Family right of veto over organ donation; why?

drkpower

Interesting IT article on the position taken by the UKs Chief Rabbi to the effect that organ-donor cards are not permissible under the Jewish law of Halacha, which, he says, does not allow for organs to be taken from people on life support. The problem with this position is, of course, that if you wait until life support has been 'switched off', the organs are no good to anyone....

But aside from silly religious rules, the bit that irks me is the general legal rule (and im pretty sure it is the same in Ireland) which means that your family can over-ride your wishes as to whether you want your organs donated. So even if you fill out your organ donation card (or execute a 50 page legal consent, for that matter), your family* (religous crazies or not) can simply say, 'nah, I dont care what Johnny wanted, I dont want his organs taken', and the Hospital have to respect your family's wishes rather than your own. Im baffled as to why this is the case.

You are fully entitled to refuse a critical treatment that will result in your death, no matter what your family might say, but you cant give up your crappy old liver when you die, without risking a family veto.....

Am I missing something here or is this just plain wrong?:mad:

http://www.irishtimes.com/newspaper/world/2011/0127/1224288397827.html
The issue of organ donations within the global Jewish community came to the fore after the family of Israeli footballer Avi Cohen – a holder of an organ-donor card – refused to donate his organs after a motorcycle accident.

* - that can actually be 'any surviving relative' according to the English legislation

Zombrex

I don't know if it is, but if it isn't, it should be possible to leave a legal document with some organisation like the HSE that in the event of your death you want your organs donated.

If a doctor has to get your families permission that is silly. I recently updated my will, that will decide what happens to my stuff after I die. The principle should be the same with my body.

mikhail

I didn't know that. Any year now, I'm going to make a will. It'll specify that if my wishes regarding my medical care or the disposal of my body are violated, everything is going to Seany Fitz. That'll, ehm, put the Fear of God in them.

Dades

Don't your next of kin get possession of your body on your death?
Maybe that's what gives them veto.

Also, where is the Old Testament did they address removing organs from people on life support for transplant operations?

drkpower

^^Agreed Wicknight; but it seems that the law allows your family to over-ride your own choice, no matter what measures you go to when you are alive to ensure that your organs are donated.

I suppose one could argue that legally, your family can over-ride your wishes as regards having a religous funeral, for instance, and that wouldnt bother me greatly (although i know others feel different).

But it seems that there is something more fundamental about your family being able to override your wish to donate your organs.

drkpower

Dades wrote: »

Don't your next of kin get possession of your body on your death?
Maybe that's what gives them veto.

That is how it works in the UK alright; and frighteningly, it seems that, in addition to your next of kin, if 'any surviving relative' objects to your organs being donated, the Hospital may be forced not to donate them. That is truly bizarre.

I havent looked into it in detail but i dont think we have legislation directly on point in Ireland and it is simply convention, rather than any rule of law, that allows your next-of-kin to overrule your own freely expressed choice.

8kvscdpglqnyr4

I've signed up to have my body donated to science after I die. While going through the process, I was advised to talk to all family members about it - which I did and all were OK with my decision. However, I was also told that the family members can over-ride my decision after I die! I was amazed that this was the case.

More info here:
http://www.medicine.tcd.ie/anatomy/donations/

One piece of the above link worth highlighting:
The donation form is not a legal document, donors may withdraw their donation at any time

Sardonicat

So i can decide what happens to my few grotty chattels that are worth feck all but I can't decide what happens to my carcass when it's useless to me, even though it could be salvaged to save and transform lives?

Surely it would be better to have to sign an "opt out" register and carry card indicating this. That way, unless you are on the register medical staff don't have to pose what can be a tough decision on families at a time when they can't really make it rationally.

After a realtive of mine died her family were asked to donate her organs. At the time I think they were in shock and too much pain to really grasp what they were being asked to do, and saddly they refused. A few years later one of them told me that he regretted that decision.

I have every one informed i want to donate if anything were to happen to me. I can only hope that if the worst came to the worst for me that my family would honour that wish. It's the last positive act you can do in the world and a fantastic legacy to leave.

Galvasean

It's a bit mad how someone who isn't me has a bigger say in what happens to my body when I die.

