone. Take that away, and you are then essentially saying that it is the duty of every person to live his/her life for the sake of others. Screw that noise.

[Mokito]

53. No, your logic is flawed!

I am Belgian, one of the countries named that uphold this donor-standard.I for one have no problem with potentially saving one or more lives post-mortum, but believe me, we can choose not to donate organs if this somehow would contradict with our personal beliefs or convictions. It's actually a reversal of current policy in the USA. If for some reason donating organs contradicts with your personal morals, you can ask to get this registered. A 'Do Not Donate'-card, so to speak.

[NashVegas]

58. Actually,

One of the doctors quoted in the article was against presumed consent and is pushing for mandated consent instead. With mandated consent, you would have to sign off one way or the other at the time you get your license. I would be more in favor of this, because with presumed consent, the government would be obligated to run a PR campaign to ensure all the public was aware of the change. Mandated consent puts that burden on the private sector bucking for the organs.

I have less trouble with the notions in the article, and donations in general, than with those in this thread who see donation as some kind of obligation.

[shoelace414]

2. only

The only reason to deny donating organs is because of religious reasons. unfortunatly, people just think it's sick or something.

Oh,. BTW, signing the back of your licence means nothing in donating organs, the next ofkin still have to make the decision.

[Heddi]

7. Not necessarily

"Oh,. BTW, signing the back of your licence means nothing in donating organs, the next ofkin still have to make the decision."

If you have an organ donation card, that pretty much trumps the wishes of your next of kin, because an organ donation card is more legally binding (being that it was obtained and signed during life) than the wishes of next of kin.

Also, having the little heart on your driver's license shows want and desire to be an organ donor, and I don't see how family members could say 'well, Heddi asked to be an organ donor, but I don't think she meant it...'....

But, as always, I urge everyone, regardless of age, martial status, or whether or not they have children to get EVERYTHING they desire in life and death written and notarized and kept on hand....from whta to do if you're in a coma, to what to do wrt your organs, life support, cremation or burrial rites, etc.

[HuckleB]

12. The donor card does help greatly. The license means almost nothing.

Unfortunately, in a health care system that feels under siege from lawsuits (another conversation, I know. let's not go there.), when family members say,
"No," their wishes are often granted despite the possession of a donor card. As for the license, it's further evidence if one has a donor card and a family that says, "Yes, that was his/her desire," but it's of little use otherwise.

[HuckleB]

17. WIthout family consent, organs simply don't get donated.

This is why so much time is spent by organ donation organizations on this matter. It's simply something that most people don't want to bring up with their families. This is a big part of the problem with the shortage.

Share Your Decision:
http://www.ordonorprogram.org/how_to_donate/share_your_decision.html

From the PDF on donation at that site:

"Laws require that at the time of death hospital staff must inform surviving family members of the option of organ and tissue donation. With family
members consent, the hospital staff will notify the organ and tissue donation
programs. Surgical removal of organs and tissues takes place either at the
hospital or at the funeral home. For individuals who die at home,the local
funeral director can usually arrange for any possible donations. I would like to donate LIFE by being an organ and tissue donor. I want you to know my
decision because you will be consulted before donation can take place.
Please see that my wishes are carried out. Thank you."

[Virginian]

43. True

Whole organs are removed at the hospital. I don't know what the times are now, but the organs critical to life can only go without blood for a certain amount of time. When I knew these things, the heart was the most fragile, it needed to be transplanted within the shortest amount of time, just a few hours. The kidneys could go a day or so before being transplanted. They may have come up with better transport solutions for organs by now, to allow more time for the recipient to be located and prepped for surgery.

[AndyTiedye]

16. Not So!

Many people do not wholely trust the medical establishment.

Suppose you are sick in the hospital, and the doctors are trying to
decide whether or not they can save you.

And you are an organ donor, and Dick Cheney needs a new heart that day.
And yours looks compatable.

Your prognosis suddenly doesn't look so good.

