Presumed consent
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One should never presume.
Just heard the discussion including the man who objected to the idea of presumed consent and the implication that you should feel guilty if you didn't agree to donate. well, I think you should feel guilty. After all, what else are you planning to do with your organs once you are dead?
I don't want to dontate my organs and I certainly don't want to receive anyone else's.
There are too many people on this planet and we need a little thinning out. We are short on space and resources. One day I am going to die and I see no point in putting off the inevitable - this is the honourable way.
Medical intervention should be for life enrichment, such as joint replacement, not life extention.
Just because we can do something doesn't mean we should.
The Blood Donation Service no longer wants blood donations from me, as I myself received a transfusion in the 1980s. If there is a risk that I have CJD, what tests would be made on organs before they are transplanted into a patient?
As to the comment that people who opt out should not be eligible to receive a transplant organ - we do not , happily, apply this principle with regard to blood transfusions.
I think state ownership of corpses is an exciting idea.
We should not overlook the potential benefit of organ farming.
Blood and other useful compounds could be retrieved from our dead.
I always thought that film 鈥淪oylent Green鈥 presented some interesting arguments for human recycling.
It is important that donor donation is protected. A simple answer that nobody seems to suggest in order to up the rate of donation and to retain donor consent is for our GPs to be asked to pose the question to each of their patients (at a time when the patients are not under stress) and to record this.
My wife and I are sure that this would meet with a very positive response from the public and stillleave people with some thought that they have control over their own bodies.
Although I think that donating organs is a good thing to do, I do not think people should have to do this, and certainly don't think they should feel guilty if they don't donate. Every case should be treated seperately; there may be personal and other reasons why a person might not want to donate. These should be taken into account.
Just listened to the gentleman who lost his 12 year old daughter, & objected to organ donation without consent. 24 years ago when my 5 month old son died suddenly, no one asked our consent for all of his ogans to be removed & then disposed of. I would have been far happier if I had found they had been put to good use. This by the way this happened at the Sheffield Childrens Hospital NOT Alderhay!
Moving away from both presumed consent or presumed absence of consent, could the next nationwide survey (e.g. the next census, or updating of the electoral register) include a simple question about donating your organs? This would, very simply, create a database of the vast majority of the population about who consented to donate their organs.
We can all start by registering as a donor. I just did because of the programme. Two minutes on the NHS website. We all mean to do it - if every PM listener did we might not need 'presumed consent'.
I am very much in favour of presumed consent. I am a big believer in organ donation and carry a donor card, but my mother, who is my next of kin, is against it and has informed me that she could never agree to donate my organs. Since family consent overrides the donor card my wishes would not be met in this event. Presumed consent allows the patient's wishes, rather than anyone else, to predominate.
I think it is an outrageous thing to suggest, this doctor should be struck off immediately. I am disgusted by the suggestion. Opt in is okay and I have but you should never presume. And the person who suggested you should feel guilt if you did'nt agree to donate is below contempt.
Having just this minute heard about the fire catasrophe at Parnassus, near Athens - the best thing (as far as I understand it from listening to environmental programmes) that the authorities can do is to leave the blackened landscape as it is - on the basis that, with time, it will rejuvenate. Mere reforestation will not replace the complex infrasturcture damaged but from what I can gather this would be politically and financially unacceptable to the goverment and developers. A sad state of affairs.
Listening to your discussion about organ donation. Yesterday I used the new DVLA online tax disc service and in the course of my application I was asked if I wanted to donate my organs. At first it seemed like a good idea - a centralised database rather than having to carry a card - and I said 'yes'. But then I bottled out!! and ticked the 'no' box. I really don't have a problem with donating my organs once I'm dead, but I worry that if I were involved in an accident and was seriously injured, if there were someone on the next bed in the emergency room who desperately needed a donor organ, would the doctors work as hard to save me if they knew I was a donor?? Maybe I've watched too many episodes of ER!!
Those who oppose "presumed consent" should try to be consistent. They should oppose ALL types of state compulsion -- for example, compulsory vehicle licensing, compulsory punishment of criminals, compulsory education, and so forth!
NO NO NO. absolutely not...the concept of me having to ask the government not to pull my body apart terrifies me. this is like something from an Orwellian nightmare. while i feel much compassion for those who need organs i am not prepared to accept this. this is an intrusion too far by a governement that can't be trusted with the truth anyway....be aware youre not long dead when these organs are removed..still warm. that horrifies me.....what if at the scene of an accident the organ removal squad conveniently have a bad connection to this so called database, and rip your liver out by default. no no no. i dont care if people call me selfish...im not selfish just scared...keep your hands off my body
I suffer from depression relating to incidents of loss. If anything, God forbid, happened to my husband, I could not leave him in a hospital room breathing (albeit by machine) and looking alive. I understand completely the need for organs and that his could save the life of someone else but I also have to think about my family. The detrimental effect this would have on my mental health would mean that I may be in a position where I could not care for my children. Or it may result in a worse scenario which would leave my children without either parent. Before making sweeping comments about selfishness I would ask people to remember that not everyone's circumstances are the same.
9 years ago, my sister who was a 28year old intensive care unit nurse found her self in her own hospital with a brain tumour. I was her next of kin. She was well aware that the surgery was very risky and at the worse, she would end up on her own unit.. She made me promise that if the worse should happen I would bring up donating her organs, because as she quite rightly said- asking a grieving person for their loved ones organs is an impossible job to give anyone, let alone expecting a nurse who socially knew the person in the bed to ask such a thing. The worse did happen. I did mention and although I lost my beloved sister there are 3 people out there living a much more fuller life thanks to her kidneys and Liver!
I am married. My body belongs to my wife, she has the right to decide not the government.
It was a pleasure listening to George Galloway just now and Eddie's grown-up approach to the interview was a refreshing change from the contempt with which most hacks treat Galloway.
There is no doubt in my mind that Galloway has been hounded by the establishment for years because he has been such a persistent thorn in their side. Whiter than white? No. But his offences pale in comparison to the savage crimes of those he accuses.
