New Opt Out Organ Donation System comes into effect today

[Al1Langdownthecleghole]

I've just gone on to register my wishes, (link below if anyone else wants to do likewise).

I was concerned that under the new regulations requiring you to opt-out of becoming a transplant donor, it would not be possible to specifically opt-out of donating my reproductive organs.

In fact, if you opt to only donate some of your organs and select the ones you are happy to be used, reproductive organs are not listed as a choice, although "tissue" is, and I do wonder how widely tissue could be interpreted.

For now, I am choosing to opt-out of donating tissue, but would be willing to donate the other organs specifically listed.

Sadly, there is the inevitable question about gender. Even when talking about cadaver transplants, it would seem gender trumps biology.

www.organdonation.nhs.uk/register-your-decision/register-your-details/?

Someone on here once recommended a film I didn't like, and that's how I knew that humans could change sex after all. Logic!

It's true, Stuck, we probably don't all agree on 100% of every topic, therefore clearly TWAW. Of course.

I should have realised that I was wrong to think TWAre’tW, when I discovered that all the women on FWR weren’t vegan like me. Dammit! How could I have been so wrong? 😭

I'm sure there have been legal cases where a widow wasn't allowed to use her husband's sperm because he hadn't given adequate consent, so I don't think a woman's eggs could be legally used for reproductive purposes without her consent.

I'd been thinking that some of the information on mn had been making me feel more gender-critical but this thread makes me wonder if I'm in really bad company and need to rethink

I'm not "gender critical". I couldn't care less whether the forms for this use "sex" or "gender".

This isn't a "gender critical" issue. I object and do not consent, as I have for over 40 years, for any part of me to be used for reproductive assistance or reproductive research. My objection has nothing to do with a "gender critical" viewpoint.

If there is cast iron guarantee that will never happen I am happy to not opt out.

I'm sure there have been legal cases where a widow wasn't allowed to use her husband's sperm because he hadn't given adequate consent

There was the (horrible) case where Diane Blood's husband had sperm extracted from him. The sperm had been removed before he died, but without his written consent while he was in a coma.

It's worth noting that family members can revoke consent under the new legislation.

As they have always been able to.

Part of the "problem" has always been relatives ignoring the deceased request (after all, how much more clear can you make it when you carry a donor card ?) and refusing permission to remove organs when it comes to the crunch.

A much simpler system would have been to simply ignore them, rather than make a seismic shift in the notion of consent (which will be leveraged further in years to come).

Well, I suppose it raises questions - does one's body belong to:

oneself, while living, dying and dead, or
one's family, or
the state, or
a combination of all of the above?

Who can give consent to what happens to our bodies, living or dead? I tend to think of it as something that is entirely up to the individual, but it doesn't seem to be quite that straightforward.

I'd vote for oneself, with possibly the family as a backup if the individual's wishes weren't known. The state? No, absolutely not, so many ways that could go horribly wrong.

Well, I suppose it raises questions - does one's body belong to

It doesn't raise any questions at all. It's a long standing legal fact there is no property in a corpse. It doesn't "belong" to anyone.

Hence my solution of just ignoring relatives in the cases where a deceased an clearly be identified as having opted-in to the organ donor scheme. Much easier than drafting new laws. Especially given the recent omnishambles the current crop of genuises in Westminster have overseen.

But at the same time if the individual's wishes weren't known then I think "don't do anything to the body" is the most ethical path, as it's the least invasive. "Proceed on the assumption that the body and all it contains is up for grabs once the person is no longer able to say no" fills me with visceral horror.

can be identified ....

Can the family overrule a DNR? That would seem like it should work in a similar way as having chosen to donate organs, legally speaking (or chosen not to).

But there are instances where the state will or does or needs to override individual consent?

(I want to put a 'content warning' here, as I don't want to upset anyone by discussing coronavirus and death):

For example at the moment, with a highly infectious disease, issues of consent must be involved? People's wishes are being over-ridden, I imagine, in terms of funerals, etc. So in this case, the state has some power (I presume) to step in and make decisions about what happens to people's bodies in the interests of the rest of society.

It's a long standing legal fact there is no property in a corpse. It doesn't "belong" to anyone

It raises questions for me, then! I have no idea about legalities of property and bodies.

I would have thought my corpse would 'belong' to me and my family. Even if 'me' is just my wishes as recorded.

