another ethical subject - organ donation and the government - page 2

This week's class discussion that's stuck with me has to do with organ donation. In Italy, there is a silence/consent rule. Unless you specifically sign that you DON'T want to be a donor, the... Read More

  1. by   psychomachia
    Quote from IowaCindy
    This week's class discussion that's stuck with me has to do with organ donation. In Italy, there is a silence/consent rule. Unless you specifically sign that you DON'T want to be a donor, the presumption is you do - and at the appropriate time after 3 physicians declare you dead, your parts will be used if/as needed. (That's the Reader's Digest version of the Italian law as I understand it.)
    Presumed or "silent" consent is not new. France enacted a policy in 1976 and other countries, such as Spain, Finland, Belgium and I think a few others have similar laws - unless you opt out, your're in.

    However, that does not mean that one is not informed. The person who "silently" gives consent has to be shown to have known (not sure how) about the law. Also, it seems that opt laws do not make a big difference in Belgium and Spain since the relative wishes are obeyed (http://www.nkrf.org.uk/pages/awareness/indexa.htm).

    Perhaps actions are better than laws. When 7 year old Nicholas Green was shot by bandits in Italy and died 2 days later after being declared brain dead, his parents donated his organs. Seven Italians received organs from Nicholas and the result was a huge increase in the donation rate for a country that had been historically very low.
  2. by   Nurse Ratched
    I'm okay with the idea that your parts are up for grabs once you're gone unless you specify otherwise. As someone else said, what do you need them for at that point?
  3. by   psychomachia
    Quote from Nurse Ratched
    I'm okay with the idea that your parts are up for grabs once you're gone unless you specify otherwise. As someone else said, what do you need them for at that point?
    I agree that no one "needs" their organs after death, but the problem comes when the government takes something against your will. There are some who refuse donation on religious beliefs/practices and others who are simply unwilling regardless of their belief. They should have that right. By stating that YOU have to "opt out" is too easy for the government because NO ONE is entitled to ANY part of you or me without our permission.

    With that said, I also feel that should I choose to be an organ donor, my family had better allow my wishes to be honored. It seems as though many would like to donate, but their relatives have other plans. Too many physicians are more afraid of the relatives' lawyers than they are of the patients'.
  4. by   talaxandra
    Surveys demonstrate that the majority of people agree in principle with organ donation, but only a tiny number of us take the steps needed (register, indicate willingness on our drivers license, talk about our wishes with friends and family). Because it's not something that's often talked about, particularly by the optimal donor pool (healthy young people), families are often left with no idea about what the potential donor's preferences were, and opt for the less squeamish option.
    In an opt-in system (as used in Australia, NZ, Canada, the UK and the US, among other countries), most people have only a sketchy idea of what's involved, and few people consider what they would prefer.
    The idea behind opt-out donor policies is that it obviates some of that uncertainty. A by-product is that, as donation becomes a norm rather than an exception, more people become familiar with the concept - they know (or know of) someone else whose organs were donated. The idea of organ donation becomes less hidden, there's more community discussion, and people become more comfortable with talking about it. Part of introducing an opt-out system is public education, which also contributes to informed debate and decision-making.
    People who decide against donation make their decision known the way people on opt-in systems do - tell their family, note it on a drivers license, or include it as part of an advanced directive.
  5. by   jnette
    You explained it far better than I could have worded it, but these were my thoughts exactly... just didn't know how to get it on "paper". Thanx.

    Am still undecided, however. I like it in many ways, but there were some issues raised above which gave me pause... still gotta think this through some more.

    At any rate, my choice is clear on my license... and family knows as well.

    Just wish that (as you said) the great majority would spend more time and thought on this as well.... and that we could find a way to really educate the people. ALL people.
  6. by   BeachNurse
    Our 10 year old son is alive today because someone signed an organ donor card...that person's family gave consent. Our then 11-month old baby received a liver transplant on 4/18/1994. Today he is an active, healthy boy and to say we are grateful is an enormous understatement. This year is his 10th year with the "new" liver..we are having a party!

    Our family members are all organ donors. I do believe that people should give consent. The problem with the organ shortage needs to be addressed with more awareness programs. I have volunteered and spoke at some places in this regard.
  7. by   psychomachia
    Quote from talaxandra
    People who decide against donation make their decision known the way people on opt-in systems do - tell their family, note it on a drivers license, or include it as part of an advanced directive.
    But the government is placing the burden on the individual to STOP something rather than to INITIATE. As individuals, we have the right to not have ANYONE do ANYTHING to us without our consent - we don't have to tell everyone who may decide they want something from us they can't have it - IF we choose to share something with others we DONATE it - individual freedom is far more important than increasing donation rates, which as I posted previously do not increase significantly with an opt out system.

    A generous gift from a seven year old and his family did more for organ donation than any government plan ever could. Perhaps the issue should be spent on education and acknowledging the actions by donors and their families rather than an unneeded government intrusion into our privacy.
  8. by   athomas91
    I agree that no one "needs" their organs after death, but the problem comes when the government takes something against your
    do you have a "will" when you are dead?? LOL
  9. by   psychomachia
    Quote from athomas91
    do you have a "will" when you are dead?? LOL
    ???????????
  10. by   Spidey's mom
    If only a tiny number of people "opt-in" because it isn't talked about how is changing the system to "opting-out" going to change anything regarding educating folks about their options? People are still going to be reluctant to talk about it and people are still going to be under-educated about it. Have you ever tried to do any patient teaching and then find out later that the person took in about 1/10th of what you said?

    I'm with the folks here who think the government needs to get my consent before they do anything with my body and with those who think once I've signed the donor card, my family should have no say.

    Fix the system in place now and do more education instead of giving the government more power. Dead or alive.

    steph
  11. by   fab4fan
    This is a terrible idea. How many places will one need to have it doumented if he/she does not wish to donate?

    I am not a donor, for my own reasons. This should be a personal choice, and no one should demand an explanation as to why someone does not donate. A person's choice should simply be respected, whether or not you agree/disagree with it.
  12. by   Spidey's mom
    Quote from fab4fan
    This is a terrible idea. How many places will one need to have it doumented if he/she does not wish to donate?

    I am not a donor, for my own reasons. This should be a personal choice, and no one should demand an explanation as to why someone does not donate. A person's choice should simply be respected, whether or not you agree/disagree with it.
    Great point . . . . how many places will one need to have it documented?!

    steph
  13. by   fergus51
    I think it would be great. A central list shouldn't be to hard to maintain, and if people feel strongly they can opt out. I just don't believe in letting people die on principle (stopping rather than initiating). People are much more likely to have their wishes to donate be ignored. Unfortunately this type of system will never happen in the US. Anything that is for the common good AND involves the government brings out worries of socialism, and that is the kiss of death in America.

    I also feel that people on the opt-out list shouldn't be ever put on waiting lists, but that's another story.
    Last edit by fergus51 on Apr 11, '04

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