[HuckleB]

18. Dude. That's one scary world you live in.

"Silly boy ya’ self-destroyer.
Paranoia, the destroyer

Self-destroyer, wreck your health
Destroy friends, destroy yourself
The time device of self-destruction
Light the fuse and start eruption"

-Kinks

:)

[Mokito]

62. Although I'm for presumed consent...

under strict regulation, organ-fraud does happen.

Chicago

Johannesburg (scroll down)

[HuckleB]

66. Of course. Fraud happens with every type of transaction.

However, it does not happen in the willy-nilly way described by many on this board. Oh, and I'm against presumed consent, myself, so it's not like my response was meant to defend the proposal.

[Virginian]

32. MYTH!

That is a myth, untrue, cannot happen.

The doctor taking care of you is not the same as the transplant doctor.

Can you spell M-a-l-p-r-a-c-t-i-c-e.

You would have to have massive head injuries to be a donor candidate. You would have to pass several brain death tests given by several different medical professionals. Your next of kin would have to give permission. You would have to be a tissue match and the whole transplant record would have to be registered with the transplant database.

Check www.unos.org for transplant FACTS.

[htuttle]

5. We're here for your liver, then.

Well, you DID sign your donor card, didn't you?

[Virginian]

73. but did you bring the onions to go with it?

Sorry, sick joke.

[Sandpiper]

8. If the government would pull their heads out of their rear ends

On the issue of therapeutic cloning, we could eventually make the issue organ donation a moot point. But as long as we keep a party in power that considers science the enemy, rather than a tool to improve the human condition, people will continue to die because they can't get a liver, heart, kidneys, etc.

[Octafish]

9. Offer money or prizes.

Everyone's a winner.

[Virginian]

11. I think it is called Implied consent

If you think of it as having a piece of your loved one live on in a host body, it might make it a little easier to give consent.

The license only indicates what the potential donor prefered. It is up to the next of kin to sign the consent forms.

There are many misconceptions about organ donation. For the facts go to the UNOS website. www.unos.org

For myths on organ transplants try the snopes website.
http://search.atomz.com/search/?sp-q=organ+donation&sp-a=00062d45-sp00000000&sp-advanced=1&sp-p=all&sp-w-control=1&sp-w=alike&sp-date-range=-1&sp-x=any&sp-c=100&sp-m=1&sp-s=0

[HuckleB]

23. Thanks. Good info.

[daleo]

14. Legal definition of death

I have read a number of articles that say that the legal definition of death may not be as clinically valid as most of us assume (i.e. people coming out of vegetative states assumed to be equivalent to death). If the state assumes that everybody is a donor unless they say no, this could become a much thornier issue.

Personally, I think even after death a person should have control over the disposition of his or her body (through an executor obviously). Organ donation should remain a gift, and a voluntary decision.

I gather for most people, the point is moot - the organs of the old and sick are not particularly useful for transplantation. Ironically, the movement to greater safety has cut into the potential organ donator pool.

[Virginian]

28. There was a case back in the 1990s

A patient had no brain activity and the Organ Procurement team was looking him over before asking for permission from next-of-kin.

They found the heart to be unsuitable for donation, it was very tiny and shriveled. So shriveled that it could not possibly have had the capacity to love. Also there were no cockles in the heart to be warmed.

One of the team said, "I have seen this once before, this seems to be a new phenomenon we should check the brain activity again."

They checked the brain activity on a different frequency and found that the brain was small but healthy, it just wasn't being used anymore since the patient started listening to Rush Limbaugh; letting Limbaugh do all of his thinking for him.

The nurse came in with a band-aid and tetanus shot and sent the patient home to continue shriveling his heart and brain.
Since then, the team is very careful to check out the neo-cons for brain death rather than brain inactivity.

[Virginian]

70. It never happened.

It was supposed to be a joke.
Read it again.
Rush Limbaugh started spewing his venom during the first Clinton Administration in the 1990s.
His listeners are called Ditto heads because they go out and repeat the Limbaugh talking points. They never use their own thought process to figure out anything. They just follow whatever Rush tells them.

[Trillo]

29. Declared Dead but Still Alive

A recent case where someone declared dead is still alive:
http://www.cbsnews.com/stories/2003/11/08/national/main582554.shtml

Over the years similar stories reoccur. With implied consent, would organs have been cut out of the body after the 'dead' pronouncement of the doctor?

