Nurses and Organ Donation

psychonaut · Jul 15, 2009

I am not. If there was some mechanism in place where my wife could get recompense for my pieces after I am gone (cash, discount on my premortem medical costs, etc) then I would be more inclined. This is my primary reason, and I am not ashamed of it.

There is another level to my reasoning, and of this I am less sure, and a bit ashamed for my possible irrationality: I do have some lingering worries of receiving a different focus of care were I in a catastrophic state.I hate to even credit it, but I have been told by other health-care types that the eagerness to get at your organs in such a situation could mean that one can be declared brain dead just a little quicker and surer if you are a known organ donor.

Now, even to my own ears this smacks of such things as being anti-vaccine, etc. And honestly, if I knew my wife would get some reward for donating my carcass, I wouldn't care about these misgivings. But the thought is there, nonetheless.

And to be clear, she does not share my viewpoint (I'm the greedy ogre, she's much more giving than me!)

UM Review RN, ASN, RN · Jul 15, 2009

ITA...there is an assumption these days that someone donating organs is a given, the idea that this is a gift has gone by the wayside. I reached my opinion through personal experience of donating a loved ones' organs and by what I see in the OR.
Organ donation is a wonderful thing on paper but there is abuse that goes on...a few years ago in my state, they were offering $200 to anyone that would put an organ donor sticker on their license. That stopped after people complained. Then of course, there are the DCD(donation after cardiac death) cases. These people are not brain dead-they are ventilated. They pull the tube and the person is give 90 minutes to expire..with propofol and morphine supposedly to ease discomfort but in the words of one organ bank employee "sometimes we give a little help". This was said with a giggle, by the way. I was horrified when I first learned of these-sheesh, why not just push a pillow over someone's face? Probably cheaper and more humane.
I have seen the organ bank allow people in the room to watch at my previous hospital that did not need to be there(ie housekeepers and orderlies). I have heard highly unprofessional things said. When my loved one passed, some people in my family didn't want to donate the organs for religious/cultural reasons. One of the organ bank people rolled his eyes at them.
And of course, good money to be made(paticularly in bone and tissue harvesting).:icon_roll
I wouldn't worry-I don't think it'll ever go to an opt-out system. Too many people would fight tooth and nail if it did-me included. I have a living will and I have expressly spelled out that I do not want to donate my organs(in bold print;)) and that if I am not brain dead, I want everything done. I know the vultures start swooping early on when you've been hurt, I don't want anything unclear.

My sentiments exactly. I was especially upset to find out about the "good money to be made" in bone and tissue harvesting.

allnurses Guide · Jul 15, 2009

I do not agree with people getting compensated for donating organs - this clouds the motivation for doing so, IMHO. Just makes it all feel a little bit... ugh.

I do not believe the stories of "declaring someone brain dead quicker and surer"... I mean, do nurses really believe this crap? You're either brain dead, or you're not. There are objective criteria to meet, by two independent physicians (and the ICU nurses generally right there). I have worked ICU/transplant/etc for about 13 years and I have *NEVER* seen or heard of any such thing.

Yes, the system is activated early (eg. notification to OPO), but that's because there IS so much testing to be done before considering donation. Ignoring for a moment DCD, which I don't know enough about to comment on, I have just never seen any conspiracy to garnish organs in any hospital I've ever worked at, in Europe, Australia or the US.

I know it's a personal decision, but it boggles my mind that some people won't consider it... just don't understand. People that would not donate, would you accept an organ for yourself or your family members? How do you reconcile that with your opinions on donation? (*genuinely interested*).

UM Review RN, ASN, RN · Jul 15, 2009

I do not agree with people getting compensated for donating organs - this clouds the motivation for doing so, IMHO. Just makes it all feel a little bit... ugh.
I do not believe the stories of "declaring someone brain dead quicker and surer"... I mean, do nurses really believe this crap? You're either brain dead, or you're not. There are objective criteria to meet, by two independent physicians (and the ICU nurses generally right there). I have worked ICU/transplant/etc for about 13 years and I have *NEVER* seen or heard of any such thing.
Yes, the system is activated early (eg. notification to OPO), but that's because there IS so much testing to be done before considering donation. Ignoring for a moment DCD, which I don't know enough about to comment on, I have just never seen any conspiracy to garnish organs in any hospital I've ever worked at, in Europe, Australia or the US.
I know it's a personal decision, but it boggles my mind that some people won't consider it... just don't understand. People that would not donate, would you accept an organ for yourself or your family members? How do you reconcile that with your opinions on donation? (*genuinely interested*).

