Organ donation, opt out system

Sitric

Hi, I was wondering what people would think of an alternative national organ donation system. At present, we have an 'opt in' system in Ireland, with people carrying organ donation cards and informing their next of kin of their wishes. There is an alternative system operating in some countries where organ donation is assumed and it is possible to register to opt out if you object to donating.

Do you think people in Ireland would support such a change? Would it have a marked benefit?

Personally I would support such a system if it was likely to increase the supply of viable organs. Morally I feel donation is the right thing to do but of course there are many reasons people do not wish to donate.

PhysiologyRocks

I could see it making a difference alright. I know some people who say that they want to donate organs but just haven't got around to getting the card.

If it were introduced as "the norm", perhaps people would feel less wary about donating their own organs.

And nobody would be forced into anything with an "opt out" system.

havana

I feel very strongly that we should have an opt out system- for personal reasons though i would always have supported it. I respect peoples decisions not to be a donor and those who feel strongly about it will opt out. But i believe that in the present opt in system there are many who wouldn't particularily mind donating or don't make their wishes known and whose organs are therefore missed out on. Also the fact that the present system allows families to override the individuals wishes is not ok.

donation is an amazing, life saving, life changing gift and i would urge people to discuss their wishes with their family.

The way i look at it is... If the person you love most in the world needed an organ would you accept one? If you would can you really ask someone to do something for you that you wouldn't do for them?

anotherlostie

Is it true that a lot fewer organs are suitable for transplant nowadays because a lot more effort is put into trying to save patients who, years ago, would have been given up on much sooner?

Personally I think an opt out system makes more sense.

sam34

i would be all in favour of an opt-out system
as far as i know a lot of european countries have this kind of set up

also, i think in some countries (spain, afaik, is one) there is a huge emphasis on public education in this regard, and they have transplant coordinators going into secondary schools etc

we have one of the lowest donation rates, afaik.

nesf

Economics studies on the topic have found that for pretty much everything, opt out systems work a lot better if the intention is to have as many people opting in as possible. (I don't have links handy but the logic of it is pretty obvious)

I'd be hugely in favour of an opt out system because while it maximises the number of organs available it also protects the liberties of those who do not wish their organs to be donated and the latter is more important than the first in many ways.

colly10

An opt out system would make a massive difference to numbers. Id say very few would bother to opt out. I personally would never opt in cause I don't like the idea of it but I wouldn't opt out either cause I would feel bad opting out

2Scoops

The Organs Donation Taskforce investigated the possibility of establishing an opt-out system for organ donation in the UK. Here are their conclusions:

ODT wrote:

Taskforce members had a wide range of views at the outset. However, after examining the evidence, the Taskforce reached a clear consensus in recommending that an opt out system should not be introduced in the UK at the present time. The Taskforce concluded that such a system has the potential to undermine the concept of donation as a gift, to erode trust in NHS professionals and the government, and negatively impact on organ donation numbers. It would distract attention away from essential improvements to systems and infrastructure and from the urgent need to improve public awareness and understanding of organ donation. Furthermore, it would be challenging and costly to implement successfully. Most compelling of all, we found no convincing evidence that it would deliver significant increases in the number of donated organs.

Source: http://www.donorfamilynetwork.co.uk/newdfn8/Information/ODTFReport_final%5B1%5D.pdf

Thoie

2Scoops wrote: »

The Organs Donation Taskforce investigated the possibility of establishing an opt-out system for organ donation in the UK. Here are their conclusions:



Source: http://www.donorfamilynetwork.co.uk/newdfn8/Information/ODTFReport_final%5B1%5D.pdf

Interesting read, thanks. The one piece that astounds me (mentioned in 1.10 and revisited throughout) was this:

recipients of organs who stressed their need to know that organs had been freely given by donors and their families

Thankfully I'm not in a situation where I currently need any kind of transplant, but would this be a big concern for most people? I would have thought that if I needed an eye, or a kidney or whatever, that I wouldn't be too worried about where it came from, as long as it was a match (however these things are matched).

Personally I'm in favour of opt-out. I used carry an organ donor card, then my mother objected, so I stopped. Since then we've had other conversations, and she's changed her mind, but I'm one of the lazy/disorganised who never got around to picking up another card. Do they still have them on chemist's counters?

Chunky Monkey

An opt out system would probably have teething problems as it could upset people who weren't aware of it but once settled I don't see why it would be a problem. 100% for it myself personally.