Many may not remember it, but hundreds of years ago caskets had bells with a string attached, so that if a body 'woke up' they could pull the string, the bell would ring, and hopefully someone would hear.

I've read that a few cultures believe in leaving the body completely untouched for several days before prepping the body for burial. Maybe one of the reasons for this custom was the fact that sometimes someone appears dead, but isn't.

Even doctors today make mistakes. It's really not hard to imagine a scenario, given today's business ethics, that a few people that are mistakenly declared dead could be sacrificed so that someone else could get their organs and so that profits and cash can flow.

[Virginian]

34. checks and double checks.

Organ transplantation is too sensitive an issue for the procurement people to make mistakes. They check and double check before removing anything. They use multiple criteria to determine brain death and there is always more than one person to independantly determine brain death. They are much more cautious than say the funeral home embalmers.

[PfcHammer]

41. Agreed. Most of the time.

Mistakes still happen though and when they do, it
weirds people out and, unfortunately, scares some off I suspect.

http://dukemednews.duke.edu/news/article.php?id=6405
Review of Blood Type Mismatch for Jesica Santillan Continues

DURHAM, N.C. -- Jesica Santillan continues to remain in critical condition and remains at the top of the donor priority list.

A thorough review of the events leading up to the blood type mismatch that occurred during the Feb. 7, 2003, heart-lung transplant for Santillan is still ongoing. However, changes have already been made to improve the organ transplant program at Duke and the complete review is expected shortly.

"As a result of this tragic event, it is clear to us at Duke that we need to have more robust processes internally and a better understanding of the responsibilities of all partners involved in the organ procurement process," said William Fulkerson, M.D., CEO of Duke University Hospital.

"To make sure that something like this never happens again, it is our intent to work even closer with organ procurement organizations to ensure that all steps are taken to maximize patient safety. Ultimately, however, our patients are our responsibility," Fulkerson said.

[Virginian]

44. Her name was not on the list of recipients.

The computer did not make the mistake. I checked the UNOS website after that incident and they had a press release stating that the mismatch did not happen within their procedures. She was not listed as the intended recipient for any of those organs.
Her name was not on the Heart list
Not on the Lung list
and not on the combination Heart and Lung list.

UNOS did not point fingers at where the problem was, the organs could have been intended for another patient at Duke and the doctor mixed up his patients.

[ElectroPrincess]

24. No way!

This country is so damn corrupt ... doubt it? Take one good, real good look at Senator "hello kitty!" Bill Frist. If there were a Forbes or Bush waiting on a heart, I believe they'd hurry you up off life support to save the wealthy and/or powerful. Nope, most likely my Husband of 22 years will be present and, by my permission, donate all my organs *after* he's sure I'm dead - Not sacrificed for someone more wealthy.

[NashVegas]

27. LMAO

"Hello Kitty" Frist.

and a protest sign is born.

[ElectroPrincess]

42. Yes, thanks

Yes, that's honestly my creation. I helps having a young daughter who's into that Okinawan fashion "Hello Kitty" brand. That term immediately popped to mind when they were describing Frist's medical school misadventures. I can just see this ghoul of a man going to the shelters in his best humanitarian voice, "I'd like to adopt a little kitty that I can love, feed and call my very own." THEN back to the lab for the dissection Par-Tee. He's a super-freak and fitting of such an apt nickname.

[Virginian]

39. And that is as it should be.

I think the only difference from the current system and the proposed system is that your license will say "I don't want to donate" rather than I do want to donate.

It only means the default is YES rather than NO. Your family still has the last say and your family still says when to pull the plug.

If you know someone who is on the wait list, you can still ask for them to be considered first. They may not be a match, but they would get the organ if they are a match.

Did you know you can donate your heart and still be alive? It is called a domino donation. If you need a lung transplant, but have a healthy heart, you can receive a combination heart and lung transplant because it is easier to transplant them as a unit. Your bad lungs would be disposed of, but your healthy heart would go to another patient if you consented. Who wouldn't consent to donate a heart if they were receiving a heart and lungs?

