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!
Specializes in Telemetry, ICU, Resource Pool, Dialysis.
PamUK : I totally agree with you. A few things I would like to add.
1. Wannabe : if you feel this strongly about organ donation, work with the public, and EDUCATE them. As you can see from this board, even nurses have grave misconceptions regarding organ donation. The general public are even more in the dark.
2. As Pam mentioned, people may refuse to donate BECAUSE of moral issues.
I think the key is education. Of health care workers and the public.
NurseGuy: I don't think notifying the organ bank of deaths is coersion. It's not like 4 guys in suits show up on the family doorstep soliciting organs.It's simply a way to broaden the chances of obtaining organs. As mentioned before, many people don't think about it until confronted with the death of a loved one. Some people will be offended, but many others report feeling a sense of purpose, and hope that their loved one can save another life.
PamUK : I totally agree with you. A few things I would like to add.
1. Wannabe : if you feel this strongly about organ donation, work with the public, and EDUCATE them. As you can see from this board, even nurses have grave misconceptions regarding organ donation. The general public are even more in the dark.
2. As Pam mentioned, people may refuse to donate BECAUSE of moral issues.
I think the key is education. Of health care workers and the public.
NurseGuy: I don't think notifying the organ bank of deaths is coersion. It's not like 4 guys in suits show up on the family doorstep soliciting organs.It's simply a way to broaden the chances of obtaining organs. As mentioned before, many people don't think about it until confronted with the death of a loved one. Some people will be offended, but many others report feeling a sense of purpose, and hope that their loved one can save another life.
They do show up on the family doorstep, in the hospital, and they do solicit organs.
They do show up on the family doorstep, in the hospital, and they do solicit organs.
Nurseguy, please don't take offense when I ask you this: Have you ever personally witnessed, or been a part of, the organ donation process in action?
I think many assumptions have been made about this process and what it entails. I believe that if you have really been there and seen how the family is approached and what is involved, then you would hold a different view of organ donation. Every bit of sensitivity that one can muster goes into the approach and discussion of organ donation with the family. They are already grieving because they have been told that their loved one is already dead. Those of us caring for the patient are grieving as well. The utmost professionalism is involved and we do not take it lightly whatsoever. We also do not COERCE the family into doing what they don't want to do no matter what our personal feelings are about the decision.
They do show up on the family doorstep, in the hospital, and they do solicit organs.
Yes, they do if you want to call it that. Obviously when someone dies they must ask to take the organs. If this is soliciting organs to you, you're allowed that opinion. However, I agree VizslaMom that it is done with profressionalism and compassion, and tailored to a case by case basis. We can't let viable organs die when the living need them so desparately.
This is why it's so important to sign up while living. This is where the bulk of their marketing and promotion is. Lives are saved or quality greatly improved with organ donation.
In this area, btw, they do not show up on families doorsteps or in the hospital. It's usually done by phone, but perhaps if the family member wants to meet in person, they can do that. But they don't show up at their homes here.
Specializes in Gerontological, cardiac, med-surg, peds.
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:
Here's a bib I wrote on "brain death" for one of my graduate courses this semester. It is a very difficult concept to understand, even for the experienced health care professional:
Sullivan, J., Seem, D.L., & Chabalewski, F. (1999). Determining brain death. Critical Care Nurse, 19(2), 37-46.
Annotation:
Death is an inherently complicated topic, especially in this age of technological complexity and rapid medical advancements. There is often disagreement about when the occurrence of death can be reliably determined and by what methods. In this article, the authors explore the phenomenon of brain death and the most recent evidence-based guidelines for determination of death by neurological criteria.
Death has traditionally been defined as the cessation of circulation and respiration. The traditional concept of death has been revised in the past several decades to include neurological criteria ("brain death") due to the explosion of technology in the critical care environment. Brain death results from brain damage that is so severe and extensive that the brain has no potential for recovery. Spontaneous respiration has irreversibly ceased owing to structural brain damage, but the systemic circulation is still maintained by artificial life-support.
Initial efforts to redefine death in the face of technological advancements included development of the Harvard criteria in 1968 and the Uniform Determination of Death Act (UDDA) of 1981. The UDDA stated that an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. The idea of "brain death" as defined by the UDDA was a revolutionary concept that challenged society's core beliefs about death. All states have since adopted statutes to provide that "brain death," when diagnosed according to accepted medical standards, may be used as a sole basis for determining that a person has died.
