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/?

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).

I would say that it's a form of consent quite distinct from one which applies to the living. Simply put, something has to be done with a body so, in the absence of information (and with none likely forthcoming from the deceased) choices are made on the balance of probabilities, hence why the Public Health (Control of Disease) Act 1984 prescribes either burial or cremation (as opposed to, for example, a sky burial or the undisturbed period for Buddhists that
ScrimpshawTheSecondmentioned).

Given that every survey has shown that the vast majority of adults are happy to donate their organs, why is it more important to safeguard the wishes of those who do not wish to donate than those who do? In other words, why is it less significant of an issue if someone wishes to be a donor but is not able to donate due to limited information?

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.

There's no need to assume, you can read the act here:
www.legislation.gov.uk/ukpga/1990/37/schedule/3
Pertinently, consent given must be for a specified period and can be withdrawn.

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.

Isn't this also an issue with socialised medicine? If the public is paying for healthcare, rather than the individual, aren't choices that prioritise healthcare workers and equipment towards those more likely to recover likely to be made? At an individual level, it seems like a healthcare professional who supposedly might let a potential donor die to save others might equally be tempted not to 'waste so much time' on a 'selfish' individual who opted out.

I don't trust the state with choices that could profit them, but need my death for that to happen.
If the state own my dead body, will they withdraw anything that is keeping 'their' dead body frustratingly alive??

I would say that it's a form of consent quite distinct from one which applies to the living. Simply put, something has to be done with a body so, in the absence of information (and with none likely forthcoming from the deceased) choices are made on the balance of probabilities,

where did this "absence if information" crock come from ?

Either we have an organ donation register. Or we don't.

WTF have people been doing all these years signing donor cards ? Playing liver lotto ?

I can only speak for myself. But when I first got my driving license - aged 17 - I immediately signed the donor consent form that came with it. And at every opportunity I have repeated signed up to donate whatever bits of me they can find working when I croak it.

I cannot describe how cross I would be in heaven if I looked down, and saw my - literally last and dying - wish ignored.

why is it less significant of an issue if someone wishes to be a donor but is not able to donate

I think because it's far more intrusive and wrong to use someone's body parts without their consent than it is to not use them, despite having consent. Taking concrete, definitive action clearly requires consent - the witholding of action does not require quite the same consent. I'm not phrasing this very well, but it seems quite clear to me.

might equally be tempted not to 'waste so much time' on a selfish' individual who opted out
For me, I couldn't give a shit, I've lived my life and I've gotta die of something. If that something is a hcp who doesn't care then so be it. Hcps however probably shouldnt be in a job when they dont care about outcomes. Shades of dr shipman there.

I don't trust the state with choices that could profit them, but need my death for that to happen. If the state own my dead body, will they withdraw anything that is keeping 'their' dead body frustratingly alive??

There's also the unfailing ability of cronyism to manage to make money out of organs, given half a chance. Just look at surrogacy.

Someone mentioned "balance of probabilities" upthread. Here's a "balance of probabilities" assertion for you. Someone, somewhere has already registered a "consultancy" to "help" the NHS deal with the deluge of donors they are going to see. You could easily get away with charging £10,000 for a heart (liver too, probably). Obviously you could never pay the estate of the deceased. That would be as immoral as paying a woman to have a baby. But there will be expense that can be invented to make sure the Right People get their snouts in the trough.

I still have some questions about the Carina Melchior case. She was "brain dead" and they were preparing to harvest her organs when she woke up! If that can happen once, it can happen again.

As those (potential) donors will (very nearly) all be dying in NHS hospitals, where there already exists an excellent information sharing system, I fail to see how an external consultancy would have a role (though it would in pluralistic systems).

Also, as there are so many people involved in ICU care (where most of these decisions are made), it would be extremely to run an illegal and unethical organ racket.

I know rogue nurses and doctors exist, but not in the numbers required to be on shift together in the right place at the right time with enough frequency to make it worthwhile

where did this "absence if information" crock come from ?

The previous gap between those on the organ donor register and those who, when surveyed, responded positively about donating their organs in the event of their death.

ScrimpshawTheSecond, I understand your point but I'm afraid I disagree. I understand that, to someone who does not wish to donate, the idea of it potentially happening is horrifying or, at least, upsetting but, equally, I find the idea of whatever parts of me prove useful being wasted to be upsetting. I believe that the approximate number of people on the register, prior to opt out, was around 60% but the number who responded positively to surveys was close to 85%. In other words, opt in potentially failed to represent the wishes of more people than opt out would if all who didn't want to donate were entirely ignored.

Someone, somewhere has already registered a "consultancy" to "help" the NHS deal with the deluge of donors they are going to see.

Do you have a citation for this?

I still have some questions about the Carina Melchior case. She was "brain dead" and they were preparing to harvest her organs when she woke up! If that can happen once, it can happen again.