[ElectroPrincess]

45. Thanks for the reminder

Virginian, I now recall receiving my VA driver's license and marking to NOT automatically donate an organ upon death. Part of me feels bad for being so jaded. My husband accuses me of being paranoid, but he has much more faith in human-kind than myself ... or less hung-up on a concept that none of us can ultimately escape death anyway.

On Edit: Addition - Kool! Heart and Lung package for only a Heart donation. <scratching down to uncover another tasteless rock layer of inane humor> TWO? Yes TWO! You get TWO organs in one = Better than double-mint gum! Seriously = that indicates a well considered, real time thoughtful and efficient exchange.

[calimary]

87. THAT is what scares me, too.

Somebody like Frist, somebody who's a real Bible-thumper, and has the chance to save - say - a dick cheney or somebody he/she considers more valuable to more people - what would stop them? How easily could they rationalize that this was God's message and a sign from the Almighty that he/she was supposed to put two and two together like this?

I'm NOT ready to lie there and be picked over. NOT yet. Maybe not ever.

[tlcandie]

38. I'm very generous and I am a donor, BUT I in no way want anyone

with the government deciding where those body parts go! The rest of my Cremains will be concreted into a reef and sunk into the ocean to help rebuild the dying reef system.

This is my body and I will have a say over it...WHILE LIVING...as to what will be done with it in death. Thank you very much.

[Heddi]

40. thank you! I wholly concur!

As I said before: MY BODY! MY CHOICE! In life AND death!

I, too, am an organ donor. However, some people in my family are not b/c they are Jehovah's Witnesses. To them, organ donation (either giving or receiving), as well as blood transfusions (again, giving or receiving any blood that isn't an autologous donation) is akin to a Catholic...I don't know...having an Abortion or something (not Catholic, so I'm not sure what a deadly sin would be to them). To my aunt and her family, who are JW's, they simply cannot give their organs to another, nor could they ever receive the organs of another, even if it was the only way they could live.

Who am I, or you, or ANYONE to say that their religious beliefs are so...unimportant....as to cause what they see as essentially eternal damnation because the doctor believes that the 'right of the state' is more important than their right to have done whatever they want, or not done whatever they don't want, with their bodies after death.

Being in the health-care profession, I know how utterly important it is for people to donate organs after death---but it's called DONATION because it's VOLUNTARY. It should STAY voluntary. It should never be mandated that upon death, neither you nor your family have any say in what is done with your body, but that all decisions should be left up to medical personnel. I trust my fellow doctors and nurses....but I trust myself and my wishes a hell of alot more.

More should be done to educate people about the benefits of organ donation, the myths v. the facts----but in the end, it's a VERY personal decision that each person must make for themselves, and not for anyone else, or for the benefit of anyone else.

[Piperay]

97. TOTALLY Agree! nt

[WHAT]

48. No Way...

NOT UNTIL NATIONAL HEALTHCARE, BABY...

I read something two or three years ago about a problem with the skin banks in Chicago...that plastic surgeons doing elective surgery had laid claim to so much or the skin available for transplant that burn victims didn't have access to the skin needed for treatment. This is the problem with donations, good faith giving is easily subverted now (see the manipulation of the law to enable torture) by burecratic machinery enabling exploitation by appropriate corporate entities. In other words, I don't trust bureacracy to weigh the variables necessary to ensure the best use of any post humus donation I may make. Look at the way young minorities (economic/racial) are being slaughtered. I think it would be a double insult to thier lives to have their organs, in death, support the well being of exploitive factions of society. And, for poor people, it may be one of the most important fulcrums of leaverage available to them.

see post 22...

IT'S ONLY BUSINESS, BABY...

