AIBU to think that it is immoral to have financial incentives to harvest peoples' organs on the NHS?

[ZhenThereWereTwo]

AIBU to think that to give hospitals financial incentives for numbers of organs donated leaves a lot of scope for corruption, especially when dealing with elderly, vulnerable, disabled or people with learning difficulty. Alder Hay and many other stories show us that medical professionals do not always act with integrity or to the Hippocratic oath.

Article here.

Evidence portfolio from NHS here.

Whatever you think about the proposals, I would encourage you to add your voice by filling in the survey here.

It is likely that they will not have many people doing the survey from non-medical backgrounds as it is not widely advertised, but it is your way of giving your opinion on the proposals.

My MIL was in intensive care with only 20% chance of survival, they told us she would not wake up again as she was on life support and in a coma with little brain activity.

Well she did wake up and she was no vegetable. Would they have harvested her organs under these new proposals, I think so.

Organs are harvested when technically you are still alive.

Some hospitals give the donor an anaesthetic and some don?t, there is medical research that shows brain stem dead people respond to pain stimuli.

The government has no right to lay claim to my organs unless I opt to give them. This automatic donation unless you opt out infringes my human rights to decide what happens to my body once I am no longer conscious in a U.K. hospital.

To be quite frank these proposals scare me. I will be telling everyone I know to be very careful about organ donation, because there are many documented cases of people waking up from comas, strokes and even some waking up in the morgue.

So unless it is your intention to occasionally kill and harvest people that could have survived, against their wishes in some cases, you need to think about these proposals. I think organ donation is important, but not at the expense of our human rights. A sick person doesn't have more rights to my organs than I have rights to choose whether to donate or not.

What is the point of saying 'something' to a keyboard warrior basing their campaign on something that didn't and wouldn't have happened to someone they are related to by marriage?
Someone whose evidence also contains references to events that hpoenec before relevant legalisation and d nothing to do with organ transplant.

If you are too selfish and / or scared to donated your organs after your deth then don't.
Why is it so important to you to dissuade others?

I cannot abide people who latch on to a cause to make themselves feel important whist doing precisely nothing to actually help anyone.

You are right, fucking hilarious

And another thing, donation if a kidney isn't an easy process. It took us two years. In which time the person I was wishing to donate to, had two heart attacks.

They make you jump through hoops and constantly pressurise you to make sure you are comfortable with the decision. I questioned myself numerous times and did it purely out of love. But was I scared? Of course I was. Live kidney donation is not an easy solve all solution. And speaking as someone whose child will eventually need a large organ transplant, the UK needs to make steps to making sure that there are more people on the register.

I think any incentive the government can use to harvest organs of the deceased is a positive step towards learning more about organs and organ donation. If a family want financial compensation to donated a deceased ones organs then so be it.

If you can't be bothered to sign your name on a form to opt out, you obviously don't give much of a shit whether they use your organs or not.
You seem to be arguing that someones right to be a lazy bastard is higher than other peoples right to not die.

Well done you, good campaign.

Seriously? WTAF?
Op organ harvest is only carried out after two Doctors who must be GMC registered for at least five years and one must be a consultant. Two series of tests are repeated on two seperate occasions. These tests determine brain death or not. Brain dead= dead. You can stay on life support untill your organs eventually fail but you won't wake up. All the harvests I have been involved with were given a full general anaesthetic, incuding opiate pain relief, They are treated with the utmost respect at all times before, during and after. To suggest that HCPs would harvest organs from patients whom may not have been diagnosed brain dead by a very strict set of criteria is actually offensive crap.

You can bet my considerable backside that if your child or you needed a liver, kidney, heart, lungs, bowel, corneas you would falling over yourself to consent. I can't quite believe that you would actually try to put people off giving their organs to help others in the event of their death.

