organ donation to non donors

[Internistt]

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Everyone knows there is a shortage of organ donors everywhere. Would it be wrong to deny organs to those who aren't organ donors? I know this might sound selfish but why give those who aren't willing to give?

 

[SpecterGT260]

Ethically that's a pretty solid no-no. On the basis that it is never Ok to deny optimal care to people due to their beliefs (deny =/= patient refusal which is not ethically complicated for lucid adults).

However Morally (which is not the same as ethically) I'd have to say I think it could be a good thing. However, the numbers may work out such that it is a moot point (not enough non-donors taking organs to make any impact). But all things considered I think it is silly for someone to think that they will give a damn what happens to their organs after they die. "Opt-in" organ donation is archaic and has no legitimate rationale that I can think of.

 

[Raryn]

Israel implemented something like that. If you'd been a registered organ donor for X years before you needed to go on the list yourself, you got some extra points towards your standing.

 

[hrandani]

Take a page from the corporations.

Just make organ donation opt-out instead of opt-in.

Boom, problem solved.

 

[DocHawk117]

Ethically that's a pretty solid no-no. On the basis that it is never Ok to deny optimal care to people due to their beliefs (deny =/= patient refusal which is not ethically complicated for lucid adults).

However Morally (which is not the same as ethically) I'd have to say I think it could be a good thing. .

Agreed. Except in the scenarios in which a person is not allowed to donate organs due to healthcare concerns.A less extreme example (rather than organ donation): pt has blood issues. told never allowed to donate blood. should they be allowed life-saving transplant? Yes, both ethically and morally.

However, I'm sure most of you would agree with the blood example bc it is quite different than actual organ donation, but there may be instances, especially in adults who were pediatric patients, that the adult cannot sign up for organ donation, as it would not be prime for the donor. In some states, each individual can be specific about what they want to donate though, and those people could still donate skin/eyes/other tissue most likely.

 

[notbobtrustme]

Take a page from the corporations.

Just make organ donation opt-out instead of opt-in.

Boom, problem solved.

yep, this is the best solution.

 

[SpecterGT260]

Agreed. Except in the scenarios in which a person is not allowed to donate organs due to healthcare concerns.A less extreme example (rather than organ donation): pt has blood issues. told never allowed to donate blood. should they be allowed life-saving transplant? Yes, both ethically and morally.

However, I'm sure most of you would agree with the blood example bc it is quite different than actual organ donation, but there may be instances, especially in adults who were pediatric patients, that the adult cannot sign up for organ donation, as it would not be prime for the donor. In some states, each individual can be specific about what they want to donate though, and those people could still donate skin/eyes/other tissue most likely.

Inability to donate is different than refusal to donate and blood=/=organs.

Blood donation requires a time commitment and I don't think it would be appropriate to alter availability of care based on some arbitrarily dictated commitment of time.
On the other hand, organ donation requires no input on the part of the donor (because he be dead when it happens). I believe the argument being made is that people who refuse to donate organs should also not expect to receive organs should the time come. However I dont think this should be expanded to include people who are unable to donate organs due to whatever reason. The issue there is that most people who need organs will be ineligible to donate anyways.

 

[DocHawk117]

people who refuse to donate organs should also not expect to receive organs should the time come. However I dont think this should be expanded to include people who are unable to donate organs due to whatever reason. The issue there is that most people who need organs will be ineligible to donate anyways.

👍

i like the "opt out" idea mentioned above a lot.

I worked for an organ donation company, and it was really interesting. I hate to say "people who refuse to donate shouldn't be allowed to receive organs," because I truly believe many people do not donate because they are uneducated about how many lives they could save and they have misconceptions about the process and just don't want to contemplate death, in general. An "opt-out" program would be great. Also, more states providing the choice of which organs to donate is a great idea. Maybe some people are more comfortable donating tissue than something they see as vital as a heart, and they do not know they have that option. It would be really cool if they designed a program at the DMVs, where you had to interactively click through computer screens about organ donation. Ex: Click the organs you think are harvested for donation. Next screen tells all of the ones that can be harvested. Next screen tells how many lives each organ can save. Next screen gives statistics about waiting lists, etc. THEN they have to make the choice, and they HAVE to go through this to get/renew their driver's license. Would be great mandatory education and probably an eye-opener.

