Organ donation - presumed consent alternative

[OMGturt1es]

I don't have time to read the entire thread. Am I the only one that thinks that a dead person ought have no claim to organs? Is it worse to treat a body against the wishes of a dead person-- or even the living relatives-- or to let someone die?

 

[Professor Yaffle]

There was a good article in The Guardian yesterday on this issue, and it brought up an issue that I don't think has been mentioned here - that of "survivor guilt". The idea is that recipients of organs often feel guilt that they are only alive because someone died, and that part of the process that makes that a bit easier is recognising that the organ was a gift that was freely given, and that it was something that the donor explicitly wanted. The argument was that if presumed consent was brought it, this might make things more difficult for the recipient to accept. Imagine having an organ in you that you weren't sure that the person concerned was happy about donating.

Anyway, here's the article:
http://www.guardian.co.uk/society/2008/nov/18/organ-donation-health-policy-transplant

 

[Ivor the Engineer]

There was a good article in The Guardian yesterday on this issue, and it brought up an issue that I don't think has been mentioned here - that of "survivor guilt". The idea is that recipients of organs often feel guilt that they are only alive because someone died, and that part of the process that makes that a bit easier is recognising that the organ was a gift that was freely given, and that it was something that the donor explicitly wanted. The argument was that if presumed consent was brought it, this might make things more difficult for the recipient to accept. Imagine having an organ in you that you weren't sure that the person concerned was happy about donating.

Anyway, here's the article:
http://www.guardian.co.uk/society/2008/nov/18/organ-donation-health-policy-transplant

I already mentioned that (ETA: see post #5). I think it's a good point.

 

[Professor Yaffle]

I already mentioned that (ETA: see post #5). I think it's a good point.

Sorry Ivor, I forgot you said that.

 

[Ivor the Engineer]

Sorry Ivor, I forgot you said that.

No problem.

I'd like to pick up on this dodge by Linda:

A private doctor isn't preventing someone from getting treatment though, even if the treatment doesn't come from them specifically.

I can only think this line of thought is to help private physicians sleep better at night, allowing them to believe that somebody, somewhere will help the people who they will not because they cannot afford to pay their fee.

 

[fls]

It can be part of the school curriculm. You get taught that you have the choice to opt in at 18. If you're apathetic you don't get the preference. That's the consequence of being apathetic - you miss out on the things in life that you don't take an interest in.

May be to be fair to apathetic people who are already over 18 the scheme should start from now with 18 year olds. To make sure people have definitely been educated how it works.

If you're going to put more resources into the system, why not just do that for an opt-in program?

Yes but the offer of reward is the incentive at the point of opting in (normally age 18).

Yeah. I'm just saying that at that point it's not going to seem like a big deal, considering that it's highly unlikely they'll ever receive that reward. It might be better to go for a cool tee shirt instead.

The 'punishment' of imminent death is not a factor for getting people to opt in - those that are already ill are not the target group. When you originally brought up imminent death I believe you were under the impression ill people were the likely people opting in, so it is a bit out of context now.

Yeah, just like the reward of imminent organ transplant is not the factor for getting people to opt in.

After going through the election here and listening to the discussions about earmarks, I keep picturing add-ons. "Lets see if we can get them to recycle, as well."

Linda

 

[fls]

I can only think this line of thought is to help private physicians sleep better at night, allowing them to believe that somebody, somewhere will help the people who they will not because they cannot afford to pay their fee.

An interesting question, but it seems to be off-topic for this thread.

Linda

 

[Ivor the Engineer]

An interesting question, but it seems to be off-topic for this thread.

Linda

I know. Sorry, it's just the way my brain works.

I've started a thread in Social Issues & Current Events for anyone interested:

http://www.internationalskeptics.com/forums/showthread.php?t=129142

 

[Soapy Sam]

I think there are aspects to this which are neither truly medical , nor social.

It seems yet another example of central government adopting a "We know better than you" attitude.
In this case they think they know better than me what I want to happen to my body when I die. Sorry, but I feel that's none of their damn business.

I have donated some 50+ units of blood over the years, for which I get a cup of tea, a biscuit and the thanks of the people in the donor centre. And that's fine.
If Mr.Brown made blood donation compulsory, or required an opt out, I would fight him tooth and nail.
Why?
Because I hate being told how to behave by a bunch of jerks, many of whom appear to have the morals of a rabid mink.
Is that petty and selfish? Possibly.
I won't carry their damned ID card either.

 

[Uncayimmy]

I agreed with the logic of the post I quoted, that once you start discriminating on one basis (having opted in) you could start discriminating on many other factors. Some of these factors may be less clear cut (eg have you lead a healthy lifestyle or other) as Ivor said "where do you stop?"

I am the one arguing that it should be a factor on which decisions are based. Why are you asking me this?

Obviously I am confused by what you mean.

They already discriminate on a number of factors. The "let's not do it because, I dunno, where do you stop?" argument is not "logic". It's just throwing up your hands and giving up.

 

[Ivor the Engineer]

Obviously I am confused by what you mean.

They already discriminate on a number of factors. The "let's not do it because, I dunno, where do you stop?" argument is not "logic". It's just throwing up your hands and giving up.

And none of those factors are currently based on how good a person you are considered to be based on arbitrary criteria, chosen to potentially exact some petty revenge on those people you don't consider worthy of saving.

What priority should you be given for health care based on your "goodness"?

 

[Cuddles]

I don't have time to read the entire thread. Am I the only one that thinks that a dead person ought have no claim to organs? Is it worse to treat a body against the wishes of a dead person-- or even the living relatives-- or to let someone die?