Count Duckula

As a Brit I can say that, yes, this is true. Your family have the right to rescind your permission for organs to be taken. I think this is probably something to do with the body passing into the hands of the next of kin when you die.

My mother always used to say that if I died she wouldn't let the doctors take any of my organs, no matter if I'd got myself an organ donor card or not. She also had misguided beliefs that if you were on the organ donor list doctors tried "less hard" to keep you alive. She's passed away now, so there's nothing stopping me any more, but shame on me for not getting myself on that list. I might do it now in fact, it's easy enough in the UK.

My personal preference, however, would be to have a system like they do in France. Organ donation is taken as implied unless you specifically opt out of it. Given that most people aren't on the organ donor list simply through laziness and forgetfulness, this would combat that. Those who feel strongly can still take that permission away.

fatmammycat

I carry a doner card at all times and it's signed by my next of kin, I doubt they'd need to ask anyone to use my bits and bobs- if they were of any use that is.

strobe

It just shows the importance of discussing this with your next of kin. It's not enough to just carry the card, you need to make your wishes clear to your husband/wife/mother/son.

Also +1000 to what the good Count says on an opt out system. This is one of the things I will seriously grill any politician on that has the bottle to ring my doorbell between now and Feb 25ft.

ShooterSF

I generally am suspicious of opt-out systems but this is one area where I'd prefer it. I don't carry a donor card cause I lose cards all the time but my friends and family are well aware of my wishes. So can they opt me in if the situation were to arise?

amacachi

I'm not in favour of the opt-out system but it shouldn't be down to the family. When some tool asks if I have an organ donor card and I say "No" and they get started on some self-righteous rant I point out that in this country it is completely pointless to have one. My family know that I'd want anything useful taken from me should something unexpected happen to me, carrying a card makes no difference.

Pygmalion

amacachi wrote: »

I'm not in favour of the opt-out system but it shouldn't be down to the family. When some tool asks if I have an organ donor card and I say "No" and they get started on some self-righteous rant I point out that in this country it is completely pointless to have one. My family know that I'd want anything useful taken from me should something unexpected happen to me, carrying a card makes no difference.

You're not in favour of opt-out, and it shouldn't be down to the family.

But you've never opted-in, despite wanting to donate, and you expect your family to make your wishes known should anything happen to you.

Does not compute.

amacachi

Pygmalion wrote: »

You're not in favour of opt-out, and it shouldn't be down to the family.

But you've never opted-in, despite wanting to donate, and you expect your family to make your wishes known should anything happen to you.

Does not compute.

I haven't opted in because my opting in makes no difference to the world in any way shape or form. If tomorrow it was changed that signing up actually did something then I'd do it straight away. Right now I have more useful things to do like tearing a sheet of kitchen roll into tiny little pieces and seeing if I can organise back to how it was, because there is no point whatsoever in carrying a donor card right now.

Zombrex

Pygmalion wrote: »

You're not in favour of opt-out, and it shouldn't be down to the family.

But you've never opted-in, despite wanting to donate, and you expect your family to make your wishes known should anything happen to you.

Does not compute.

I think if you wanted to donate you would opt in, wouldn't you? It would be less likely someone did but never opted in.

It would be more likely someone didn't but never opted out.

vinchick

I can finally get a donor card and give blood now that I have relocated. I don't have CJD I swear!

Bottle_of_Smoke

Count Duckula wrote: »

She also had misguided beliefs that if you were on the organ donor list doctors tried "less hard" to keep you alive.

That is absolutely brilliant. Just love the idea of scheming doctors trying to accumulate organs at any cost.

virmilitaris

Bottle_of_Smoke wrote: »

That is absolutely brilliant. Just love the idea of scheming doctors trying to accumulate organs at any cost.

I live in korea where the blood bank won't even take my blood because its not korean. Seriously.

And at the same time organ theft has been known to happen here. Again seriously.

Plowman

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Dades

Vatican officials wrote:

Furthermore, if papal organs were donated, they would become relics in other bodies if he were eventually made a saint.