As a 'victim' of the organ retention scandal I abhor the idea of presumed consent. I agree wholeheartedly with David Wilshire in his view that the state's intrusion into something as private and personal as death should not be welcomed. My baby son, Robert, died when he was six months old, had anybody asked if his organs could be used to save someone elses life, then the matter would have been given very careful consideration. As it turns out the Government already assumed that they could take what they wanted without permission. I dread to think where this could end up if carte blanche was given. Yes there is a need for more organs, but if people want to donate then they will....just ask please,please don't presume it won't work.
We should all be invited to become members of a transplant scheme. Membership conditions would require permission to donate organs and confer right to transplants if required.
Beryl Houghton
The issue of consent certainly appears to be divisive. I certainly think that no-one should be penalised/stigmatised for not wanting to donate their organs on death. However, I doubt that it is really effective to ask grieving parents/partners/children if their loved one's organs can be used when they are going through the most traumatic of times. It should be a case whereby everyone can make it known what they want to happen with their organs ahead of time. I seem to remember that on the old driving licences there used to be a donor form at the bottom. We need a push to make everyone more aware of this issue and to make a choice....
When my son was 12 his dog died - this prompted the discussion about what happens to body etc. etc.
He then dictated a "will" disposing of his favoured possesions, but was adamant any parts of himself should be donated to help other people.
If more people had this discussion before the trauma of death .....
ps he is now 21 and a scuba diving instructor - but I know he still holds the same views
can I be name and address witheld as I am talking about someone else's views
ps if any of my bits are fit for recycling when my time comes - bring it on
The state will not presume that I want to leave all my wordy goods to a charity of its choice. Therefore why should it presume to decide what I want to do with my body, the only thing I can truly call my own?
In addition, how can we be sure that the system of records of people who opt out will work properly? The government hasn't got a faultless history on these type of systems. Distressing errors will occur.
No. let us opt in, the same way as we make a will for our worldly goods.
I am somebody who had jaundice at an early age and am unable to GIVE BLOOD, for fear of contaminating the receiver.
So the thought of a presumption that I can donate an organ, which could result in a death/rejection, is not something I consider thinking about.
What does Liam Donaldson say about that?
is the 100% identification certainty required for organ donation opt out schemes just another good reason to enable a DNA database that does allow the certain identification of individuals?
After all, if superstition had been allowed a veto on progress we would not be blogging today would we !!
I would like to know how the poll figure of 70% of the population saying they want to donate their organs was derived. I have never been asked, nor has anyone i know, so how dare it be used for the purpose of making a case for presumed consent.
The state should not decide organ donation, it is a purely personal decision. By all means raise the awareness of how to donate organs for those who wish to do so but do not make it compulsory, or (opt-out) non-compulsory but with guilt strings attached.
Can't understand why this wasn't organised a long time back. But the idea mentioned up in PM that, as a precaution, the family of a deceased person should be consulted (in case they object) is utterly ridiculous! Will they also be asked if they want to rewrite my will?
Sonia (14)
When you're faced with a trauma patient or a crash call the last thing on your mind was "has this patient signed up to the transplant register?" In every hospital that I have worked in the priority has been to save every life.
I was asked whether I wanted to join the register when I changed doctors. I signed up because I wasn't under pressure. When I changed my address on my driving licence I noticed that I'd been invited to indicate my status too.
Some people have strong cultural or religious grounds for not wanting to participate. Some people change their minds. Presumed consent cannot be acceptable.
I would have no problem with seeing people who opted out of being a donor being at the end of the queue when it comes to receiving organs.
If someone had a religious or moral objection to being a donor, they'd be a hypocrite if they changed their view of donation at the point when they found they were in need of an organ.
If someone has an objection is based on squeamishness or just not wanting to think about being a donor, if they think that's more important to them than being a possible recipient, or saving someone else's life, that's their choice.
Well, Meir seemd a little more restrained today and that is a good thing.
But unfortunately he was at his worst again today at a vital moment. The two MPs discussing organ donation both put very carefully the two sides of the argument.
On the one hand sensibilities about human remains on the other the need for life saving donations.
We seemed close to trying to consider what might be acceptable to those who would not wish they or their families to donate.
But... then Eddie quoted a listener who thought those refusing to donate should not receive and another who wanted to know what the refuseniks were planning to do with their organs after death.
Again Meirs add - ons seemed to me to be boistrous sensationalism.
This is a serious topic. I remember those suffering from drought in Ethipoia travelling south and saying they were looking for soft ground. 'To sow and plant?' asked the 大象传媒 reporter who had met them. No, came back the reply, to bury our dead.
The sensationalism of 'What do they plan to do with their organs after death' and the cynical unforgiveness of coercive mechanisms wipe out the possibility of genuinely contemplative assessment. Yet meir brought these things to the debate.
Well, we all know about such clever clogs arguments and how easy it is to trade them:- Murder is the victimless crime. Necrophilia is too. Carrion cannibalism is as well. Etc. How about 'When those refused organs die they won't have anything to worry about will they? So 'Exit' them early'
Its the cheap shot sarcasm that we get from Meir (that his listeners feel encouraged to contribute to) that spoils PM and makes it so unpleasant, not its politcal biases.
The sensibility that would allow donation from one's own child if, God forbid, s/he should die, lies somewhere between how one feels when one sees children up for adoption telling us how much they would like a 'real' home and how one feels when one sees a poor mite dying of toxins that their liver can't cope with.
I really do not believe that such sensibilities are nurtured in the smart aleck world that Meir encourages on PM.
As for bias, well thats another subject. But I haven't heard anything substantial from PM about the two doctors (?) who were released earlier this week after the London and Glasgow car devices. Yet stuff upon stuff about raising holding time from 27 to 90 days.
How consistent of this disreputable government,
First a war....no consent.
Then arrest without trial....no consent.
Then shoot to kill policy.... no consent
Then ID cards... no consent.
