another ethical subject - organ donation and the government

[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.)

I think I was the only in class who considered this a scarey prospect. My classmates felt this should be the American standard.

I on the other hand heard the footsteps of Big Brother. I must have been the only one listening.

My initial thoughts on this have been:

1) I don't consider my body to be a resource for the government.

2) Just as there is a problem now with available organ donation that is linked to a lack of 'informed consent' and education of the general public, doesn't the Italian law use that lack of education to procure organs without informed consent?

3) I'm not sure how this fits but it's nagging at me - if many claim that the government shouldn't tell a woman what to do with her body (abortion), how can the government enforce this?

4) I think this is just another step down the 'slippery slope' - could this lead to non-treatment of persons deemed to have little value in life (MR, Alzheimer's, etc) in order to have a source of organs? I know that's a far-fetched supposition but I think it's a reasonable concern.

I think that there should be a vastly increased education process through which hopefully many, many people would consider organ donation. Of course, I realize that this would have to go with increased education in STDs, birth control, the hazards of smoking...all those health issues and more that can result in increased human misery. And where would it happen? Who's going to fund it? etc., etc., etc.......

I have signed my driver's license and discussed my wishes with my family so should the occasion occur, they'll respond as I've directed. I believe in the absolute value of organ donation.

However, the Italian protocol scares me.

What do y'all think? Wanna discuss?

[fergus51]

There is a HUGE difference between stem cells from cord blood and that from embryos as far as research and development is concerned. One of the hospitals I was at saved cord blood if parents wanted to. The thing is there is so much prep work, that it isn't something that can be decided on the spur of the moment.

[transplant]

I would have to agree with christine on this one. I also have had an organ transplant and it's scary the amount of people out there who don't know the first thing about it.

[mattsmom81]

I feel the decision to be a donor is very personal and patients and families that are not comfortable with it should not be pressured to conform. I am not comfortable hearing/reading of nurses who try to inflict their own opinions about this subject on others. It is a choice I offer to patients and their families. Period. It is not my job to pressure them (or 'educate them' as to the great need for organs.) I feel badly when I must ask families for a decision and it traumatizes them. Even though I tell them I MUST give them the choice by law, it frequently upsets people who are already going through a very hard time. Perhaps I resent traumatizing them further than they already are.

I feel there is a huge pressure to donate today and it is almost to the point it has become unethical the way some push this...and track nurses and facilities that have lesser donors than others. Another example, IMO, of 'big brother' tactics..and the government should have NO role or interest in this matter either, IMO. I can see a dangerous precedent and a slippery slope, as others have alluded to. Do our spare parts belong to the government? There are unscrupulous people out there...I've seen quite a few TV shows dealing with this type of thing and its not too outlandish to consider. Would you consider killing off the right blood type person so your dying child would have an organ donor match? Some would. Women have conceived children just to donate tissue or an organ to an older sibling. Unethical to me. Many think this is OK. Again, a slippery slope I feel.

I understand many nurses disagree with my point of view but I wish to present another viewpoint. As I stated previously, I resent the government or any agency telling me what to do...while I am alive AND after I die. JMHO.

[TMnurse]

Here's a thought... and it is nothing against you. As a student, I am guessing that your exposure to persons losing the battle and needing an organ might be limited (at least for a little longer). More over, you might have more limited exposure to the amount of people who have donor cards or really understand anything about it (and more importantly their families who even after the dead donor checked they want to donate the family can an often say NO!). Once you have more exposure to donation and need I think you might be less likely to believe in the Feds harvesting organ on people who don't pay taxes and more in the fact that everyday people die needlessly. Good Luck in school.

[TMnurse]

I have read several threads here. The funny thing is the "Goverment" doesn't currenly play a big role in organ donation. It is usually private charities that work to make sure that if someone wants to donate THEIR organs they don't go wasted. I work at a major teaching university where we do all types of transfers and our organ program delegate is neither employed by the goverment or the hospital. She is part of an organization funded by people who know the need and waste of organ donation. Oj a side note, it took several years for lobbyist to get a organ donor check thing on your drivers licenses. MOST IMPORTANTLY if you know anything about that it really holds no meaning. It is only something that can be shown to the family as proof that the deceased wants to donate. In fact, many many many families still say "NO" to the donation. Actaully, if you need a organ the goverement would probably be happier if you died. A reciepent will cost health care subsidizing and eventually plenty of Medicare dollars.

[psychomachia]

In fact, many many many families still say "NO" to the donation.

Which is something that will probably occur even with an "opt-out" system. Physicians' fear of lawyers and litigation from the family will overule the patient's wishes almost every time.

[Energizer Bunny]

Hubby already knows - organ donation, science experiments, medical school cadaver, fertilizer, whatever; I am an avid recycler in life; it would be way cool to think I could do it one last time.

Yep...me too...get rid of it all for the greater good of whoever!!!

[mattsmom81]

The government HAS a strong interest in it or there wouldn't be a federal law dealing with organ donation, as I see it.Government agencies (Medicare)are involved (my risk manager tells me) in monitoring facility compliance issues for organ donations through Lifegift, etc. It makes me wonder where this may eventually be going. But I'm one of those silly people who like to keep government OUT of my life and my decisions as much as possible.

Nothing irritates me more than a healthcare worker with an agenda to push. Our role is to assist people in making the best decision for THEM and their loved ones. And their decision may be to donate organs or tissues, or NOT. It isn't our call.

[Energizer Bunny]

The government HAS a strong interest in it or there wouldn't be a federal law dealing with organ donation, as I see it.Government agencies (Medicare)are involved (my risk manager tells me) in monitoring facility compliance issues for organ donations through Lifegift, etc. It makes me wonder where this may eventually be going. But I'm one of those silly people who like to keep government OUT of my life and my decisions as much as possible.

Nothing irritates me more than a healthcare worker with an agenda to push. Our role is to assist people in making the best decision for THEM and their loved ones. And their decision may be to donate organs or tissues, or NOT. It isn't our call.

I don't think anyone is talking about pushing, or I could be wrong, but I think we are talking mostly about educating people before organ donation ever becomes an issue. Right? or not?