Opt-Out Organ Donation

bnt

As of January 1, France has brought in an opt-out system for organ donations. Unless you are on an official refusal register, organ donation will be a possiblity, regardless of what next-of-kin say at that time.

Here in in Ireland, there is talk of legislating a "soft opt-out" position, as in this press release. The idea is similar to France's except that next-of-kin will have the right of refusal.

Personally, I think France has the right idea. The "soft" opt-out position under discussion for Ireland doesn't tackle the main reason there is a shortage of donor organs in the first place: the next-of-kin saying "no". They already have the ability to give consent, regardless of whether or not the deceased carried a donor card, but it's very easy to fall back on a default position of "no" if you don't understand something.

So I'm favour of the French position, both for what it is, and also for the fact that it's forcing people to talk about what they want while they are able to do so. The minutes or hours after a loved one has died are not the time to have this discussion for the first time. Organ donation is a time-critical process - there is no time for next-of-kin to go away and have a think about it.

ohnonotgmail

They can have mine if they want but they'll be fairly well used by the time i'm done with them.

It's fine as opt-in, it's the whole thing of asking grieving people for permission that's the issue. I don't have a donor card because it means nothing, my family know what I'd want.

Vic_08

bnt wrote: »

As of January 1, France has brought in an opt-out system for organ donations. Unless you are on an official refusal register, organ donation will be a possiblity, regardless of what next-of-kin say at that time.

Here in in Ireland, there is talk of legislating a "soft opt-out" position, as in this press release. The idea is similar to France's except that next-of-kin will have the right of refusal.

Personally, I think France has the right idea. The "soft" opt-out position under discussion for Ireland doesn't tackle the main reason there is a shortage of donor organs in the first place: the next-of-kin saying "no". They already have the ability to give consent, regardless of whether or not the deceased carried a donor card, but it's very easy to fall back on a default position of "no" if you don't understand something.

So I'm favour of the French position, both for what it is, and also for the fact that it's forcing people to talk about what they want while they are able to do so. The minutes or hours after a loved one has died are not the time to have this discussion for the first time. Organ donation is a time-critical process - there is no time for next-of-kin to go away and have a think about it.

I'd go further and disqualify people that opt out from receiving donated organs.

sashafierce

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Vic_08

Deleted User wrote: »

It's fine as opt-in, it's the whole thing of asking grieving people for permission that's the issue. I don't have a donor card because it means nothing, my family know what I'd want.

It's not fine, people die every day waiting for transplants while viable organs are left to rot in a pine box.

Hector Bellend

Nobody wants my liver

Vic_08

Vic_08 wrote: »

It's not fine, people die every day waiting for transplants while viable organs are left to rot in a pine box.

And having grieving people have the final decision ain't gonna fix that.

the_pen_turner

A relative of mine needed a new kidney. He went on the list and all that.
They were at some group meeting or I formation night or some such on the ins and outs of it. (Pardon the pun)
The person there hand d out leaflets on donation and signing up.

My mother was down at the house a few days later to see how he was. Got talking about the sheet on donating.
Turns out all 5 of his family refused to sign into be doners. Because the didn't like the idea of it. All the while having g their son and brother dying while waiting g for a kidney

He got it in the end

sashafierce

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aphex™

I read with collision avoidence systems and auto pilot in new cars theres going to be a huge decrease in available tissue in years to come.

Squeeonline

Hector Bellend wrote: »

Nobody wants my liver

Mine is well exercised. Preserved well.

Crea

aphex™ wrote: »

I read with collision avoidence systems and auto pilot in new cars theres going to be a huge decrease in available tissue in years to come.

The motorcyclists will make up for it

maudgonner

I think soft opt-out would be a great thing. I'm hugely in favour of organ donation and have made my wishes clear.

I've also been there when a family member's organs were donated, and while it was absolutely the right decision for them, it's not an easy one. I can see how some families would find it incredibly difficult and traumatising to have their loved one's organs donated against their wishes.

