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Organ Donation becomes Opt Out from June

Raichų

change to the law means you’ll now need to specify you dont want to be not that you do wish to be.

Not sure how to feel about this. My initial thoughts are fine and fair enough I suppose, but I think the family or next of kin should be asked before you start harvesting a persons organs when they are gone.

That said is it better to let them decompose and become part of the earth or give someone a new lease on life? Very conflicted on this. I lean towards not really having any issue since you can just opt out if you feel strongly opposed.

I am listed as a donor on my drivers licence anyway, so this wouldn’t affect me, but curious how people feel, especially if you’re not currently a donor? Are you going to opt out or just roll with the punches?

https://m.independent.ie/irish-news/people-will-automatically-be-organ-donors-unless-they-object-during-their-lifetime-under-law-change-agreed/a539869892.html

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silliussoddius

https://www.boards.ie/discussion/comment/123440661#Comment_123440661

Sorry, but this is is everything that is wrong with Ireland. Like it or not, the state controls the medical system for the entire population. The vast majority of people want this free service provided by the government. The idea that this is suddenly some over reach by the same government that people demand a health service from is bonkers.

If people fear the government this much, opt out and go fully private and if they ever need a transplant, then decline organs on noble the basis that they may have been harvested.

MrMusician18

https://www.boards.ie/discussion/comment/123441064#Comment_123441064

Its the government laying claim to you because you haven't said what you want to do with your organs. It's like the State taking your possessions if you haven't made a will but obviously more intimate and invasive.

I think there are better ways to improve organ donation rates, ways that foster a positive attitude towards it.

magicbastarder

https://www.boards.ie/discussion/comment/123441017#Comment_123441017

i suspect they already are?

i know someone who received a liver transplant last year - and they're very strict on giving up drink. almost like drug testing for athletes, from what i was told.

eightieschewbaccy

https://www.boards.ie/discussion/comment/123441036#Comment_123441036

(6) Where a designated family member is approached to confirm that there is no objection to the donation of relevant organs for the purpose of transplantation, the family member shall consider and give substantial weight as to whether or not he or she believes that the relevant person, the subject of the request, would have had an objection to such a procedure.
(7) Where a designated family member objects to the donation of a relevant organ, the relevant organ shall not be used for transplantation and the objection of the designated family member shall be recorded in writing by the relevant professional and retained with the deceased person’s medical records for a period of 30 years.
(8) Where the designated family member has confirmed that he or she has no objection to the removal and donation of a relevant organ, he or she shall provide confirmation that the relevant organ may be used for transplantation in accordance with section 10 (1).
(9) A designated family member may, at any time up to the commencement of the process for removal of the relevant organ for transplantation, object to the donation but no objection can be made once the process for removal of such relevant organ has begun.

Reading the law, family objections absolutely will act as an effective opt out. Also @Ezeoul , no family member would mean you wouldn't end up donating as well.

https://www.irishstatutebook.ie/eli/2024/act/5/section/18/enacted/en/html#sec18

banie01

The notion that there will be a wholesale organ harvesting and storage industry is a little bit hysterical TBF.

Organs have a short shelf life outside of the body, From 6/7 hours for a heart to maybe 36hrs for a kidney. Outside of corneas, heart valves and cadaver tissue, organs as they are conventionally thought of, cannot be stored.

We should dispel the notion that folks are going to be harvested as a matter of course. Indeed even where an end of life patient in an ICU has viable organs and a matched patient? That's a matter of luck as much as it is foresight. The likelihood of a donor being matched outside of a living donor is low, and whilst it improves with assumed consent, in the UK, which has adopted the assumed consent system, the wait is still up to 3 years.

There is also, as I touched on in my 1st post on this thread (as have others) the simple calculus of the capacity of the Irish system to harvest and transplant organs. The logistics around such procedures are complex, the number of surgeons skilled in the procedure is low, both in harvesting and transplanting them.

