Opt-Out Organ Donation

Manion

maudgonner wrote: »

Yeah, people have strange notions about what they will and won't donate.

I will also say though, that while it makes no difference to the dead person, it can be incredibly difficult for families. The process of donating organs isn't an easy one, especially for a grieving family. Most people don't realise that it's not like in the movies - there is no 'switching off life support' moment (at least not in my experience). You say goodbye to your loved one and walk away, while they are still 'breathing', still connected to life support. They 'die' in the operating theatre. That's something that can be very difficult to handle.

I say this not to discourage anyone from donating a loved one's organs, or from wanting to be a donor themselves. (Like I said, I've made my own wishes clear that I want to have anything useful donated.) But a lot of people are very hard on families who decide not to donate their loved one's organs. I can understand that, if you're the one waiting for a transplant it must seem incredibly cruel. But I have sympathy for anyone that can't bring themselves to do it, it's a really fúcking hard decision to make.

Come on science! Give us the ability to grow organs in a lab and not need to worry about this.

Frankly this!

There's a lot of condescension on this thread, and rolling of eyes but this is actually the issue. When you're with someone you love as they are dying things like Logic and rationality go out the window. I would not be OK with someone I loved dying on an operating table surrounded by strangers with no one to hold their hand.

El_Duderino 09

weldoninhio wrote: »

My organs are mine. I'm not incubating them for someone else. What if they come out next and say, housing crisis, from now on if you don't opt out, we'll take your house and give it to a homeless person if you die?? Sure what do you need a house for when your dead?

Lol. Then I'd opt out. What would you do?

Zillah

weldoninhio wrote: »

My organs are mine. I'm not incubating them for someone else. What if they come out next and say, housing crisis, from now on if you don't opt out, we'll take your house and give it to a homeless person if you die?? Sure what do you need a house for when your dead?

A - They're your organs until you die. When you're dead you're not a person any more. Only the living can own something.
B - If you have next of kin then they take ownership of your house. If no next of kin can be found then yes indeed the state does take your house and use the proceeds for the collective good.

So unless you want your next of kin to inherit your organs - so they can what, watch them dissolve on the mantlepiece? - I'm not sure you have a point here.

All your squeamishness aside, we're talking about people who are slowly dying, and the thing that can save them, which could become a living, vital part of their body, you want to throw it in the ground to rot.

It's madness. Juvenile, selfish, obtuse madness.

bnt

That's why it's important to be clear about what you want, ensure your next of kin are in agreement with you, and express your wishes officially. The need for a change in legislation doesn't arise from such cases, it's for the cases where there has been no expression of wishes. The "default setting" of "no donation" is what needs to change.

Calhoun

El_Duderino 09 wrote: »

That's a bit precious. You can think whatever you like. And if you don't want to donate you can opt out.

Exactly, ill think how i want and what i believe is that if we are going to implement something like this we had better make sure we have all the right kind of checks and balances.

I will also be opting out until this is the case, when i do opt in i would also like to do it without judgement.

Allowing your organs be harvested is a personal decision, or thats what the folks who opt-in today would say. I should be given the peace to do that without the whole peer pressure to force folk into doing it.

El_Duderino 09

Calhoun wrote: »

El_Duderino 09 wrote: »

That's a bit precious. You can think whatever you like. And if you don't want to donate you can opt out.

Exactly, ill think how i want and what i believe is that if we are going to implement something like this we had better make sure we have all the right kind of checks and balances.

I will also be opting out until this is the case, when i do opt in i would also like to do it without judgement.

Allowing your organs be harvested is a personal decision, or thats what the folks who opt-in today would say. I should be given the peace to do that without the whole peer pressure to force folk into doing it.

Do what you like. You're complaining as if there was no opt out but as you point out there will be an opt out. So then you can make your own decision. Sounds like you'll be happy as Larry

Calhoun

El_Duderino 09 wrote: »

Do what you like. You're complaining as if there was no opt out but as you point out there will be an opt out. So then you can make your own decision. Sounds like you'll be happy as Larry

I will, you should double down on the pressure to optin for people, really tell them what scum they are for opting out. I think it will help the case.

animaal

bnt wrote: »

The "default setting" of "no donation" is what needs to change.