So while I'd prefer hard opt-out to seeing people die needlessly, I think soft opt-out is a good middle-ground that would hopefully improve donation rates enough to meet need. I'd love to see that brought in very soon.

sashafierce

sashafierce wrote: »

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Even without the automatic thing just have it so that if someone registers then it's done.

gramar

Crea wrote: »

The motorcyclists will make up for it

Better again.

freedominacup

Vic_08 wrote: »

I'd go further and disqualify people that opt out from receiving donated organs.

Perfectly logical. Never occured to me though. The process to opt out should require a serious amount of hassle and expense.

Agree fully OP. If anybody remembers - I certainly do as it was a flagrant abuse of any serious data protection legislation - when that gobshíte Noel Dempsey was minister in charge of the electoral register he made his law (the Electoral (Amendment) Bill 2000) so that our personal details could be used by commercial entities for targeting us unless we opted out.

That's our government: we have to opt out when our data during our life is being given en masse to private companies for marketing purposes; we have to opt in if we would like our organs after our death to save somebody's life. Wonderfully revealing priorities from Irish legislators. Wonderful.

seamus

I think you'd be surprised the amount of people who silently have a problem with this. People are funny and squeamish and sentimental about death. I've heard people saying things like, "I'd be OK donating my kidneys, but I'd feel weird thinking that someone might have my eyes". And "I don't like the idea that doctors could just take bits without asking".

What difference does it make, you're dead!

The main issue in an Irish context is that of property rights. Ownership of the body passes to the next-of-kin, so the state cannot just step in and assert ownership in the timeframe required to make the decision about organ donation. You also cannot enter into agreements that take effect after your death - dead people can't fulfil contracts, so no matter what agreements you have made about donating all or part of your body, those agreements are invalid when you die. Ownership of your body has passed to someone else, and they are not party to those agreements and therefore not bound by them.

This is why the "soft opt-out" is the proposal on the table. A conversion to a proper opt-out system would likely be subject to a lot of challenge from certain groups and may even require a constitutional amendment/referendum.

Disqualifying non-donors from receiving organs is an idea, but still encounters the same ownership problem. They can opt-in so they get on the transplant list, but then the family can just refuse after they die.

maudgonner

freedominacup wrote: »

Perfectly logical. Never occured to me though. The process to opt out should require a serious amount of hassle and expense.

Don't agree with this at all. The opt-out process should not cost money and be simple enough that anyone can do it without, for example, needing to pay for legal advice.

It's bad enough that our health system is two-tier, making organ donation something that poorer people or less educated people are forced into would be the wrong signal to send, in my opinion.

People need to trust the system. This would damage that trust.

freedominacup

maudgonner wrote: »

People need to trust the system. This would damage that trust.

People need to grow up. Rich/poor doesn't come into it. It does make a difference to recipients.

seamus

maudgonner wrote: »

Don't agree with this at all. The opt-out process should not cost money and be simple enough that anyone can do it without, for example, needing to pay for legal advice.

But not so simple though that someone could put up a link on facebook with an hysterical false claim about hospitals harvesting organs for profit and urging everyone to opt-out immediately. Because that's what would happen.

Opting out should be free, but annoying enough that only the determined will go through with it. Like having to make an appointment with the GRO and attend in person.

sashafierce

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sashafierce

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maudgonner

seamus wrote: »

I think you'd be surprised the amount of people who silently have a problem with this. People are funny and squeamish and sentimental about death. I've heard people saying things like, "I'd be OK donating my kidneys, but I'd feel weird thinking that someone might have my eyes". And "I don't like the idea that doctors could just take bits without asking".

What difference does it make, you're dead!

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.

ScumLord

seamus wrote: »

I think you'd be surprised the amount of people who silently have a problem with this. People are funny and squeamish and sentimental about death. I've heard people saying things like, "I'd be OK donating my kidneys, but I'd feel weird thinking that someone might have my eyes". And "I don't like the idea that doctors could just take bits without asking".

What difference does it make, you're dead!

And in heaven with Jesus, what if you're having a pint with Jesus and then look over at the window only to see dude looking back at you lovingly because you're eyes are now in his girlfreind, as we all know, the eyes are the window to the soul.

