Opt-Out Organ Donation

222233

osarusan wrote: »

I think this is a bit silly to be honest. Just because you wouldn't like your organs removed after death doesn't mean that logically you wouldn't like a diseased lung removed either.

But if your reasoning is that you want you body fully intact then you wouldn't want to be embalmed.

Yes the organ removal is just my argument to "I want to be buried with all of my organs", if that's the case then you would assumably prefer not to have any organs removed if it's likely you will die but a small chance of survival with removal. We make that decision for people everyday, if someone has been in an accident a doctor will do whatever they can to save their life, surely they should be able to do the same for people on the organ transplant lists.

I can understand there are many reasons why someone might not want to be a donor (fear, beliefs etc and thats fine by the way if you have considered reasoning)

maudgonner

Calhoun wrote: »

What kind of regulation do we have in place to make sure everything is being done for those who are in a position to donate that all measures are exhausted to bring them back ect?

The process is described here:

Brain stem death is the permanent loss of function of the brain stem and this is ascertained through tests carried out by two senior doctors to determine absence of brain function. When these tests show that there is no brain function and no chance of recovery, the patient is declared dead.

kylith

osarusan wrote: »

I'm not baffled by the idea of wanting to be buried/cremated completely intact. I don't need more of an explanation than that.

I can understand that. What I can't understand is why an adult would continue to hold that view after logical consideration, especially when they could help so many people without it putting them out in the slightest.

KERSPLAT!

kylith wrote: »

I can understand that. What I can't understand is why an adult would continue to hold that view after logical consideration, especially when they could help so many people without it putting them out in the slightest.

It's could put their family out amd cause further distress, a poster above already gave that as a possible reason for not donating

kylith

KERSPLAT! wrote: »

It's could put their family out amd cause further distress, a poster above already gave that as a possible reason for not donating

It is unfortunate that the family be so distressed, which is why it's important to discuss these things with your family and make your wishes very clear beforehand.

Unfortunately the organs do need to be taken as soon as possible after death or they become unusable. I very much doubt that the doctors enjoy making that request.

KERSPLAT!

Again, as above, the poster said they would donate unless it would cause further stress to their family. You asked for a reason and there is a simple one.

Whatever reason someone has, it's their body to do with as they please.

Arbie

ShaShaBear wrote: »

I'm glad to see some people have sympathy and understanding for next of kin and families that have made the excruciating decision not to donate a loved one's organs after death. My father died 6 years ago after several brain hemorrhages and we were veritably harassed by the spokespeople there to donate anything and everything we were willing to. My sister, only 14 at the time, begged that they would not take his eyes or his heart - that she wanted him to "go to heaven" with the memory of his love for us and what we looked like. It was a huge shock, and he was kept on life support for far longer than necessary while we came to a decision. Eventually, being told that he would be transported elsewhere for the surgery and that we could be waiting up to a week before we were issued with the emptied corpse was what made the decision for us. That and a concerned nurse coming to us on the QT to tell us that, if we consented, they would and have taken everything that was useful, despite our wishes.

I've told my husband that if my death is natural or expected, that I wish to have all useful bits and bobs donated. If it is a shock death, especially if the kids are young, that he is to make the best call he can on how to minimise the trauma and suffering for my immediate family. There's not a lot I can give my husband and children when I die, so the decision on how to dispose of me can lie with them. If I were forced to "opt-in" or "opt-out" exclusively with no in-between, I'd be forced to opt-out to protect my loved ones.

I have worked on a surgical transplant team and have close relatives who have donated organs, so I have been on both sides.

That nurse may have meant well but he or she was totally incorrect. In my experience the co-ordinators take the utmost care to get input from all the family and make sure that everyone agrees what will be done. You mentioned eyes above but eye donation has not been carried out in Ireland for many years due to the risk of CJD, so the eyes are not touched. All donor eyes (corneas) come from abroad. The organs that can be donated in Ireland are lungs, liver, heart, pancreas, kidneys.