Here you go OP educate yourself, brainstem death tests and criteria,
Brain-stem death testing can only be carried out when clinicians have satisfied themselves fulfils the pre-conditions for testing, and
that the influence of potentially reversible causes of coma and/or apnoea have been excluded. See Neurological Death, Planning for
details.
Detailed guidance on undertaking brain-stem death tests is published by the Academy of Medical Royal Colleges.
Clinical assessment of brain-stem function
Clinical examination must be carried by two physicians working together and must be repeated. At least one of the doctors must be a
consultant and both must have been fully registered with the GMC for more than 5 years). Neither must be potentially involved in the
care of patients who might be in receipt of organs donated by the patient.
Clinical examination of brain-stem reflexes
Demonstration of brain-stem areflexia variously reveals loss of hind brain function at the level of the mesencephalon, pons and
medulla oblongata.
? The pupils are fixed and do not respond to sharp changes in the intensity of incident light. (mesencephalon, II and III).
? There is no corneal reflex (pons, V and VII)
? The oculo-vestibular reflexes are absent. No eye movements are seen during or following the slow injection of at least 50mls
of ice cold water over one minute into each external auditory meatus in turn. Clear access to the tympanic membrane must be
established by direct inspection. (pons, VIII, III, IV, VI)
? Access to the above reflexes may be prevented on one or other side by local injury or disease but this does not invalidate
clinical testing. In the case of bilateral injury or disease, ancillary testing should be considered.
? No motor responses within the cranial nerve distribution can be elicited by adequate stimulation of any somatic area, e.g. by
supraorbital pressure and pressure applied to the nail bed of a finger (the latter may be contra-indicated by a spinal injury).
Care must be taken to distinguish central response from primitive spinally-mediated reflexes that can be ignored in this context.
? There is no cough reflex response to bronchial stimulation by a suction catheter placed down the trachea to the carina, or gag
response to stimulation of the posterior pharynx with a spatula (medulla, IX, X).
Apnoea Test
The apnoea test should only be considered once brain-stem areflexia has been confirmed, and is performed as follows:
? Increase FiO2 to 1.0
? Check arterial blood gases to confirm that the measured PaCO2 and SaO2 correlate with the monitored values
? With oxygen saturation greater than 95%, reduce minute volume ventilation by lowering the respiratory rate to allow a slow rise
in ETCO2
? Once ETCO2 rises above 6.0 kPa, check arterial blood gases to confirm that PaCO2 is at least 6.0 kPa and that the pH is less
than 7.40.
? If cardiovascular stability is maintained, disconnect the patient from the ventilator and deliver oxygen at 5L/min via an
endotracheal catheter. Observe for five minutes. If the maintenance of adequate oxygenation proves difficult, then CPAP (and
possibly a prior recruitment manoeuvre) may be used
? After five minutes of apnoea repeat arterial blood gas, confirm a minimum of a further 0.5 kPa rise in PaCO2. Loss of respiratory
drive is confirmed at this point and mechanical ventilation resumed.
A summary of the tests to be undertaken are:
? The pupils are fixed and do not respond to sharp changes in light intensity
? There is no corneal reflex
? The oculovestibular reflexes are absent.
? No motor responses within the cranial nerve distribution in response to stimulation of any somatic area
? There is no cough reflex response to bronchial stimulation by a suction catheter placed down the trachea to the carina, or gag
response to stimulation of the posterior pharynx with a spatula
? There is no evidence of spontaneous respiration or respiratory effort during the apnoea test

www.organdonation.nhs.uk/ukt/about_us/professional_development_programme/pdf/Neurological_Determination_of_Death_Testing.pdf

I fear you waste your breath.
The op has a cause.
Because of what she imagines might have happened to her MIL but didn't.
Idiot

I AM A REGISTERED DONOR, for the third time. My husband is not, he is happy to not get the benefit of a transplant in return for not being a donor.

Implenting an opt out system would cost 45 million as quoted on site Reindeer linked to. They also talk about the fact that the opt-out system in Spain did very little to improve donation rates.

This is not about my MIL, this is about people having the choice to donate or not.

Not all people have the contact with the services needed in order to choose to opt-out. Some people are vulnerable, illiterate, have learning difficulty, mental illness, who will opt out for them if they wish to?

I am on a campaign to get people to fill in the survey, to make your views known to the NHS.

My opinion is my opinion, I do not expect you to agree nor do I want you to.

Thank you for the information Demented, better to be informed than ignorant.

People DO have the choice whether to donate or not. Even if they change the system, they will still have the choice whether to donate or not.

So, again, what are you wittering about?

But people will still have the choice

Like demented said much more eloquently than I could, you can't just have your organs "harvested" on a whim.

There is strict criteria.

Implenting an opt out system would cost 45 million as quoted on site Reindeer linked to. They also talk about the fact that the opt-out system in Spain did very little to improve donation rates.

Peanuts really, 45 million. It's a day in Afghanistan paid for.

however if 'compulsory' donor (or even blood) were legislated, you would have the same apathy with people not bothered to opt out, as you have for people not bothered to opt in.

I can't see it has bankrupt the Scandanavian counties where it is compulsory to donate blood in order to retain your driving licence.

lets face reality. Organ harvesting? anything a 70/80/90 might have quite probably would be of no use for 'recycling' due to the age of the original owner.

