To ask you not to leave it until it's too late.....

[KnappShappey]

to discuss organ donation with your family and next of kin.

New statistics released today show that organ donation has dropped by 5% for the first time in 10 years.....

Only 58% of families allowed organ donation to go ahead despite the wishes of their loved ones.

Don't leave it to your family to struggle with the decision once you have gone, discuss it today........

You can register online and share your decision on Facebook to raise awareness amongst friends.

The fact you are on the Organ Donation Register would protect the medical staff, but in practice, if a next of Kin refused to let the donation to go ahead, the medical staff would not proceed, as the adverse publicity would do much more damage to organ donation than not taking the organs from one body.

You have to bare in mind too, that healthcare staff all work on the basis of consent, so anything that involves opting out or presumed consent, such as measuring children in schools, organ donation in Wales, summary care records, care.data etc etc are all morally and ethically dodgy. A lot of healthcare staff are against these things.

But the implication of that statement is that the person whose consent matters is the relative and not the patient. Why shouldn't you be able to make a binding decision and give consent before you lose capacity?

You can make a binding decision, but the staff at the time have to look at the bigger picture. The fall out from one badly handled donation would cause a big problem.

Remember Alder Hey?

Exactly, Libraries. I must be able to write a legally binding document surely about what happens to my body, just as I can do so regarding my other material assets such as money?

My bodily autonomy is up to and including death, isn't it?

Adler Hey was the opposite of consent, though.

Yes a badly handled situation could have fall out. But all the DM type situations you are envisaging stem from the fact that the medical team have a choice. It would be different if they had no discretion.

I wouldn't be surprised if this small drop in donations is due to recent events in the NHS - the care.data debacle. Perhaps the public are starting to show their emerging distrust of the medical professions.

It will be very interesting to see what reaction to donation rates the presumed consent law in Wales will cause. I would not be surprised if the plummet. I hope they do - not because I want people to die, but because politicians need to be sent a message that people should have the autonomy to make their own decisions It is not the State's place to make decisions for them.

But people don't have autonomy to make their own decisions now. Relatives do.

I don't agree with opt out. But I do think people should have autonomy (whether yes or no )

Alder Hey was the opposite of consent.

Exactly. Opt-out is the opposite of consent.

Relatives making decisions is better than the State making decisions. Ideally, the donor's wishes would be acted upon. But how can they be given priority over relatives without damaging the medical staffs' reputation?

How would it damage their reputation if the law was that a binding decision by the donor couldn't be overruled?

Because by entering into a conflict situation, that could turn violent, and generate adverse publicity. And why should medical staff uphold a donor's decision above a relative's refusal? It is not the place of medical staff to do that. It could be argued that a relative has more say over a dead body than medical staff, or indeed the previous decisions of the person when they were alive.

I am not saying that I agree with that, but it it would not be in the interests of the medical staff involved to enter into a disagreement about someone who is dead.

It is for these reasons that people are encouraged to talk about organ donation and their wishes while they are still alive. So that these decisions do not have to be made when they are dead.

Why should they uphold an individual's own decision over that of the relatives? Is it really so hard to see why so many people feel that that is EXACTLY what they should do? It is my body, I should be able to make a binding decision.

Also, this is still coming from the assumption that the relative has some say. Why shouldn't it be (to paraphrase) "I am very sorry, but your husband made his wishes very clear and affirmed his consent 7 times at the regular renewals. I know this is painful but it is not my decision or yours. It was his and he has made it.".

Really interesting posts, Zadoc, I think people need to get used to the idea of the mechanics of organ harvesting so that it doesn't present as a great shock should the worst happen.

Yes, that is what should happen, but who do you propose is responsible for upholding that decision? If you were there, would you deliberately enter into a conflict situation? They are doctors and nurses, and they are not going to drag a dead body they do not own away from grieving relatives, who they have just made angry, into an operating theatre to 'steal' (in the eyes of those relatives) organs.

A family friend's beautiful, gorgeous, delightful little boy suffered heart failure after a massive infection at a few months old. He was lucky enough to have a donor match, and at 18 months he is now doing really, really well.

The other family's appalling loss is something his mother is so aware of, and she wrote a letter to be passed on expressing her condolences and her gratitude that this unknown mother's choice allowed someone else's child to survive.

We are all on the donor register. To have our organs used, we'll be dead. We won't need them or even be able to use them, or know anything about it. Someone else's family will be spared, hopefully, the agonies of grief premature death inevitably brings. It's the one positive from unbearable loss, surely? That another family can possibly escape it?

I completely support an opt-out. I respect people's right to bodily autonomy, absolutely. But if it matters to that degree, people should log that objection. In cases of apathy, the assumption should surely be to save life.

Libraries but at present we do not have a registration system which permits regular renewal/reaffirmation of wishes. Even if we did (and it was somehow paid for/administered), the vast majority of people wouldn't bother to keep their details up to date. How many remewals would count as 'binding'? How does that get over the situation where the relative raises issues of capacity? How does the medical team justify the physical removal of a grieving relative from the deceased's bedside?
The adverse publicity would do too much harm. Donation rates fall every time there is a major incident which undermines the public's trust in the medical profession - this is documented. Organ retention scandals, unauthorised PMs - even Harold Shipman. Anything that undermines that trustneeds to be avoided, and all it takes is a few cases which are not clear-cut and you get exactly that 'Hospital killed my granny and stole her organs' kind of headline.

Relatives need to be convinced to consent -not simply overruled. And the best way to do that is to make sure yours know what you want.

Opt out all the way - I assume, perhaps wrongly, that a big part of the problem is that people simply forget to opt in.
Am also shocked family can 'overrule'. I'd be livid if ghostly-me saw my family override my donor card!

I didn't say it should take renewals to become binding.

I really don't see that a binding consent which expired after two years if not reviewed would be that hard. My driving license asks me every 10. My doctor manages to ask me.about the fucking coil and smears all the bloody time. I don't see why some sort of nudge that your consent had expired and to log on could not also flash up if you registered your decision with your GP. If we wanted to we could make it happen . I am not saying everyone has to have a decision on record. Just that you should be able to.

I am all for not arguing with relatives. but it makes no sense that not creating upset with them is more important than honoring the patients decisions.

vvviola Spain has an opt-out system.

I have a question for any experts out there.

I can't give blood because I had cancer / chemotherapy 27 years ago. I have tried again recently (thanks to a nagging thread on MN) but been told that they won't ever be able to use me as a donor because of possible risks to recipients.

Will this also mean that my organs won't be used?

Is there anything else useful I could sign up to eg medical research or would that be ruled out too?

The thought that my ghastly mother could swan in and overrule my deeply held and recorded wishes to donate, seems ethically wrong to me.

My body, my choice.