'Moral values' and organ donation

[wannabee]

Ok, I know that organ donation has been discussed here more than once, but I couldn't find anything that addressed my particular question/issue........so here goes.

In this year's presidential election, many of the exit polls showed that people voted based on their "family/moral values." It seems they (not me!) voted for Bush because they felt he stood for those values, especially in regards to gay marriage, abortion, etc. I was very distraught after the election because I hear these people talking but I don't see these people taking moral action! Organ donation is just one of the areas that angers me.

How can the majority of this country stand on such moral high-ground and then show such PATHETIC organ donation numbers? People are dying because they can't get an organ when there are plenty available, but they get buried with the patient! How can you proclaim to be such a good person with such high moral values when you aren't even willing to donate your or your family's organs in the event of their death? I really don't see that as being a whole lot less than murder.

I'm not even a nurse yet, so I'm not right in the middle of this yet, but I do dread it! Anyway, this is just something that disturbs me deeply and I wanted to get your take on it, especially those of you, if any, that are not willing to donate. I'd like an explanation!

[robsta]

I'm an organ donor, but have some concerns about it now. A couple of months ago, my mom posted an article about this on her online journal (blog): "Are You Licensed to be Killed? Understanding Brain Death". Apparently the person has to be living for the organs to be donated. Umm, anyone know if this is true?

Very scary if true. Anyone else got the hard facts to back this up?

[NurseGuy_in_06]

No. I'm saying people who refuse to go on the donor list in the event that they die, should not be allowed on the recipient list. No free ride. Either people are willing to contribute to the system or they should not expect to take from the system.

What if you are in an accident and need blood. Should only blood doners receive blood? If you want me to be a donor then convince me, don't bribe, coerce, or threaten me. (Not you personally but society in general) Organ donation is a personal decision. Let's leave it that way and not make receiving one conditional. Only when the same rules apply to everyone, that is, the sickest gets the organ, will the system remain fair.

[Tweety, BSN, RN]

Very scary if true. Anyone else got the hard facts to back this up?

I've seen some donor cases happening in my sister unit when I worked neuro. It's quite a process. It's not like a person dies and their organs are immediately removed at the scene or when they arrive to the hospital.

Say a person has massive head injuries and is brain dead, it's determined are a donor, or the family wants to donate, and then they have to find a match for the organs, test those organs for disease (do an echo, do a bronchoscopy, blood work, etc.), then take the person to the OR to remove them. This can take hours. During this time they do whatever is necessary to keep those organs perfused and viable, using ventilators, medication, etc. So the heart is beating, the patient is on a ventilator, etc. being kept by alive by artificial means. Brain death is confirmed with EEGs.

It's hard for the lay person to understand that during this time, the person might be technically alive while being brain dead. Am I making sense. Perhaps an ICU nurse with more experience can explain it better.

:)

[Tweety, BSN, RN]

No. I'm saying people who refuse to go on the donor list in the event that they die, should not be allowed on the recipient list. No free ride. Either people are willing to contribute to the system or they should not expect to take from the system.

That's probably not a bad idea. But remember many of us are diseased. I've had hepatatis and carry it. If my liver fails can I have a chance at a liver please?

What about people who are wiling to donate and are on the list, but whose lifestyle choices cause them to fail. For instance the person with hypertension who doesn't take their meds or loose weight and whose kidneys fail?

[robsta]

What if you are in an accident and need blood. Should only blood doners receive blood? If you want me to be a donor then convince me, don't bribe, coerce, or threaten me. (Not you personally but society in general) Organ donation is a personal decision. Let's leave it that way and not make receiving one conditional. Only when the same rules apply to everyone, that is, the sickest gets the organ, will the system remain fair.

Well said. :)

[robsta]

I've seen some donor cases happening in my sister unit when I worked neuro. It's quite a process. It's not like a person dies and their organs are immediately removed at the scene or when they arrive to the hospital.

Say a person has massive head injuries and is brain dead, it's determined are a donor, or the family wants to donate, and then they have to find a match for the organs, test those organs for disease (do an echo, do a bronchoscopy, blood work, etc.), then take the person to the OR to remove them. This can take hours. During this time they do whatever is necessary to keep those organs perfused and viable, using ventilators, medication, etc. So the heart is beating, the patient is on a ventilator, etc. being kept by alive by artificial means. Brain death is confirmed with EEGs.

It's hard for the lay person to understand that during this time, the person might be technically alive while being brain dead. Am I making sense. Perhaps an ICU nurse with more experience can explain it better.