[struggle4progress]

49. What's happening now:

<snip>
The kidney is not a spare part. If you talk to kidney sellers the world over, within one to five years of selling their organ, they're not doing well. It's a far more invasive surgery to take a kidney out than to put one in. Sometimes doctors must take out a rib.
Economically, nearly everyone is worse off a year after selling their kidney. One reason is that almost all of them are manual laborers - stevedores, agricultural workers, etc. When they're told they can't lift heavy objects for a month after surgery, it excludes them from work. They tend to lose their niche.
<snip>
http://www.csmonitor.com/2004/0609/p12s03-wogi.html

<snip>
The Indian government tried to stop illegal organ transplants with a 1994 law that criminalizes organ sales but allows for "unrelated kidney sales," a loophole that has led to corruption. Nonprofit organizations in the area claim the trade is rising now that it has gone underground.
<snip>
It's illegal to buy or sell organs in China. But a 1984 law allows organs to be transplanted from an executed prisoner if family members don't claim the body right away. Amnesty International says Chinese media reported 1,060 judicial executions in 2002. But it says the actual figure may be as high as 15,000. Most harvested prisoner organs are sold to medical "visitors" from Hong Kong, Taiwan, or Singapore.
<snip>
A British woman may be the first citizen to face prosecution under the country's Human Organ Transplants Act of 1989, which prohibits the sale or solicitation of any organ within the country. Last month, to pay off her legal debts, the woman closed a deal over the Internet to sell her kidney for $50,000 to an American.
<snip>
http://www.csmonitor.com/2004/0609/p12s02-wogi.html

Harris Co. morgue under investigation for alleged sale of body parts
Prosecutors are looking into allegations that a company illegally harvested bones, tissue and veins from bodies at the Harris County morgue.
County Attorney Mike Stafford said Friday he asked the district attorney's office to investigate whether Biograft Transplant Services Inc. desecrated corpses or violated a prohibition against the sale and purchase of body parts or tissues.
<snip>
http://abclocal.go.com/ktrk/news/060604_APlocal_bodyparts.html

[Baltimoreboy]

51. Organs are valuable, then pay the familes of donors

Simply really. Set a value on each body part and add it to the cost of the surgery. It wouldn't have to be much. Let's say $1,000 for some things. If that doesn't help enough, make it more.

If you die and your family gets cash they can use toward your funeral, many will agree.

[HuckleB]

55. Great. Only the wealthy will get organs.

What a great idea.

:eyes:

[Baltimoreboy]

63. Not at all, the organs would still be covered by insurance

And insurance would pay the families.

Like I said, start by keeping it reasonably low, but still enough to make people reluctant to say no.

[HuckleB]

65. In what world is that?

Sorry, the ethics of marketing one's body have been dealt with at length -- and that is exactly what you are proposing. This is an unethical proposition from the word go.

Nevermind the faulty logic behind "insurance will pay for it." In other words, here's another way to increase insurance premiums. Under any such proposal, the family would likely have paid more to the insurance company due to such a system than it could ever hope to get back. It simply doesn't make sense.

[Virginian]

69. No! I am against paying for body parts.

I say keep it a donation.
IMHO you would get fewer organs, the next of kin would feel crummy selling pieces of their loved one.

[suegeo]

61. organ donation

It should be a voluntary choice made by the donor.

Putting money into the equation is a horrible idea.

my 2 cents

Oh, and not all organ donation is done to extend life. A cornea transplant saves vision, and enhances life. But one can go on living with bad eyesight. For what that's worth.

[Baltimoreboy]

64. Why is it horrible, it would still be voluntary

Like it or not, we live in a largely free market system. If asking people to volunteer doesn't work, try giving them an incentive.

Another option would be a tax break of some sort for the family. But I doubt that would have much impact. Tax rebates are a bit hard to grasp.

[struggle4progress]

74. Yeah, let miserably poor people sell their organs to the rich ...

to get enough money to feed their children; the compassionate conservatives will love it.

[suegeo]

79. or better yet

let the miserably poor sell their children off to get the money from little Tammy' and little Tommy's spare (heart, lungs, kidney) parts.

[w4rma]

75. Imho, it should be an opt-out system, instead of an opt-in one, here. (nt)

[n0_data]

76. Assume nothing

Most everything should be an opt-in system, IMHO - spam, telemarketing, organ donation, etc.

I shouldn't have to waste my time opting-out of anything. If I want someone to have my kidneys after death, I'll be sure to let them know ahead of time.

