Hell, I don't see how opting-out would be any harder than going to a government website, printing out a form, and mailing it in.
Those who aren't donors can be kept in a database that hospitals can check beforehand so as curb mistakes.
Hell it could be something even their GP knows so they can be contacted.
And if no identification can be obtained well just default to 'don't harvest' if you want to ensure people's rights aren't violated.
Oh, I know. I'm just pointing out that whatever reasons people put forward, it's basically that they're uncomfortable with being painted as the ones being selfish/unreasonable.
The extreme examples of situations being brought to support opt-in not coming into effect do not seem realistic in the slightest. Also, with the malpractice lawsuit situation like it is, any hint of incorrect behaviour would leave hospitals, staff, doctors all open to mass lawsuits especially in cases of wrongful death. These arguments that doctors are going to cut corners to steal organs and shit like that don't hold any weight for me.
Its from an article in the UK. Interesting read if you have the time its discussing the ethical concerns of organ donation in non heart beating donors. Ive quoted a section here
Manoeuvres directed towards optimal organ viability
After confirmation of ‘lack of objection’, procedure is inevitably directed towards retrieval at optimal organ viability, which seemingly creates conflict with that primary principle of ‘best interests’. Viability is promoted by minimization of both warm and cold ischaemia time and protective measures, such as the administration of antibiotics, steroids and heparin.
Since the process of dying cannot legitimately be actively foreshortened, warm ischaemia time is mainly minimized by rapid access to a surgical retrieval team immediately after death. The time taken to mobilize such a team usually dictates that supportive care be continued despite the prior declaration that this could no longer be considered in the patient's ‘best interests’ on the grounds of futility. This process, amplified by any escalation of care pending the readiness of the retrieval team, is seemingly at variance with the law.24
Post-retrieval cold ischaemia time is minimized by ensuring that a suitable recipient is identified early by taking blood for tissue typing, and transplanted early by determining via virology screening that there is no contraindication to utilization of the organ. This process too is at variance with the dictates of the UK Code of Practice—‘any tests or treatment carried out on a patient before he dies must be for his benefit and not solely to preserve his organs’25—a position which also generates difficulties in administering the above therapies directed towards organ viability.
Process of dying
The process of dying comes under scrutiny since the time scale dictates the warm ischaemia time. Relief of pain and distress is a basic medical duty and the potential for this process to shorten life is accommodated under the doctrine of ‘double effect’.26 27 This latter principle, which has already been challenged,28 becomes more vulnerable, however, when there is prior knowledge that such shortening will benefit a third party. Since it can be argued that patients with significant neurological disability should be beyond pain and distress, there is a distinct possibility that those individuals that warrant comfort care may inappropriately be denied this to avoid any such accusations.
Timing of death
Timing of death is problematic within the UK and most jurisdictions, there being no professional guidelines or definition at law other than for brainstem death, leaving uncertainty as to when death can be certified and when the process is sufficiently established to permit organ retrieval. The declaration that brainstem death constitutes the only true death29 does not assist certification by cardiac criteria: ‘A person is not dead unless his brain is dead. Arrest of the heart and circulation indicate death only when they persist long enough for the brain to die’.30 Clinical examination for absence of responsiveness, respiratory effort, cardiac output and pupillary response should not be undertaken within 2 min of the onset of asystole, since autoresuscitation is theoretically possible within this time scale. The Pittsburgh approach31 of surgical intervention 2 min after asystole is unlikely, therefore, to be accommodated within UK practice and a more pragmatic position of only initiating perfusion/retrieval at 10 min after certification should be capable of reassuring all parties that death has become sufficiently established at that stage, given the primary neurological insult and likely progression of this during the process of dying.
Also you are correct, if they cant stop the bleeding then they cannot save your life. However at what point do they stop trying? When its at maximum viability to extract the organs, or past the point they can save you?
The incentive for doctors and nurses to rob accident victims of organs simply does not exist. Not in any developed country. They won't personally get any use of the organs, and as devoir said, they'll get a massive fucking hit if they're caught doing anything improper. I'd imagine there might be criminal penalties, as well.
It's just paranoia.
Elki on
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KageraImitating the worst people. Since 2004Registered Userregular
edited May 2008
I heard you should never drink anything a doctor offers you because it has roofies in it and you'll wake up in a bathtub full of ice with your kidney removed.
Kagera on
My neck, my back, my FUPA and my crack.
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AegeriTiny wee bacteriumsPlateau of LengRegistered Userregular
edited May 2008
Increasing the number of organ donors also devalues black market organs or selling organs to people anyway, so there is even less incentive to go around organ thieving.
Also you are correct, if they cant stop the bleeding then they cannot save your life. However at what point do they stop trying? When its at maximum viability to extract the organs, or past the point they can save you?
What the hell are you talking about? Those two situations are identical. They can't save you - that's the point. The paper is discussing the fact that they had a patient they couldn't save, but who didn't meet the technical criteria for brain death.
If a paramedic at a car crash didn't do everything reasonably possible to save a person's life, they would be hung and quartered. I don't care how much collusion you reckon is going on in the medical profession to cover up these practices where people are harvesting organs for "insurance profit", the ambulance chasing legal profession would gut them for fun, but instead do it for profit.