The ODTI also have a limited number of liaison nurses to manage and address donor family support during the process. I mentioned in an earlier post that the limit for harvest in Ireland is currently 300 per year (+/-25). That is based on both the Surgeons available, operating theatre time and the logistics surrounding the process.

The viability of the current organ donor system is also very much dependant upon ICU capacity. COVID highlighted just how tight Ireland is on capacity in that regard. Ideally I'd love to see our ICU capacity grow, along with that of ODTI to better manage the process.

Issues such as incomplete medical histories, unknown drug use and necessity for post mortem already mean a chunk of otherwise viable donors are excluded from consideration. Opening up the pool of potential donor's is IMHO vital. The assumed consent option has been discussed for over a decade and it's roll out must come with an educational and information component.

The family of the presumed donor will still be at the centre of the choice to donate. I've seen nothing to show that precept has changed.

https://legalblog.ie/organ-donation-transplant/

[Deleted User]

https://www.boards.ie/discussion/comment/123440950#Comment_123440950

This conversation is over.

You are being disingenuous. You are also making an assumption that I would not donate my own organs, without my having divulged my preference to donate or not.

Where once I would have engaged you, I have no patience with this kind of posting anymore.

[Deleted User]

https://www.boards.ie/discussion/comment/123441115#Comment_123441115

Reading the law, family objections absolutely will act as an effective opt out. Also @Ezeoul , no family member would mean you wouldn't end up donating as well.

Thanks. Glad to hear that, at least.

Though I would like some clarity on what "designated" family member means.

MrMusician18

https://www.boards.ie/discussion/comment/123441115#Comment_123441115

I stand corrected. Thanks for clarifying for us

osarusan

I expect that once this comes into place, GPs and other healthcare providers will be checking whether paitents are already on the new register (either as confirmed as a donor or opted out) and anybody who has not made an active decision will be advised of the new opt-out system and encouraged to make a decision.

[Deleted User]

That is far too open to interpretation.

It could leave a/the designated family member (just one?) having to defend their decision if they decide not to donate their family member's organs. It could be implied that they haven't given the decision "substantial weight".

I'm liking this less and less, as I can see clearly how that could leave newly grieving families open to feeling pressured to donate, when they don't want too.

ancapailldorcha

https://www.boards.ie/discussion/comment/123441602#Comment_123441602

It's not. It's very, very clear.

You seem determined to twist this into something it isn't.

TokTik

https://www.boards.ie/discussion/comment/123440723#Comment_123440723

It’s the government that want the organs. The government should pay. Not the recepient.

[Deleted User]

https://www.boards.ie/discussion/comment/123441617#Comment_123441617

I disagree.

Within a family, who decides who is the "designated" person? What if the family members cannot agree?

These are the issues that come with an opt-out system and assuming consent for someone who cannot state their preferences. Unlike the current opt-in system, where at least the deceased has stated their preferences while still alive.

You can argue until you're blue in the face, but I feel an opt-out system is wrong. There will be organs harvested from people who would not want that, but didn't know they had to opt-out, mark my words.

Wouldn't be the first time we had a scandal around human organs in this country.

[Deleted User]

https://www.boards.ie/discussion/comment/123441690#Comment_123441690

Have you thought about what the government want them for? Like to save the lives of those who actually need them?

One eyed Jack

https://www.boards.ie/discussion/comment/123441837#Comment_123441837

Andrew I’m reluctant to draw the analogy as I know you’re going to outright reject it on the basis that it’s completely different, but the above reasoning you’re using is the same reasoning that was used to justify treating women as mere vessels whose bodies weren’t their own.

It was ethically unjustifiable then too.

