Organ donation - presumed consent alternative

[fls]

That was not the point that I was making at all. My question was, what gives government automatic claim to my carcass?

It looks more like the government is the last resort after no one else claims your carcass.

But to answer your question, I'm not particularly concerned about my carcass after I'm gone because I'm fully aware of the situation and can make an informed decision on organ donorship.

What about those that aren't in the same position; people who don't have family, or who are in homes, in institutions or wards of the state? Who protects their interests or choice from a government that is determined to have automatic "claim" to their carcass?

But those who are unable to protect their own interests have someone assigned to protect their interests for them. Again, it seems that the government is last on the list, not first.

Don't take my objection to extening state power over individual's rights to being an objection to the idea of organ donation.

I didn't (don't know why you thought I did).

Linda

 

[EHocking]

It looks more like the government is the last resort after no one else claims your carcass.

We obviously disagree. An opt-in process gives the last "dibs", since it is assumed that you do not wish to be an organ donor. Hospitals, doctors (ie gov) can then approach whomever takes responsibility for your remains to suggest the option of donating your organs.

In an opt-out situation, it is assumed that removing organs is the first "choice".

But, again, that was not my point. My point is, the government has NO claim on my remans in any way whatsoever - this system sets a precedent for them to claim that they do. I would like to see the argument that gives them he right to make such a claim form my physical body.

But those who are unable to protect their own interests have someone assigned to protect their interests for them. Again, it seems that the government is last on the list, not first.

Well you seem to have ignored the groups of people I listed.

Those without family - who is assigned to protect their interests? The state.
Wards of the state - I would have thought that was the most obvious indication of the groups of people I was referring to. Who is assigned to protect their interests? The state.
Don't forget the homeless and others in refuges and government institutions - who is assined to protect their interests? The state.

I thought it was obvious I was talking about the groups of people who do NOT have someone other than government agencies to protect their interests, therefore I was discussing those who will have the state as being the FIRST on the list to "protect" their interests.

What we have is a conflict of interest.
The government would hardy not want to support their own opt-out system, therefore, first choice for those under their "care" is organ donation.

It's not as though removal of organs without the permission (or indeed knowledge) of families is unprecedented in the UK, either.

But again, I ask the question, what gives the government ANY claim over my remains. On what argument can they possibly base this claim to my remains?

What would you say to compulsory blood donation?
Same argument.

 

[fls]

We obviously disagree. An opt-in process gives the last "dibs", since it is assumed that you do not wish to be an organ donor. Hospitals, doctors (ie gov) can then approach whomever takes responsibility for your remains to suggest the option of donating your organs.

In an opt-out situation, it is assumed that removing organs is the first "choice".

You and then your family (and realistically, your family gets to over-ride your wishes anyway) gets dibs under either circumstance. Both opt-in or opt-out get last dibs if there is no one to provide consent. Which assumption is more likely to represent your wishes - that you would be willing to donate or that you would not? All indications point to the former.

Clearly protection of the idea that a human carcass is sacrosanct deserves the sacrifice of a human life?

But, again, that was not my point. My point is, the government has NO claim on my remans in any way whatsoever - this system sets a precedent for them to claim that they do. I would like to see the argument that gives them he right to make such a claim form my physical body.

They do already have a claim on your remains in that they regulate what can be done with them, and they protect your ability to direct what happens to them. If the government had no claim on your remains, then your organs would be taken without any consideration as to you or your family's wishes.

Well you seem to have ignored the groups of people I listed.

Those without family - who is assigned to protect their interests? The state.
Wards of the state - I would have thought that was the most obvious indication of the groups of people I was referring to. Who is assigned to protect their interests? The state.
Don't forget the homeless and others in refuges and government institutions - who is assined to protect their interests? The state.

The state assigns a neutral party to protect their interests. The task of a guardian is to serve the best interests of the individual, not the interests of the state.

I thought it was obvious I was talking about the groups of people who do NOT have someone other than government agencies to protect their interests, therefore I was discussing those who will have the state as being the FIRST on the list to "protect" their interests.