:)

Yes, you're making sense if I understand you correctly: the patient is still alive even though EEGs indicate possible brain death. Autonomically, the body is still functioning. So the patient is not clinically *dead* when the organs/parts are surgically removed... is this correct?

robsta

:uhoh21:

[VizslaMom]

I'm an organ donor, but have some concerns about it now. A couple of months ago, my mom posted an article about this on her online journal (blog): "Are You Licensed to be Killed? Understanding Brain Death". Apparently the person has to be living for the organs to be donated. Umm, anyone know if this is true?

Yes, the BODY must be kept alive until the organs are harvested. If the body dies, the organs die with it and there can be no donation. The body is kept alive by a multitude of drugs, on ventilator support. Testing is done, such as echocardiogram and bronchoscopy, to verify if the heart and/or lungs are suitable for donation. For example, we had a young female MVA that they were not able to harvest the heart from because her heart had apparantly suffered trauma as well. Her ejection fraction was between 5-10%.

There IS testing done that shows if the patient is brain dead or not before organ donation is brought up to the family. One of these is an apnea test. The ventilator will be stopped and the patient observed for any signs of spontaneous respirations for a matter of minutes...NOT exactly the favorite of conclusive brain death tests for a critical body you're trying to keep alive. There is also EEG for wave activity and blood-flow scan done in radiology to determine if the brain is getting any blood flow at all. When a patient has a severe head injury, there can be so much pressure built up in the brain that prevents further blood flow and oxygenation. This is often how brain injured patients become brain-dead patients. The built up pressure can also cause brain-stem herniation which also results in brain death.

It is unfortunate that so many in the public, even other nurses, don't have a complete understanding of the process. That is why some assume that we are "killing people for their organs". That is not the case. These patients are already technically DEAD. If you are brain dead, you are dead. If these patients were not organ donors and simply taken off the ventilator, their bodies would die naturally in a matter of minutes due to lack of oxygen. There is no command from the brain to tell the body to breathe.

[Marie_LPN, RN, LPN, RN]

My values have nothing to do with me donating my organs. They can have them when i'm gone, i mean after i'm dead, what the heck do i need them for?

[Spidey's mom, ADN, BSN, RN]

No. I'm saying people who refuse to go on the donor list in the event that they die, should not be allowed on the recipient list. No free ride. Either people are willing to contribute to the system or they should not expect to take from the system.

What if you are still on the fence? :)

steph

[Spidey's mom, ADN, BSN, RN]

I've seen some donor cases happening in my sister unit when I worked neuro. It's quite a process. It's not like a person dies and their organs are immediately removed at the scene or when they arrive to the hospital.

Say a person has massive head injuries and is brain dead, it's determined are a donor, or the family wants to donate, and then they have to find a match for the organs, test those organs for disease (do an echo, do a bronchoscopy, blood work, etc.), then take the person to the OR to remove them. This can take hours. During this time they do whatever is necessary to keep those organs perfused and viable, using ventilators, medication, etc. So the heart is beating, the patient is on a ventilator, etc. being kept by alive by artificial means. Brain death is confirmed with EEGs.

It's hard for the lay person to understand that during this time, the person might be technically alive while being brain dead. Am I making sense. Perhaps an ICU nurse with more experience can explain it better.

:)

Hey, I saw that on ER!

steph

[Marie_LPN, RN, LPN, RN]

I'm saying people who refuse to go on the donor list in the event that they die, should not be allowed on the recipient list. No free ride. Either people are willing to contribute to the system or they should not expect to take from the system.

I agree.

[fergus51]

What if you are in an accident and need blood. Should only blood doners receive blood? If you want me to be a donor then convince me, don't bribe, coerce, or threaten me. (Not you personally but society in general) Organ donation is a personal decision. Let's leave it that way and not make receiving one conditional. Only when the same rules apply to everyone, that is, the sickest gets the organ, will the system remain fair.

Blood is very different from organs. How many people died last year waiting for blood? Apples and oranges.

Organ donation is a personal choice and I don't think it should ever be mandatory. I just don't think people should be able to have it both ways either. If you would never consent to donation, I think it's selfish and hypocritical to accept an organ from someone else. Obviously people who can't donate shouldn't be penalized for that, but if you just don't want to then that's another matter. It's completely your right to do and I am not going to try to convince you to do otherwise, but no one ever said that choices don't have consequences. I think an opt out system where those who opt out of organ donation are also opting out of the option to receive organs is completely sensible. Don't worry though, I am sure it will never happen and you'll always be able to get on the organ recipient wait list should you need it regardless on your stance on donation.