I'm not sure that's what needs to change. There's a growing tendency for people in this country to assume that the answer to all life's problems is for the state to interfere more. The problem is a lack of donated organs. Rather than look at why people might not want to donate, and maybe try to address those concerns, the kneejerk response is to decide that our organs revert to state ownership after death, unless formally told otherwise.
The number of organs needed is probably not that large. Not everybody needs to be a donor. Some concerns voiced on this thread include:
- how long will the family be without the body?
- what if there are particular organs that owner/family don't want harvested?
- What if the owner wants the family to have a say when the time comes?

I'm sure if more people were asked, there would be many more. Maybe some of these concerns are unfounded. But if that can be demonstrated by the authorities, or if any valid issues that are raised can be addressed, then it is likely to increase the number of people willing to donate. I would argue that if the state does introduce organ-taking (as opposed to organ donation), there's an even bigger need to address people's concerns.

weldoninhio

El_Duderino 09 wrote: »

That's a bit precious. You can think whatever you like. And if you don't want to donate you can opt out.

Currently if you want to donate you can opt in. Just because people aren't doing this doesn't mean you should change the rules so that someone that doesn't get round to opting out is suddenly seen as giving consent. It's incredibly easy to become an organ donor currently.

OldNotWIse

animaal wrote: »

For the record, I think organ donation is a good thing, but if it's done without express permission, it's no longer "donation". It's taking. Lack of refusal is not consent!

I do agree with this. I support organ donation of course and I'd be lying if I said I wouldn't be delighted to get someone else's if I needed it! Donor numbers are low and this is something that needs to be addressed but not in the manner suggested IMO. I believe implied consent or inertia consent are dangerous precedents that have no place in a society that places a constitutional value on privacy, property and bodily autonomy.

Zillah

Calhoun wrote: »

I will also be opting out until this is the case, when i do opt in i would also like to do it without judgement.

I assume you mean "when I do opt out", in which case:

You don't get to decide how people react to your decisions. If you make a selfish, irrational decision about leaving your organs to rot instead of saving someone else's life then you will most certainly get condemnation from me.

osarusan

animaal wrote: »

The problem is a lack of donated organs.

This isn't always down to donor rates either though. A good year in terms of reducing road traffic fatalities is going to be a bad year in terms of organ transplants.

A poster mentioned earlier in the thread that in Ireland, one key issue is the organ donation infrastructure - that is, ensuring that as many organs as possible actually get used - and that without improving that, this new policy might just mean there are more organs that go untransplanted.

I know that Beaumont Hospital, a couple of years ago at least, had a shortage of operating theatres and transplant specialists.

Things have improved in one way - there are now positions called Organ Procurement Coordinators - trying to identify needs and corresponding donors for different diseases, to try and ensure that as many donated organs as possible actually get used.

So, while I don't have any issue with an opt-out system myself (and it would help to reduce the number of cases in which it simply is down to shortage of organs), I'm not sure how much of an impact it will actually have.

Zillah

OldNotWIse wrote: »

I believe implied consent or inertia consent are dangerous precedents that have no place in a society that places a constitutional value on privacy, property and bodily autonomy.

I would agree with you if this was about the living. But it's not. It's about dead people. I don't think dead people should get rights.

weldoninhio

Zillah wrote: »

I would agree with you if this was about the living. But it's not. It's about dead people. I don't think dead people should get rights.

So you don't agree with wills etc??

seamus

animaal wrote: »

Some concerns voiced on this thread include:
- how long will the family be without the body?

Not long. The window for harvesting organs is pretty small and the nature of the death has a lot of bearing on when and how it occurs. Any delay caused by routine donation will be 24 hours at the absolute most. The body decays very quickly. Outside of this window the tissues are useless.

Since most funerals occur 3-7 days postmortem, this 24 hour delay will make no odds.