The MPs "opt out" of freedom of information act.No consent
Just today there was a report that police in London will be able to "use the info from traffic charging cameras for so called "terrorist tracking".No consent.
The last time a party took away the rights of the people like this, it was the National Socialists in Germany.
They made people have ID cards, account for their movements, were arrsted without cause or due process. They imprisoned without trial, confiscated property etc etc. It took the Allies to give Europe back its freedom. Who will come wading into Britain in defence of ours.
There is no government in the world that has a right to take things away from citizens. Those that do we call dictatorships.
A government has only the powers granted to it by the people, to protect and defend the citizen.
As for "presumed consent", it is eerily similar to the way absolute monarchs used to deal with "their" people. Theirs was a presumed arrogance.
Our government is an elected body, paid for by the taxpayer. It has NO RIGHT to assume kingship over citizens.
New Labour under Brown was supposed to be a "listening government".
Same old lies, same old spin.
How dare a non elected official presume anything about 6o million citizens.
Your body (containing an eternal spirit) is brought into the world as a gift from God. There is no way that politicians have any claim to disturb the age old d9ivide between citizen and government in the way this lot have since 1997.
Shortage of organs for transplant is a real problem.However,"presumed consent" may not be the best answer.As a doctor and from my personal experience I know how sensitive the time of death is for the loved ones.My heart goes out to the genleman who was talking about his daughter.Whether the consent was given or not attending personel has to discuss the subject of donation with the family most sympathetically after a death.In fact hospitals could start having a "Transplant Team"who will be properly trained to undertake the discussion.
Main problem seems to be lack of public awareness through discussions,publications etc.GP's surgeries and media would be the most suiatable places. Also process of registaring one's wish for organ donation has to be made easy and accessible to everybody.
I just don't understand why people have any hesitation about donating either their own or their relatives' organs. After all, what is left when you die? It's just a body, an empty shell - it's not the person you were, or the person you have lost. Surely, if some good can come out of a tragedy then that is the best possible outcome.
Organ donation was something that my husband and I never discussed but then he died suddenly of a heart attack. As soon as I saw his body lying in the hospital it was one of my first thoughts to offer any of his organs that could be used. It just seemed the natural thing to do. I offered - they did not need to ask. They used his eyes, some bones and skin - not for work as high-profile as a heart transplant but I was assured that they could help a number of people or may be used for research.
What a privilege to be able to do something for our fellow humans, even after we have died. Why would anyone not want to do it?
Consent should definitely be implied.
No No No.
No more presumptions by MPs or officials.
What we need is a stop to the above making up policy on a matchbox and pretending it is for "our own good".
Having seen the way people in hospitals are treated at times the fact that they would in future only looked upon as a convenience to the NHS is an horrific thought.
The only compulsion there should be is that citizens have the rights that have been taken away by NL replaced, and the organ donation arrogance should be quietly dropped.
But like everything else this administration does, it is for its own ends, not we the people!
Shame I say!
I've recieved S-U-P-E-R-B medical attention and service from the NHS during my life.
Following a very serious accident (not my fault, for what it's worth) recently, I've also received, amongst other things, substantial blood transfusions from anonymous donors I do not know and, regretably, cannot thank...
From what I understand (not an exact figure), presently, my medical bills, if paid privately, would have exceeded my, so far, NHS contributions (of some 30 years) by some 150%..!
So, for what it's worth, if ANY part of my body can be used for the benefit of others - anyone - once I'm gone. It's theirs...
With the greatest pleasure and love.
And, I've "Willed-it" and carry the appropriate notification in my wallet.
I'd actually like, once I'm dead, to make a positive, measurable, contribution to the life of a less fortunate human-being which, once-upon-a-time, I, medically, was.
Heart, Lungs, Liver, Kidneys, Corneas, Face (God forbid for the donee...!) Anything; take them.
Part of me will maybe live-on. What a wonderful legacy!
When you're dead, you're dead.
If you don't want to donate. Fine. Why should you? Opt-out. Easy.
But if, in dying, you save the lives of, maybe a couple of people..?
Or, perhaps, your body parts do that AND, give someone, or maybe two someone's, eyesight...
Then what..?
Fabulous!
This is not about politics! It's about people suffering or dying because of the short sightedness or selfishness of others.
Wasn't able to hear the programme today, but would be interested to know if any cover was given to those countries which do have presumed consent. Have there been any problems, how well has it worked?
Mac;
The people who think that 'if you don't donate then you cannot receive' are on this thread, the Glass Box and elsewhere on this Blog. They exist and believe that they have a valid point of view (I disagree with them, incidentally). Why not bring that idea into the discussion. See Dave W immediately above your own post for an example. This isn't "boisterous sensationalism", it's broadening the deabte to include other ideas.
Your own comment about Ethiopia has no bearing on the topic under discussion. Are you therefore guilty of the same offence of introducing other material? Are you a "boisterous sensationalist"?
It is not sarcasm to introduce the sincerely held points of view of others to a debate so that their opinion may also be debated, or at least given an airing and commented upon.
I hope that all those who share that point of view are blood donors, because judged by their own standards they are not entitled to receive blood in the event of their needing it.
Si.
Anne (currently 38);
It's not short-sightedness.
There is a medical aspect to it, certain categories of people are barred from donating after medical events in their past.
Or in a different category, would you want the organs of an alcoholic or a drug-abuser? Or someone suffering from disease?
There is a religious aspect to it, one can understand that a Jehovah Witness has the most profound views against this and others have similar views.
What about foreign nationals who die in Britain? Will the rush to whip their organs out and redistribute them be alright with their relatives? Will they care that we do it differently to them and that we expect them to go along with it?
What about those who carry no form of identity or who cannot be identified? Do they get to donate anyway? Never mind that they were on the opt-out list. Whoops! Too late.....
One can imagine the transplant teams hovering like vultures for the attending doctor to pronounce death, swiftly pulling the curtains around and removing whatever they please. Never mind the many-faceted objections and sound common-sense reasons why you might not want to take organs from someone. Just do it anyway.