It is a rotten position to be in to ask a family to consider donating their still-breathing relative's vital organs, particularly considering it is usually after a sudden injury like a car accident. You always feel like a bit of a vulture and that you are adding to their pain but the donation window is short and it has to be done.

In my experience families will try to think about it fairly and discuss it but it's a huge emotional pressure. If the person has been vocal about wanting to donate then it's often a short conversation as people typically want to respect their wishes. If there was never a clear opinion expressed by the person, then the reaction can vary from total agreement among family members to the rare but sadly real occasions where fights have broken out. Death of a loved one churns up so much emotion that it seems cruel to be adding to it by asking people about organ donation. Some people feel very guilty that someone might die if they don't agree. I would hate for my family to be in that position.

On a social/ethical level, we really can't have our cake and eat it. I imagine more than 90% of people would be willing to accept an organ from someone if they needed one. Can you imagine an insurance plan where everyone is covered but only a fraction of people are willing to pay the premium? It would be unethical to force everyone to donate but if by default we would all be willing recipients then surely we should all be presumed willing donors unless we actively state otherwise.

Smoked Tuna

What if you need your organs in the after life?

KERSPLAT!

Smoked Tuna wrote: »

What if you need your organs in the after life?

Then keep them. Simple.

kylith

Smoked Tuna wrote: »

What if you need your organs in the after life?

If a deity can make an entire infinite universe out of nothing, rustling up a few organs shouldn't pose much of a problem.

byhookorbycrook

carrieb wrote: »

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.

Due to meds I am on, I cannot donate as I might be passing on a potentially fatal condition. I have signed up to donate my body for research, so that's a reason for you.

mags1962

I think that "harvested" is the wrong word and gives the completely wrong impression of what actually happens.
Even in the current system there is still a large amount of families that go against the deceased's wishes where they have opted in by way of a donor card or driving license.
Education and correct information is the key and I don't think internet forums is the place to get those.

weldoninhio

kylith wrote: »

There is an opt-in register but between people not bothering to put their names on it and people thinking that donating their organs is somehow icky (again, after they're dead, when you don't have the capacity to be icked-out by anything) there are people dying or spending years on waiting lists and dialysis, or blind while thousands upon thousands of perfectly good organs are put in the ground to rot (like that's not icky :rolleyes:) or incinerated.

But that doesn't answer my question WHY do you not want your organs donated? 'I just don't want to', isn't an answer. After all, if you were walking past a lake and saw someone drowning and you could throw them a rope you would, wouldn't you?

So if people "aren't bothering" to put their name on it, they don't want their body harvested after death. If they did it would take 2 mins to sign up or get a donor card. It's the same as an opt-out list in reverse.

osarusan

weldoninhio wrote: »

If they did it would take 2 mins to sign up or get a donor card. It's the same as an opt-out list in reverse.

It is indeed. Thus the argument that anybody that has a strong wish one way or the other can easily be accommodated.

Podge_irl

weldoninhio wrote: »

So if people "aren't bothering" to put their name on it, they don't want their body harvested after death. If they did it would take 2 mins to sign up or get a donor card. It's the same as an opt-out list in reverse.

There is no opt-in register and nor would it have any legal standing if such a thing was created as things stand.

However a lot of people who would happily donate their organs won't sign up to the register out of a)laziness or b)assuming they have plenty of time before dying to do it. If you have a strong feeling about it you can opt-out. The benefit of doing it as an opt-out system is that apathy/laziness doesn't lead to people dying needlessly.

weldoninhio

Podge_irl wrote: »

There is no opt-in register and nor would it have any legal standing if such a thing was created as things stand.

However a lot of people who would happily donate their organs won't sign up to the register out of a)laziness or b)assuming they have plenty of time before dying to do it. If you have a strong feeling about it you can opt-out. The benefit of doing it as an opt-out system is that apathy/laziness doesn't lead to people dying needlessly.