No you're not, that's exactly what I was thinking. Once you're dead, your body is no longer you. Are some people really so spiteful that they're willing to let people die just because saving them would involve a piece of meat that used to be part of them?

And none of those factors are currently based on how good a person you are considered to be based on arbitrary criteria, chosen to potentially exact some petty revenge on those people you don't consider worthy of saving.

What priority should you be given for health care based on your "goodness"?

It's a nice strawman and slippery slope fallacy, but has nothing to do with the question at hand. The point has nothing to do with arbitrary criteria, "goodness", revenge or any of that crap. It simply says "If you agree to give X, you are more likely to recieve X if you need it.". That is in no way comparable to "If you do/say/believe/are/have Y, you are more likely to recieve X if you need it.". There is no slippery slope. A preference criterion based on the thing you are giving preference to is not related to criteria based on something else entirely. There are plenty of reasons I disagree with such a preference, being unfair to people who can't donate for example, but there is no need to try to make that argument via logical fallacies.


Overall, I think the donation system has two major flaws that nothing discussed in this thread would address. Firstly, families having the final say renders any system, opt-in or opt-out, irrelevant. Some people, especially various religious fanatics, will refuse to allow either donation or receipt of organs, regardless of the wishes of the person in question. I am sure there are other people who will do the exact opposite. As long as your choice is irrelevant as soon as it actually matters, it really doesn't matter what choice you have in the first place.

Secondly, there simply isn't enough clarity on the matter. Merely encouraging people to donate is not going to help if they don't know how to opt in (or out), and may not even know if they have or not. For example, I have no idea if I'm a registered donor or not. I've never signed up specifically and don't have a card, but I ticked the box when signing up for a driving license, and I think I remember ticking one somewhere else as well. Changing the system, adding incentives and so on won't make any difference if people still don't know what's going on.

 

[Ivor the Engineer]

<snip>

It's a nice strawman and slippery slope fallacy, but has nothing to do with the question at hand. The point has nothing to do with arbitrary criteria, "goodness", revenge or any of that crap. It simply says "If you agree to give X, you are more likely to recieve X if you need it.".

<snip>

It is a totally arbitrary criterion.

What does your willingness to donate your organs have to do with your need for someone else's?

 

[Uncayimmy]

What does your willingness to donate your organs have to do with your need for someone else's?

Selection is not based solely on need, so why do you ask?

As a donor I would much rather my organs go to someone willing to help others in the same way I am. From a practical standpoint I think it *might* result in more people taking the active step of signing the card and making their wishes known to family members.

 

[Cuddles]

From a practical standpoint I think it *might* result in more people taking the active step of signing the card and making their wishes known to family members.

This is the part I disagree with, and is one of the reasons I wouldn't support such selection. The chance of needing a transplant in the UK is around 1/10,000. Between 1/2 and 1/3 of those will actually get a transplant in any given year. People just won't consider odds like that as anything worth worrying about. Sure, wouldn't be much effort to sign up as a donor, but given that there are many more effective ways of reducing risk that take just as little, or even less, effort that people still completely ignore, that's probably more effort than most would bother with.

For example, the chance of being injured in a vehicular accident are around 1/200. That can easily be reduced by not speeding, not using mobile phones, not taking drugs and so on, yet millions of people do them anyway. If people are going to actively make an effort to make things worse for themselves with such a high and high profile risk, it doesn't seem to make sense to assume that they would bother to try to make things better for themselves for such a small, low profile risk.

 

[EHocking]

I think there are aspects to this which are neither truly medical , nor social.

It seems yet another example of central government adopting a "We know better than you" attitude.
In this case they think they know better than me what I want to happen to my body when I die. Sorry, but I feel that's none of their damn business.

I have donated some 50+ units of blood over the years, for which I get a cup of tea, a biscuit and the thanks of the people in the donor centre. And that's fine.
If Mr.Brown made blood donation compulsory, or required an opt out, I would fight him tooth and nail.
Why?
Because I hate being told how to behave by a bunch of jerks, many of whom appear to have the morals of a rabid mink.
Is that petty and selfish? Possibly.
I won't carry their damned ID card either.

I am totally with you on all of this.

The government has absolutely no claim on my body whatsoever.

They didn't pay for me to be born, to be educated, for my nutrition, for my health and certainly won't pay for my funeral.

Before anyone drops the "T" word - any public health or education services I have received during my life has either been paid by myself or my parents through taxes. The government has merely spent my money.

On what can they claim to have greater "ownership" of my carcass than my family that I leave behind?

No to opt-out and No to ID cards.

 

[fls]

On what can they claim to have greater "ownership" of my carcass than my family that I leave behind?

No to opt-out and No to ID cards.

I'm confused. How would an opt-out program prevent you from directing what happens to your carcass?

Linda

 

[Ivor the Engineer]

I'm confused. How would an opt-out program prevent you from directing what happens to your carcass?

Linda

Here's an idea which may make the idea of opt-out rankle with some people.

Opt-in differentiates between those who care about being a potential organ donor and those who are ambivalent about the issue. Opt-out groups them together.

 

[Uncayimmy]

This is the part I disagree with, and is one of the reasons I wouldn't support such selection. The chance of needing a transplant in the UK is around 1/10,000. Between 1/2 and 1/3 of those will actually get a transplant in any given year. People just won't consider odds like that as anything worth worrying about.

So, you oppose it because the net effect would be no more additional donors?

 

[EHocking]

I'm confused. How would an opt-out program prevent you from directing what happens to your carcass?

Linda

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

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