What about those like myself who have the most profound objections to the way that governments seem to think that they can intrude into every aspect of our lives and that we have no say in the matter. We are supposed to go along with this kind of thing without saying a word.
Government should intrude into our lives as little as possible. And disrespect for the dead is as bad as grave-robbing.
I see that the morality of those who would not wish to donate is already being questioned. Selfish and short-sighted, my backside. What about the rights of individuals to choose without their choice their own destiny being made or 'presumed' for them?
What about Free Will? The ability to make our own choices on the basis of informed understanding is the one single thing that raises us above the beasts.
Si.
Simon (40) and others - on the question of giving and receiving, it seems to me that the gift has to be given freely and without strings.
As a blood donor I could not, and would not wish, to insist that my blood be used only for some specific category of recipient. Apart from being administratively impossible, I'd regard that as morally repugnant.
There are many reasons why someone might not be a potential organ donor, including of course not wishing to do so, but also being medically unsuitable in some way. As with blood donation I would not regard it as morally right to exclude them from receiving an organ they needed.
I find the arguments on both sides of 'presumed consent' to have merit. Personally I think that as long as I can be assured that they are only removed when I really do have no further use for them, I'd be delighted if I can give someone else a little longer.
And as I seem to have lost my old donor card, I'm off to look for the donation website.
Many 'anti' comments on here seem to be deliberately missing the point.
As Donaldson presents it, presumed consent allows everybody to opt out should they not wish to donate organs after they die.
If many of you who are so vehemently opposed to this idea had close contact with a friend or relative who was in desperate need of an organ, then I suspect you would swiftly change your frankly rather sanctimonious tunes.
First, let's get the terminology right. Once we presume consent, we can no longer talk about "donation". A donation is given freely. What is being proposed by Liam Donaldson is more akin to a tax or tythe.
I'm sure I am not alone in sharing the concerns outlined in #14 in this matter; that in extremis, some practitioners could see me not as a patient to be cured, but as a basket of organs ripe for the picking.
My recent personal experience of the workings of the NHS and the comment from the doctor who contacted the programme to say that those who do not support 'default consent' should not be entitled to receive organs only serve to confirm these concerns.
At 06:51 PM on 17 Jul 2007, Anne wrote: I just don't understand why people have any hesitation about donating either their own or their relatives' organs.
Well, I just don't understand why some people take up smoking in this day and age. I don't understand why some people deliberately get drunk when they have no serious life problems. I don't understand why...
Simon W
You raise an interesting point. JWs can give and receive solid organ transplants but not whole blood products which seems a little bizarre.
Another consideration that wasn't covered by Sir Liam was the fact that transplant surgery is expensive - you need two theatres, an ITU bed, two specialist theatre teams and then some expensive anti-rejection drugs thereafter.
Even with the ideal of loads of spare organs available does the NHS have the spare money to do anything with them?
Simon (41) I thought the idea was to make it possible to opt out of the scheme - in which case, your phrases ''we have no say in the matter'' and ''without saying a word'' seem unfounded.
Anyone who doesn't wish to participate should be able to do so quietly, simply and without recrimination. We would all be able to excercise our Free Will.
As for ''disrespect for the dead'' - I would rather respect the living. I have made all my family aware that after my death,if it is at all possible, I would like the surgeons to take whatever they can use - and my family have expressed the same wishes in relation to their own remains.
Christopher H (44) We do indeed see ourselves as ''baskets of organs ripe for the picking''. I don't expect everyone to hold this view, and I certainly wouldn't question their morality, religious views or any other reasons for disagreeing with me.
There are so many misconcpetions about organ donation raging on this comments board and it is absolutely ridiculous to assume that the doctors will not work as hard to save you knowing you could be an organ donor!
1. The doctors that treat you and the doctors that decide if you are a good organ donor are entirely seperate.
2. No-one knows if you are on the organ donor register because it is held on a database held by UK Transplant NOT your medical records
3. Your organs will only be removed once a million forms have been signed and 2 seperate sets of doctors have confirmed that you are indeed dead.
To all those who think that there are too many people on the planet and medical intervention should be stopped: How would you feel if it was your sick 5 year old son waiting for a new heart, and oly had 24 hours to live if a donor wasn't found?
Well,i personally think to presume unless instructed otherwise is better because nearly of us who would sadly be in the position to need a transplant one day (for whatever reason-disease,accident etc) would hope there is one available and would be scared stiff to think hardly anyone bothered to signed up and there was a big chance could die before one is available. Most people think there are lots of people on the register-there may well be but blood/tissue types means in some respects there's hardly any.
Personally i will need a transplant one day if im still well enough by then which may make me biasd but in fact all its done is make me more aware,sadly even before my need for a transplant problems started i could not be on the register or even give blood because of having other chronic illness that can effect such things and im one of those who who donate anything if it helped someone,blood,bone marrow and after death etc but sadly its not to be so we need healthy people to make an effort to either say "no" (and im not judging you on your opinions) or it is presumed you dont mind.
46 Simon W
The cost to the NHS of keeping someone on dialysis can be up to 拢34,500 a year compared to the average cost post transplant for drugs is around 拢6500
The savings to the NHS over a period of 9 years which is the average length of a transplant is around 拢191,000 you should bare in mind that transplant are not a cure rather they are a treatment like dialysis which vastly improves the quality of life of the patient.
There are currently 6500 people desperately in need of a kidney transplant if we were to transplant all of them that would save the NHS an incredible 拢1.2 billion over 9 years or 拢137 million a year
I am not aware of the figures for heart/lung/liver patients but I imagine there is substational cost saving there through less drugs, hospital visits and admissions.