Please show me in the last 20 years a case in Australia where someone's family has sued (not won, but just sued) for wrongful death in the case of a potential organ donor due to preference going to viability of organs over trying to reasonably save someone's life. Your mother must know of a case, seeing as how it happens so often for her to have such a strong grasp of how it happens.
I heard you should never drink anything a doctor offers you because it has roofies in it and you'll wake up in a bathtub full of ice with your kidney removed.
This is also a good rule for dealing with mechanics, lawyers, the guy who installs your cable, and all girls ever. You're free to ignore this rule in these contexts, sure, if you're an idiot who deserves it. Afterall, why would anyone talk to you or perform a paid service for you unless they were trying to take ur organs and mail the money back to Mexico?
The extreme examples of situations being brought to support opt-in not coming into effect do not seem realistic in the slightest. Also, with the malpractice lawsuit situation like it is, any hint of incorrect behaviour would leave hospitals, staff, doctors all open to mass lawsuits especially in cases of wrongful death. These arguments that doctors are going to cut corners to steal organs and shit like that don't hold any weight for me.
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything. I do not believe in opt out because it opens the system up to being easier to abuse.
I think a better approach to the problem would be more education in convincing people to donate their organs. When I was asked to be an organ donor it was a yes no question. I did not have the option to ask questions and get educated answers. The person at the DMV is probably not the best person to be asking about organ donation.
Perhaps we could start programs to sign people up, have like organ drives where they go out and sign up people to be organ donors. Explain whats entailed, as well as asking people specifically which organs they are ok with donating. Until i had talked to my mother I was not informed on just how much stuff they can take, i had no idea you could donate your corneas.
Anyway, i think before you institute a policy that affects everyone universally they might want to try something less invasive. Would the opt-out be kept in their medical file? A card they carry? A tattoo over their chest that says "No organs for you." How do you prevent mistakes from being made?
Increasing the number of organ donors also devalues black market organs or selling organs to people anyway, so there is even less incentive to go around organ thieving.
which would be super, because those fuckers doing Indian peasants out of their bits for equivalent AU$600 or whatever need to not be doing that, and its far more effective to make the practice both unprofitable and criminal than simply criminal.
I'm honestly going with the more likely proposition that as an ER nurse, despite likely being pretty damn proficient in the techniques of the practice, since the decision is never up to her she never paid any attention to the factors under which these things are decided but nonetheless developed the same distrust of authority that seems to pervade all of human society.
It's like most other cases of armchair ombudsmanship.
EDIT: Or, to try and be slightly less caustic - it's very easy to overhear a conversation and decide that since those distant authority figures are the ones having it that it must be being carried out maliciously especially since doctors have a good habit of talking flippantly about serious situations just because they encounter them so often.
The extreme examples of situations being brought to support opt-in not coming into effect do not seem realistic in the slightest. Also, with the malpractice lawsuit situation like it is, any hint of incorrect behaviour would leave hospitals, staff, doctors all open to mass lawsuits especially in cases of wrongful death. These arguments that doctors are going to cut corners to steal organs and shit like that don't hold any weight for me.
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything.
What the hell are you talking about? Those two situations are identical. They can't save you - that's the point. The paper is discussing the fact that they had a patient they couldn't save, but who didn't meet the technical criteria for brain death.
As opposed to posting twice i put the response to you in the same post, as i was adding it.
Correct, the patient did not meet the criteria for brain death, or even death at all for that matter. Which i found interesting. The section I posted was in reference to things that would need to occur while a patient was still alive for them to be able to extract your organs at maximum viability.
Such as testing your blood, and alerting the recipient they might have a kidney for them. Now lets extrapolate that to another patient who is not brain dead. They have much less time to get those two things done before you die. Which means they would need to perform medical procedures upon you that are not in your best interest before you die.
The point at when, where, and how that decision is made is vital to that discussion. At what point do you start injecting them with antibiotics, steroids and heparin? What happens if they stabilize and do not die?
Who pays for the blood work done to determine the viability of your organs if you do in fact not die?
Its a very complicated process, and religious concerns aside a policy change of this magnitude is going to have large and far reaching consequences. I'm looking at it from the perspective of where do things break down.
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything.
Why would they do that?[/QUOTE]
Simply put, because they may not be sure they can save you, and you indicated organ donation was important to you. So they have to juggle possibly keeping you alive, with respecting your post mortem wishes.
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything. I do not believe in opt out because it opens the system up to being easier to abuse.
I guarantee that if the choice is between saving someone who is dying right in front of you, and saving someone who is probably going to have another "opt out" donor come up anyway, you will fucking well save the person in front of you. There is no goddamn way that you would get all the staff who oversee the treatment of those kinds of patients (nurses, doctors, plus all the people who scrutinise the paperwork afterwards) to collude and pass off organs to someone else by letting someone die.
If the choice came down to one doctor, and there was even a whiff of them making the wrong choice when the dust settled, they would be crucified. We're talking loss of licence, being sued, possible criminal charges. If this shit is going on, people like your mother would have stood up and said something. It's not, because it's just fearmongering.
If anything it is more likely to happen now than it would with an opt out system, and there is no evidence. You would think that programs like A Current Affair and 60 Minutes would be all over that shit if it were.
I think a better approach to the problem would be more education in convincing people to donate their organs. When I was asked to be an organ donor it was a yes no question. I did not have the option to ask questions and get educated answers. The person at the DMV is probably not the best person to be asking about organ donation.
