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.

You do know that there have been many lengthy debates about about what constitutes brain stem death by many practitioners, politicians, and members of the public who are either donators or recipients.

You aren't the first person who has thought of this debate. Google Emily (founder of the website I linked to) she has been debating this issue with consultants and politicians since she 20. Fair enough to bring it on MN but the biased 'immoral' stance doesn't help the cause that has affected to many MN'ers. Why not think of a non contentious way to argue your case.

Sauvignon - was your comment about being a knob aimed at me? paranoid

Timmy Mallet, Peter Andre, whoever, it is their right to make an informed choice about donation and given that death comes to us all, then why shouldn't Joe Bloggs be able to be part of the discussion or is the discussion reserved only for a certain 'type' of person.

If the medical professionals view is the only one that counts then why do they have to defer to the individuals wishes and those of their family? Because it is their human right.

The brain stem death criteria are formed by consensus, but not everybody even in the medical profession agrees with it.

Dr David Evans, Consultant Cardiologist says "The retrieval of organs from the so-called ?brain stem dead? must now be seen as a pre-mortal surgical procedure upon a paralysed patient who is not certainly permanently unconscious." Source.

Dr David Hill, Consultant Anaesthetist objects on these grounds: Source

1. We are removing organs from people before we would declare them dead for any other purpose.
2. We are deliberately concealing this from would-be donors and their relatives.
3. We are failing to obtain properly informed consent - the donor card is inadequate.
4. We are failing to offer anaesthesia for the operation (this last one is variable depending on the hospital).

Is it biased to have ones own view and opinion? Do we not live in Britain?

The whole issue is contentious by its very nature.

Would my view be less biased if I agreed with yours, or are the only biased views the ones that disagree with yours?

Its too late and I'm too tired to debate all the points you raise in your scattergun postings (and many are doing so much more eloquently than I could) but I had to respond to that post quoting David Hill. I worked with him on many occasions. Lets just say he was known for his um... lets call them 'individual' views? I never heard a single one of his anaesthetic colleagues support his views on this subject, in fact many vehemently opposed him.

And to be frank, the stuff about how staff reacted and who put what in the operating register is a lot of irrelevant nonsense.

No you said a debate about what death means.
The point of having a scientific debate with Timmy Mallet would be what exactly?

I know several doctors who would scoff at this claim: 'We have a pretty solid definition of death already, and its for medical professionals to determine it, not the likes of you.' Will have to check with my anaesthetist friend - maybe she's more skilled in this - but my GP friends joke about not being trained or qualified to diagnose death at all. Yet they are the ones called on to issue death certificates for anyone who dies outside hospital.

'Not the likes of you' is a worrying stance - you may disagree with the OP or find her posts irritating but the debate about switching to an opt-out system and making other big changes to organ donation is a debate for everyone, not just the medical profession.

One thing I have wondered about the organ donation debate, is that if they want more people to opt in, then why don't they ask people to do it more often?

Personally, I disagree with an opt out system, but even more so because the opt in system isn't used as well as it could be.

When I go to the doctors, I'm asked almost every time whether I still smoke and whether I want help to give up. Why can't they ask whether I want to be a donor? If every form we have to fill in for each and every government organisation asked the question, surely that would get more donors.

If people were more educated about what happends with organ donation so that anything they might be worried about could be addressed, that could also get more organ donors.

I agree about 'opting in'; every person has the right to decide what happens to them and their own body. I've never agreed with an 'opt out' principle.

I think the point about apathy is valid; easily overcome though - the same way as Census is. You're required to complete those details - this could be tackled in the same way.

Does your DH know anyone who needs a transplant? Ovviously i may be wrong but I'm guessing no close family members. Did he hold his current view before the experience with his mum?

Focusing solely on organ donation, is there any evidence this has happened to people on the register, any cases of taking organs from people who might has survived? I've never heard of a case but do you think this will have happened? It seems to me that if it was going to happen, it would be more likely to at the moment at a time when there is such a shortage of organ donors whereas if there were more donors the pressure might be less and so the potential for this reduced. Following on from this, it seems to me that those of us currently on the organ register are more at risk now than if an opt-out system were introduced.

