What do you think about the new organ donation law? (Opt out)

[Nameitychangity]

Not sure if this across the whole NHS but the leaflet received today is from NHS Scotland.
The organ donation law is changing on 26th March, we will now have an 'opt out' system which means that if you do not specifically register yourself as NOT wanting to donate your organs and tissue after death, then the law will allow your body to be used for organ and tissue transplantation.
What do you think? I'm already an organ donor so it doesn't change things for me personally but it does leave me slightly uncomfortable and gives me the feeling that you do not have control over your own body after death, in fact the state 'owns' it unless you specifically make an effort to declare otherwise. Is this right?
Leaflet also states "if you do nothing it will also mean you agree to certain medical tests and procedures that may be carried out before your death as part of the donation process".
What do you think of an 'opt out' system? Is it fair enough that if you don't register that your body can be used after death?
YABU - I'm dead, they can do whatever they want with my body and I'm happy for my organs and tissue to be used
YANBU - the system should remain opt in and 'opt out' systems are not right

@AlternativePerspective I merely asked if people who wanted to opt out would accept an organ. I never said that I thought that people who opted out shouldn’t receive a transplant.

I don’t agree with it, as my concern is it lead to more refusals from next of kin. The way it stood previously, being on the organ donation register meant that a person has chosen to be there, and represents their wish after death. Family are asked to consent but they had a positive affirmation that the deceased wished this to happen. Many families like to think that it’s what the deceased would have wanted. Now however the next of kin can’t be sure that they are following the deceased wishes, they hadn’t opted out but how do they know it wasn’t an oversight.
We need to ensure our nok are aware of our wishes and that they will respect them.

Tbh I think that we need to be careful not to go too far either way in terms of the outcomes of transplant.

The proclamation that giving someone an organ will mean you’ve given them a new life is heading into the realms of fairy tale thinking, as if all that is needed is a new organ and their life will go back to the way it previously was.

Similarly the suggestion that transplant isn’t the magical cure we think it is is potentially heading down the road of scaring people into not wanting transplant surgery when that surgery may well prolong their life.

The reality is that the answer lies somewhere in the middle.

Transplant recipiants do often go on to live long and fulfilled lives, and sometimes they don’t.

It is true to say that when you have a transplant, if you make it through the surgery and the recovery period, you will still need to take medications for the rest of your life to prevent your body from rejecting the organ. Many people will go through rejection, but others won’t. Many people will rebuild their lives, and others will have more complications, and sometimes people will have complications as well as rebuilding their lives.

There is a poster on MN whose DH had a heart transplant not long after I joined here, so several years ago. He was in hospital on the urgent list and had days to live if he didn’t find a heart, and one came up at the last hour so to speak.

He absolutely did go on to rebuild his life, and I believe they had several more children etc after his transplant. But I tagged that poster in a thread a few months ago, and she said that there had been some issues over the years.

So his life was by no means straightforward, but equally without the transplant it wouldn’t have been there at all.

Sometimes you have to weigh up the choices.

I have to go to the transplant clinic tomorrow to find out how my heart is and whether they need to start work-ups for the list. At the moment I feel incredibly well, so the idea that I could be put on the list and that a heart might come up and I might have to go from well to ... not, overnight is one which I am not entirely comfortable with.

But conversely I have been at the other end of that scale where I had no life, no independence, not even the ability to get out of bed some days, and it scares me more that I could regress back to that state. And as transplant is my only chance of a longer term future, I have to be open to the fact that I may have to undertake this journey sooner rather than later. Bearing in mind that the wait for a transplant can be significant, so if I went on to the list today while feeling relatively healthy, by the time a heart came up I might not be.

There are no black and white answers here.

To all those saying they would opt out - would you be happy to accept an organ from someone else if you needed it?

I’d accept an organ, and will donate if appropriate but my family will give informed consent, I don’t agree with presumed consent so will opt out.

@Jellycatspyjamas families (more accurately next of kin) still have to give consent in an opt out situation. That hasn’t changed.

@countbackfromten

To all those saying they would opt out - would you be happy to accept an organ from someone else if you needed it?

Absolutely not. There aren't any circumstances under which I'd accept a dead donation.

Living donations such as blood is a different concept which I actively support (donate regularly) because it's only a boost to the system that self replenishes frequently. Living with the organ of a dead person inside me is just not something I could do psychologically.