Perhaps we could start programs to sign people up, have like organ drives where they go out and sign up people to be organ donors. Explain whats entailed, as well as asking people specifically which organs they are ok with donating. Until i had talked to my mother I was not informed on just how much stuff they can take, i had no idea you could donate your corneas.
The best approach is education along with opt out. Hell, when people go for their learner's permit, give them the documentation. Up until the time they get their P plates, they are on the ineligible register. When they sign the final documents for their P plates, they go into the eligible register by default unless they fill in the appropriate paperwork.
And seriously, what the hell, why are you bothered by your corneas being taken? You'll be dead.
Anyway, i think before you institute a policy that affects everyone universally they might want to try something less invasive. Would the opt-out be kept in their medical file? A card they carry? A tattoo over their chest that says "No organs for you." How do you prevent mistakes from being made?
Opt out does not mean there isn't a register that gets checked. It just means that by default more people go in the "donate" registry than in the "do not harvest" registry. I think, based on this post, you are confused (possibly misinformed) as to how it would work. It would work exactly as it does now; people are identified as being organ donors, and _then_ they are subject to the appropriate harvesting. The bureaucratic process of opting in and opting out does not come into that decision process at all.
devoir on
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KageraImitating the worst people. Since 2004Registered Userregular
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything.
Why would they do that?
Simply put, because they may not be sure they can save you, and you indicated organ donation was important to you. So they have to juggle possibly keeping you alive, with respecting your post mortem wishes.
And they would risk losing their jobs, doing something they weren't trained to do, for someone they didn't know why?
What the hell are you talking about? Those two situations are identical. They can't save you - that's the point. The paper is discussing the fact that they had a patient they couldn't save, but who didn't meet the technical criteria for brain death.
As opposed to posting twice i put the response to you in the same post, as i was adding it.
Correct, the patient did not meet the criteria for brain death, or even death at all for that matter. Which i found interesting. The section I posted was in reference to things that would need to occur while a patient was still alive for them to be able to extract your organs at maximum viability.
Such as testing your blood, and alerting the recipient they might have a kidney for them. Now lets extrapolate that to another patient who is not brain dead. They have much less time to get those two things done before you die. Which means they would need to perform medical procedures upon you that are not in your best interest before you die.
What patient? What possible situation could they have much less time before they are dead? You are inventing medical fiction to support your argument and it is diverse from reality. Furthermore, in the case of the paper cited, the next of kin were consulted as to how to proceed from the point where it was decided medically that the patient was non-viable.
EDIT: And to be clear your fictional medical scenario does not hold up because you've decided the situation would arise where there's a chance that the patient would survive. Doctors would not start prepping your for transplantation if there was any chance you would live. The case in the paper cited was a situation where the patient was going to die, to medical certainty.
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything.
Why would they do that?
Simply put, because they may not be sure they can save you, and you indicated organ donation was important to you. So they have to juggle possibly keeping you alive, with respecting your post mortem wishes.
No. I don't think you understand how important it is to doctors that they do everything possible to keep someone alive unless they have a DNR. It has become such an important part of medicine that for them to make that kind of decision, they would have to violate:
a) the strongest imperative of any health worker
b) the human moral choice to keep another person alive
c) everyone else's a) and b) who will ever know the details of the situation
d) the guidelines set down by their professional association
e) the guidelines set down by their place of employment
If the choice is between some of your organs getting messed up a little bit or you living, it is not a choice.
And this is possibly the single most improbable situation I have ever argued against in my entire time on this board, where you see dozens of hypotheticals brought up everyday in discussions just like this in relation to any number of topics.
devoir on
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KageraImitating the worst people. Since 2004Registered Userregular
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything.
Why would they do that?
Simply put, because they may not be sure they can save you, and you indicated organ donation was important to you. So they have to juggle possibly keeping you alive, with respecting your post mortem wishes.
And they would risk losing their jobs, doing something they weren't trained to do, for someone they didn't know why?
Apparently the hospital makes $Texas for every organ they transplant.
I'm honestly going with the more likely proposition that as an ER nurse, despite likely being pretty damn proficient in the techniques of the practice, since the decision is never up to her she never paid any attention to the factors under which these things are decided but nonetheless developed the same distrust of authority that seems to pervade all of human society.
It's like most other cases of armchair ombudsmanship.
EDIT: Or, to try and be slightly less caustic - it's very easy to overhear a conversation and decide that since those distant authority figures are the ones having it that it must be being carried out maliciously especially since doctors have a good habit of talking flippantly about serious situations just because they encounter them so often.
Nursing is quite a bit different than your average TV show. Nurses also have a good habit of talking about serious situations that they encounter often. Also it helps to have a bit of gallows humor. The story of the hobo who jumped in front of the train, and was rushed to the ER with his leg in a 5 gallon bucket of ice remains one of my moms favorite stories. Imagine a ward full of nurses scrambling to find a missing leg because no one is sure where it got put down. Ended up being in the employee lounge by the ice machine.
Anyway, on a more grim note in defense of nursing they have a very hard job. They are working with 2-3 patients when it should be 1:1 based on the severity. 12 hour shifts is a long time to be on your feet. The environment sucks. However the one story i tell to people who do not think nurses have a hard job. About 10 years ago on mother day my mother came home, hugged me and cried she passed out. Come to find out that day a kid my age had been in a motorcycle accident and was brain dead. My mother was the one who had to tell her that her son was never going to wake up, and would be a vegetable the rest of his life, on mothers day.