I'm in favour of opt-in because I find the idea of paying people who may be desperate and very vulnerable for their organs complete abhorrent. I know having one kidney is no problem for most (I would have given DF one if he's been willing to accept) but I would think this decision is more likely to be taken by people living in extreme poverty whose general health and access to healthcare might be compromised. In the same vein, I think any opt-out system should have a system in place to protect people who aren't able to make a fully informed choice.

Sorry - I am in favour of opt out for the reason above

Bloody hell did you read your own link? They are not incentivising hospitals, they are proposing to give enough money to cover the hospital's expenses.

No your MIL WOULD NOT HAVE HAD HER ORGANS HARVESTED, you have to be brain dead.

You are not kept alive to harvest, this is a proposal, at the moment you have to be dead - personally if I am brain dead I would not care if they took my organs while I was on a ventilator.

there are many documented cases of people waking up from comas, strokes and even some waking up in the morgue.

And not a single one has recovered from being brain dead.

At the moment OP you do not have a choice of whether to donate organs or not - your next of kin does.

When they are issuing a death certificate for someone who dies outside hospital, a trained monkey could do it, since they would have been dead for hours at that point.
If you know doctors who can't tell a cold corpse from a living patient, I wouldn't be going to them for a check up.

And seriously, don't quote people so badly, edam, its insulting to both of us. "not for the likes of you" was clearly (as you know) referring to the "discussion of what constitutes death" means that OP wants. And since she can't tell the difference between a coma and brain dead, and beleives doctors are waiting to pounce on the organs of anyone who takes a quick nap, I maintain she (and the general populace) aren't qualified to decide what death means. Especially since we already know that.

Penis, quite - I said my friends were joking but like many jokes it contains a kernel of truth, that doctors are not actually trained to diagnose death.

'Not for the likes of you' is a pretty patronising thing to say about any topic. Better to explain why you think someone is wrong or ill-informed rather than dismiss them as not being allowed to express their opinion.

Oh but of course Penis the doctors do? They never get diagnoses wrong do they?

It is not so simple.

Here and here and here and here and here and here and <a class="break-all" href="http://www.foxnews.com/health/2011/03/07/teen-returns-home-2-months-hospital-turns-life-support/print%20;%20redirected%20to%20www.nzherald.co.nz/" rel="nofollow" target="_blank">here.

Then we have the 1993 ruling by the House of Lords that patients with no awareness or consciousness, in a Persistent Vegetative State (or PVS), need not be kept alive. Since then, 43 PVS patients have been ?allowed to die? via the withdrawal of treatment and care. Each case has been heard by a judge, but again there are studies showing that PVS can be misdiagnosed source.

They get diagnoses wrong, sure. But not, generally, of DEATH, ffs.

And PVS is not brain dead. All your sources are very well linked, but really have nothing to do with your original stupid point.

Doctors are trained to diagnose death, edam, for most doctors its easy. The ones who have the harder job of determining brain or circulatory death have a lot of extra training. So, yes, they are as trained as they need to be.

PVS is not brain death
So what is your point?

She doesn't have one. We're just supposed to so blinded by all her sources and amazing google skills that we don't notice.

So my GP friends are liars, are they? Maybe junior docs these days are trained but docs who have been working for 20 years were not?

Normally I would agree with you edam re the 'know better than you' thing.
But this is a scientific point not an emotional subjective one.
As a parent I was an expert in how the disease affected my DD but not the disease iyswim.
So I would stand my ground over certain aspects of her care and treatment but would not have been able to treat another child with the same disease.
In the case of brain death we surely cannot leave it to lay people with no proper knowledge?

No, but the opinions of members of the public are entirely valid in terms of responding to a consultation that asks for our views. And the views of members of the public are important when considering major changes to organ donation policy, practice, and the law. And FWIW shared decision making means doctors should involve patients in choices about their treatment. Drug X or Y may give better clinical outcomes but there needs to be a discussion about whether these clinical outcomes actually improve anything that is important to the patient - better scores for, I dunno, lung function may be useful but not significant enough to be worth the side effects or drug regime for an individual, for instance.

Views about policy change are very important.
But the op keeps banging on about near misses as if they are relevant to the decision making process.
The op is a prime example of why expert knowledge is so important.
What if people make decisions based on believing being in a coma is the same as being brain dead?
It is this aspect that enrages me.
Misinformation based on a flawed premises e.g. Her mils organs would have been whipped out regardless.

Wel put Mrs DV

Well -sorry.