In a small number of cases the body will kept on life support after clinical death has occurred, but these would require interaction with the family who would be kept advised anyway.

- what if there are particular organs that owner/family don't want harvested?
- What if the owner wants the family to have a say when the time comes?

The proposal is that the family will still always have final say and can refuse consent if they wish.

Presumed consent will mean that people with no next-of-kin or none that are easily contactable, will be opted-in by default.

El_Duderino 09

Calhoun wrote: »

El_Duderino 09 wrote: »

Do what you like. You're complaining as if there was no opt out but as you point out there will be an opt out. So then you can make your own decision. Sounds like you'll be happy as Larry

I will, you should double down on the pressure to optin for people, really tell them what scum they are for opting out. I think it will help the case.

I probably won't do that if it's ok with you (but it does give an interesting insight into your view of people who don't opt in). I'd encourage people to take an interest and opt out if they want to. I'd want the opt out to be very simple

OldNotWIse

Zillah wrote: »

I would agree with you if this was about the living. But it's not. It's about dead people. I don't think dead people should get rights.

I'm taking a more holistic view. My concern is that the precedent which would be set by implied or inertia consent would likely evolve into other areas which do involve persons who are living. The necessary rationale of taking something just because it is no longer needed means that post- death that their bodies become a sort of free for all. In a context where bodily autonomy is enjoyed by the living, whilst this possession does not "carry over" it cannot simply "revert" to the state or to hospital boards either, since that possession never existed in the first place.

El_Duderino 09

weldoninhio wrote: »

El_Duderino 09 wrote: »

That's a bit precious. You can think whatever you like. And if you don't want to donate you can opt out.

Currently if you want to donate you can opt in. Just because people aren't doing this doesn't mean you should change the rules so that someone that doesn't get round to opting out is suddenly seen as giving consent. It's incredibly easy to become an organ donor currently.

And it should be easy to opt out. They're the same really. One way solves a major problem but the other way doesn't. The solution is obvious.

Anyone who doesn't want to donate should opt out. Anyone who cares will get around to it

seamus

weldoninhio wrote: »

So you don't agree with wills etc??

A will is actually a good example of an "opt-out" system.

The state has devised a set of rules which govern how a person's assets are to be divided up after they die. Everyone is "opted-in" to this system by default.

If you don't want these rules to apply to you, you have to "opt-out" by making a will.

In fact the rules are slightly more oppressive in that if your will isn't "good enough", then the default rules will apply and your will may be partially or wholly ignored

maudgonner

OldNotWIse wrote: »

I'm taking a more holistic view. My concern is that the precedent which would be set by implied or inertia consent would likely evolve into other areas which do involve persons who are living. The necessary rationale of taking something just because it is no longer needed means that post- death that their bodies become a sort of free for all. In a context where bodily autonomy is enjoyed by the living, whilst this possession does not "carry over" it cannot simply "revert" to the state or to hospital boards either, since that possession never existed in the first place.

I think that's quite an unfair description of the organ donation system. You make it sound like they're vultures scavenging over the body. You should read the post earlier on the thread by someone involved in the process - it's very respectful and considerate of the family's feelings.

Cee-Jay-Cee

judeboy101 wrote: »

No problem accepting as I have private health insurance and will be charged handsomely by the HSE for the privilege

No you won't, your health insurer will be charged, you will not have to pay any additional charges for an organ transplant...you should really read up on the terms and conditions of your health insurance as you're pretty clueless on how it works.

And just for your information, chances are that if you were to receive an organ because of a medical emergency, it would be coming from some selfless person who didn't have medical insurance...but I'm sure that wont matter to you.

OldNotWIse

maudgonner wrote: »

I think that's quite an unfair description of the organ donation system. You make it sound like they're vultures scavenging over the body. You should read the post earlier on the thread by someone involved in the process - it's very respectful and considerate of the family's feelings.