It was obvious what you were talking about.

What we have is a conflict of interest.
The government would hardy not want to support their own opt-out system, therefore, first choice for those under their "care" is organ donation.

Why would there be a conflict of interest? A guardian will not have any particular commitment to a government policy.

But again, I ask the question, what gives the government ANY claim over my remains. On what argument can they possibly base this claim to my remains?

If the government has no claim to your remains, then they are not charged with protecting your remains. This means that once you are dead, it's a matter of first come, first served. If you deny any role for the government, then anyone is free to take whatever bits and pieces of you they want, regardless of the wishes of you or your family.

What would you say to compulsory blood donation?
Same argument.

The only difference being that while I'm alive I can fight back if someone tries to remove it by force?

Linda

 

[Stitch]

I've been a registered organ donor for over 20 years and a blood donor for a similar period. The day the govenment make it madatory is the day I'll opt out it.

ETA: My view on donation wouldn't actually change and my relatives are well aware of my intentions and would still offer my organs if something were to happen to me. I just object to the state making decisions about my body.

 

[Soapy Sam]

I will not attempt to logically defend my stance on this, because my distaste for ever increasing government interference in private life is not based on logic any more than most distate is logic-based.
I agree with EHocking that what happens to my corpse is not a decision for Her Majesty's Government.

However, I wonder how many people would opt in if (say) HMG decided that those who do get a 10% Tax rebate?

Stitch puts my position exactly.

 

[ZirconBlue]

I've been a registered organ donor for over 20 years and a blood donor for a similar period. The day the govenment make it madatory is the day I'll opt out it.

I don't see how the proposal makes anything "mandatory". It's just shifting the presumed "default" position from "anti-donate" to "pro-donate". I guess the question is, of the many people who don't choose to opt in under the current system, how many are actually opposed to donation? Do we presume that most people who don't sign up actually object to their organs being donated, or have they just not gotten around to it?

What if every adult was required to register their preference, in or out? Then there wouldn't be a need for a default position.

 

[Stitch]

What if every adult was required to register their preference, in or out? Then there wouldn't be a need for a default position.

Is that practical, what about people that don't respond are you go to fine them? Should we then have to register a preference on everything?

I'm all for promoting that people should sign up and should tell their families of their intentions, but because that's something they feel passionately about, not because somebody else if forcing them to make decisions about their body that, IMO, they have no right to be doing.

 

[fls]

I just object to the state making decisions about my body.

Okay, let's go with your idea that the state should have no interest in your body. In that case, what's to stop the doctors in the hospital from simply taking your organs once you're dead? They are most likely to be on hand, after all.

Linda

 

[ZirconBlue]

Is that practical, what about people that don't respond are you go to fine them? Should we then have to register a preference on everything?

I don't know if it's practical. I was sort of thinking out loud. Is there anything else in the UK that requires (near-)universal registration of adults? What percentage of adults in the UK have drivers licenses? Perhaps, whenever you renew your license, there could be yes or no checkboxes. Would that cover most adults?

I'm all for promoting that people should sign up and should tell their families of their intentions, but because that's something they feel passionately about, not because somebody else if forcing them to make decisions about their body that, IMO, they have no right to be doing.

It doesn't seem that unreasonable to ask people to actually make a decision. Putting it off just means you're forcing your family members to make a decision for you. If one is really ambivalent about it, maybe "undecided" could be a third option.

 

[Stitch]

Okay, let's go with your idea that the state should have no interest in your body. In that case, what's to stop the doctors in the hospital from simply taking your organs once you're dead? They are most likely to be on hand, after all.

Linda

I would assume the fact that the organs are not their property, they are mine or if I am dead, my relatives.

 

[Stitch]

I don't know if it's practical. I was sort of thinking out loud. Is there anything else in the UK that requires (near-)universal registration of adults? What percentage of adults in the UK have drivers licenses? Perhaps, whenever you renew your license, there could be yes or no checkboxes. Would that cover most adults?

Not that I'm aware of. Your birth certificate would probably be the most universal thing, then you NI number which you're issued at 16. Driving license certainly isn't universal.