So yes, if my mother says to keep organ donor off my license i listen to her, and relay that advice to others. They can choose to believe me, choose to think I'm full of shit, or do their own research and make an educated decision for themselves. I would rather everyone consult a doctor they trust and get both their opinion on it, and have a frank discussion about organ donation. Find out what you are, and are not comfortable donating, and notify your next of kin what you are willing to have removed.
That to me is a lot better than a government policy stating they can take everything unless you say otherwise.
So basically your concern for your decaying corpse decaying completely whole is greater than your concern for the lives of others.
Because other than religious influence, what belief can you have about organs that makes you think it would be bad to donate them?
Okay, so you're trying to detatch the emotional angle from a persons concern for their body based upon the fact that they're dead and thus can't care about anything anymore, but trying to play up the emotional angle of what happens to others after said person's death? dubious.
In life I care about my personal beliefs and take comfort in the fact that there will be some respect for those beliefs even after I'm dead. Yes, it's terrible that someone is sick and requires an organ in order to have a chance at living (not all transplants succeed), but that is neither my fault, nor does it entitle them to my body after I die. If I wish to help someone, it will be in line with my beliefs and a result of a choice I have made so that I can ensure that the decision is made in the best interests of those I care about.
What belief would make me want to hand onto my organs after death? Simple, I'm not comfortable having them taken from me. Those organs are me. That corpse - the lump of rotting meat - is me. I'd like my family to be able to say goodbye to what I felt was me and not a collection of unwanted leftovers. And then there's the fact that there's some bits I just feel should remain unique to my existance.
The whole point in an organ donor program of any kind is to avoid having to ask the permission of friends and family at the time. Grieving people are not noted for their rational decision-making ability.
And assuming the choice for someone, when they haven't gone though the important process of making that decision and discussing it with loved ones is going to make that grief better for them?
Not only do they have to cope with their grief, they also have to cope with finding out their loved one has been claimed for spares without implicit consent and potentially against their or their loved one's beliefs because they happened to be unaware of the system or didn't quite get around to claiming their rights.
You're right though, grieving relatives don't make for great decision makers. That's why the choice needs to be made and discussed beforehand. Seeing a loved one's body being harvested and given away should be an implicit choice before death, not a potentially unwelcome consequence of it.
Your story of how hard nursing is was summed in my point that nurses are not stupid and are capable practitioners of their job. It does not make them qualified, generally, to say that they know when people are being harvested over being saved when they are not qualified to determine the medical status of a patient.
EDIT: Also your final paragraph simply restates nothing that isn't covered equally well by opt-out schemes.
nursing is hard so don't be an organ donor unless you've really really thought about it?
one, A doesn't even remotely follow B, and two, there's no compulsion involved. Its really easy to say 'no thanks'. Teh gubmint isn't stealing anything.
So yes, if my mother says to keep organ donor off my license i listen to her, and relay that advice to others. They can choose to believe me, choose to think I'm full of shit, or do their own research and make an educated decision for themselves. I would rather everyone consult a doctor they trust and get both their opinion on it, and have a frank discussion about organ donation. Find out what you are, and are not comfortable donating, and notify your next of kin what you are willing to have removed.
That to me is a lot better than a government policy stating they can take everything unless you say otherwise.
Sorry to be utterly heartless, but none of the stories you laid out give any kind of credence to this theory that doctors operate secretly trying to harvest organs where possible. You've changed your tune from them making money off it, to them trying to respect your wishes as an organ donor, and I think, demonstrated that your primary basis for your objection to this is an emotional attachment that your mother has strongly encouraged in you.
I suggest that if you truly believe this, that you ask your mother for detailed situations in which doctors have made a choice to harvest which has resulted in someone not being given the very best medical attention reasonably possible to ensure that they live. You've suggested that others talk to their GPs, but by the sounds of it you haven't been given much more than an emotional mother's request so that she can bury you whole should the time come in her lifetime.
If that's why she said you shouldn't donate organs, that's fine. It's an acceptable reason for doing so, just like any other reason to opt out. It is not the basis for an argument against a policy move which will save lives and give more meaning to death.
The best approach is education along with opt out. Hell, when people go for their learner's permit, give them the documentation. Up until the time they get their P plates, they are on the ineligible register. When they sign the final documents for their P plates, they go into the eligible register by default unless they fill in the appropriate paperwork.
And seriously, what the hell, why are you bothered by your corneas being taken? You'll be dead.
Because i feel that putting people on the spot with a yes or no question, a stack of papers, and a person completely unqualified to answer their questions is not the best way to get them to say yes. As for my corneas, i just happen to like my eyes inside my head.
Opt out does not mean there isn't a register that gets checked. It just means that by default more people go in the "donate" registry than in the "do not harvest" registry. I think, based on this post, you are confused (possibly misinformed) as to how it would work. It would work exactly as it does now; people are identified as being organ donors, and _then_ they are subject to the appropriate harvesting. The bureaucratic process of opting in and opting out does not come into that decision process at all.
It means everyone goes into the registry and people remove themselves. Which changes the way things are handled from "might be an organ donor", to "most likely an organ donor."
Considering the policy is in Australia, with a different system of medical care it would/will be interesting to see how this policy turns out. I do not think it is something that the American medical system would be able to efficiently handle.