I think human death is generally determined by convention rather than specific science. And it's been a problem since whenever.

Maybe it's another area for non binary activism ?

Someone, somewhere has already registered a "consultancy" to "help" the NHS deal with the deluge of donors they are going to see.

Do you have a citation for this?

Balance of probabilities, someone will have.

We crashed through the looking glass decades ago. There's no longer even a pretence that government is run for anyones benefit other than the 1% (who have recently seen a 17% uptick in their fortunes) of society that really matter.

So: totally unnecessary (albeit engineered) shift in donor legislation ? Can only mean one thing. Boris and the Big Boys (who will speak with American accents) have found a way to skim more money away from the UK taxpayer and into the deserving coffers of MegaCorp Inc.

Or did I imagine surrogacy agencies that do the same thing ?

I tend to get more cynical the hotter it gets. 25C at the moment. Wait till it gets to 30.

Balance of probabilities, someone will have.

Can you please give one example of an existing private consultancy that does this at the moment?

www.theguardian.com/society/2009/jul/31/private-organ-transplants-face-ban

Balance of probabilities, someone will have.

Can you please give one example of an existing private consultancy that does this at the moment?

Not really. Far better you read what I wrote. No use citing laws that can be changed on a whim. Or simply ignored, which appears to be the current vogue (I guess it's cheaper).

I stand by my point, and you are free to agree or not. But the whole area of organ donation has for too long been held back by the inability of private capital to monetise it. Not what I believe, of course. But how it will be sold.

But the whole area of organ donation has for too long been held back by the inability of private capital to monetise it. Not what I believe, of course. But how it will be sold.

I'd be more inclined to agree if this legislation change were causing the number of donors to shift by an order but it's a rather modest increase and, compared to, for example, blood product manufacture, rather small economically. A tragic number of people already die each year while waiting for an organ, NHSBT are already doing most of the work tracking those individuals. My experience with recipients is limited but those I do know who have received organs took several 'turns' of being prepared for surgery only to have it called off due to factors that made the potential donor unsuitable. I don't see this as a system ripe for corporate exploitation.

I'd be more inclined to agree if this legislation change were causing the number of donors to shift by an order but it's a rather modest increase and, compared to, for example, blood product manufacture, rather small economically.

A journey of a thousand dollars starts with a single cent.

It does seem like a poor return, given all the investment in very specific qualifications that would be required. Putting my conspiratorial hat on, it seems more like a better way to profit off of organ transplants in a country with socialised healthcare would be to artificially limit supply, driving the desperate and wealthy to private clinics to help them jump the queue. This could be achieved through, for example, inflating concerns about the danger of an opt out system.

If the state did not interfere with people’s bodies, the soft tissues and organs would naturally decay and cease to be. The state are not interfering with your bodily autonomy by allowing your body to cease to be after death. Nobody has a right to have their organs used in research or be inserted into other people. That’s not something you can insist the state do. It is something you can request, or agree to, but it is not something you can insist is done because you find the idea of your organs being wasted upsetting.

It is not at all equivalent to me saying the state cannot use my body for its own purposes, particularly harvesting my body for organs when I am still alive. The state then are interfering with my bodily autonomy.

Didnt organox get slapped for buying organs in China (literally taken out of prisoners) and transport them to the UK?

Cba looking just now , later maybe.

Not read the whole thread but these stats are interesting

'More women (54%) than men (46%) have signed up on the NHS Organ Donor Register'

'Research shows that women are 30% more likely to start a conversation about organ donation than men'

I was not surprised by those stats.

Women have these things more on their radar than men for various reasons.

Would a man who said he refused to donate X, y, or z part be berated as women on this thread are being?

Another example of women doing the thing more and being told off when they have boundaries in a way that men rarely are.

It does seem like a poor return, given all the investment in very specific qualifications that would be required.

You don't have to pay medical professionals that much. Just look at the UK now. The cheapest part of healthcare is the medical staff.

I think it's got a bit hotter

Regards brain death -

The NHS' strategy for 2020, which I've just had a quick squizz at, notes that 50% of UK donors are 'DBD' - brain stem dead. 42% are 'DCD' - circulatory death. So, does this mean that if you are DCD, you still have brian stem activity? It really isn't as clear cut as it first sounds, is it? I presume the remainder of donors are living ones, for kidneys, bone marrow, etc.

The strategy is on this page, if anyone wants to see it. I can't link directly as it's a pdf

www.nhsbt.nhs.uk/who-we-are/performance-and-strategy/

So, does this mean that if you are DCD, you still have brian stem activity? It really isn't as clear cut as it first sounds, is it?

You can read the full explanation and professional guidance here:

www.odt.nhs.uk/deceased-donation/best-practice-guidance/donation-after-circulatory-death/

The Code of Practice (PDF) contains an explanation for brain stem activity as well as the criteria by which circulatory death is established.

Thanks, Gronky.