another ethical subject - organ donation and the government

Nurses General Nursing

Published

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. :rolleyes:

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?

IowaCindy

53 Posts

I'm not using this for a paper.

I'm wondering if the differences in my reaction to this topic compared to my classmates' raction may be related to the age difference. I am significantly older than most of them.

Or is it just a difference in beliefs?

Ethical discussions are often difficult for me because I often feel as if I agree with 'both sides'. This one is more definitive for me. It feels like govenmental intrusion. I don't like it.

canoehead, BSN, RN

6,890 Posts

Specializes in ER.

A person could argue that once you leave your body it isn't strictly yours anymore. So you don't need to be informed or consent to anything that happens to it. However, if you or your family have an objection, they are willing to forego harvesting organs, just to avoid hassles and hurt feelings.

In the USA we had a news story recently about a medical school that had bodies donated for research that actually sold them for profit. Families were very upset, and felt 1) diverting the bodies for profit was unethical, and 2) if the body was sold for profit without consent the seller should be forced to give back the money.

athomas91

1,093 Posts

the thought behind it is...than many don't consider organ donation because it never crosses their minds, and they have a misconception that organs will be taken prior to them "actually" being dead - so they have to specify "no" rather than like us specifying "yes"

what do you need em for anyway when you're dead? - do you know how many people/kids are dying every day waiting for organs? i think that you will change your opinion once you start working - it has a way of changing your view. in nursing school i felt the same as you - now i believe that this is the way to go!

athomas91

1,093 Posts

in addition as far as the government having your organs...it is how they come up w/ cures to disease.....and did you know that many medical programs are no longer able to dissect cadavers (which is an invaluable learning tool) because - they are no longer allowed to use unidentified individuals that die - and not enough people donate their bodies to science after they die......

Chrislynn2003

285 Posts

Having had two organ transplants myself, I would agree with Italy's government. Many people are not aware of their families wishes regarding organ donation. Having to make the decision whether or not to donate after a death can be very hard; I believe that unless you specifically state somewhere that you don't want to be an organ donor, that all organs should be donated. This is a touchy subject and I am just giving my opinion.

Christine

suzanne4, RN

26,410 Posts

Definitely for donation.................but please be aware that currently in the US, even if you sign your driver's license to be an organ donor, unless your next of kin agrees to it, you are not a donor. That is actually what is limiting much of the donation in the US right now.

:balloons:

tmiller027

310 Posts

I have to say that I'm against the government doing ANYTHING without the consent of the person or their family. This "greater good" mentality is a form of socialism. I know we have mild forms of it here, but not to that extreme. I agree with an earlier poster who said that a bigger problem is that the actual donor's signature isn't binding if the next of kin doesn't want it. I think the law should be changed so if I sign my donor card, no one from my family can step in after I'm dead and deny them my organs.

jnette, ASN, EMT-I

4,388 Posts

Specializes in Hemodialysis, Home Health.

Italy is not the only country where this is done... there are many more, and I would agree with this system. It's been around for some time now, and if I'm not mistaken, the idea has been tossed around here in several states as an option, as well.

At least that way, if ppl are given to understand that if they DON'T sign, then their organs WILL be able to be used, these same ppl might be more inclined to make a decision one way or another. I see too many ppl not taking it seriously enough... not putting much thought into it... in our current system, and many, many, many who just offhandedly sign "NO" simply because they haven't been educated or are just apathetic.

I would also agree with the issue of making your signature on your card valid regardless of the wishes of next of kin.

mattsmom81

4,516 Posts

Many people have the idea that once they're dead who cares what is done...but the story of the medical school selling the cadaver is a problem for me.Someone is profiting monetarily. I support individual choice and directed donation. I also don't like the propoganda I see in this organ donation business. I even go so far to say I resent having to call the organ people everytime someone dies in my ICU.

It has a big brother ring for me too Cindy. I don't think the government has a right to decide what happens to my body... not when I'm alive and not when I'm dead.

jnette, ASN, EMT-I

4,388 Posts

Specializes in Hemodialysis, Home Health.
Many people have the idea that once they're dead who cares what is done...but the story of the medical school selling the cadaver is a problem for me.Someone is profiting monetarily. I support individual choice and directed donation. I also don't like the propoganda I see in this organ donation business. I even go so far to say I resent having to call the organ people everytime someone dies in my ICU.

It has a big brother ring for me too Cindy. I don't think the government has a right to decide what happens to my body... not when I'm alive and not when I'm dead.

I can agree with you here... the much publicized matter you mentioned above about the selling of cadavers really ticked me off as well, and I believe, did some real damage to organ donation.

On the other hand, I don't thing the "reverse consent" takes away from individual choice/directed donation.

The choice to say NO is still available to all, and for those who wish not to donate, it would be more of an incentive to make that clear.

I, too, don't like the idea of the gov't. deciding or claiming rights to my body (dead or alive), but I don't see where that would happen as the choice is still there to be made by individuals. The gov't. would need to be responsible in making its citizens fully aware, but after that, it's up to the ppl to sign "nay".

I see it a making things a whole lot less complicated and it may well save many more lives this way.

tmiller027

310 Posts

I can agree with you here... the much publicized matter you mentioned above about the selling of cadavers really ticked me off as well, and I believe, did some real damage to organ donation.

On the other hand, I don't thing the "reverse consent" takes away from individual choice/directed donation.

The choice to say NO is still available to all, and for those who wish not to donate, it would be more of an incentive to make that clear.

I, too, don't like the idea of the gov't. deciding or claiming rights to my body (dead or alive), but I don't see where that would happen as the choice is still there to be made by individuals. The gov't. would need to be responsible in making its citizens fully aware, but after that, it's up to the ppl to sign "nay".

I see it a making things a whole lot less complicated and it may well save many more lives this way.

With me, its the idea that the state has the RIGHT to your body once you die unless you specify otherwise. Thats not how civil liberties work. If you want to do something, then you choose TO do it, not tell the government that they can't. To me that just sounds backwards. We should be very careful what rights we give up, because if we were to give a little, the goverment would be more than happy to take 5 times as much.

I understand it would save more lives, but I don't agree with the price. I'm all for better education.

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