[mulethree]

77. more options would be good

like say - ok I will opt-in, but don't give my giblets to any spammers, telemarketers or ambulance chasers ... etc.

Give priority to people who are still raising minor children, people who didn't 'earn' their organ failure and people who donated a kidney and then have a problem with their remaining one.

[Hoping4Change]

81. Give priority to people who have signed donor cards,

I would love to know how many people in need of transplants have (prior to their need) signed donor cards? Priority should be given to those who have made that commitment. Signing a donor card early in life would then be a form of insurance.

It's very strange that people feel quesy about signing donor cards but when it comes to them needing an organ the quesiness disappears.

[Bridget Burke]

82. Few people "suddenly" need an organ transplant.

It's generally the last resort after years of failing health. These people would not have been good donors.

[Hoping4Change]

84. But early in their life they were healthy & suitable as donors.

It's just the same as insurance, people buy insurance when they are healthy. I put this forward as a way to encourage people to sign donor cards. I think it would be preferable to paying for organs.

[daleo]

85. This has some logic

It makes organ donation a quid pro quo, which is an ethical arrangement most people can relate to. There may be flaws in such as system, if one really thought about it, though.

Perhaps the biggest problem is that people would tend to sign on when they got older and sicker and thus could forsee a personal need, and would tend to ignore the issue when they were young and healthy and wouldn't forsee the need. However, the usefulness of organs is in the opposite direction, so you would have a large donor pool of unusable organs and a small donor pool of healthy organs.

[Hoping4Change]

88. If priority was based on the age one signed on as a donor that

might circumvent the pitfall you describe. It would also give young people incentive to sign donor cards. Signing donor cards would be presented as a type of catastrophic insurance. In the unlikely event one needed an organ priority would be given according to the age the donor signed on.

The selling point (if I may be so crass) is that if someone has been a donor since an early age they'll get first dibs on an organ.


In fear of being viewed as heartless which I am not let me venture to say that even older people have skin and other tissue which can be "harvested" (a term btw I hate).

[daleo]

89. Yes, that would help get around the objection

There might still be some issues about education, awareness of the program, that sort of thing - for example the poor and working class may be less likely to go along simply because they didn't know about it, or on the basis that "it will never help me, as I wouldn't be able to afford the operation if I needed an organ anyway". But, I am not trying to knock the concept - as I say, I think the quid pro quo aspect has a firm foundation in everyday morality.

Perhaps a (medical) financial inducement related to years signed on might be added in. For example, for each year of being signed up, some subsidy might be provided for an operation if the person ended up needing an organ themselves (when an organ became available). That would provide some targeted financial incentive, without selling organs, which seems morally repugnant and fraught with dangers of all kinds.

[Hoping4Change]

91. The points raised about the poor & working class are very true .

Kind of knocking myself for not having considered that however I do think that a good solution would be "financial inducement related to years signed on." That solution adds to the notion of this being a type of insurance.

[DarbyUSMC]

83. How would you like your kidney to go to a pedophile? In jail no less.

For heaven's sake. Aside from assuming that people would want to donate but forgot to say so, what kind of people are we dealing with here? People so good hearted that they hadn't done anything about donating their organs? I don't want a kidney from somebody who had no say in the matter. Thanks anyway ---- keep your kidney.

BTW the pedophile? Yes, he got the kidney. Isn't that special? I hope the donor family never accidentally found out.

[amjsjc]

93. To anyone opposed to this:

<smack!> No offense guys/gals but the needs of the living outweigh the needs of the dead... You have every right to care what happens to your body while you're residing in it, but once you're gone it simply dosen't matter. I don't care if my kidney goes to a billionaire plutocrat, or even a child molester after I die--I'll be dead, while that person will be alive, so their need will be greater than mine (oh, and btw if you make donation automatic then there'll be a lot more organs floating around and it'll be possible to get one without massive amounts of money or good connections...)

[Heddi]

94. well good for you

However, I happen to cherish individual freedoms and the freedom of choice, and I really don't care about the 'good of the state' or whether more people will live after I die or not.