One eyed Jack

https://www.boards.ie/discussion/comment/123441064#Comment_123441064

It’s not an overreach by Government, it’s an overreach by the State. The idea of a public healthcare service provided by the State is because it has an obligation to do so. Only 30% of healthcare is free, and the rest is subsidised to ensure that healthcare is affordable (I know, ‘affordable’?), but Government are working on delivering Slaintecare - a universal healthcare system that would offer the same standard of services and benefits to everyone regardless of their ability to pay. I can understand why it seems like bonkers to you given your second paragraph, which in my view is, well, equally bonkers tbh, although it is a fairly prevalent attitude among people who imagine they’ll never fall foul of the criteria they set for other people to avail of assistance from the State. It’s indicative of the kind of misery some people would inflict on other people if only they could.

It’s not a question of whether or not anyone fears Government, and to suggest that anyone who doesn’t want to ‘opt in’ go fully private and decline a transplant is just sneering really at people who you hope are forced to consider whether to remain opted in, or opt out and forego healthcare. It’s irrational at best, and irresponsible at worst.

Fortunately for myself and my family at least, we’re in a position where I can afford private healthcare, I have no qualms about refusing a transplant (that’s what the whole blood thing was about earlier - refused to give consent to allow a blood transfusion if it became necessary during a surgical procedure, I’m the same about organ receiving - no, but thank you. Nothing noble about it, just it’s not for me). Many other people are simply not so fortunate.

The point being that I’m not troubled in the least by your declarations, but I know many people who would be, but because of everything that’s wrong with Ireland in your opinion, they don’t have to worry about Government either if they decide to register to opt out, because the State is obligated to provide for their welfare, healthcare, education and so on. Basic human rights stuff that I won’t get into, it’s often overlooked by individuals who wish to inflict misery on other people who don’t comply with their demands anyway, but that’s also the reason I pay taxes - not because it’s.a question of consent, but simply because as a citizen of this country it’s my civic duty to do so. What Government have done here though, is taken what for some people was once a moral obligation, and turned it into a civic duty for everyone, with some people wanting to go even further than that because it’s a new and exciting way to inflict misery on other people who aren’t in a position to object.

witchgirl26

https://www.boards.ie/discussion/comment/123441698#Comment_123441698

I would imagine your designated person is your next of kin which should be listed in your medical files as standard or at least a note made of it. If you don't have it stated, it is your spouse (has to be spouse not just partner) or if you are not married, it is your child if you have one. I would imagine if the child is under 18, it would then revert to your parents, if they are living. If no living parents, it would be your next closest living relative (brother or sister). Almost like what they do when someone dies without a will. It's not complicated at all. And again this is why it is incredibly important to have this conversation with your family at any point in time & not just assume they know your wishes. A bit like having a will. It is also like the opt-out system in the sense of family members, if you hadn't recorded your wishes, could opt you in if they didn't know that you had objections to it.

https://www.boards.ie/discussion/comment/123441935#Comment_123441935

Oh my god it is very different things. The "State" isn't growing people to be organ donors like we're on a farm. And people have a choice. The difference now is that those who don't want to donate organs actually have to do something about it. What is the massive issue with that. And next-of-kin (designated family member) will still have a say so again, if you've discussed the topic with them, where is the issue? It's not like they're going to grab people off the streets to steal a kidney for a transplant. Women weren't being given a choice in your analogy. Here everyone is getting a choice, you just actually have to do something about it.

twinytwo

https://www.boards.ie/discussion/comment/123436880#Comment_123436880

God forbid, the organs you do not need anymore might save/improve someone else's life…..

MrMusician18

https://www.boards.ie/discussion/comment/123443071#Comment_123443071

If family retain the ultimate veto post enactment, I can't see how this law will be effective at increasing donation rates since family already can opt in or out for the deceased.

Raichų

https://www.boards.ie/discussion/comment/123441114#Comment_123441114

no they are not.

Being a smoker won’t put you any lower on the list for cancer (or any other treatment) the same as being an alcoholic.

You might be made to stop drinking before a transplant but that’s regardless of a liver transplant or a fecking arse transplant. You can’t have major surgery if you’re full of drink.

Thankfully our health service tends not to discriminate.