I agree, i have no problems with people opting out if thats really what they want,but im sure if we need an organ we wouldnt want to have to feel its doughtful or not going to happen "in time"
If people cant donate because of health reasons then thats fine and opting out or having it on record that you cant donate is fine. If you just don want to then yes,i believe you should not be presumed you dont want to (i mean this argument can go either way) and overall the positives say "opt out" rather than "opt in" As some of you say,its a body part,your not going to need it anymore and yes there have been some terrible scandles with organs being taken without consent and those people have my up-most sympathy and i do not condone that but the bigger picture is that the shortage of organs/blood is so low that drastic action needs to be taken....even if you cant think about it for yourself,think if your child,wife,husband,mother,father,sister,brother etc needing a life saving transplant....how would you be feeling right now?
It may not be a simple ansewer but it is an ansewer so all you have to do is "opt out" its not difficult and it just makes doctors lives a tad easier if there is debate after someone has died and the family dis-agree even though the person that died agreed.
So much passion about opting out rather than opting in when polls suggest that organ donation is supported by 70% or 90% (depends which source) of the population. And yet only 20% have got round to opting in. If you feel very strongly that you dont want to help others live after your death then please opt out if the law is changed.
There were only approx 780 dead donors last year so you can see that the appropriate circumstances which make it possible to donate organs apply to very few deaths. Statistically you are far more likely to need an organ than die in a position where you might be able to donate organs.
Meanwhile people like me who waited 3 years for a kidney and never got a call are staring death in the face every day. Half the cystic fibrosis patients on the waiting list, needing new lungs, die within 12 months. They literally run out of air. So do many others with cancer its just that the best treatment for us on the waiting list is a new organ. Would you want to deny cancer patients the best treatment available on the basis that the planet already has too many people living on it? Would you deny a patient going to a GP for a course of antibiotics? Antibiotics were the new and best treatment when they were discovered.
New drugs and surgical techniques mean that the pool of possible living kidney donors has widened. My half brother gave me a kidney 3 months ago. It has saved and transformed my life. By agreeing to donate your organs after your death you could leave a lasting and precious legacy to many people. The car accident victim who gave a kidney to my niece helped 16 other people.
In the meantime in case the law is not changed why not opt in on www.uktransplant.org.uk
It is not as if the government does not already legislate about what we are allowed to do with our bodies after we are dead, and for good reason. I don't think that you can reasonably argue against the policy of presumed consent as a principle without wishing to do away with laws that insist peoples bodies are disposed of in certain ways. For example, it is not legal (as far as I am aware) to have your body parts fed to your pet after you die. The governments legislates against this, most likely on public health grounds. How is this different from the government legislating against the unnecessary discarding of potentially useful organs from a public health point of view?
Mike (50)
You haven't factored in the theatre costs, surgeon costs, medication costs in theatres, follow up costs, training costs for staff and the ITU bed costs.
Anti-rejection medication needs monitoring either in the community or in outpatients - these attract costs too. Some of the anti-rejection medicines can cause further damage to other organs which may also need medication to treat them.
The point is that I'm not certain that there is the capacity in the NHS to carry out the transplants even if there were the trained staff and the money. I'm sure that there are cost savings along the line but there are also significant costs too.
Like many others I am astonished by the level of ignorance displayed on this subject, and by the illogical responses. To the person who said that there are too many people in the world and transplants shouldn't be allowed, then by the same token we shouldn't treat any illness that requires intervention such as antibiotics, surgery or other active treatment - frankly that is ridiculous.
I am sure that I was previously like the majority of the population who intended to donate my organs but had never got around to discussing my wishes until I found that I would one day need a transplant, funny how that concentrates your mind. Well I have been waiting nearly six years for my chance and I am just lucky that the organ I am waiting for is a kidney and that there is an option of dialysis to sustain me until that chance finally comes.
So why all the fuss? All presumed consent does is require you to register your refusal so that there are fewer 'wasted' organs because of the majority of people who meant to donate and never got around to discussing their wishes or registering. If you feel strongly about it then you will indeed opt out and so there is no compulsion for those who have a strong moral objection to donate, or even to donate specific parts. I do, however, think that if you opt out on moral grounds you should also refuse to accept on moral grounds.
Karen
Yes there is capacity within the NHS to clear the waiting list and reduce waiting times for all types of organs.
The problem is a shortage of organs. The numbers who could benefit from a transplant rise every year while the number of dead donors has fallen sharply over 5 years due to better road safety and prevention of strokes in young people. Those two factors are good news for those patients.
If everyone who dies in the appropriate circumstances were to donate their organs the waiting list and waiting times would be reduced markedly.
In end stage kidney patients its cheaper to treat them with a transplant than to keep them alive on dialysis. So living kidney donation will become the treatment of choice in the future. But that wont help those who dont have a living donor or those who need an organ which has to come from a dead donor until medicine advances further.
I think I have read all the comments and not seen any reference to this but forgive me if it has been discussed. My wife's main objection to being put in the involuntary donor's register was the fear that her organs would go to "unworthy" people such as criminals, self-abusers (alcohol or drugs) or religious fundamentalists (no particular type - just those that promote the killing of otherwise innocent non-believers-in their-flavour-of-God). If some account could be taken of the donor's wishes on this matter she would sign the register. However she thought that I had gone too far when I pointed out that as an atheist I wouldn't want my organs going to any believers of any sort - let their God look after them.
Karen (54)
I am a kidney transplant patient so I know a thing or 2 about what is involved. I鈥檓 sorry I may not made myself clear but those costs include all you mentioned, I鈥檒l address your points one by one.
You haven't factored in the theatre costs, surgeon costs, medication costs in theatres, follow up costs, training costs for staff and the ITU bed costs.
(Information provided by National Kidney Federation)
All solid organ transplantation (with the exception of liver transplantation for alcoholic liver disease) is cost-effective, particularly in relation to NHS spend.
Kidney transplantation is very cost-effective and is the treatment of choice for those with end-stage renal failure.
Maintaining a patient with end-stage renal failure on renal replacement therapy (dialysis) costs 拢20,000 per patient per year for a patient on peritoneal dialysis and 拢34,500 per patient per year for a patient on haemodialysis.