You also cannot enter into agreements that take effect after your death - dead people can't fulfil contracts, so no matter what agreements you have made about donating all or part of your body, those agreements are invalid when you die.

How come a will doesn't have the same problem?

Reg'stoy

I'm going to wait on the god botherers and the same people who think we're all being dumbed down by chemtrails and that vaccines are laced with cancer to kill us all off and see if they object to this. I want to find out from them if my organs will be harvested and given to Chinese Billionaires or if I'm going to be resurrected minus my testicles on judgement day.

seamus

ScumLord wrote: »

How come a will doesn't have the same problem?

It kind of does, any agreement to do something after your death will be invalid unless it's stated in the will.
Someone could make a claim against the estate, but unless you could prove that a debt has been incurred, any agreement not in the will would be unlikely to be enforced.

So if you told your next door neighbour, for example, that he could have half your garden after you die, but you actually give it to your son in your will, the neighbour would be unlikely to be able to claim what was agreed.

But in any case, the probate process takes too long for either organ or bodily donation. The process is rarely started until the body is well in the ground. Until that point, functional control over the estate (and therefore the body) lies with the next-of-kin or executor.

eviltwin

freedominacup wrote: »

People need to grow up. Rich/poor doesn't come into it. It does make a difference to recipients.

It's not just about the recipient. Every one in the process deserves respect and consideration especially the family who have just lost their loved one and even the deceased.

Im all for Organ donation, but I'll admit, that I would hate for any of my organs to go to some aul bastard like David Rockefeller, who is reported to have had 5 or 6 heart transplants.

Wrongly or rightly, I would hate that

freedominacup

eviltwin wrote: »

It's not just about the recipient. Every one in the process deserves respect and consideration especially the family who have just lost their loved one and even the deceased.

I meant that the transplant process is expensive and can be particularly difficult where both parents are working where you are talking about young children. We had a good fundraiser locally here around 12 months ago. 35k raised just to cover income loss and travel for parents of a little girl needing a multi organ transplant. Her dad was on the points of giving some/part of his own organs to keep her going a few months ago but a donor came up at last minute. As I said people need to grow up. Opt out only and extremely difficult, time consuming and expensive to get it is the only way.

ohnonotgmail

freedominacup wrote: »

I meant that the transplant process is expensive and can be particularly difficult where both parents are working where you are talking about young children. We had a good fundraiser locally here around 12 months ago. 35k raised just to cover income loss and travel for parents of a little girl needing a multi organ transplant. Her dad was on the points of giving some/part of his own organs to keep her going a few months ago but a donor came up at last minute. As I said people need to grow up. Opt out only and extremely difficult, time consuming and expensive to get it is the only way.

You think people should have to pay to opt out? They should pay to keep themselves intact after death? I'm all for organ donation but this kind of attitude is just going to turn people against it.

weldoninhio

freedominacup wrote: »

I meant that the transplant process is expensive and can be particularly difficult where both parents are working where you are talking about young children. We had a good fundraiser locally here around 12 months ago. 35k raised just to cover income loss and travel for parents of a little girl needing a multi organ transplant. Her dad was on the points of giving some/part of his own organs to keep her going a few months ago but a donor came up at last minute. As I said people need to grow up. Opt out only and extremely difficult, time consuming and expensive to get it is the only way.

Absolute nonsense. It should be a choice. No one should be forced to give up any part of their body before or after death.

I won't be donating any of my organs when I die.

carrieb

I really don't understand why anybody would not donate. I am very very pro donating and my parents and partner know this. I carry a card too. I think that a family member blocking a donation is absolutely disgusting. I would be all for a strong, not soft, opt out.

RobertKK

It is all going to be irrelevant in the next 20 years or so when we can get new bits using our own DNA to grow organs or bone in the lab.

Though they don't seem to be too far off.
http://www.popsci.com/scientists-grow-transplantable-hearts-with-stem-cells

Parchment

I cannot comprehend not being ok with being an organ donor. You're dead - give someone else a chance at life.

end of the road

Vic_08 wrote: »

I'd go further and disqualify people that opt out from receiving donated organs.

so, people should be left to die for not making the "right choice" . i wonder what type of person that reminds me of. oh yes.

freedominacup wrote: »

People need to grow up. Rich/poor doesn't come into it. It does make a difference to recipients.