Opt out does not mean there isn't a register that gets checked. It just means that by default more people go in the "donate" registry than in the "do not harvest" registry. I think, based on this post, you are confused (possibly misinformed) as to how it would work. It would work exactly as it does now; people are identified as being organ donors, and _then_ they are subject to the appropriate harvesting. The bureaucratic process of opting in and opting out does not come into that decision process at all.
It means everyone goes into the registry and people remove themselves. Which changes the way things are handled from "might be an organ donor", to "most likely an organ donor."
Considering the policy is in Australia, with a different system of medical care it would/will be interesting to see how this policy turns out. I do not think it is something that the American medical system would be able to efficiently handle.
Which is only a concern under your fictional medical scenarios which fail the test of internal consistency. You start with the premise "if doctors think you're probably an organ donor, they will not treat you" - to remove the bullshit flourish added around that last part, this is what you're argument boils down to.
Sorry to be utterly heartless, but none of the stories you laid out give any kind of credence to this theory that doctors operate secretly trying to harvest organs where possible. You've changed your tune from them making money off it, to them trying to respect your wishes as an organ donor, and I think, demonstrated that your primary basis for your objection to this is an emotional attachment that your mother has strongly encouraged in you.
I suggest that if you truly believe this, that you ask your mother for detailed situations in which doctors have made a choice to harvest which has resulted in someone not being given the very best medical attention reasonably possible to ensure that they live. You've suggested that others talk to their GPs, but by the sounds of it you haven't been given much more than an emotional mother's request so that she can bury you whole should the time come in her lifetime.
If that's why she said you shouldn't donate organs, that's fine. It's an acceptable reason for doing so, just like any other reason to opt out. It is not the basis for an argument against a policy move which will save lives and give more meaning to death.
Oh i completely agree that my emotional attachment to my mother is why I feel the way i do. However you miss the fact that i am an organ donor. I just do not have it on my drivers license. She is also an organ donor. However her advice was not do not donate your organs. Her advice was to make sure that they do everything they can to keep their focus on keeping you alive, as opposed to worrying about the maximum viability of organ transfer. When they contact her to let her know i have been in a horribly accident, advise her that I am in fact brain dead, and would like to know if they can have my organs and that point she would tell them what to take.
Either way, i don't drink much so some poor alcoholic will be enjoying my liver.
I really don't think you're in a position to judge a foreign country's health system, D. Aside from your arguments making no sense on the sole basis of 'you can't trust those shifty doctors' and 'no-one will check the registry before passing the scalpel'.
I really don't think you're in a position to judge a foreign country's health system,
Oh I agree, I am in no more of a position to judge Australia than an Australian has to judge America's fucked up health care system. Its just one of those things where you have to live there.
The best approach is education along with opt out. Hell, when people go for their learner's permit, give them the documentation. Up until the time they get their P plates, they are on the ineligible register. When they sign the final documents for their P plates, they go into the eligible register by default unless they fill in the appropriate paperwork.
And seriously, what the hell, why are you bothered by your corneas being taken? You'll be dead.
Because i feel that putting people on the spot with a yes or no question, a stack of papers, and a person completely unqualified to answer their questions is not the best way to get them to say yes. As for my corneas, i just happen to like my eyes inside my head.
You're not comprehending what I'm writing. You get given everything when you go for your Learners, all the relevant documentation, a recommendation to talk to your family and your GP. Until you get your P plates (i.e. 18 years old, age of consent, adulthood etc), you are ineligible anyway. If you decide against it, when you get that P plate licence, you opt out. You have plenty of time from the time you get your L plates to when you get your P plates to do your own research, read everything given to you at the initial point of contact and ask your questions.
It means everyone goes into the registry and people remove themselves. Which changes the way things are handled from "might be an organ donor", to "most likely an organ donor."
No. You have this increasingly ridiculous view of doctors and the realities that they face in terms of being sued, licensed removed and possibly jailed. It will be checked, just like it is now. No doctor is going to jump in with scalpel and start hacking away at someone without getting the all clear that they are a donor. No doctor. I wouldn't do it, you wouldn't do it, why are doctors these fucking monsters?
Considering the policy is in Australia, with a different system of medical care it would/will be interesting to see how this policy turns out. I do not think it is something that the American medical system would be able to efficiently handle.
I have no idea what you're talking about here. I am an Australian. I'm talking about the Australian system. I only have experience with the Australia system, I'm not arguing based on the American system.
If anything the American medical health system has an advantage that we do not; indexing and reference via the social security number.
This is chain-email stupid. Anyone can look at the incentives (nothing) and the punishment (career destruction), and know what the outcome will be. How can any doctor/nurse with a brain pick the wrong choice here?
The whole point in an organ donor program of any kind is to avoid having to ask the permission of friends and family at the time. Grieving people are not noted for their rational decision-making ability.
And assuming the choice for someone, when they haven't gone though the important process of making that decision and discussing it with loved ones is going to make that grief better for them?
Not only do they have to cope with their grief, they also have to cope with finding out their loved one has been claimed for spares without implicit consent and potentially against their or their loved one's beliefs because they happened to be unaware of the system or didn't quite get around to claiming their rights.
You're right though, grieving relatives don't make for great decision makers. That's why the choice needs to be made and discussed beforehand. Seeing a loved one's body being harvested and given away should be an implicit choice before death, not a potentially unwelcome consequence of it.