There are 37,500 patients with end-stage renal failure. Over 20,000 are on dialysis, whilst the remainder have a transplant. Of those on dialysis, 70% are on haemodialysis and 30% on peritoneal dialysis.
The average cost of dialysis is 拢30,000 per patient per year.
3% of the NHS budget is spent on kidney failure services.
The cost of a kidney transplant (excluding UK transplant costs) is 拢20,000 per patient per transplant.
The immunosuppression required by a patient with a transplant costs 拢6,500 per patient per year.
Kidney transplantation leads to a cost benefit in the first year of 拢3,500 and 拢23,500 in subsequent years.
The cost benefit of kidney transplantation compared to dialysis over a period of nine years (the median graft survival time) Ref 5 is 拢191,000 or 拢21,200 per year for each year that the patient has a functioning transplanted kidney.
In 2002-3, 1775 people benefited from a kidney transplant. These transplants are now saving the NHS 拢37.6m in dialysis costs each year for every year that the kidney functions.
In 2002-3, as a result of increased investment in organ donation initiatives, 75 more kidney transplants were provided than in the previous year. These transplants are now saving the NHS 拢1.6m every year until graft failure.
In 2002-3 UK Transplant recorded 17,110 people in the United Kingdom with a functioning kidney transplant. In this year, these patients will save the NHS 拢363m in the dialysis costs that they would need if they did not have a functioning kidney transplant.
In 2002-3 UK Transplant provided support for 5,077 transplants (2,780 solid organ transplants and 2,297 cornea transplants).Ref 6 In the same year, UK Transplant鈥檚 net operating cost was 拢8m. The UK Transplant cost of a single transplant was 拢1,575 and includes promoting organ donation, matching and allocating donor organs, collecting clinical follow-up data on all transplanted patients until death or graft failure and providing a programme of clinical audit and analysis.
The Transplant units have to have beds available for transplants, the staff are still working there, surgeons getting paid etc so if transplants are not taking place they may be lying empty still costing the NHS the same amount of money.
The patient on the waiting list would be attending clinic more regularly and having monthly blood test than post transplant. Initially you are monitored very closely but as time goes on and provided things are going well your would be seen less and less. At the 2 year mark I should be attending the clinic just twice a year as opposed to on dialysis monthly thus saving money.
Anti-rejection medication needs monitoring either in the community or in outpatients - these attract costs too. Some of the anti-rejection medicines can cause further damage to other organs which may also need medication to treat them.
Very true but as I addressed above these costs are much lower as you would attend clinics much less frequently. It is true that anti-rejection drugs can damage the kidneys but there is no guarantee this would happen and the newer drugs are much more kidney friendly. It may take 15-20 years for the damage to get to a point where dialysis or transplant would be needed if at all. I personally know kidney patients who have had fully functioning transplants in excess of 30 years.
The point is that I'm not certain that there is the capacity in the NHS to carry out the transplants even if there were the trained staff and the money. I'm sure that there are cost savings along the line but there are also significant costs too.
There is the capacity to carry far more transplant a year than are currently being carried out. As I said above beds have to be keep empty and surgeons on standby for if an organ comes in. They may be empty for weeks or even months at a time! When my transplant took place there were 5 other transplants carried out in 4 days (4 cadaveric & 1 live)
I've read a lot of the blog referring to this ridiculous idea of presumed consent. Having, many years ago, seen an edition of Panorama about organ donation and how this one lady was actually still alive but unable to communicate in any way after a seemingly fatal accident, I don't ever wish to find myself in that position. It may, of course, never happen, but it is one of my worst fears about my life coming to an end. When my Mum died recently, I found out a few things I didn't know before about what happens at the end, e.g., hearing is the last one of your senses to go. It's probably inconsequential in my own case, as I was recently diagnosed as having Multiple Sclerosis, so I am sure my organs would be rejected for such use anyway!
Pat (59)
I'm sure this program you saw 20 years ago was a very rare case and it is extremelly doubtful it would happen again to anyone.
The point about presumed consent which so many of you dont seem to get is if you dont want to donate your organs you opt-out its as ridiciously simple as that.
The majority of people want to donate their organ after death but for one reason or another haven't got around to or cant be bothered to sign the donor register.
I just wonder how quickly those of you against organ donation would change your mind if your 5 year old daughter desperately needed a heart transplant?
Just how are you going to use your organs when they are rotting away in the ground along with the 5 or 6 people who died because you so selfishly took them with you.
I have to admit that I am biased. A few years ago my father received a liver transplant. I can't tell you how grateful I am to the donor and their family. Without a transplant my father was told that he only had months to live. His return to health after the transplant was amazing. Every year I think back to that time and think about that other family. I don't know anything about them and can only guess at awful time they were having while we celebrated my dad's recovery but I am so glad that consent was given.
However it is done - opting in or opting out - it is a difficult situation.
Yes - opting out could have unfortunate implications - but it might force everyone to think and act. If that means taking your name off the register - fine, I respect your opinion.
Unfortuately the opt in choice isn't working. Death and organ donation - eewww - it's not nice to think about. Until it happens. When it is the last think you want to deal with.
I'm just glad that my father's donor opted in.
We see here an example of unfortunate conflation which troubles amny a discussion:
From Mike (60):
"I just wonder how quickly those of you against organ donation would change your mind if your 5 year old daughter desperately needed a heart transplant?"
To be opposed to the presumption is NOT the same as to be opposed to donation.
xx
ed
It appears that the majority of those most vehemently opposed to a system of 'presumed consent' base their arguments on emotional fallacies which is fine. And they also appear to be the same folk who would consciously not register an intention to donate their organs on the national register, which is also fine.
A system of 'presumed consent' would not affect these people in any way as they would be the first in line to register their opt-out. From my own experience I hope they never find themselves in want of a kidney or other organ within the current system as they might be in for a very long wait.
But it is the vast majority of the population, some 70%, who have indicated their wishes to donate in recent surveys but who haven't got around to registering, that 'presumed consent' will affect directly.