Raichų

https://www.boards.ie/discussion/comment/123443082#Comment_123443082

To be fair the surgery saves the life but you wouldn’t expect the surgeon to work for free?

Just saying….

magicbastarder

It's not about being sober for the operation itself, from what I understand - it's that they do not want to give a liver to a drinker.

magicbastarder

To be eligible, individuals must be abstinent from alcohol and even pass an alcohol blood test (which can detect alcohol use within the previous 3 months).

https://www.liverfoundation.ie/alcohol-related-liver-disease-ald

The woman I know who had the transplant has lifelong health issues; her transplant was not the result of alcohol damage. But she was told she could be tested.

[Deleted User]

https://www.boards.ie/discussion/comment/123441935#Comment_123441935

My analogy was specifically in response to the suggestion that the government should be paying for harvested organs.

The difference with the 'vessels' scenario would be that in this case, the donors are dead.

Yeah Right

https://www.boards.ie/discussion/comment/123441154#Comment_123441154

I'm not being disingenuous at all, that's your own interpretation.

I'm also not making any assumptions about you either. You've already stated that you're not disclosing your own stance and that it's irrelevant what way you think (I disagree, but deliberately didn't press you on it).

When I say "I'm uncomfortable with you receiving an organ…..", I'm not talking about you specifically. I'm talking about someone, anyone, everyone who, hypothetically, doesn't donate and is trying to understand why they're being 'discriminated' against. I'm using you as a stand-in for anyone who a person who refuses to donate their organs but would happily accept donated organs if the shoe was on the other foot. If everyone thought like that there'd be no such thing as transplants.

Yeah Right

https://www.boards.ie/discussion/comment/123441021#Comment_123441021

WTF has this got to do with anything I've said?

I never mentioned sick people, did you mean to quote someone else?

jackofalltrades

https://www.sciencedirect.com/science/article/pii/S003335062400355X

"Our longitudinal analysis suggests that changing to an opt-out default does not increase organ donation rates. Unless flanked by investments in healthcare, public awareness campaigns, and efforts to address the concerns of the deceased's relatives, a shift to an opt-out default is unlikely to increase organ donations."

witchgirl26

https://www.boards.ie/discussion/comment/123443108#Comment_123443108

Because if someone has discussed it properly, the new legislation states that the designated family member must give weight to what the individual wanted. Therefore if the person had not chosen to opt out, that must be considered and there may even be an argument that if they didn't discuss it with family, they just were happy to go along with it.

Again it's giving families a chance which others were complaining about.

Honestly I don't get the issue here. If you don't want to donate, that's your decision (even if I might disagree) but opt out & discuss with your family. End of.

[Deleted User]

https://www.boards.ie/discussion/comment/123443555#Comment_123443555

Because if someone has discussed it properly, the new legislation states that the designated family member must give weight to what the individual wanted. Therefore if the person had not chosen to opt out, that must be considered and there may even be an argument that if they didn't discuss it with family, they just were happy to go along with it.

And this is exactly the assumption I'm uncomfortable with. Just because someone may not have "gotten around" to opting out or having that discussion with their family, it should not mean they should be considered as "happy to go along with it".

Let's be honest how many people between the ages of 18 and 35 have seriously thought about organ donation? It's not a coincidence that this is also the age group they want to target as donors the most.

I know if I ever found myself in the circumstances were a relative had not formally opted out, and I did not know their wishes that I would default to an automatic refusal.

witchgirl26

https://www.boards.ie/discussion/comment/123443648#Comment_123443648

I had the conversation with my parents when I was 16. That was because they educated me to have that conversation. Maybe that is what's needed. An open & frank discussion about it between parents & teens.

Also I would hope that people would discuss their wishes with their next of kin. And if you are next of kin to someone, you should be discussing it with them too.

Look it's not a fun topic by any stretch but it's important. And 18 - 35 year olds are definitely old enough to understand the importance.