I wrote that, not Kagera. If you have a problem with your organs being used, then my view is that it's your responsibility to do something about it. Part of the disconnect between us is that I'm honestly struggling with the idea that families or next of kin would object to it having happened if they discovered it after the fact.
As I've said already, I'm principally basing this on the idea that the majority of people aren't going to have a problem with the idea of their organs being harvested. If that isn't the case, hen I'm disappointed in humanity generally.
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AegeriTiny wee bacteriumsPlateau of LengRegistered Userregular
This is chain-email stupid. Anyone can look at the incentives (nothing) and the punishment (career destruction), and know what the outcome will be. How can any doctor/nurse with a brain pick the wrong choice here?
Particularly in a country with a generally socialist healthcare system anyway.
I don't believe doctors care about a persons organs more than the individual, but there are some cases where a person would be technically dead but have perfectly viable organs still (which can and does happen), that would be useable under this system. Otherwise it's mostly pro-wormfood anti-living people rhetoric.
Oh i completely agree that my emotional attachment to my mother is why I feel the way i do. However you miss the fact that i am an organ donor. I just do not have it on my drivers license. She is also an organ donor. However her advice was not do not donate your organs. Her advice was to make sure that they do everything they can to keep their focus on keeping you alive, as opposed to worrying about the maximum viability of organ transfer. When they contact her to let her know i have been in a horribly accident, advise her that I am in fact brain dead, and would like to know if they can have my organs and that point she would tell them what to take.
Either way, i don't drink much so some poor alcoholic will be enjoying my liver.
While I applaud you for being upfront and clear (I'd be very surprised if anyone else realised that you were a donor), you still continue to miss a very clear and precise question I'm raising.
Does you mother have any kind of details on a situation in which a doctor has made a choice that negatively impacted a person's chance of survival due to a desire to more effectively harvest organs?
Because if she does, she has not done her duty of care and informed the proper authorities.
If she does not, she is scaremongering and has encouraged in you a perverse fear of doctors and their motives.
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Oh, I know. I'm just pointing out that whatever reasons people put forward, it's basically that they're uncomfortable with being painted as the ones being selfish/unreasonable.
Also if they can't stop the bleeding in a car crash they sure as fuck can't keep you alive anyway.
http://bja.oxfordjournals.org/cgi/content/full/94/4/474
Its from an article in the UK. Interesting read if you have the time its discussing the ethical concerns of organ donation in non heart beating donors. Ive quoted a section here
Also you are correct, if they cant stop the bleeding then they cannot save your life. However at what point do they stop trying? When its at maximum viability to extract the organs, or past the point they can save you?
It's just paranoia.
What the hell are you talking about? Those two situations are identical. They can't save you - that's the point. The paper is discussing the fact that they had a patient they couldn't save, but who didn't meet the technical criteria for brain death.
Please show me in the last 20 years a case in Australia where someone's family has sued (not won, but just sued) for wrongful death in the case of a potential organ donor due to preference going to viability of organs over trying to reasonably save someone's life. Your mother must know of a case, seeing as how it happens so often for her to have such a strong grasp of how it happens.
This is also a good rule for dealing with mechanics, lawyers, the guy who installs your cable, and all girls ever. You're free to ignore this rule in these contexts, sure, if you're an idiot who deserves it. Afterall, why would anyone talk to you or perform a paid service for you unless they were trying to take ur organs and mail the money back to Mexico?
I agree that we are discussing extreme examples, that are unlikely to be an every day occurance. The doctors are not acting maliciously however, they are not "stealing organs" they are just adding organ viability to the equation which may or may not change anything. I do not believe in opt out because it opens the system up to being easier to abuse.
I think a better approach to the problem would be more education in convincing people to donate their organs. When I was asked to be an organ donor it was a yes no question. I did not have the option to ask questions and get educated answers. The person at the DMV is probably not the best person to be asking about organ donation.
Perhaps we could start programs to sign people up, have like organ drives where they go out and sign up people to be organ donors. Explain whats entailed, as well as asking people specifically which organs they are ok with donating. Until i had talked to my mother I was not informed on just how much stuff they can take, i had no idea you could donate your corneas.
Anyway, i think before you institute a policy that affects everyone universally they might want to try something less invasive. Would the opt-out be kept in their medical file? A card they carry? A tattoo over their chest that says "No organs for you." How do you prevent mistakes from being made?
It's like most other cases of armchair ombudsmanship.
EDIT: Or, to try and be slightly less caustic - it's very easy to overhear a conversation and decide that since those distant authority figures are the ones having it that it must be being carried out maliciously especially since doctors have a good habit of talking flippantly about serious situations just because they encounter them so often.
Why would they do that?
As opposed to posting twice i put the response to you in the same post, as i was adding it.
Correct, the patient did not meet the criteria for brain death, or even death at all for that matter. Which i found interesting. The section I posted was in reference to things that would need to occur while a patient was still alive for them to be able to extract your organs at maximum viability.
Such as testing your blood, and alerting the recipient they might have a kidney for them. Now lets extrapolate that to another patient who is not brain dead. They have much less time to get those two things done before you die. Which means they would need to perform medical procedures upon you that are not in your best interest before you die.
The point at when, where, and how that decision is made is vital to that discussion. At what point do you start injecting them with antibiotics, steroids and heparin? What happens if they stabilize and do not die?