As shown from the RSA stats most people tick no on the form.

maudgonner

weldoninhio wrote: »

As shown from the RSA stats most people tick no on the form.

That's not true. There is no 'No' option on the form. There is just a box to tick if you want to the code to appear on your licence to indicate you wish to be a donor.

(I'm not nitpicking - these things have a significant effect on behaviour).

infogiver

weldoninhio wrote: »

As shown from the RSA stats most people tick no on the form.

You have to tick the box if you want to be a donor
Leave it empty if you don't
As I said, I fill loads of these forms for folk and no more then 2 out of ten let me tick the box.

Capt'n Midnight

Smoked Tuna wrote: »

What if you need your organs in the after life?

IIRC it's traditional to keep them in separate jars and besides your brain won't much use after being pulled out through your nose.

jackofalltrades

222233 wrote: »

I don't think it's ethically questionable? You have the option to opt out.

Provided you actual are aware that you have the option.
Is it really fair to give people the option to opt-out when they're not aware of the option existing.
Opt-out is designed to take advantage of the people being "lazy".
Proponents of this system openly admit this.
And even encourage the creation of barriers to dissuade people opting out.

Podge_irl wrote: »

However a lot of people who would happily donate their organs won't sign up to the register out of a)laziness or b)assuming they have plenty of time before dying to do it.
If you have a strong feeling about it you can opt-out. The benefit of doing it as an opt-out system is that apathy/laziness doesn't lead to people dying needlessly.

If you have a strong opinion you can opt-in.
Is there proof that a lot of people haven't opted-in due to laziness?
And if that's the problem whey isn't they're a campaign to sign people up?
I'd go door-to-door to sign people up if this was an issue.
And just to clarify other issues raised I'd support a hard opt-in.

JupiterKid

I would support the soft opt-out policy. I think it's very sad and frankly a bit of a disgrace at how anyone could refuse to allow an organ donation to take place. I think educating people on this issue is the way forward. There is a lot of ignorance out there.

I would be willing to donate any organ if anything were to happen to me, but I don't think my liver would be up to the job given the punishment I've given it over the years.

judeboy101

If I receive blood transfusion is it true that ibts charge hospital for blood who in turn charge my health insurance?

maudgonner

judeboy101 wrote: »

If I receive blood transfusion is it true that ibts charge hospital for blood who in turn charge my health insurance?

They do charge hospitals for blood, yes. I think that's how the service is financed, rather than being directly financed by the HSE.

judeboy101

maudgonner wrote: »

They do charge hospitals for blood, yes. I think that's how the service is financed, rather than being directly financed by the HSE.

Id be interested to know if the ibts makes a profit on this or does it for cost. Also because I'm paying for my blood through private health ablnd they are receiving the blood for free from donors in my case they are profiting as they are getting something for nothing and charging me for it.

ohnonotgmail

judeboy101 wrote: »

Id be interested to know if the ibts makes a profit on this or does it for cost. Also because I'm paying for my blood through private health ablnd they are receiving the blood for free from donors in my case they are profiting as they are getting something for nothing and charging me for it.

they may not be paying donors but there is still a cost to get the blood. they dont get it for free. their staff dont work for free.

maudgonner

judeboy101 wrote: »

Id be interested to know if the ibts makes a profit on this or does it for cost. Also because I'm paying for my blood through private health ablnd they are receiving the blood for free from donors in my case they are profiting as they are getting something for nothing and charging me for it.

Pretty substantial costs in processing the blood though. It doesn't just go straight from you to the recipient. It has to be screened, typed and treated, stored properly, transported etc etc.

Then there's the costs of gathering it in the first place - quite a few staff employed, their travel costs. The costs of running the donor database, publicising clinics, renting hotel function rooms for the clinics etc etc.