What else do you call a suggestion that when a person dies that the state has an automatic right to harvest that person's organs. I am aware of how the process works but as I said, my concerns are more holistic in the context of the implications implied consent would have across the board, not just in relation to organ donation. I have not said that I disagree with how organs are harvested or the concept of donation in general but I am opposed to inertia consent, notwithstanding that this might offend some with strong feelings and / or sensitivities on the matter of organ donation more generally.

The family having the final say is the biggest issue I would have thought. As it is we don't even have an "opt-in" system. Whether you have a donor card or not the next of kin still has to be asked for permission.

weldoninhio

El_Duderino 09 wrote: »

And it should be easy to opt out. They're the same really. One way solves a major problem but the other way doesn't. The solution is obvious.

Anyone who doesn't want to donate should opt out. Anyone who cares will get around to it

So I'll just be able to pick up an opt out card in an doctors surgery? Or click online?

You know as well as I do that it'll be a convoluted process designed to put people off opting out.

maudgonner

OldNotWIse wrote: »

What else do you call a suggestion that when a person dies that the state has an automatic right to harvest that person's organs. I am aware of how the process works but as I said, my concerns are more holistic in the context of the implications implied consent would have across the board, not just in relation to organ donation. I have not said that I disagree with how organs are harvested or the concept of donation in general but I am opposed to inertia consent, notwithstanding that this might offend some with strong feelings and / or sensitivities on the matter of organ donation more generally.

The state will not have an automatic right, just as they don't under the current system. The organ donor register will not give or deny final consent - that right will continue to remain with the next of kin. The register, like current organ donor cards, will really just be an indication of your wishes.

El_Duderino 09

weldoninhio wrote: »

El_Duderino 09 wrote: »

And it should be easy to opt out. They're the same really. One way solves a major problem but the other way doesn't. The solution is obvious.

Anyone who doesn't want to donate should opt out. Anyone who cares will get around to it

So I'll just be able to pick up an opt out card in an doctors surgery? Or click online?

You know as well as I do that it'll be a convoluted process designed to put people off opting out.

Well we don't know what it will be but I'd say there could be a physical card or something like the driving licence but I'd imagine it will mostly be an electronic tick box. Similar to registering to vote in the U.K. You need a pps no. Address and date of birth. Couldn't be simpler for the person who cares enough to opt in/out.

osarusan

weldoninhio wrote: »

You know as well as I do that it'll be a convoluted process designed to put people off opting out.

You don't know this at all.

Welsh opt-out system is an online process - Select 'Opt Out', fill in your details so they know who take take off the donor list, click submit.

OldNotWIse

maudgonner wrote: »

The state will not have an automatic right, just as they don't under the current system. The organ donor register will not give or deny final consent - that right will continue to remain with the next of kin. The register, like current organ donor cards, will really just be an indication of your wishes.

It is intended as an indication of one's wishes then why is a wish to donate being "read-in" where it has not expressly been indicated?

weldoninhio

El_Duderino 09 wrote: »

Well we don't know what it will be but I'd say there could be a physical card or something like the driving licence but I'd imagine it will mostly be an electronic tick box. Similar to registering to vote in the U.K. You need a pps no. Address and date of birth. Couldn't be simpler for the person who cares enough to opt in/out.

So already a lot more convoluted that the current system of just carrying a card.

jackofalltrades

Disappointing decision, but I suppose Simon Harris has to do something to deflect the heat he was getting from the NMH fiasco.

animaal wrote: »

I'm not sure that's what needs to change. There's a growing tendency for people in this country to assume that the answer to all life's problems is for the state to interfere more.
The problem is a lack of donated organs. Rather than look at why people might not want to donate, and maybe try to address those concerns, the kneejerk response is to decide that our organs revert to state ownership after death, unless formally told otherwise.

OldNotWIse wrote: »

I believe implied consent or inertia consent are dangerous precedents that have no place in a society that places a constitutional value on privacy, property and bodily autonomy.

The above pretty much encapsulates my opinion on the matter.
As a nation we're getting a bit to eager for my liking to resort to authoritative solutions like opt-outs to solve problems.
First it was the opt-out on civil partnership and now this.
I hate to think what's next for this kind of solution.