'Presumed consent' works very well in many countries who surprisingly have among their populations people who do not wish to participate and their wishes are honoured. Why it should be any different in the UK beggars belief and for those who wish to point the finger the Government, it won't be the Government or MPs who will manage such a system but health professionals who do this very demanding job every day and night of the week.
It is these same professionals who have to care for the thousands of desperately ill patients on transplant waiting lists and who, more often than not, see them fade and die before their eyes.
Mike (58)
It's getting a little heated now which wasn't my intention.
The current system does still have spare capacity but with opt-out rather than opt-in the number of donors would increase. I'm not certain that there is the capacity for this expansion.
I really appreciate you finding the time to provide me with the information - I was aware that kidney transplants are the most cost effective but that livers were not. These are still major operations and they do not go smoothly for everyone.
Some people DO require protracted stays in critical care beds and some people do encounter problems within the first 5 years that result in them ending up in a critical care bed again. Not everyone can tolerate the medicines particularly well and we may encounter problems with the new medicines that weren't shown up in the trial.
I fully support transplantation. I've signed up. I'd encourage anyone to sign up. We also need to ensure that there is the capacity to cope with the ability to do these transplants. I don't agree with presumed consent because some individuals do have religious grounds for not giving or receiving transplants.
I think what the CMO was aiming to do was to get a debate started. I think he's achieved his aim.
Ed;
You are quite correct. But you missed or overlooked the use of "selfish" at the end of (60).
That's what you face from certain quarters if you *dare* to opt-out, or mention doing so. Stigamatisation will be rife and society will have another new division to trouble itself with.
The cry of 'He can't have a transplant, He's opted-out' will be heard, indeed it's already being heard on this Blog.
Peter C.;
What about my genuine concerns at (41) ? Not too many emotional fallacies there...
Si.
I am not going to post my full views on this subject, as my main points have already been raised.
However, in response to Karen (64):
I don't agree with presumed consent because some individuals do have religious grounds for not giving or receiving transplants.
I would have to disagree with this.
All of the major religions in the UK support organ donation and transplantation.
The organisation responsible for maintaining the organ donor registry, UK Transplant, has worked with all of the 6 major UK religions (Buddhism, Christianity, Hinduism, Islam, Judaism and Sikhism) and has produced leaflets explaining the point of view of each of the religions, which you can view on their website.
Hal.
You confuse 'abusive' with bluntness.
Having lost both our parents, my brother and i were then faced with finding out that he had kidney failure and would require a transplant. I had no doubt in my mind that should i be compatible i would donate and risk my life to save his. Now i know that not everyone feels that way and I am not judging and nor am i questioning people's love, but this then brings me onto donating once gone. If there are people out there who can donate live then surely people can donate deceased and those who wouldn't be willing to donate deceased should not be entitled to receive either - that's hypercritical and should you not be willing to save numerous lives by donating your organs then you shouldn't be entitled to live yourself. Not only that, but should they change legislation to opt out as opposed to opt in (which is what i'm hoping will happen), if people feel that strongly about it then they'll opt out. Let's face it most who haven't opted in haven't because they have not got round to it as it's not their number one priority as doesn't currently affect them in any way. These things are only at the forefront of your mind should they affect you and it will affect you if you're automatically enlisted, so just opt out. It's unethical to remove organs from one patient to save another if the patient still has a chance of living. If intensive care nurses who see this happen all the time fill in their donor cards as well as ensure their families are aware of their wishes to donate then surely that reassures those who think otherwise - they wouldn't do that should they think their life will end to save another! Other countries function with the opt out scheme without issues, so why can't we? It's not taking away your rights as if you feel so strongly about it you can opt out, but what it is doing is saving many more lives, by registering those who are busy and obviously fortunate enough not to have had to think about any of this yet.
It's the most amazing feeling to be able to give life. I highly recommend it to anyone as would no doubt most families of those who have passed on and done so too.
Re (65) Many folk as above have raised potential issues with a 'presumed consent' system all of which have been addressed in various ways in the countries where the system is in use and has been successfully deployed for many years. I don't recall any deceased British or Irish tourists in Spain of late been shorn of their organs before being repatriated for burial. On the other hand given the alleged legendary appetite of same for alcohol and chips perhaps that's not a good example....
The debate and insipid counter arguments against Presumed Consent is a zillion times more irritating than the seemingly endless debate about whether it was acceptable to lie in order to bring about the removal of mass murderer Sadam Hussein; Sometimes radical change is required to achieve positive results.
And Lets be clear about Presumed Consent: It does not restrict human rights, as is suggested. Indeed it protects human rights across the board. And here's why:
a) If you don't want your organs to be used after your death, then the system allows you to register this wish. No one is going to come along and rip out your organs - you've already said NO to this. Simple, Simple, Simple.
b) The thousands of people ( and their families - remember the ripples of disease are vast) awaiting organ donation get the chance to live. Not just exist with the daily fear and pain of illness and the prospect of death.
ALL human rights protected. Can't think of a simpler, less painful system.
Anyone who really objects to Presumed Consent should spend time learning about the real physiological and emotional ( oh yes, disease is not just physically painful, but is stressful...frightening...depressing) effects of living with diseases where transplant is the only hope of escaping death.
Think of this: Many of us are on the recycling band wagon. We seperate our waste. Make little trips to the skip and dispose of our cardboard and wine bottles. We relish in the pleasure of putting the green bottles into the 'green glass only' bins and so on - We stand back with a feeling of smug satisfaction that we are doing our bit to save the planet ...and yet , are perfectly happy to bury or burn perfectly good organs.
Organs that could save lives, families, peoples ability to carry on working and pay their mortgage. Kidneys, livers, hearts, lungs chucked away everyday, because neither the government nor the British public have a true understanding of what it really feels like to live with disease.
People are dying unecessarily. Actually Its a form of murder!
Congratulations Sir Liam Donaldson for raising the debate again, but we need to fight harder, much harder!
