another ethical subject - organ donation and the government - page 3
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
Apr 11, '04Occupation: cynic Joined: Aug '02; Posts: 284; Likes: 49Quote from fergus51And I say they can "opt in" if they feel strongly. What's next, "opt out" plans for euthanasia?? Sterilization?? I admit it sounds far-fetched, but if you trust your govt. that much, well maybe you wouldn't mind if they take your house / car / money / belongings when you die...'cause you're not going to need them, right??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.
Quote from fergus51Did you read my post about the problem other countries have with presumed consent?? The families still get their way with the corpse, and you can bet that will happen just as much here as it already does.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.
Also, how does one protect a patient's right to be FULLY informed. Can you truly expect our government to implement a program of informing the entire populace?? And what will you do when a presumption of consent turns out to be a mistake?? Ooops...sorry...
Quote from fergus51It won't happen because one of the fundamental rights in this country is the right to privacy and property. If you think socialism is a better choice....well......Bye!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.
Speaking of common good, are you aware that the higher the level of education, the more likely the person will be an organ donor? Why don't you spend my tax dollars to improve both the education level and the organ donation rate of this country??
And what if presumed consent doesn't meet the demand?? Will you continue to demand for the patient's right to autonomy and consent to be eliminated??
The government is merely a servant -- merely a temporary servant; it cannot be its prerogative to determine what is right and what is wrong, and decide who is a patriot and who isn't. Its function is to obey orders, not originate them. -- Mark Twain
Apr 11, '04Joined: Jul '00; Posts: 11,351; Likes: 388Wow, take a breath! Yeah, I am in favour of instituting socialism in America and opt out programs for sterilization and not educating people and taking organs from those who have expressely said they didn't want it done just to meet demand.... Believe it or not, I am not a nutcase.
There are already presumed consent set ups for medical studies in the US. It isn't so far fetched or out there.
No, i don't think opt-out rules in this case would mean that the government will try to steal my family's inheritance or apply it to sterilization or euthanasia or anything else. (In case you didn't notice, I don't even think they will apply it to organ donation).
I think laws can be written so that the person's who has died will have their wishes respected, rather than defer to the family. There could be mistakes, but that's true of any system and doesn't generally make me decide to give up an idea as useless. It makes me want to know how proponents plan to deal with the possibility of mistakes.
As far as education... Unfortunately i don't get to decide how to spend your tax dollars or mine for that matter. I would be thrilled with making education more available to people.
And no, if presumed consent doesn't meet demand I will not advocate mandatory organ donation from people who do not wish it. I find it pretty insulting that you would even suggest that when you obviously don't know me. Just because I think an opt out system is a good idea doesn't mean I am some crazy organ snatcher.
Apr 11, '04Occupation: Assistant Director of Nursing Specialty: 15 year(s) of experience in Gerontological Nursing, Acute Rehab ; From: US ; Joined: Dec '03; Posts: 800; Likes: 258The problem I have with "silent" consent is the following scenario (now, I know this may be far fetched and maybe there are clauses in the law in this situation, but it's the first thing that popped in my mind).
The law states that people need to tell the government "No" to organ donation, otherwise their organs will automatically be used. What about children? What parent, as soon as they bring their infant home, runs out and decides about organ donation? So, God forbid something happens to this tiny baby. Well, the parents didn't decide one way or another, but now it's too late. Since they didn't register "no" for their child, their childs organs are automatically taken?
Granted, maybe they have clauses in place for situations like that, but if organ donation is running low, who's to say they can't "unclause" the law? Who's to stop them from doing pretty much anything?
I say stick with the present way....there's too much left for corrupt people to abuse in the silent consent law.
Apr 11, '04Joined: Apr '03; Posts: 235; Likes: 5After seeing many of whom were able to obtain transplants despite noncompliant histories, minimum abstinence from substance use, and those who've gotten transplants, rejected, gotten another,etc. I and several of my colleagues have second thoughts about organ donation. I realize not all programs are alike, but these experiences I believe create ethical questions for further consideration.
Apr 12, '04Joined: Mar '04; Posts: 27; Likes: 1"Don't take your organs to Heaven. Heaven knows we need them here."