"people" don't need to "grow up" . the proposal of having the opt out as an expensive undertaking = a 2 tier system where only those who can afford to opt out can and everyone else doesn't get a choice. not only is that ridiculous but actually it's undemocratic, and any attempt to introduce such nonsense would have to be stamped out hard, using all means necessary. freedom of choice is absolute.

osarusan

It should be opt out, but opting out should be easy enough.

Family (even immediate family) should have no say in it though (in the case of adults at least).

sillysmiles

weldoninhio wrote: »

Absolute nonsense. It should be a choice. No one should be forced to give up any part of their body before or after death.

I won't be donating any of my organs when I die.

I don't think I've spoken to anyone who is stauchly anti-donation. While that is your right, but you mind elaborating on why you feel that way.

Anita Blow

The evidence shows that an opt-out system doesn't drastically improve organ donation rates. The rate-limiting step in organ donation is organ donation infrastructure, which is how Spain came to be one of the best countries in the world for organ donation. I do favour a soft opt-out option but it should be accompanied by investment in transplant coordinators and means of transporting the organs in a timely fashion. Going from having 50 potential donors in a hospital to 200 means feck all if they can't be identified ahead of time, the family counselled regarding organ donation and the physical infrastructure being in place to get the organs to the recipients. 
Of course that requires investment so the government will be happy to just switch to an opt-out system to give the illusion they're doing something while in fact spending no money

bnt

I'm a bit confused by the above post, which says that opt-out doesn't drastically improve organ donation rates, then goes on to say that there would need to be significant improvements in organ donation infrastructure to cope with the ... drastic increase in organ donations?

Yes, opt-out on its own, without other improvements to the system, would be problematic. If you read the OP again you can take that as read. And as for the evidence that opt-out does improve rates, a 2009 New York Times article on the topic cited the differences between Germany (opt-in, 12% consent) and Austria (opt-out, 99%). Or I could cite a 2003 study that shows drastic increases in rates between opt-in and opt-out countries.

I do get the objections to the idea of "the government taking bits of your body without consent", but it's a difficult topic. I think more people would give consent if they had a free and frank discussion of the topic well in advance. But the problem is that they aren't doing that, and instead leaviing the decision to bereaved next-of-kin at the worst possible time to be thinking about such things.

Capt'n Midnight

There's a tick box to donate when getting or renewing your driving licence.

Just change the default to Opt-In.

Would capture most potential organ donors at near zero cost, and of course you could opt-out any time.

No point in putting stuff in your will as organs won't last to the reading.

osarusan

bnt wrote: »

I'm a bit confused by the above post, which says that opt-out doesn't drastically improve organ donation rates, then goes on to say that there would need to be significant improvements in organ donation infrastructure to cope with the ... drastic increase in organ donations?

Yes, opt-out on its own, without other improvements to the system, would be problematic. If you read the OP again you can take that as read. And as for the evidence that opt-out does improve rates, a 2009 New York Times article on the topic cited the differences between Germany (opt-in, 12% consent) and Austria (opt-out, 99%). Or I could cite a 2003 study that shows drastic increases in rates between opt-in and opt-out countries.

I think the point was that our weakness in organ transplants is not down to a lack of donors, but rather a lack of infrastructure in place to maximise success of use of organs.

So, even if an opt-out system saw a significant increase in organs available, without the infrastructure being improved, there's no guarantee that transplant success would improve. It just means that there are more donors that are not being availed of.

I think that was the point anyway.

weldoninhio

sillysmiles wrote: »

I don't think I've spoken to anyone who is stauchly anti-donation. While that is your right, but you mind elaborating on why you feel that way.

I'm not anti-donation, I just don't want to give up mine. I'd rather stay while when I'm dead that be harvested. I'm not religious or anything like that, it's just a personal feeling.

osarusan

weldoninhio wrote: »

I'm not anti-donation, I just don't want to give up mine. I'd rather stay while when I'm dead that be harvested. I'm not religious or anything like that, it's just a personal feeling.