What a shame - at least one of those organs has never been used. :pac:

magicbastarder

getting back to the original question, i don't see how it can be any other way - regardless of your beliefs or wishes, the last thing the hospital would want to do is get into an argument with a grieving family about cutting up their recently/soon to be deceased relative to remove bits against their will (whatever their reasons are).

it's a reasonable enough debate to have taken out of that context, but in the aftermath of (for example) a car accident leaving someone brain dead, it'd be ludicrous to insist the hospital should override the family's wishes.

strobe

magicbastarder wrote: »

getting back to the original question, i don't see how it can be any other way - regardless of your beliefs or wishes, the last thing the hospital would want to do is get into an argument with a grieving family about cutting up their recently/soon to be deceased relative to remove bits against their will (whatever their reasons are).

it's a reasonable enough debate to have taken out of that context, but in the aftermath of (for example) a car accident leaving someone brain dead, it'd be ludicrous to insist the hospital should override the family's wishes.

About as ludicrous as insisting the family should be able to override the organ owners wishes surely? My organs, my decision. Just like if I signed a DNR, my family should not be able to over rule my decision. It's not about the family over ruling the hospital, it's about the family over ruling the individual they are related to.

magicbastarder

and that's not an argument it's up to the hospital to enter into.

strobe

magicbastarder wrote: »

and that's not an argument it's up to the hospital to enter into.

It shouldn't be an argument at all.

magicbastarder

i agree wholeheartedly.

but to suggest that the hospital should proceed to remove organs from someone when his or her distraught daughter, for example, has a serious problem with it, is unworkable.

strobe

magicbastarder wrote: »

i agree wholeheartedly.

but to suggest that the hospital should proceed to remove organs from someone when his or her distraught daughter, for example, has a serious problem with it, is unworkable.

Is it unworkable to have a unitarian church carry out a wedding for someone if their distraught daughter has a serious problem with it? It is awkward, certainly, but not unworkable, it happens all the time.

In principle I see no difference. I have made a decision about myself, nobody but me should be able to over rule it regardless of how distraught they are.

drkpower

magicbastarder wrote: »

i agree wholeheartedly.

but to suggest that the hospital should proceed to remove organs from someone when his or her distraught daughter, for example, has a serious problem with it, is unworkable.

No, its not.

A hospital will* respect a patient's advance refusal of a blood transfusion, or any other life-saving treatment, no matter how many distraught daughters scatter the waiting room.

Compared to organ donation, that is a decision of monumental importance yet very few would dream of over-ruling a patient's wishes. But 5 minutes later when that patient dies, it is suddenly unworkable for the Hospital to respect the patients wishes vis-a-vid their organs because of distraught relatives.....????:D

* - with some exceptions

magicbastarder

drkpower wrote: »

A hospital will* respect a patient's advance refusal of a blood transfusion, or any other life-saving treatment, no matter how many distraught daughters scatter the waiting room.

possibly because once a patient enters the point that organ harvesting is possible, it has ceased to become a care issue, and their duty of care changes.

drkpower

magicbastarder wrote: »

possibly because once a patient enters the point that organ harvesting is possible, it has ceased to become a care issue, and their duty of care changes.

Not really.

A doctor's duty of care to a patient extends beyond that patient's death. Obviously the nature of that duty changes, given the patient is dead (:D), but it persists nonetheless.

For instance, the duty of confidentiality extends beyond death. There is no good reasons why a duty to respect a patient's wishes in respect of their body/organs should not persist beyond death also.

Edit: of course, procurement of organs for donation often occurs while a patient's cardio-respiratory system is still being maintained, so there is an interesting argument as to whether the patient can be said to have died.

johnmcdnl

Plowman wrote: »

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what if I become a saint

Plowman

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strobe

Plowman wrote: »

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Hi Plow, have you any links to stories about the 'relic market'? I just have images of Indiana Jones in my head. Who buys the stuff? Is it private collectors or do religious orders buy them or what?

Plowman

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Butch Cassidy

What if the family is non-contactable and you die/are about to die and have a donor card w/ next if kin signature? I assume surely that that means the hospital is covered or have they to wait to contact a member of family? Surely this is of no use in cases where people have no connections to family?

MrPudding

Dades wrote: »

What a shame - at least one of those organs has never been used. :pac:

But they can't transplant brains yet...

MrP