I don't think the IBTS is particularly efficiently run (every time I go to donate the waste I see annoys me), but you can't ignore that there's huge costs involved.

Podge_irl

jackofalltrades wrote: »

If you have a strong opinion you can opt-in.
Is there proof that a lot of people haven't opted-in due to laziness?
And if that's the problem whey isn't they're a campaign to sign people up?
I'd go door-to-door to sign people up if this was an issue.
And just to clarify other issues raised I'd support a hard opt-in.

Laziness is perhaps the wrong word. Apathy would be better. Dying suddenly while quite young is just not something a lot of people want to think about.

There are two main issues at play. I would be ok with an opt-in system with a donor register if it was well advertised and easy to sign up to as long as that became legally binding. As things stand it would have no legal standing and it would remain the decision of the deceased's next of kin, who have obviously just suffered a traumatic loss and aren't necessarily in the best position or frame of mind to be deciding such a thing.

judeboy101

ohnonotgmail wrote: »

they may not be paying donors but there is still a cost to get the blood. they dont get it for free. their staff dont work for free.

If you read what I said I asked for profit or run at cost. I cant find annual accounts for ibts I'm curious why they would charge if they run at a loss. Surely get it from hse funding?

maudgonner

judeboy101 wrote: »

If you read what I said I asked for profit or run at cost. I cant find annual accounts for ibts I'm curious why they would charge if they run at a loss. Surely get it from hse funding?

I can't find official figures either, but there are comments on this article (for what it's worth ) saying that the IBTS is set up as a non-profit organisation and any surplus they make is returned to the HSE.

judeboy101

maudgonner wrote: »

I can't find official figures either, but there are comments on this article (for what it's worth ) saying that the IBTS is set up as a non-profit organisation and any surplus they make is returned to the HSE.

Thanks. So ibts do sometimes turn a profit in free blood.

maudgonner

judeboy101 wrote: »

Thanks. So ibts do sometimes turn a profit in free blood.

Can a non-profit organisation make a profit? I don't think so.

Here's another way to think about it, probably more accurately. The blood they supply is free, but they charge for collecting, screening, processing, storing and transporting it.

seamus

maudgonner wrote: »

Can a non-profit organisation make a profit? I don't think so.

It's called a surplus.

It's all on their website actually, financial statements for 2010 - 2015. IBTS have made a surplus a few years, but equally have fallen short in other years.

Their income and expenditure typically remain pretty close, which is a good indicator that the price they charge for supplying blood is a fair reflection of the cost of collecting it.

judeboy101

seamus wrote: »

It's called a surplus.

It's all on their website actually, financial statements for 2010 - 2015. IBTS have made a surplus a few years, but equally have fallen short in other years.

Their income and expenditure typically remain pretty close, which is a good indicator that the price they charge for supplying blood is a fair reflection of the cost of collecting it.

No, its called a profit. The other side is a loss. If they have an equal number of profits and losses that's ok but if they have more profit years than loss years then they are running a surplus and are not a non-profit organization. Me think they siphon off profits to other government quangos to make it look like they just run for cost. And they have the cheek to take our blood for free.

ohnonotgmail

judeboy101 wrote: »

No, its called a profit. The other side is a loss. If they have an equal number of profits and losses that's ok but if they have more profit years than loss years then they are running a surplus and are not a non-profit organization. Me think they siphon off profits to other government quangos to make it look like they just run for cost. And they have the cheek to take our blood for free.

they take our blood? here was me thinking that people gave their blood. Should i be on the lookout for roving gangs of phlebotomists?

KERSPLAT!

Only here do we go from organ donation to government quangos. Christ almighty.

judeboy101

ohnonotgmail wrote: »

they take our blood? here was me thinking that people gave their blood. Should i be on the lookout for roving gangs of phlebotomists?