Who pays for the blood work done to determine the viability of your organs if you do in fact not die?
Its a very complicated process, and religious concerns aside a policy change of this magnitude is going to have large and far reaching consequences. I'm looking at it from the perspective of where do things break down.
Why would they do that?[/QUOTE]
Simply put, because they may not be sure they can save you, and you indicated organ donation was important to you. So they have to juggle possibly keeping you alive, with respecting your post mortem wishes.
I guarantee that if the choice is between saving someone who is dying right in front of you, and saving someone who is probably going to have another "opt out" donor come up anyway, you will fucking well save the person in front of you. There is no goddamn way that you would get all the staff who oversee the treatment of those kinds of patients (nurses, doctors, plus all the people who scrutinise the paperwork afterwards) to collude and pass off organs to someone else by letting someone die.
If the choice came down to one doctor, and there was even a whiff of them making the wrong choice when the dust settled, they would be crucified. We're talking loss of licence, being sued, possible criminal charges. If this shit is going on, people like your mother would have stood up and said something. It's not, because it's just fearmongering.
If anything it is more likely to happen now than it would with an opt out system, and there is no evidence. You would think that programs like A Current Affair and 60 Minutes would be all over that shit if it were.
The best approach is education along with opt out. Hell, when people go for their learner's permit, give them the documentation. Up until the time they get their P plates, they are on the ineligible register. When they sign the final documents for their P plates, they go into the eligible register by default unless they fill in the appropriate paperwork.
And seriously, what the hell, why are you bothered by your corneas being taken? You'll be dead.
Opt out does not mean there isn't a register that gets checked. It just means that by default more people go in the "donate" registry than in the "do not harvest" registry. I think, based on this post, you are confused (possibly misinformed) as to how it would work. It would work exactly as it does now; people are identified as being organ donors, and _then_ they are subject to the appropriate harvesting. The bureaucratic process of opting in and opting out does not come into that decision process at all.
And now we know the truth as to why Cloud didn't revive Aeris, he was smuggling organs.
And they would risk losing their jobs, doing something they weren't trained to do, for someone they didn't know why?
EDIT: And to be clear your fictional medical scenario does not hold up because you've decided the situation would arise where there's a chance that the patient would survive. Doctors would not start prepping your for transplantation if there was any chance you would live. The case in the paper cited was a situation where the patient was going to die, to medical certainty.
Descendants of the Ancients' organs are probably worth more than your organs and mine put together.
No. I don't think you understand how important it is to doctors that they do everything possible to keep someone alive unless they have a DNR. It has become such an important part of medicine that for them to make that kind of decision, they would have to violate:
a) the strongest imperative of any health worker
b) the human moral choice to keep another person alive
c) everyone else's a) and b) who will ever know the details of the situation
d) the guidelines set down by their professional association
e) the guidelines set down by their place of employment
If the choice is between some of your organs getting messed up a little bit or you living, it is not a choice.
And this is possibly the single most improbable situation I have ever argued against in my entire time on this board, where you see dozens of hypotheticals brought up everyday in discussions just like this in relation to any number of topics.
Apparently the hospital makes $Texas for every organ they transplant.
Nursing is quite a bit different than your average TV show. Nurses also have a good habit of talking about serious situations that they encounter often. Also it helps to have a bit of gallows humor. The story of the hobo who jumped in front of the train, and was rushed to the ER with his leg in a 5 gallon bucket of ice remains one of my moms favorite stories. Imagine a ward full of nurses scrambling to find a missing leg because no one is sure where it got put down. Ended up being in the employee lounge by the ice machine.
Anyway, on a more grim note in defense of nursing they have a very hard job. They are working with 2-3 patients when it should be 1:1 based on the severity. 12 hour shifts is a long time to be on your feet. The environment sucks. However the one story i tell to people who do not think nurses have a hard job. About 10 years ago on mother day my mother came home, hugged me and cried she passed out. Come to find out that day a kid my age had been in a motorcycle accident and was brain dead. My mother was the one who had to tell her that her son was never going to wake up, and would be a vegetable the rest of his life, on mothers day.
So yes, if my mother says to keep organ donor off my license i listen to her, and relay that advice to others. They can choose to believe me, choose to think I'm full of shit, or do their own research and make an educated decision for themselves. I would rather everyone consult a doctor they trust and get both their opinion on it, and have a frank discussion about organ donation. Find out what you are, and are not comfortable donating, and notify your next of kin what you are willing to have removed.
That to me is a lot better than a government policy stating they can take everything unless you say otherwise.
Okay, so you're trying to detatch the emotional angle from a persons concern for their body based upon the fact that they're dead and thus can't care about anything anymore, but trying to play up the emotional angle of what happens to others after said person's death? dubious.
In life I care about my personal beliefs and take comfort in the fact that there will be some respect for those beliefs even after I'm dead. Yes, it's terrible that someone is sick and requires an organ in order to have a chance at living (not all transplants succeed), but that is neither my fault, nor does it entitle them to my body after I die. If I wish to help someone, it will be in line with my beliefs and a result of a choice I have made so that I can ensure that the decision is made in the best interests of those I care about.
What belief would make me want to hand onto my organs after death? Simple, I'm not comfortable having them taken from me. Those organs are me. That corpse - the lump of rotting meat - is me. I'd like my family to be able to say goodbye to what I felt was me and not a collection of unwanted leftovers. And then there's the fact that there's some bits I just feel should remain unique to my existance.