I would have thought my corpse would 'belong' to me and my family
I think it legally belongs to whoever will dispose of it. So the crematorium or local council if no family around or willing to dispose.

But it's a hella long time since I did this in law school.

I'm surprised ova are included tbh. I'd have thought that was an ethical minefield. How certain are we that they're included?

The coronavirus thing is more to do with public safety rather than ownership of the body.

As I understand it, the recent laws passed about the state response to Covid19 have some slightly alarming aspects wrt things like burials/cremation, autopsy etc. Frankly, I do not have any confidence in laws made hastily and without thorough scrutiny, or based on emotion-led arguments. I'm genuinely concerned about the Covid19 laws and the shift to presumed consent.

And has been said, the argument of 'our government would never use these laws badly' is possibly the most stunningly naive statement I can think of.

www.theguardian.com/science/2004/oct/18/medicineandhealth.lifeandhealth

According to this 2004 article on the Diane Blood case, the law now forbids storing of a man's sperm without his written permission, so I assume the same applies to ova.

It raises questions for me, then! I have no idea about legalities of property and bodies.

Have fun: pubmed.ncbi.nlm.nih.gov/15040359/

It's a very niche area. If there's no property in a body, then it can't be stolen - not can removing bits of it be considered stealing. Hence the outrage when it emerged that certain hospitals had been playing collector cards with bits of bodies that had been through their care. Especially childrens remains. Who remembers Alder Hey ?

There are some very good scientific reasons (some impinging on the focus of this forum) why the law might need updating. However with tiresome predictability this isn't really the best way to go about it.

When it comes to stories about the potential of tissue samples from human beings, the Henrietta Lacks case - albeit US - is a fascinating and depressing story centering on her race and sex making her (and her family) fourth class citizens.

I haven't opted out but have sent feedback.

Such stupidity needs to be addressed

According to this 2004 article on the Diane Blood case, the law now forbids storing of a man's sperm without his written permission, so I assume the same applies to ova.

Unfortunately, I don't think it's safe to rely on that assumption. It wouldn't be the consent is required from men, but not women.

‘ For example at the moment, with a highly infectious disease, issues of consent must be involved? People's wishes are being over-ridden, I imagine, in terms of funerals, etc. So in this case, the state has some power (I presume) to step in‘

Yes, it’s an explicit part of the coronavirus emergency law, subject to same reviews and sunset. I don’t think they have had to use any of the provisions about dealing with bodies in a timely and safe manner. Had the planned expansion of mortuary arrangements not have been sufficient, then I expect we would have seen some/all of them activated

I think many people are not aware that the harvested person is not dead at the time the organs are removed. The person is anaesthetised during the process just in case they are aware. This means that if you donate your relative's organs then you don't get to sit with them as they die, they are taken away and operated to death.

Yes, I think maybe people don't realise this.

Nor do they realise that "brain death" is a particular idea of what death is. Are you dead when a certain amount of brain activity stops? What counts as "you" anyway? This si not just an aside - in some countries organ transplant is rare because people do not see a divide between brain/body the same way many westerners do. That's not wrong, it's a different way to conceptualise the person.

There is often a similar take in religions where they require the body to be buried intact (Orthodox Christians or Jews for example.)

The other aspect of this is when someone looks like a potential organ donor, certain steps need to be taken around their death for the organs to be suitable. Institutions and regulations are all too likely to push for certain outcomes, because it is all abstract. It's not even the individual doctors necessarily, it's the system that pushes towards particular outcomes.

It's very easy for this to become a matter of deciding that certain people (like the ones someone thinks are brain dead) no longer count and should be sacrificed to the more worthy people, that is the ones not as close to the end of their lives. A utilitarian view of lives and people is pretty horrific and it needs to be guarded against by systemic measures - like an opt in system.

In general we are moving more and more in much of the west to a utilitarian approach to valuing life, so I would not even say it's an abstract or theoretical issue at this point in time - I think it's quite possible things will go farther in that direction if it's not prevented.

Yes, indeed, Goosefoot. Some Buddhists wish the body to be undisturbed for a period of three days to allow the full process of dying/death to unfold.

While some people presumably are quite happy to share that utilitarian approach, I do think it's vital that we don't presume everybody does so.

Thanks for the link, Professor. Interesting subject!