Jane (70) The debate and insipid counter arguments against Presumed Consent is a zillion times more irritating than the seemingly endless debate about whether it was acceptable to lie in order to bring about the removal of mass murderer Sadam Hussein; Sometimes radical change is required to achieve positive results.
I am compelled to point out that no one in the government has been shown to have lied in respect of Iraq. It may be 'received wisdom' these days but to my mind that is due to the "groupthink" of which some froggers have been accused on other threads, and stems from laziness. Not that I am suggesting you were subscribing to that view in your post: you don't actually state your position. Nevertheless, the allusion to it strikes me and I feel strongly that repetitions of this 'received wisdom' should be challenged, as should all stories that perpetuate in that way.
Appy,
"no one in the government has been shown to have lied in respect of Iraq."
But we all KNOW we were lied to:
1. Not about oil?
2. WMD definite evidence?
3. Not committed to Bush well in advance?
4. A threat to UK? A threat to Israel, no doubt.
If thet's "groupthink", it's a pretty big group, and I'm in it.
xx
ed
No Ed (72), You can't say that you know, only that you strongly suspect. And "all"? -- Those who think that may shout the loudest but it doesn't mean they speak for everyone.
If thet's "groupthink", it's a pretty big group, and I'm in it. -- The belief of a number of people that something is true does not make it so.
Appy,
Quite, Quite, but I know we haven't been told the truth. And If some of our leaders actually believe(d) what they told us, they're not intelligent enough form high office.
xx
ed
Oh for crying out loud!!
I neither know nor care whether the decision to enter Iraq and wipe out Saddam Hussein was under false pretences!
Frankly though - since I feel compelled now to give an oppinion - if any lying did go on then well done; at least it got rid of him!
This blog is not about Irag, it's about 'Presumed Consent'. Surely we should stick to the point.
However judging by many of the limp, ill informed objections to Presumed Consent posted on here I suspect the debate will rage on for some time.
Bring it on!
Jane (75),
"I neither know nor care whether the decision to enter Iraq and wipe out Saddam Hussein was under false pretences!"
You brought it up.
"if any lying did go on then well done; at least it got rid of him!"
And ends justify means.
xx
ed
Jane(75) But you were compelled to give your opinion in your post number 77!!!! Why didn't you stick to the point then?
Our debates are usually well-informed, polite and erudite. They rarely ''rage on'', but can be protracted when those engaged in them have fresh information or evidence to back up their opinions.
Your use of the words ''limp'' and ''ill-informed'' are offensive and inaccurate, and because of this you are likely to be considered as one not worth engaging with.
I did indeed bring it up. Iraq, that is! Not because I wanted to launch a debate on the topic, but.....ooh, refer back to my original posting. I think(in fact I'm certain) you get my point!
Ends justify means? Yes, no , sometimes. Re Presumed Consent: ABSOLUTELY!
Gillian,
I think I stuck to my point rather well. I expressed my views about Presumed Consent, only to discover that my posting triggered a gamut of responses about Iraq; no reference whatsoever to any points I raised about PM.
No wonder then that 4 years after PM was thrown out that we are still going round in circles.
I cannot comment on whether this blog is usually 'well-informed, polite and erudite'. Currently I am only concerned with the debate that surrounds Presumed Consent. Reading through the postings on here I have not found one single logical argument against Presumed Consent; fears of having organs removed against their will, fears that organs will be transplanted in unworthy recipients such as criminals, fears that organs may be removed from people who are believed to be dead but are not, fears that more organs will result in less people dying and hence cause a population explosion!
Yes, 'limp' and ill-informed'. Of course, these are opinions and peoples feelings should be respected. Which is why Presumed Consent is the perfect solution; it does exactly that. If anyone has a strong objections to their organs being used then all they have to do is register this wish. Simple, as I said earlier.
My concern that this blog reflects human natures tendency to over debate topics ( rage on) is important because time is against us. People are dying. The time is now.
Gillian,
I think I stuck to my point rather well. I expressed my views about Presumed Consent, only to discover that my posting triggered a gamut of responses about Iraq; no reference whatsoever to any points I raised about PM.
No wonder then that 4 years after PM was thrown out that we are still going round in circles.
I cannot comment on whether this blog is usually 'well-informed, polite and erudite'. Currently I am only concerned with the debate that surrounds Presumed Consent. Reading through the postings on here I have not found one single logical argument against Presumed Consent; fears of having organs removed against their will, fears that organs will be transplanted in unworthy recipients such as criminals, fears that organs may be removed from people who are believed to be dead but are not, fears that more organs will result in less people dying and hence cause a population explosion!
Yes, 'limp' and ill-informed'. Of course, these are opinions and peoples feelings should be respected. Which is why Presumed Consent is the perfect solution; it does exactly that. If anyone has a strong objections to their organs being used then all they have to do is register this wish. Simple, as I said earlier.
My concern that this blog reflects human natures tendency to over debate topics ( rage on) is important because time is against us. People are dying. The time is now.
Gillian,
I think I stuck to my point rather well. I expressed my views about Presumed Consent, only to discover that my posting triggered a gamut of responses about Iraq; no reference whatsoever to any points I raised about PM.
No wonder then that 4 years after PM was thrown out that we are still going round in circles.
I cannot comment on whether this blog is usually 'well-informed, polite and erudite'. Currently I am only concerned with the debate that surrounds Presumed Consent. Reading through the postings on here I have not found one single logical argument against Presumed Consent; fears of having organs removed against their will, fears that organs will be transplanted in unworthy recipients such as criminals, fears that organs may be removed from people who are believed to be dead but are not, fears that more organs will result in less people dying and hence cause a population explosion!
Yes, 'limp' and ill-informed'. Of course, these are opinions and peoples feelings should be respected. Which is why Presumed Consent is the perfect solution; it does exactly that. If anyone has a strong objections to their organs being used then all they have to do is register this wish. Simple, as I said earlier.
My concern that this blog reflects human natures tendency to over debate topics ( rage on) is important because time is against us. People are dying. The time is now.