I understand what your concerns are. Organ donation can be a hot and often misunderstood topic. Personally, I like Italy's method and wish it were so in the U.S.
Apr 12, '04Joined: Jul '00; Posts: 11,351; Likes: 388I have a t-shirt with that written on it Robinette. It's quite a conversation starter. I think I have personally done my job about educating people cause they always say things like "But, then can't they use your body for experiments?" and "But, they can use any part of your body then can't they?".
Apr 12, '04Occupation: Clinical Endpoint Coordinator Specialty: 12 year(s) of experience in Research,Peds,Neuro,Psych, ; Joined: Jun '01; Posts: 1,681; Likes: 4Those of you "re-thinking" organ donation because of all the non-compliant patients, please think of the innocent children like my son who was born with a liver disease. He received an adult "cut-down" liver...2 days before I was to undergo surgery to donate a portion of my liver to him. These kids go through so much.
Apr 12, '04Occupation: Supporting my Cruise habit! Joined: Dec '03; Posts: 207; Likes: 13I think that many people do not address their own preference to organ donation is that because it is addressing their own mortality...and most Americans seem to have problems admitting that they are going to die. Some people look at it as "if I don't talk about it, it's never going to happen".
Speaking from personal experience, most families are quick to decline donating their loved-ones organs in that emotional time because that alone is conceding that there is no hope for a recovery for their family member. "If you take her heart or lungs, then she is never going to have the chance of living (even though docs have declared that person brain-dead)."
I've been on all sides of the arguement: a family member being asked to sign a consent for organ donation for my dad, the best friend of a girl who needed a kidney transplant, and the staff member talking to a patient's family about organ donation (only because they asked me what I thought).
I declined donating my father's organs, and it is a decision I have regretted ever since.
Just because you're an organ donor, doesn't mean the doctors are not going to do everything in their power to save your life when the need arises. I think some people get the idea that once you sign your card, you essentially sign your life away.
I agree the U.S. should adopt a practice similiar to Italy, but with stipulations (such as age and circumstance).
Apr 12, '04Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70Quote from HeadhurtExactly - there does seem to be a misconception (not here, but in the lay public) that having an organ donor card marks you as "spare parts" in the event of an emergency, rather than a patient.Just because you're an organ donor, doesn't mean the doctors are not going to do everything in their power to save your life when the need arises. I think some people get the idea that once you sign your card, you essentially sign your life away.
Ashes to ashes; what does it matter what happens to your shell after you're gone? Unless you have very specific religious concerns (and those folks would be sure to "opt out" and should also be precluded from receiving organs) then seems like once you're gone, your body should go toward some useful purpose. 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.
Apr 12, '04Occupation: Nursing Student Joined: Apr '04; Posts: 35The way this would work is that if you agree to donate your organs you would be placed in a higher priority status should you ever need an organ. Obviously, this wouldn't apply to kids, or the mentally impared. I am already a donar, but if I was on the fence (or just lazy) knowing that being a donar might mean that I could more easily get a kidney or liver (in the event I needed one) would probably push me over onto the donation side. Also, I think that the government should consider offering incentives for healthy living donars of a kidney, part of the liver, or bone marrow. If I could have part of my student loans forgiven I might give a kidney, and would certainly consider risking part of my liver . In fact I think many people would do this for free, but offering some compensation wouldn't be a bad thing considering the likely lost work (and considerable risk) involved.
Also here's another related question. Why can't parents donate the placentas from their children for stem cell research? My microbiology professor said that there was virtually no difference between the stems cells that come from foetuses (aborted) and those that are available in the "cord blood" of placentas. It seems like a whole lot of cord blood (and the stem cells inside) are being wasted. Plus, I'm not aware of any ethical objections by anyone to using cord blood which would just be thrown away anyway.
Apr 13, '04Joined: Jul '00; Posts: 11,351; Likes: 388There 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.
Apr 13, '04Joined: Apr '04; Posts: 8I 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.
Apr 14, '04Joined: Jan '02; Posts: 5,673; Likes: 159I 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.