The most recent criteria for clinical determination of brain death are thoroughly described in the article, including: coma, absence of cerebral responses to pain, absence of brain stem reflexes, and apnea. Confirmatory tests are also discussed in the article, such as cerebral angiography, electroencephalography, transcranial doppler sonography, somatosensory and brain stem auditory evoked potentials testing, and cerebral blood flow magnetic resonance imaging studies. A confirmatory test is voluntary for patients with clinical testing consistent with brain death. A confirmatory test is mandatory for patients in whom complete brain stem evaluation cannot be performed.
When death is pronounced on the basis of neurological criteria, the time of death is recorded as the time at which the patient met the criteria of brain death. Death is not recorded as the time of withdrawal from ventilatory support. An individual who has been given the diagnosis of brain death (though his or her heart may still be beating) is considered a corpse, no longer a living patient. This is because brain death is considered irreversible. Most healthcare professionals and the lay public remain confused about the meaning of brain death, as historically, the presence of a heartbeat indicated life.
Support and education of the family is critical. Families of brain dead patients need to be educated that death has occurred and that there is no hope of recovery. Terms such as "mechanical ventilation" or "artificial respiration" should be used in lieu of "life support" to avoid confusion. The nurse should avoid talking to the brain-dead patient in front of the family. Correct understanding of the concept of brain death is an important factor that influences a family's decision to donate organs and tissues for transplantation.
If the patient is to be an organ donor, mechanical ventilation is continued to maintain organ viability. If the family does not give consent for donation, mechanical ventilation should be stopped and the patient given standard post-mortem care. Regardless of the family's decision regarding organ donation, the critical care nurse needs to be nonjudgmental and supportive.
They do show up on the family doorstep, in the hospital, and they do solicit organs.
This is NOT my experience but then here organ donation is done almost exclusi ley by the public health system. There is a very long thread in the neurosurgical ICU forum covering brain death - I suggest that you read this thread to for further insight into what happens.
IF you ever witness an approach to a family by an organ donor team that you feel would be unethical then you are well within your rights to take it up with the ethics committee of your hospital or some other higher authority.
I suspect however the unethical approach is one more heard of than witnessed.
I cannot speak for the ethics of organ donation throughout the world as I know that there is an active and illegal trafficking of organs from South East Asia.
When someone dies in our hospital we have to call The Donor Network and answer a bunch of questions and then they decide if they will talk with the family. I hate it. I understand it. But I hate it. It is the law in California.
Specializes in Gerontological, cardiac, med-surg, peds.
When someone dies in our hospital we have to call The Donor Network and answer a bunch of questions and then they decide if they will talk with the family. I hate it. I understand it. But I hate it. It is the law in California.
steph
It's the law in North Carolina, too. Regardless of the inconvenience involved, I think it is a good thing.
I think a fair thing would be to refuse to give organs to anyone who is unwilling to donate them.
Just out of curiosity...is the recipient of a transplanted organ eligible to donate an organ themself? Like say, someone has a heart transplant. Something goes wrong on down the road. Are the kidneys, liver, lungs, corneas, skins, etc, etc eligible for donation?
I work in a tranplant unit (heart, lung, heart/lung). I've never heard of a recipient donating upon their death. I suppose they could? I don't know about the life-long immunosuppressants, and other drugs and what those do to the eligibility of donating. I also can't remember ever seeing a fresh post-op transplant who didn't make it, donate. I suppose it's because in this case it's not a brain death.
So hypothectically and by your standards, who donates for me as the recipient of an organ if I'm unable to follow through with donating myself?
pricklypear
1,060 Posts
PamUK : I totally agree with you. A few things I would like to add.
1. Wannabe : if you feel this strongly about organ donation, work with the public, and EDUCATE them. As you can see from this board, even nurses have grave misconceptions regarding organ donation. The general public are even more in the dark.
2. As Pam mentioned, people may refuse to donate BECAUSE of moral issues.
I think the key is education. Of health care workers and the public.
NurseGuy: I don't think notifying the organ bank of deaths is coersion. It's not like 4 guys in suits show up on the family doorstep soliciting organs.It's simply a way to broaden the chances of obtaining organs. As mentioned before, many people don't think about it until confronted with the death of a loved one. Some people will be offended, but many others report feeling a sense of purpose, and hope that their loved one can save another life.