It's my choice to do what I want with my body in life and in death. As it so happens, I *AM* an organ donor, but it was MY CHOICE to be an organ donor. Not yours, not my husband's, or my mothers, or the doctor's or the state's.

What other individual choices and liberties are you willing to give up for the good of the state?

How about this---at birth, everyone must be enrolled in the bone marrow transplant registry. And they must donate blood every month. And any time you get your hair cut, all the hair must be given to that foundation that makes wigs for cancer patients out of it. And you must undergo blood tests in the event that someone in the world needs a kidney donor and hey! you match!

So what if it violates the very ideals of your religion? So what if you're not willing to go through the painful process of bone marrow removal? It doesn't matter---because YOUR WISHES DO NOT MATTER. only the lives of people who COULD live longer, and the best interests of the state matters, right?

And why allow women to have abortions? I mean, if they don't want the baby, we can just put it in an "organ donation orphanage" until the child's organs mature, then off the kid and harvest their organs for those who need them most. I mean, they weren't going to be born anyways, so they should be lucky that we gave them a few years of mediocre life so that others could live :rolling eyes:

What if a couple had a child with...hmm...a bad liver, or kidney disease. Why not force that couple to have ANOTHER child just so the 2nd child could be a donor of organs so that the first child can live a long, prosperous life?

As I've stated REPEATEDLY in this thread, it's called ORGAN D-O-N-A-T-I-O-N because it's just that--a DONATION---

http://www.m-w.com/cgi-bin/dictionary?book=Dictionary&va=donation

Main Entry: do·na·tion
Pronunciation: dO-'nA-sh&n
Function: noun
Etymology: Middle English donatyowne, from Latin donation-, donatio, from donare to present, from donum gift; akin to Latin dare to give -- more at DATE
: the act or an instance of donating : as a : the making of a gift especially to a charity or public institution b : a free contribution

I don't note the words 'mandatory', or 'against one's wishes' or 'forced' ANYWHERE in that definition.....

[amjsjc]

95. I hate to tell you this, but...

Goverment compelled virtue is alive and well, and necessary for society to function.
People by nature are naturally selfish creatures (and if you don't believe me, reread the first sentence of your last post) and as such it is necessary for the government to step in and artificially compell them to do the right thing. This is the reason governments exist; this is what laws are.
Laws are checks on your individual freedom-- in a perfectly free society, there'd be nothing to stop me from robbing, raping, or killing you. Same thing with taxes. In a perfectly free society I'd never have to give a cent to anybody-- and indeed this was how things worked in this country in the past, but that led to a lot of poor, starving people, so the government now has the right to appropriate a slice of my income and arbitrarily give it over to a retiree in Florida, or a working class mother in Chicago who needs food stamps. And as a Democrat, I'm okay with this. I support the government attempting to advance the common good. And since depending on human virtue has resulted in a world where thousands of people are dying because much of the population dosen't care about what happens to people after they die, then yes I support government intervention.
Come to think of it, in the event of a severe blood shortage, I'd also support the government's right to force me to donate blood. Because, frankly, the theoretical loss of my personal soverignty is less horrible than the thought that some badly injured person might not be able to have a transfusion...
Though I do thank you for having the decency to sign up as a donor...

[Piperay]

96. It's MY body and it

has to be MY CHOICE! :wtf: I will not have the government tell me that I can't get an abortion or that I have no say in what happens to my body parts after I'm gone! :mad: :grr: :nuke:

[KDLarsen]

98. My view - though not popular I guess.

Just to add: I'm listed as a full donor - if I ever die, and any part of my body can be used to rescue/positively affect other peoples lives, then I feel that I really have excuse not to be a donor.

Anyway, my proposal no. 1 would be, that at the age of 18, people would recieve a donor card. They wouldn't have to fill it out, but just giving people a reason to think about it would go a long way, I think.

A more controversial idea, would be to let patients, who themselves are registred donors, have preference over patients who are not registred donors (of course, for people who have a valid reason, such as religion etc., this would be ignored and they would still be first in line). But then again, this might clash with the doctors oath.