What do you guys think about systems that harvest convicts' organs when they die?

 

[Morsetlis]

What do you guys think about systems that harvest convicts' organs when they die?

Chinese prisoner executions and abuse come to mind, but in less totalitarian countries it seems fine ethically. I'm not possessive about my organs after I die, but I sure as hell care where/who they actually go to.

Ethically, it is fine to deny optimal care to people based on the principle of not having the resources to give optimal care to everybody. Furthermore, division of scarce goods have to be balanced on both utility and justice. If a person didn't want to be a part of the system when they didn't need it, why should they benefit from the system when they do need it? Obviously, opt-out is the best solution since there are a lot of people who can't donate blood / etc for medical reasons. This would also maximize the supply part of utility.

However, I am tired of people's "beliefs" trampling over my rights and benefits and people getting special statuses and exemptions for themselves. It's not a matter of actual contribution to the system, but a matter of intention.

 

[SpecterGT260]

, but I sure as hell care where/who they actually go to..

No you don't. Unless you have some obscure religion I am not aware of this is inconsequestial to your doctrine

Also right now I feel like I'm setting a rep 😛

 

[Mdard]

OP, if you're serious about that line of thought, here's a pretty interesting article.

View attachment Goodwin.pdf

 

[Internistt]

thanks everyone for your contribution. i like the opt-out idea. one of the posters mentioned an important point that most people who actually need organs cant donate and its going to be hard to draw a line of when actualy is a person allowed to change his mind about organ donation.

 

[Freddie Mercury]

.

 

[peteB]

Take a page from the corporations.

Just make organ donation opt-out instead of opt-in.

Boom, problem solved.

Is an opt-out system legal? I feel like it violates some sort of law or principle.

 

[SpecterGT260]

Is an opt-out system legal? I feel like it violates some sort of law or principle.

Not necessarily. Consent is technically something that only applies to living people.

 

[peteB]

Not necessarily. Consent is technically something that only applies to living people.

Related article I just found: http://muse.jhu.edu/login?auth=0&ty...tute_of_ethics_journal/v012/12.4wicclair.html

 

[hrandani]

Is an opt-out system legal? I feel like it violates some sort of law or principle.

You should try thinking instead of feeling.

We have the same system for emergency blood transfusions and vaccines. I think you'll agree it works fairly well in those cases.

 

[SpecterGT260]

Related article I just found: http://muse.jhu.edu/login?auth=0&ty...tute_of_ethics_journal/v012/12.4wicclair.html

I don't think "opt out" violates this. The paper you mentioned discusses violating pre-death wishes. "Opting out" would be an expression of those wishes.

 

[peteB]

I don't think "opt out" violates this. The paper you mentioned discusses violating pre-death wishes. "Opting out" would be an expression of those wishes.

I thought we needed informed consent for anything we did to the person's body. For example, you can't have an "opt out" system for surgeries or any medical intervention.This article argues that informed consent is also important for after death. The person needs to be able to consent to what is done to their body after death as well as during life. So that means we can't do something to the dead body without the person's consent pre-death.

 

[SpecterGT260]

I thought we needed informed consent for anything we did to the person's body. For example, you can't have an "opt out" system for surgeries.This article argues that informed consent is also important for after death. The person needs to be able to consent to what is done to their body after death as well as during life. So that means we can't do something to the dead body without the person's consent pre-death.

There are also things like blanket consent, extenuating circumstances, and..... that may be it 😳

The point is that many aspects of ethics are opinions. I don't know of a law that forbids it and I don't think a family would have a strong case if they chose to sue in an opt out system.



Let's say someone dies without a family and without a will. What do we do with them? I believe the standard is cremation but I may be wrong. Either way cremation or burial are still "things we do to them". A default has to be set. Organ donation is a reasonable default. Nobody is compelling it

 

[peteB]

There are also things like blanket consent, extenuating circumstances, and..... that may be it 😳

The point is that many aspects of ethics are opinions. I don't know of a law that forbids it and I don't think a family would have a strong case if they chose to sue in an opt out system.