Did you not read any of the personal stories on that website I linked to?

Clearly not.

Donate or don't donate but please don't bring about a campaign against donation when there are already fewer donators than those in need.

And Demented Housewife explained perfectly about brain stem deaths and organ harvesting. Stop scaremongering, it makes people who didn't have an opinion on organ donation too afraid to join the register in the first place.

What is it, you would rather people not be aware of the survey and proposed changes? Anybody reading this who wants to donate still will and anybody who doesn't won't, but they have a right to make an informed choice.

"First it is not clear that, in the syndrome usually diagnosed as brain death, the whole brain is entirely destroyed. Residual hormonal function, maintenance of blood pressure and the presence of certain reflexes, as well as the presence, in some cases, of measurable electrical activity in the brain, particularly in response to stimuli, all cast doubt of the supposedly 'total' character of brain death [McCullagh (1993), Byrne (1993), Kaukinen (1995)].

Most strikingly, the beating-heart cadaver often has to be anaesthetised, or paralysed, to prevent it reacting to the operation; otherwise blood pressure sometimes rises dramatically when the incision is first made [Evans (1989)].

The supposition that the body cannot maintain itself as a system without a functioning brain is also one that is open to question. There have been cases, particularly among children, where brain dead patients have been 'maintained' for many weeks.

The continued functioning of the body as a whole - blood flow, metabolism, body heat, blood pressure, growth, healing - is evidence that the body is not dead [Seifert (1989), Jones (1995), Shewmon (1997), cf. Jonas (1974)].

For such reasons many people, again including medical professionals, prefer to believe that what is significant is not the death of the body, but the 'death of the person' [Gillon (1990), Gillet (1990), Lizza (1993)]".

Source.

I am not campaigning against donation, I am on the donor register. It is I believe funamentally wrong that people who cannot for whatever reason opt-out themselves will be forced to donate organs against their wishes. If free-choice is still ok in the U.K opting in would be fine, just campaign to get more people to register.

We need to also have a discussion as a society about what constitutes death involving not just medical practicioners, seeing as it affects us all.

Is it not on to have your own views and voice them on MN anymore? If you don't agree have your say, but don't tell me not to have mine. You can call it scaremongering, whatever you like that is the beauty of free speech.

People don't just read the OP's post, they also read the replies and will make up their own mind based on the links I provided as well, unless you think people on MN are sheeple who follow the OP's post, well not in my experience, people on here are independent minded enough to decide for themselves

I have had 2 transplants. Between the 1st and second I was so ill my parents thought there may be a way to 'buy' an organ. That is how desperate it sometimes gets. Please don't try and discourage this you have no idea unless you have been there

"We need to also have a discussion as a society about what constitutes death involving not just medical practicioners, seeing as it affects us all."

No we really don't. We have a pretty solid definition of death already, and its for medical professionals to determine it, not the likes of you.

No noddy, the OP knows fuck all.

I know SB I don't think you can ever know without experience so really should keep quiet. There is nothing as bad as being kept alive by a machine that is what I found the hardest I kept looking at it like it was in charge of me and it was so scary to be so attached to something mechanical and so reliant on it .

I just didn't realise you needed personal experience of a situation to stop you being a complete knob about it.

Well you don't you just need compassion but in the absence of that you need to have experienced it to really get it.

I can't imagine the OP ever 'getting' anything!

Do you have any links to recent research OP'
The most recent you have quoted is 17 years old.

We need for this all to be much more open because if it was those waiting for an organ would be relieved of the guilt of basically feeling that they are wishing someone dead so they can live. That is hard to say but its true there is a huge survivial instinct in us and when you feel life slipping away you do somewhat lose your morals and mind a bit! Once you are well you are appalled at yourself and can't believe you ever thought that way.

A discussion about what constitutes death? With whom?
Amy Childs, Timmy Mallet, Noel Edmonds and Peter Andre?

Do you understand about the brain, central nervous system and autonomic nervous system op? Blood pressure and pulse rate rise due to stimulation of nerves during surgery, registering pain by increasing blood pressure and pulse. Opiates are given alongside anaesthesia to conteract this response and prevent sudden rise in BP which can damage organs. The respiratory motor in brain stem death does not work. There is no brain actitvity that will support life. The heart will beat untill it fails. Brain stem death means the brain can no longer function, the body can no longer function without full life support, the patient won't ever recover, there is no brain activity to support life.