It doesn't seem that unreasonable to ask people to actually make a decision. Putting it off just means you're forcing your family members to make a decision for you. If one is really ambivalent about it, maybe "undecided" could be a third option.

I don't have too much of an issue with familiy members having that final say. I have expressed my views to them, if they choose not to follow them, then so be it. It's pretty much like my funeral, I don't care what the ceremony is, I won't know anyway, so despite being an athesit, many of my family are not and would perhaps gain some solace from me having a Christian burial.

 

[fls]

I would assume the fact that the organs are not their property, they are mine or if I am dead, my relatives.

But you are dead and you don't have relatives (i.e. there is no one to provide consent for organ donation).

Linda

 

[Ivor the Engineer]

But you are dead and you don't have relatives (i.e. there is no one to provide consent for organ donation).

Linda

In that case it comes down to the aesthetic preferences of society with regard to dead bodies. Are they spare parts, or are they something else?

 

[EHocking]

<snip> Not intending to be rude by that massive snippage, but Stitch and SoapySam have basically summarised the objection to this subject that I wished to discuss - the discussion with yourself was a diversion from my true objection. Government interfering, yet again, in the way in which I wish to run my personal life. Thus my reference to ID cards. Their track record on managing personal data is abyssmal, as well as their track record for abusing those records. Not forgetting plain stupidity (such as HSBC bank freezing a woman's account because her surname was Mugabe).

But following my objection to government pushing "big brother" population control...

If the government has no claim to your remains, then they are not charged with protecting your remains. This means that once you are dead, it's a matter of first come, first served. If you deny any role for the government, then anyone is free to take whatever bits and pieces of you they want, regardless of the wishes of you or your family.

Actually, it is not first come first served, since disposal of human tissue is covered by legislation. THis is not for protection of my remains, but protection of the health of others pertaining to the disposal of my remains. Not the same argument at all. The legislation is the Human Tissue Act, and it is just this act that the government would need to revise to put their op-out system in place. OK, legislation is amended all the time, but, while concentrating on amendments wrt one issue, other amendments can be sneaked in as well. A common ploy in contract negotiations and one that this government has a track record of doing.

Food for thought, here are two items in the Act that would need to be closely watched during such an amendment again, pertaining to my objections to government intereference where not warranted. Admittedly, these were additions in 2004 to the 1961 Act:

The HT Act creates a new offence of DNA ‘theft’. Having human tissue with the intention of its DNA being analysed, without the consent of the person from whom the tissue came, will be unlawful from 1 September 2006.
The HT Act makes it lawful to take minimum steps to preserve the organs of a deceased person for use in transplantation while steps are taken to determine the wishes of the deceased, or, in the absence of their known wishes, obtaining consent from someone in an appropriate relationship.

The first statement is ripe for abuse and change to suit their ID card database proposals.

The second statement is probably the one they would wish to amend to give greater control on the "steps to preserve the organs".

Again, I apologise for the massive snippage, I take your point on each item - it's just that they weren't the points that I joined this thread to discuss. In fact, as far as personal attitude to organ donation, I pretty much agree with you. After further reading, not many others agree that the UK gov's approach will in fact help the problem of donor organ availability that much anyway. And indeed, we don't need to get too hot under the collar until 2013 it seems. But each of these seemingly small invasions by government into private lives is (as I see it) part of their insidious drive for totalitarian governmenting, kicking off with ID cards.

Stitch and SoapySam were more succint!

 

[fls]

Actually, it is not first come first served, since disposal of human tissue is covered by legislation. THis is not for protection of my remains, but protection of the health of others pertaining to the disposal of my remains.

If that were the case, then it wouldn't include provisions for consent as to what use is made of those human remains, since transplantation, anatomy labs and other research uses are obviously considered suitable areas for disposal.

Linda

 

[Soapy Sam]

At the very least, we have clear evidence in this thread that some of those people who currently do go to the trouble of acting on these issues would be likely to walk away at any sign of further government big-brotherism.
Small sample, I know, but perhaps significant?