People give their blood? Should I be on the look out for roving gangs of anamic Irish people handing out jars of O -ive?

maudgonner

judeboy101 wrote: »

No, its called a profit. The other side is a loss. If they have an equal number of profits and losses that's ok but if they have more profit years than loss years then they are running a surplus and are not a non-profit organization. Me think they siphon off profits to other government quangos to make it look like they just run for cost. And they have the cheek to take our blood for free.

How do you think the service should be funded? Directly, through taxation? Then why should private hospitals be able to get blood for free, at the taxpayer's expense?

It's entirely up to you whether you want to donate or not. Nobody is forcing you.

If you feel it's unfair that they get your blood for free, why not go to the US, where they pay for blood donations. Then take a look around you at the type of people who donate when it's an easy way to make money.

Personally if I ever needed a blood transfusion I'd rather it came from someone who donates it freely rather than because they're desperate for money. I'm happy to donate my blood to help people who need it. I've had friends & family members who needed transfusions and am extremely grateful that the blood was available to them.

judeboy101

maudgonner wrote: »

How do you think the service should be funded? Directly, through taxation? Then why should private hospitals be able to get blood for free, at the taxpayer's expense?

It's entirely up to you whether you want to donate or not. Nobody is forcing you.

If you feel it's unfair that they get your blood for free, why not go to the US, where they pay for blood donations. Then take a look around you at the type of people who donate when it's an easy way to make money.

Personally if I ever needed a blood transfusion I'd rather it came from someone who donates it freely rather than because they're desperate for money. I'm happy to donate my blood to help people who need it. I've had friends & family members who needed transfusions and am extremely grateful that the blood was available to them.

I was under the impression that the service was not run for profit and that any in going surplus was put back into the service, not distributed to the rest of a bloated health service. As a private patient who also pays for the public to get free healthcare through my taxes I have a major issue of them using my blood to make money

seamus

judeboy101 wrote: »

I was under the impression that the service was not run for profit and that any in going surplus was put back into the service, not distributed to the rest of a bloated health service. As a private patient who also pays for the public to get free healthcare through my taxes I have a major issue of them using my blood to make money

I'm not sure any surplus does go back into the HSE. The financial details are all there in public. At the moment they're running a 40-odd million cumulative deficit because they've been investing in new facilities and paying pensions for 5-ish years.

I know another poster said it, but I don't see any evidence that anything is going into the HSE.

maudgonner

judeboy101 wrote: »

I was under the impression that the service was not run for profit and that any in going surplus was put back into the service, not distributed to the rest of a bloated health service. As a private patient who also pays for the public to get free healthcare through my taxes I have a major issue of them using my blood to make money

I give up. They need to finance the service somehow. The way they have chosen is to charge for usage. Since usage can't be forecasted with 100% accuracy they need to estimate it, and set a price per unit as best they can. This means that some years they'll run a surplus, some a deficit. As Seamus' figures point out, they seem to be doing a fairly decent job of balancing it.

You would prefer that they blindly plough any surpluses back into the service? Whether it's needed or not? Rather than doing the fiscally responsible thing and returning that money to the pot needed to run the rest of the Health Service? The Health Service that continually runs a budget deficit and needs to be propped up by the Government. You're advocating that they waste the money? Rather than using it properly and somewhat (although to a tiny degree in the scheme of things) reduce the overall tax burden?

You're talking absolute rubbish.

Boom_Bap

Can this please be brought back on topic.

And shame on this thread not having more jokes about bone(r) donations.

Eggonyerface

I'm not sure linking to other forums is allowed so I'll err on the side of caution and not directly link, but there was a thread on reddit's front page today from a giril who recieved a lung transplant.

Im pretty sure I signed up to being a doner at some point, my own mortality is something I avoid thinking so I havent given it as much thought as I should, but after this thread and that I'm going to make a point of making my intentions known

Commotion Ocean

jackofalltrades wrote: »

Opt-out is designed to take advantage of the people being "lazy".

