'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!

[fergus51]

What if you are still on the fence? :)

steph

Not to sound harsh, but I was always raised to believe that almost doesn't count. If you're on the fence and you're not going to donate the strength of your belief doesn't matter. You aren't going to donate period. In my ideal world you would just have to answer this question at a certain age, maybe when you get your license or register to vote or something. Something tells me if you did have to be on the donor list in order to receive organs, people wouldn't be "on the fence" anymore. They'd make up their mind one way or the other and I can respect either decision.

[susanna]

WOW! This thread got a lot of responses really fast. It looks like a good topic that everyone has a lot of input on.

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.

Yeah, in a perfectly just and fair world, a system could be enforced that, if you are eligible(healthy, no transmittable diseases, old enough to make the decision yourself and take responsibility for it) to donate and choose not to for any reason, then you would give up your right from being higher up on the list of accepting donations than other people who do choose to donate. That will never happen and can never happen.

Its like charity and fundraising for diseases. When I did fundraising in college, we had people that were taking the money for themselves and whose lives were being very much saved by our funds come in and admit that they NEVER, EVER did anything to raise funds or contribute to charity for anyone else in their same kind of situation in the past. Is it fair that they should receive so much help from us when they never would have thought about lifting a finger to help another person in their situation? When they never contributed and other people have? No. But can you turn them away? No. Can you make a clause that says that, now that they have been helped, they have to make an effort in the future to help others in the same situation? No, that doesn't feel quite right either.

I see how you feel though. Its like, so many people suffered in the past from lack of this resource and here you are, giving the resource to someone who wouldn't help someone else with that same resource. You feel irked for the people who still aren't getting the help but who would help someone else in their situation. It makes you angry, its depressing, and its not fair but thats the way it has to be and there is not much more to do about it because, as everyone else has said, its such a personal issue and, even though it makes me feel angry, it just doesn't feel morally right to force people to become donors in order to receive donations.

[NurseGuy_in_06]

What is it about the decision not to donate your organs that makes you so angry? Why are you angry?

[fergus51]

What is it about the decision not to donate your organs that makes you so angry? Why are you angry?

Are you asking me? If so I'm actually not angry at all. If I gave you that impression I'm sorry. I tend to speak pretty bluntly, but it doesn't mean I'm mad. The problem with an internet bb is no one can hear tone of voice or see facial expressions.

If you or anyone else wants to keep their organs, that's your business and I don't care. I already said I don't think what I suggested will ever happen, so it really won't impact you or me or anyone anyways. I just think it's the logical way. We're talking about a finite resource and people are dying for them. Litteraly. Where is the logic in saying everyone who wants organs should be placed equally on the list when only some people are willing to give? I don't see it.

You've made the blood comparison, I would compare it more to a pension plan. I can't spend a year working in the US and expect to get the same pension as someone who contributed to it for 40 years, my needs notwithstanding. There are times in life when your contribution will affect what you get. I just believe organ donation should be one of them too. It's just a personal opinion, nothing more.

[stbernardclub]

organ donation is a beautiful thing >and im not ashamed to say i feel that way. Why answer a thread and then say you don't want to discuss your opinion...how STUPID!!!!!!!!

[NurseGuy_in_06]

My question is posed to those who said "it makes me angry". I totally disagree with putting stipulations on who is on the list to receive a donation. That is putting a price on receiving an organ. Would you be willing to let me on the list to receive if I found someone else to donate in my name?

[Elenaster]

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.

Thank you fellow ICU nurse!

Just to re-iterate the most important point of your post:

BRAIN DEAD = DEAD

This concept is very difficult for people to grasp, I know it's difficult to understand that if Momma is breathing on the vent and has a heartbeat, how can she be dead? But we do extensive testing to validate brain death and it must be 100% conclusive for the patient to be declared.

If you are seeking more information about organ donation, please visit this website of FAQs about donation:

http://www.carolinadonorservices.org/display.cfm?displaySection=gettingTheFacts&sub=faqs

Just reading this thread shows how many misconceptions there are about organ donation. Having cared for many donors and potential donors, I can tell you that it is a grueling, time-consuming process, requiring the highest level of ICU nursing care available.

Please educate yourselves. Even if you don't support organ donation, you will at least be able to clear up common misconceptions when confronted with them in your nursing practice.

[NurseGuy_in_06]

I would compare organ donation more to being in a major disaster. Neither the person needing an organ nor the person in the disaster asked to be put in their situation. And I have never heard of there being a requirement to work a disaster if you received aid during one. I just want to keep the donation process totally voluntary.

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

organ donation is a beautiful thing >and im not ashamed to say i feel that way. Why answer a thread and then say you don't want to discuss your opinion...how STUPID!!!!!!!!

Who said they didn't want to discuss their opinion?

Everyone here has chimed in very well - this is an interesting thread with alot of great education going on.

steph

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

I would compare organ donation more to being in a major disaster. Neither the person needing an organ nor the person in the disaster asked to be put in their situation. And I have never heard of there being a requirement to work a disaster if you received aid during one. I just want to keep the donation process totally voluntary.

I agree with you here ... this needs to be totally voluntary. You don't need to feel coerced if you aren't ready to make a decision. Just look at all the misconceptions here.

I didn't really start thinking seriously about this issue until I was in my 30's. And I was very under-educated. What would happen if I needed a heart transplant at 32 before I'd made a decision? Sorry, you have to make a choice to donate before we place you on a list? That is coercion.

The answer is to continue to educate people and try to reach out to those who don't have a clue about donation. In Italy after Nicholas Green's parents donated his organs, organ donation increased 3 fold if I remember correctly.

steph

[Marie_LPN, RN, LPN, RN]

People have their reasons for why they choose not to discuss the basis of their opinion on this subject on a public board. It's a very personal issue for some people, a little more to some than others.

[robsta]

You've made the blood comparison, I would compare it more to a pension plan. I can't spend a year working in the US and expect to get the same pension as someone who contributed to it for 40 years, my needs notwithstanding. There are times in life when your contribution will affect what you get. I just believe organ donation should be one of them too. It's just a personal opinion, nothing more.

Or the welfare comparison, where for whatever reason, a person isn't able to or doesn't want to participate in the labor market - we still feel that they should get something back, even if they weren't able to or didn't want to contribute to the system.

This *eye for an eye* mentality seems a little harsh - a person may have contributed much in other ways, saving lives, supporting worthwhile causes, and when they may be in need, even if they didn't sign up as a donor, I hope that they'll get the best possible medical care - including organs if necessary.

robsta

:)