Thankfully this is still a choice, so those who support donation can offer up their body or accept organs. Those who oppose it can make clear that they do not consent. Judging people for either of those decisions is pointless, it achieves nothing but animosity.

To all those saying they would opt out - would you be happy to accept an organ from someone else if you needed it?

By this statement, you are saying that assumed consent is ok. As such, if you state that you would accept an organ taken without explicit consent, you would also have to accept organs without explicit consent. So, would you be happy having a transplant of a pig organ? Or organs grown on mouse backs? (Like ears) where does this end?

I opted out due to presumed consent.

It’s up to my nok. Do they need to be there as I take my last breath or are they happy for me to be wheeled away alive and then be dead.

That’s the bigger thing those who are in the position to donate which many are not have to be taken away from their families to die they don’t get that bit of closure if they want it of holding their loved ones hand while they slip away that are taken away and then announced dead in a room of surgical staff who aren’t trying to save their lives. That’s something the living have to live with knowing that they could of died peacefully surrounded by family or they could die in that operating theatre to maybe help others.

I say help because there is no certain outcome in receiving an organ either.

I think it's disgusting and sets a very dangerous precedent.

The idea that somebody else (or the state) is somehow entitled to our body to use as they see fit unless we specify they are not is just plain wrong. I thought people were pretty clear now that silence does not mean consent, but I guess not.

If silence is not enough to prevent strangers harvesting our organs after we die, then it certainly isn't enough to prevent strangers using our bodies as they see fit when we are still alive.

The law change is sexist as it will affect women the most. No longer can "I didn't give him permission to have sex with me" be a valid argument in a rape trial - the victim would have to actively be fighting the attacker off in order to claim she hadn't consented. And what about drug rape? An unconscious victim can't actively withhold her consent - so according the the Scottish government, she's now fair game for any chancer who happens to come across her?

It's madness, and the shocking thing is people can't see it.

And once you allow the state to own you before death (organs need to be harvested from living people) then what? Does the state get Power of Attorney once you lose your marbles?

Anyone who’s bothered about it should make the effort to opt out.

And I really don’t think relatives should have the right to override that decision.

I think opt out is terrible.

My body, is still my body even after death. I also want to be buried next to ds2.

But that is my opinion and what I want. I would even tick a box that said if you choose to opt out, then you become ineligible for a transplant yourself for 5 years. Just in case I change my mind, I would need to wait.

They can take the bloody lot and welcome.

well, given that opt out came into force in Spain in the 1970’s, and the take-up of organ donation has only increased there in the past 10 years I think that’s a fairly good estimate as to how successful opt out is. (Not).

What do you think is a "successful opt-out". The measure of success would be: have the number of organ transplants increased? Has the register of the number of organ donors increased?

So in Spain we can see that since the 70s there has been an increase in the number of organ donors. There could be many reasons for that, not limited to:

• information has taken a long while to spread, but it has and people have agreed that organ donation is something they want to be on board with
• older people who may have objected more to organ donation have died and younger people who have only known the opt-out system have died and their organs have been donated
• the argument for opt-out / donating organs has, over the past 15 years, taken hold and captured people's imaginations
• etc etc

So you'd need to study what has happened in Spain over the last 50 years to make the take-up of being an organ donor increase.

My guess would be it's a combination of what i said above coupled with great leaps in our ability to transplant organs with better outcomes. I don't know enough about Spain to take more of a guess.

I would also like to see data from countries like South Korea or Scandinavian countries which have, in completely different ways, slightly (or greatly) differing ideas about social responsibility than exists in the UK.

It's a massive massive topic.

Oh and pp mentioned about the consultation that "presumably many people objected". You could, presumably, research that. Or do an FOI. But presuming wouldn't really be appropriate. We must assume, or we'd all go bananas, that our government really doesn't want to harm us. That they want the greatest public good by whichever means their particular stripe of politics allows, and that public consultation is carried out properly. And yes, I'd have a few thoughts about this in some countries, but in general for things like this i don't believe the UK government is completely corrupt.

(as an aside because i am supposed to be working: when did the opt-out happen in the UK?)

I've carried an organ donor card for nearly 40 years, always believed in it.

I think presumed consent is very bad and I am against it, however I don't want to take away the chance for someone to get my organs after I die just because I disagree with a government policy.

@Jellycatspyjamas families (more accurately next of kin) still have to give consent in an opt out situation. That hasn’t changed.