 

[fls]

At the very least, we have clear evidence in this thread that some of those people who currently do go to the trouble of acting on these issues would be likely to walk away at any sign of further government big-brotherism.
Small sample, I know, but perhaps significant?

This may not be relevant as it's from the US, but 28% said they wouldn't sign up under an opt-in system and 31% said they would opt-out under a presumed consent system. This suggests that 3% change their mind, but it doesn't say whether or not these are the same people that have already indicated their preferences.

http://www.organdonor.gov/survey2005/presumed_consent.htm

The numbers may be different in the UK where there is considerably higher support for a presumed consent system (64% vs. 43.2%).

http://www.bma.org.uk/pressrel.nsf/wlu/SGOY-784DRQ?OpenDocument&vw=wfmms

Linda

 

[Soapy Sam]

I suppose actually acting- on any issue- takes effort.
If the system is not something of great personal interest, the default position is to do nothing.
There are two issues here- organ donation, which really doesn't interest me much and government intervention in my life, which interests me considerably.

Under the present system, I used to have a donor card, but when it fell to bits, did not bother to replace it. If someone handed me one, I would probably put it in my wallet. Beyond that, I'm uninterested.
If Whitehall tell me I should have one, I'm likely to throw it away.

This is irrational, even petty. But there it is.

 

[EHocking]

If that were the case, then it wouldn't include provisions for consent as to what use is made of those human remains, since transplantation, anatomy labs and other research uses are obviously considered suitable areas for disposal.

Linda

The reason it includes provisions for consent is because the previous act(s) did not. The following are the notes on the reasons (in part) for reviewing the 1961 act:

...in the legislation, there is no specific requirement for consent to be given for the removal or use of tissue and organs. It is only required that 'reasonable enquiry' is made of relatives where a patient has died without making his or her wishes known. In practice, the Department of Health now interprets this provision as requiring properly informed consent.

However, a fundamental consideration for the legislative review is to clarify this process of obtaining consent.

All studies on the subject that I've read so far have all stated that the 2004 act will require changes in order to implement the opt-in system. Thi concern has even been address by the Taskforce put in place to improve donor rates in the UK state,

"any move away from a system relying on expressed consent
must be shown to be a justifiable exception to the current ethical norms."

Clearly this indicates that there is concern that the government wishes to change the current protection of individual's wishes by legislation that protects their instructions of informed consent, and implicitly refusal.

Under the op-out proposal, they do not intend to create a register of those that wish to opt-out, but to automatically register everyone as a donor unless informed otherwise. Smacks of totalitariansim, to me.​

 

[fls]

I suppose actually acting- on any issue- takes effort.
If the system is not something of great personal interest, the default position is to do nothing.
There are two issues here- organ donation, which really doesn't interest me much and government intervention in my life, which interests me considerably.

Under the present system, I used to have a donor card, but when it fell to bits, did not bother to replace it. If someone handed me one, I would probably put it in my wallet. Beyond that, I'm uninterested.
If Whitehall tell me I should have one, I'm likely to throw it away.

This is irrational, even petty. But there it is.

I understand concern over government intervention, but to elect to show that concern over an intervention as trivial as this seems misguided. It's not even that they are telling you what you have to do. You can still do whatever you want. You just have to tell someone what that is. And you don't even have to do that if you feel the same way as most other people. All that would be changed is that last line, from "you don't even have to do that if you feel differently from most other people".

If it was made that easy to marry someone of the same sex, we'd all be dancing in the streets.

I guess that wasn't fair, since you did admit that it was irrational and petty.

As it is now, if the system fails (i.e. the true wishes of the dead are not followed), another person fails to receive an organ transplant and dies. If the system fails under presumed consent, the organs are removed from a dead person when there is no one to care if they are gone. Does our society really consider the avoidance of the latter more important than the avoidance of the former? It may be that the answer is "yes".

Concerns about ID cards and DNA theft may be legitimate, but they are a separate issue from that of presumed consent. To piggyback those concerns onto this issue only serves to obscure it. And I say all that without being in favour of presumed consent.

Linda