See, I have no problem with this at all - I can understand why people feel this way, and it's why I don't think that opting out should be made deliberately difficult/time-consuming.

If somebody feels like that and wants to opt out, so be it.

But if they themselves don't make the decision to opt out, I don't think their family should be able to make it for them.

Capt'n Midnight

weldoninhio wrote: »

I'm not anti-donation, I just don't want to give up mine.

You selfish bastard :P

https://www.youtube.com/watch?v=aclS1pGHp8o

mags1962

First of all people need to understand the process as I think that most people believe that when they pass that there will be a scramble to "harvest" all the bits that can be transplanted and that they will go to the highest bidder.
Donors need to be alive or the organs are not viable for transplant if there is no blood pumping through the body and they are no longer functioning.
Transplants are based on need, not money, and weather or not the transplant will be a success and the recipient will have a good chance of a relatively normal life.
I have a huge interest in this subject having received a life saving organ transplant and find it hard to understand peoples refusal to consider the option to save numerous other peoples life at a time when their passing could actually mean something wonderful for others.
The actual number of people that qualify as donors of major organs, Heart, Liver, Lungs etc, the ones that you can't live without, is really not that many every year and I think that the record number for deceased donors was something like 91, not that many when you consider the amount of people that die every year.

maudgonner

By the way, for anyone on here who wants to be an organ donor (and even those who don't), if you haven't already put yourself on the bone marrow donor register that might be something you could also consider - you don't need to be dead to donate

It's a very easy process to get on the register (details are on the giveblood.ie site). The chances are tiny that you will ever match someone in need, but if you do you could save a life.

Calhoun

Not a chance I would agree with anything like this, there are few things in life you truly own and your body is one of them. Not to mention on top of that Ireland being Ireland the rules would want to be razor tight less you be thrown under the bus for the 'greater good'.

Be also interesting to see how this would stand up for people in vegative states, from what I understand they are researching folk being locked in rather than lights being on no no on home.

Finally I would say I'm not anti donation but would like eduction to work with people to get the message across rather than what I have seen in the past name calling,attempting to shame and looking down on people.

mickstupp

I find it kinda disgusting that my family would have any say to go against my wishes regarding donation of my organs. My donor card basically means nothing if one of them decides otherwise.

I hate the idea that their wishes might supercede mine when it comes to my organs getting donated. I don't agree that they should have any say in the matter. I don't agree that their feelings should be taken into consideration, as they already know my wishes, whether or not they agree. My body, my organs, not theirs.

I am fully, 100% in favour of opt-out only.

And to be honest, I can't understand how anyone would be fine with the remote possibility for their family to override their wishes.

KERSPLAT!

the_pen_turner wrote: »

A relative of mine needed a new kidney. He went on the list and all that.
They were at some group meeting or I formation night or some such on the ins and outs of it. (Pardon the pun)
The person there hand d out leaflets on donation and signing up.

My mother was down at the house a few days later to see how he was. Got talking about the sheet on donating.
Turns out all 5 of his family refused to sign into be doners. Because the didn't like the idea of it. All the while having g their son and brother dying while waiting g for a kidney

He got it in the end

It's not as black and white as that. I know from experience.

I had someone waiting for a kidney transplant and from a pool of about 7-8 that could have put themselves forward, only 2 of us did. Turns out we weren't suitable candidates but that's another story.

Anyway, the reasons put forward were that some day they may in fact need their second kindey if one of theirs fails. Then there's the fact that their son/daughter may also someday need one and the risks involved in the whole thing.

With regards to kidneys, it's highly unlikely you'll die when waiting for a kidney. You can survive for years and years on dialysis, however difficult it may be.

On organ donation, I believe we should have an opt out system but as others pointed out, next of kin have the final say.

I certainly want my bits put to good use and I'm forever grateful to the poor woman and her family who made my family members life infinitely better through organ donation. It's horrible to think that some people have to wait for someone to die in order for them to live.