It’s very different to object from a place of presumed consent than coming to it knowing your loved ones wishes. I can imagine just how that choice might be presented, if the assumption is that my body belongs to the state unless I say otherwise. I’d rather opt out and let my family make an active decision.

@Brefugee Wales changed to opt out in 2015, England last year. Northern Ireland are still consulting and Scotland are about to move to opt out as per this thread.

thanks. I'll keep an eye out for any studies that cross my path.

I think presumed consent is very bad and I am against it, however I don't want to take away the chance for someone to get my organs after I die just because I disagree with a government policy. you won’t if you’ve had the conversation with your family and they agree to your donation. You could, however, take away someone’s chance to receive your organs if your family were either unaware or disagreed with your wishes and said no.

@SimonJT

Your body is just a bag of flesh, it isn’t any different to a raw chicken in a supermarket.

I think those who refuse to give their organs are very selfish. I’m always amazed by people who believe weird myths around organ donation, my mother genuinely believed if you were a donar and you ended up in ICU you wouldn’t be treated so they could use your organs. That is the level of stupidity we are dealing with with some people.

You may genuinly believe that but I actually doubt it. So your loved one dies and immediately they are just a 'bag of flesh' are they? You would just leave them to be treated however anyone wanted? Why have a burial etc then, just chuck that bag of flesh on a bonfire and be done with it, or hack it up and feed it to zoo animals. Of course I'm being ridiculous but so is your comment. Of course we show respect for the dead and treat their bodies with care even after death, because that body is so much more than merely flesh. I reiterate I have no problem with organ donation for myself, but I previously actively put myself on a register, I thought about it and made an informed choice. Opt out is presumed consent which I totally disagree with. Even if I believed that I am no more than a 'supermarket chicken' when I die, its MY fucking chicken, not the states.

I wonder if we'll eventually get statistics about how many "terrible" families overrode their loved ones wishes because people opted out as a protest but told their families they were willing to donate.

Why bury/burn organs that can save someone's life?

I don't think too many would argue with the principle of this - it's the assumption of consent that's the issue

A PP said that opting out takes "no effort at all", but to use just a few examples, what about the physically disabled, the mentally incapacitated and non-English speakers ... doesn't the picture start to look a bit different if the disadvantaged come to be seen as sources of body parts, especially in context of how easily human rights have been brushed aside recently?

And what about the possibility of targets being introduced, once this is brought in? It would be only to easy to "rank" hospitals by their success in enabling transplants and even to link this to funding ... anyone care to think about where that could lead?

You may genuinly believe that but I actually doubt it. So your loved one dies and immediately they are just a 'bag of flesh' are they?

this is one of the reasons that the opt-out is being introduced, though. If there is only opt-in, and the NOK have to sign it off anyway, the doctors have to approach the grieving relatives who then have to make a quick decision to either go along with their relative's wishes to donate, or go against their relative's wishes to donate, or absent donor card to try to guess what they would have wanted etc etc.

Imagine it's a child? how difficult is that conversation? (and I'm assuming that children are not included in the opt-out anyway so those difficult conversations will still have to take place)

Where there is a legal requirement to say "sorry for your loss i have to ask about donation" the conversation must take place, and absent clear instructions the presumption is "ok, go ahead". The conversation is still incredibly difficult but it is approached from a completely different direction.

Ownership of a dead body is also a really interesting discussion. if you believe that the self dies when the body dies, is it still really yours? What about your soul? (again i keep coming back to this: religions and belief-systems with very clear ideas about this make it a lot easier). And of course, there are those that believe very firmly that if one or more of their organs are donated, they become a part of that person and thus their body goes on alive (for a while) while the soul and the self have gone elsewhere.

Must dig out the philosophy books again...

The law change is sexist as it will affect women the most. No longer can "I didn't give him permission to have sex with me" be a valid argument in a rape trial - the victim would have to actively be fighting the attacker off in order to claim she hadn't consented. And what about drug rape? An unconscious victim can't actively withhold her consent - so according the the Scottish government, she's now fair game for any chancer who happens to come across her?

You really need to go and look at what change to the law has happened. This only relates to organ donation. Absolutely nothing at all to do with rape.

So many people talking about not wanting to donate reproductive organs, face, hands etc...

I’ve just had a look at the NHS organ donor registration website, and the organs it lists are heart, lungs, kidneys, liver, corneas, pancreas, tissue and small bowel.

No mention of any reproductive organs.