Yes, but blanket consent is still a type of consent. An opt-out system where you can manipulate the body after death with no prior consent would definitely be sue-able. In our legal system, you need to have some sort of consent to do anything to a person's body.

 

[SpecterGT260]

Yes, but blanket consent is still a type of consent. An opt-out system where you can manipulate the body after death with no prior consent would definitely be sue-able.

..... not if it is blanket consented. They do organ donation status updates at several places. The DMV is the most common. You sign the thing you are blanket consented.

All you need is a signature on one thing that specifies standard sets of consent.

 

[peteB]

..... not if it is blanket consented. They do organ donation status updates at several places. The DMV is the most common. You sign the thing you are blanket consented.

Ok, but you're still signing something, so you're giving consent. So technically speaking that's not "opt out". A system where we could take the person's organs even if they never signed anything would be truly "opt out".

 

[SpecterGT260]

Ok, but you're still signing something, so you're giving consent. So technically speaking that's not "opt out". A system where we could take the person's organs even if they never signed anything would be truly "opt out".

True. But we also only need consent for things the law dictates. An opt out system would be legislated and therefore not against the law

 

[peteB]

Let's also keep in mind that opt out systems don't neccessarily increase donations. Sweden has an opt out system and it has a donation rate of 15 donors/million. The US average is 26 donors/million.

 

[SpecterGT260]

Let's also keep in mind that opt out systems don't neccessarily increase donations. Sweden has an opt out system and it has a donation rate of 15 donors/million. The US average is 26 donors/million.

Thats fine. The impact on donation rates also has nothing to do with the legality 😉
And.... the sveedish are much less lazy than the average 'Murikan

 

[peteB]

True. But we also only need consent for things the law dictates. An opt out system would be legislated and therefore not against the law

Of course it was legislated then it wouldn't be against the law, by definition. But it's not legislated right now. The question is would we be able to get it legislated. I think that would be difficult because it goes against what most Americans want in terms of consent.

 

[SpecterGT260]

Of course it was legislated then it wouldn't be against the law, by definition. But it's not legislated right now.

😕 nobody is saying it is.... we were talking about the possibility of implementing such a system. It would have to be legislated.... I thought that was understood. We werent just gunna start snagging livers and hope nobody notices.

 

[peteB]

😕 nobody is saying it is.... we were talking about the possibility of implementing such a system. It would have to be legislated.... I thought that was understood. We werent just gunna start snagging livers and hope nobody notices.

Right- so the question is can it be legislated. I think it will be difficult since most Americans would probably take issue with the government mandating that things can be done to their dead body without their prior consent. Obviously I have no evidence to back this up so my statement isn't very meaningful, but that's my feeling.

 

[SpecterGT260]

I see what you did there

 

[peteB]

I see what you did there

👍

 

[Internistt]

I thought we needed informed consent for anything we did to the person's body. For example, you can't have an "opt out" system for surgeries or any medical intervention.This article argues that informed consent is also important for after death. The person needs to be able to consent to what is done to their body after death as well as during life. So that means we can't do something to the dead body without the person's consent pre-death.

optout is actually how it works in medicine and surgery of emergency patients who cant consent.

• 
  if you come with hemorrhagic shock with no relatives by you, you are getting blood unless it was stated before that u don't want transfusions.

• if you are mentally unstable, your consent means nothing.

• if your family refuse to give consent for an important medical procedure when you are unconscious/ cant consent for whatever reason, it might take longer with the involvement o superitendant and magistrates but you are most likely gonna get that procedure.

• if you are super healthy and state that you dont want an autopsy after death, you are gonna get it if you die of unnatural causes.

this is how it works in South Africa so take what i say with a grain of salt.

 

[yesno]

Fine by me. But I am not an organ donor and prefer it to stay opt-in. I am a healthy person and I think there is a greater chance that in case of some car accident I might be forced to donate organs rather than I will ever make use of somebody else's organs.