And assuming the choice for someone, when they haven't gone though the important process of making that decision and discussing it with loved ones is going to make that grief better for them?
Not only do they have to cope with their grief, they also have to cope with finding out their loved one has been claimed for spares without implicit consent and potentially against their or their loved one's beliefs because they happened to be unaware of the system or didn't quite get around to claiming their rights.
You're right though, grieving relatives don't make for great decision makers. That's why the choice needs to be made and discussed beforehand. Seeing a loved one's body being harvested and given away should be an implicit choice before death, not a potentially unwelcome consequence of it.
Your story of how hard nursing is was summed in my point that nurses are not stupid and are capable practitioners of their job. It does not make them qualified, generally, to say that they know when people are being harvested over being saved when they are not qualified to determine the medical status of a patient.
EDIT: Also your final paragraph simply restates nothing that isn't covered equally well by opt-out schemes.
one, A doesn't even remotely follow B, and two, there's no compulsion involved. Its really easy to say 'no thanks'. Teh gubmint isn't stealing anything.
Sorry to be utterly heartless, but none of the stories you laid out give any kind of credence to this theory that doctors operate secretly trying to harvest organs where possible. You've changed your tune from them making money off it, to them trying to respect your wishes as an organ donor, and I think, demonstrated that your primary basis for your objection to this is an emotional attachment that your mother has strongly encouraged in you.
I suggest that if you truly believe this, that you ask your mother for detailed situations in which doctors have made a choice to harvest which has resulted in someone not being given the very best medical attention reasonably possible to ensure that they live. You've suggested that others talk to their GPs, but by the sounds of it you haven't been given much more than an emotional mother's request so that she can bury you whole should the time come in her lifetime.
If that's why she said you shouldn't donate organs, that's fine. It's an acceptable reason for doing so, just like any other reason to opt out. It is not the basis for an argument against a policy move which will save lives and give more meaning to death.
Because i feel that putting people on the spot with a yes or no question, a stack of papers, and a person completely unqualified to answer their questions is not the best way to get them to say yes. As for my corneas, i just happen to like my eyes inside my head.
It means everyone goes into the registry and people remove themselves. Which changes the way things are handled from "might be an organ donor", to "most likely an organ donor."
Considering the policy is in Australia, with a different system of medical care it would/will be interesting to see how this policy turns out. I do not think it is something that the American medical system would be able to efficiently handle.
Oh i completely agree that my emotional attachment to my mother is why I feel the way i do. However you miss the fact that i am an organ donor. I just do not have it on my drivers license. She is also an organ donor. However her advice was not do not donate your organs. Her advice was to make sure that they do everything they can to keep their focus on keeping you alive, as opposed to worrying about the maximum viability of organ transfer. When they contact her to let her know i have been in a horribly accident, advise her that I am in fact brain dead, and would like to know if they can have my organs and that point she would tell them what to take.
Either way, i don't drink much so some poor alcoholic will be enjoying my liver.
Oh I agree, I am in no more of a position to judge Australia than an Australian has to judge America's fucked up health care system. Its just one of those things where you have to live there.
You're not comprehending what I'm writing. You get given everything when you go for your Learners, all the relevant documentation, a recommendation to talk to your family and your GP. Until you get your P plates (i.e. 18 years old, age of consent, adulthood etc), you are ineligible anyway. If you decide against it, when you get that P plate licence, you opt out. You have plenty of time from the time you get your L plates to when you get your P plates to do your own research, read everything given to you at the initial point of contact and ask your questions.
No. You have this increasingly ridiculous view of doctors and the realities that they face in terms of being sued, licensed removed and possibly jailed. It will be checked, just like it is now. No doctor is going to jump in with scalpel and start hacking away at someone without getting the all clear that they are a donor. No doctor. I wouldn't do it, you wouldn't do it, why are doctors these fucking monsters?
I have no idea what you're talking about here. I am an Australian. I'm talking about the Australian system. I only have experience with the Australia system, I'm not arguing based on the American system.
If anything the American medical health system has an advantage that we do not; indexing and reference via the social security number.
I wrote that, not Kagera. If you have a problem with your organs being used, then my view is that it's your responsibility to do something about it. Part of the disconnect between us is that I'm honestly struggling with the idea that families or next of kin would object to it having happened if they discovered it after the fact.
As I've said already, I'm principally basing this on the idea that the majority of people aren't going to have a problem with the idea of their organs being harvested. If that isn't the case, hen I'm disappointed in humanity generally.
Particularly in a country with a generally socialist healthcare system anyway.
I don't believe doctors care about a persons organs more than the individual, but there are some cases where a person would be technically dead but have perfectly viable organs still (which can and does happen), that would be useable under this system. Otherwise it's mostly pro-wormfood anti-living people rhetoric.
While I applaud you for being upfront and clear (I'd be very surprised if anyone else realised that you were a donor), you still continue to miss a very clear and precise question I'm raising.
Does you mother have any kind of details on a situation in which a doctor has made a choice that negatively impacted a person's chance of survival due to a desire to more effectively harvest organs?
Because if she does, she has not done her duty of care and informed the proper authorities.
If she does not, she is scaremongering and has encouraged in you a perverse fear of doctors and their motives.