Frankly, at this stage of the game, if I needed a transplant, I would not do it. Living with a transplant can be pretty problemmatic. However, I did offer to donate a kidney to one of our local kids a few years back.

I just know that no matter what my loved ones' wishes, there's a huge difference to me between letting someone die and keeping them alive so the organs will stay viable. I simply could not make the decision to do that. Call me a coward or a pollyanna, whatever you wish, but I personally could not live with my last memory of a loved one would be one of letting them die in OR as strangers removed their parts.

And then, even more unnerving, to know that someone out there in donorworld is making huge bucks off the backs -- literally! -- of my loved ones-turned-donors.

rngolfer53 · Jul 15, 2009

Quick answers:

Yes, I will be an organ donor if they're worth having. :lol2:

That decision pre-dates nursing school.

:twocents: I think nurses should give very serious consideration to being donors. We practice in a profession dedicated to the well-being of people, and donating likely provides at least one person with a major gain in health, and also sets an example for others.

psychonaut · Jul 15, 2009

[snip]People that would not donate, would you accept an organ for yourself or your family members? How do you reconcile that with your opinions on donation? (*genuinely interested*).

If it was required for me, then I would thereafter become a donor; I would feel obligated.

In rereading a post above mine, I realized I expressed myself wrong regarding "brain death." I was thinking more along the lines of what SquirrelRN71 wrote regarding extubation with a little MSO4 to "ease the transition." I've known transplant workers who were clearly very passionate about there work, to the point where I have a feeling on which side of caution they would err on.

However, I do want to repeat that this is very much a secondary concern for me. If I could be assured that my carcass would in some way benefit my survivors, then I would be the first one to sign up. Really, the ideal for me would be a deal where all of my hospital debt would be forgiven in return for organ donation.

rubystar · Jul 15, 2009

I'm a registered donor, I'll be (brain) dead so I might as well do something useful. It's not like I need them.

I feel terrible for people waiting for an organ that they will probably never get, so that's a decent motivator. I also recall getting another form in the mail the other day I so I passed it off to my boyfriend to make him sign up as well.

Katnip, RN · Jul 15, 2009

I will be a donor. When my son died in a car crash, he was a donor. We were prepared to go through with it but he needed an autopsy and by the time they were done there was nothing viable to donate. I think it would have been a great comfort to have been able to donate his organs.

My other two kids have also signed the donor portion on their license.

Katnip, RN · Jul 15, 2009

Outside of religious reasons, I have no idea why someone wouldn't want to be an organ donor. You're dead: you don't need them anymore. Give someone else a chance at life.
Obviously I am a donor. Take everything you can, and donate the rest of my body to science.

I worked with a very well-educated man who refused to be a donor. He understood that he would be dead, nobody would kill him for his organs, but kept insisting it would hurt. Nothing I could do or say would convince him that he wouldn't feel pain when he was dead.

DolceVita, ADN, BSN, RN · Jul 15, 2009

Wow. Thanks for the opinions.

I am for donating my organs but don't know if they would take them (I too lived in Europe during the "mad cow" thing).

I completely forgot about that whole opt-out rather then opt-in debate. That is where I really have trouble deciding. I lean toward the opt-out version because I think it would make people think about it who normally could care less.

I feel like the father in Fiddler on the Roof:

One the one hand....but on the other hand......

geekgolightly, BSN, RN · Jul 15, 2009

If there were any way for me to be there in the OR while my son's body ceased to work just before they began procurement, I would do it, but the thought of my son MY SON alone while his body stopped is just too much for me. I can handle it being myself or my husband, but not my little boy.

If he is older and chooses this, I'm ok with it, but not while he is still so young.

Editorial Team / Admin · Jul 15, 2009

The organization we work with is excellent. Very respectful and all that. When it comes to DCD cases, they are not allowed in the OR until 5 minutes after the resident pronounces. They aren't involved in extubation either, anesthesia is responsible for that, so there is no "helping along" with morphine or other drugs. I personally don't like being involved in DCDs because that's the only exception we make for allowing family in the OR.

I am an organ donor. I certainly won't need them if I'm brain dead, so whatever's usable can go to someone who needs it.