If you believe people are too lazy to opt out, then they'll be even more lazy about opting in.

222233

jackofalltrades wrote: »

Provided you actual are aware that you have the option.
Is it really fair to give people the option to opt-out when they're not aware of the option existing.
Opt-out is designed to take advantage of the people being "lazy".
Proponents of this system openly admit this.
And even encourage the creation of barriers to dissuade people opting out.

It's up to the people and the Govt. to inform people on this position. As another poster mentioned (Can't remember his/her name) but I thought it was a really good point, probably the best argument I have heard for this debate. If most people would willingly accept a donated organ than surely it is fair to assume everyone would donate unless they for whatever reason choose to opt out.

I don't think it is designed to catch people out, if your informed and clearly state you don't want to be an organ donor no one is going to assume the rights to take your organs. Laziness is the people's fault not the systems. I think it's really important.

I read recently there are approx. 700 people waiting on a transplant, that fate could fall at any of our doors. There were 81 deceased donors in 2015 the total no. of transplants was 294 (http://www.organdonation.ie/facts.html)can you imagine how many potential recipients could be knocked off that list if we had an opt-out system? Donation would be based on the donors decision and wouldn't have to rest with the family.

jackofalltrades

222233 wrote: »

I don't think it is designed to catch people out, if your informed and clearly state you don't want to be an organ donor no one is going to assume the rights to take your organs. Laziness is the people's fault not the systems. I think it's really important.

I think I've already covered this but, why is there's the need to make assumptions for people?
Especially when in a number of cases this assumption will be incorrect.
An opt-in system is the most ethical way of doing this.
As opposed to taking advantage of uninformed people or people who can't afford or don't have the time to jump over the hurdles put in the way of opting out.
It's an end justifies the means type of system.
What's the problem with actually asking people?

I read recently there are approx. 700 people waiting on a transplant, that fate could fall at any of our doors. There were 81 deceased donors in 2015 the total no. of transplants was 294 (http://www.organdonation.ie/facts.html)can you imagine how many potential recipients could be knocked off that list if we had an opt-out system? Donation would be based on the donors decision and wouldn't have to rest with the family.

According to the OP the family will still be consulted and will have the final say.

paleoperson

I'm not psychologically able to deal with it.

222233

jackofalltrades wrote: »

An opt-in system is the most ethical way of doing this.
As opposed to taking advantage of uninformed people or people who can't afford or don't have the time to jump over the hurdles put in the way of opting out.

You may be correct with regards to ethics, but I don't imagine it would come down to a "cost" thing. I would be reasonably happy with an "opt-in" system, something very formal that takes the responsibility away from the family after a shock death. I would like it to be the case that those who do not opt in can not receive deceased donor organs though.

jackofalltrades wrote: »

What's the problem with actually asking people?

I would imagine many people simply wouldn't be bothered to opt-in, like what has currently happened with licences etc.

jackofalltrades

222233 wrote: »

I would imagine many people simply wouldn't be bothered to opt-in, like what has currently happened with licences etc.

Yes but by asking them a YES/NO question you take people not being "bothered" out of the equation.
They have to pick an answer unlike the current system.
Even ask them face-to-face when applying for a Drivers Licence.

osarusan

jackofalltrades wrote: »

As opposed to taking advantage of uninformed people or people who can't afford or don't have the time to jump over the hurdles put in the way of opting out.

Why the assumption that opting out would be costly or troublesome?

Upon reaching 18, every person could get a donor card along with a letter which explains that they are now on the list of donors, and here is why being a donor is so helpful, but if they want to opt out, the can call this number/visit this website and have the ID code on the back of the card.

biko

Chuffed that only two people have spelled donor "doner" so far

I'm a donor myself but would not be in favour of the French option.
My organs are actually mine even when I am dead.
I personally have signed away the rights to them (or my family can) but I would hate for the government/HSE feel they can just barge in and take what they want from me without my expressed consent.