Alun

The thing that annoys me intensely about the current system, and this may be a feature of opt-out systems as well, I don't know, is that apparently even though you have made your wishes known through carrying a Donor Card, relatives are still asked for permission and can intervene and refuse that permission in direct contradiction of your wishes. I tell you, if that happened to me, I'd come back and haunt whoever made that decision. Ridiculous.

Gazza22

I think that would be a great idea, i'd fully support such a system. Organ donation is very poor in this country.

It would greatly increase donations while still being respectful to the selfish people who do not wish to donate.

Alun wrote:

is that apparently even though you have made your wishes known through carrying a Donor Card, relatives are still asked for permission and can intervene and refuse that permission in direct contradiction of your wishes.

Indeed, they need to give written permission too, which is ridiculous. Not only will an opt-out system do away with this nonsense but it will also end the unpleasant task medics have of asking the grieving family can they harvest organs, so soon after being informed of the death.

2Scoops

Well, don't let the facts get in the way or anything. :pac:

I think the US system would be much more feasible, successful and infinitely more affordable than instituting an opt-out program. Simply put, everyone that gets a driver's license is asked if they want to donate. That way 'lazy' but willing donors are passively exposed to the choice and people who are unwilling to donate won't feel bitterness and resentment at a state-endorsed opt-out program.

Alun

In the Netherlands they have a national organ donor database. Everyone over the age of 12 (yes, 12!) can be registered on the database and state their preferences. They can choose between a simple yes / no, plus two other options firstly to let any family member decide and secondly to nominate another 3rd part to decide. I can't quite see the point of the second two options myself, but there you go.

http://www.donorregister.nl/english/

Alun

2Scoops wrote: »

Well, don't let the facts get in the way or anything. :pac:

What facts would those be then

Chunky Monkey

2Scoops wrote: »

Well, don't let the facts get in the way or anything. :pac:

I think the US system would be much more feasible, successful and infinitely more affordable than instituting an opt-out program. Simply put, everyone that gets a driver's license is asked if they want to donate. That way 'lazy' but willing donors are passively exposed to the choice and people who are unwilling to donate won't feel bitterness and resentment at a state-endorsed opt-out program.

Do they not have something similar in the UK at the moment?

heyjude

sam34 wrote: »

we have one of the lowest donation rates, afaik.

Gazza22 wrote: »

Organ donation is very poor in this country.

Not according to these figures from the Irish Kidney Association

This table shows Deceased Donations per million and Ireland is 7th of 33 Council of Europe countries


While this table shows the rate of kidney transplantation from deceased donors per million and Ireland is 10th of the 33 countries


See http://www.ika.ie/index.php?option=com_content&task=view&id=112&Itemid=85

Gazza22 wrote: »

It would greatly increase donations while still being respectful to the selfish people who do not wish to donate.

Sticks and stones......is it any more selfish than some aspects of wills that people make ? Besides, I assume that some religions would prohibit it.

Gazza22

heyjude wrote: »

Not according to these figures from the Irish Kidney Association

Ok thanks for those stats, there may be stats to show how we rank among other countries and within those ranks it looks like we're doing a great job on the donation front but the reality is donation is still poor, be it an Irish issue or a world wide one.

Sticks and stones......is it any more selfish than some aspects of wills that people make ? Besides, I assume that some religions would prohibit it.

Well will's don't save lives, organs do. It is a persons own decision at the end of the day and one which must be respected, however i still believe it's a very selfish act not to donate when there are so many people in need.

Many people have a taboo on organ harvesting yet many of those same people will undergo an autopsy whether they like it or not. All their organs will be removed and slices taken for examination. All said organs will then be dumped in a plastic bag and it will put into your chest cavity - and you are sewed up. A few hours/days earlier those organs could have saved up to five people.

I can't help but feel annoyed when i think about the mentalities of people who refuse/don't like the idea of donating. If it for religious reasons, fine, but if they won't agree to donate simply because their poor corpses will be 'butchered' - shame on them.



A taboo still actively exists with organ donation and it needs to be broken. An opt-out system or perhaps a system like 2Scoops mentioned may help to break this by exposing people more to the idea of donation. An opt-out system will gain more donations through guilt if nothing else.

There are over 600 people annually on the transplant list and yet there is only an average of about 140 decreased organ donations available each year. Only 81 deceased people donated last year. This is very poor when the potential donations is considered.

One area where Ireland is going very wrong, is refusing donations from donors with Cardiac death. This would dramatically increase deceased donations. 41% of all transplated organs in the Neatherland's and 23% in the UK originated from Cardiac death donors.