Axver ([info]axver) wrote,
@ 2008-01-15 22:37:00
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Current music:'Inner Silence' by Anathema
Entry tags:australia, death, health, life, medicine, organ donation

An important issue: organ donation
The news this evening broadcast a story about a call to introduce an "opt out" scheme for organ donation in Australia to replace our current "opt in" system. This follows a similar proposal being put forth in the UK, and the successful implementation of such a system in Spain. The Health Minister has nonetheless ruled out an "opt out" approach for now, and I have noticed one thing - nobody seems to have come forth with a reasonable case against an "opt out" system (it seems the main argument is that Australia's just not ready for it), or for that matter, a reasonable case against organ donation.

I cannot think of a single logical reason why someone would not wish to donate their organs after their death. I occasionally hear someone state that they have legally lodged their intent to not donate, but this is never followed by an explanation as to why. In the couple of Internet forums where I have had the chance to question someone on this matter, they have either not posted again or dodged/ignored the question entirely. Come on. You're dead. You don't need the organs; they're not of any benefit left in your body. If you want to have an open viewing at your funeral, there is no external evidence that you're missing some of your insides. I'll go as far as saying that opting out is a decidedly selfish and stupid move, especially as it seems objectors are incapable of providing a persuasive argument in their favour. I'm willing to reconsider and publicly retract my accusation of stupidity though, so if you object and think you have a good reason, please, speak up. I'd like to hear it.

The argument against donation that I do hear regularly is the basic religious argument, which comes in various forms - the sanctity of the body as God's creation, the state of the body at a resurrection before a final judgement, and others. All of these arguments completely irk me, as I think they are, to put it mildly, theologically flimsy. They essentially imply either or both of two things. Firstly, the weakness of a deity; it does not have the power to restore any organs that may be necessary, or to wholly remake the body in the case of cremation - all the while seemingly ignoring the emphasis put upon the soul as an intangible part of being that exists beyond the temporal plane of existence. Secondly, the malevolence of a deity; for reasons not stated, the deity has some kind of opposition to a generous act that can prolong the life of another person. Surely, if life itself is the creation of the deity, it would not just approve but actually ordain any actions that can be taken to prolong life and improve its quality?

Well, in any case, for those of you in Australia, if you wish to opt in to the current organ donation scheme, you can do so here on Medicare's website. For the record, I have made it very clear to my mother that I wish every useful part of my body to be donated; I have realised that I am not actually on the register and shall rectify that immediately upon my return from New Zealand (the online registration requires the receipt of an item of mail, and I do not wish to have letters piling up while I am away). I have furthermore made it clear that if I cannot donate my organs, if at all possible I want them to be given to science for any research that can be done. I have to die at some point, and while I bloody well hope that's many decades away, when I do die I might as well be usefully dead rather than worm food.



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[info]liamtreasure
2008-01-15 01:15 pm UTC (link)
The news this evening broadcast a story about a call to introduce an "opt out" scheme for organ donation in Australia to replace our current "opt in" system.

GOD YES!

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[info]axver
2008-01-15 01:18 pm UTC (link)
Yeah, but it's not happening if our short-sighted, stuck-in-the-mud Health Minister has her way. She seems to think changing the law would be just too much effort.

It's kind of disturbing that this is a marked improvement on Tony Abbott.

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[info]spaztick
2008-01-15 05:41 pm UTC (link)
Unfortunately, having grown up in the Bible Belt, I know far too many people who are dead set against organ donation and against cremation for the very reason you listed: that body needs to be intact for when the resurrection happens.

So... if you suffer the terrible death of burning up in a fire, are you just fucked?

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[info]axver
2008-01-22 12:05 pm UTC (link)
You know, I've seen threads on Christian messageboards about that very issue, and nobody oppsoed to organ donation/cremation has ever adequately responded to the "what if you die in a fire?" question. I once had to laugh at a response that those who do die in a fire will be restored - so why can't God restore those who choose to charitably donate their organs?

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[info]cat_incarnate
2008-01-15 06:20 pm UTC (link)
Background: This http://www.bbc.co.uk/health/donation/factfilesod_comparisons.shtml article and other stuff I remember from a while back (can be fuzzy)

Like the article said--some systems will go ahead and take the organs without consulting the relatives. This can be bothersome for religious reasons (which, though they can be irrational, should not be completely disregarded) or health reasons if the patient donating the organs has health complications the doctors don't know about.

What I think would be a bigger issue is completely handing the decisions over to the doctor. From my knowledge, most of the organs that are useful for donation are from people who don't die from natural causes and are often younger. Organs need to be fresh and so people in comas are ideal for this. They are brain dead but physically still alive and ticking. Families would find it much harder to say "Yes, go ahead and take the organs because we are %100 sure our family member is dead and will never wake up out of the coma." I'd be worried about doctors being too quick to harvest the organs (I also don't know what tests they do to determine if a person is brain dead and qualifies for organ donation, and maybe the tests are fairly definitive and there isn't room for rational argument). On the flip side the person shouldn't sit there in a coma for years on the wishes of the family. Lots of organs are needed, and having the power to take the organs and not consult the family would leave considerable room for abuse for some. I like the soft opt-out option the best, where consent is assumed and the relatives are consulted and supported throughout the discussions(this is Spain's system http://news.bbc.co.uk/2/hi/health/7183798.stm ) I don't know what checks and balances are in the hard opt-out option.

I think the basic conflict is a scientific one verses an emotional one with different views of the brain dead body, and in those cases people are going to be talking past each other.

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[info]axver
2008-01-22 12:23 pm UTC (link)
'This can be bothersome for religious reasons (which, though they can be irrational, should not be completely disregarded)'

I'm willing to completely disregard those religious reasons which fly against all logic, reason, and sense and defy even the prevailing views of religious authorities. Anybody who refuses to donate for no better reason than "then I won't be able to participate in the resurrection of the dead" is a genuine idiot who worships an incompetent God. Blunt, but I stand by it.

'... or health reasons if the patient donating the organs has health complications the doctors don't know about.'

Now that's a genuine issue, but in Western countries with rigorous medical standards, I can't say I'm too worried about it. Now, no system is ever going to be perfect, but I think it's a minor problem in the most modern healthcare systems.

In impoverished countries, however - then you've got a point.

'From my knowledge, most of the organs that are useful for donation are from people who don't die from natural causes and are often younger. Organs need to be fresh and so people in comas are ideal for this. They are brain dead but physically still alive and ticking.'

That isn't entirely true. The sources I've read agree that most useful organs come from those who die young (and that stringent drink driving laws have actually had the unintended consequence of lowering organ availability due to a decline in younger deaths), but organs from people in comas are never - legally - harvested. From the Australian Organ Donor Register FAQs:

In most cases, a person may only be able to donate organs where they have been declared brain dead in an intensive care unit in hospital. Brain death is when blood circulation to the brain ceases, and the brain stops functioning and dies with no possibility of recovery ... People are sometimes confused about the difference between brain death and coma. Brain death is completely different from coma. A patient in a coma is unconscious because their brain is injured in some way, but their brain can continue to function and may heal. Medical tests can clearly distinguish between brain death and coma.

So as long as brain death is the standard, I don't think there are any concerns about organs being removed from people who could potentially recover. Again, this only applies to those systems with rigorous legal standards. In countries where things are a bit more murky and where the health system is not as well-trusted, I would be much more reluctant. I know Brazil has had issues. But I fully trust Australian and New Zealand health practitioners and believe sufficient checks and balances exist to counter error.

'I like the soft opt-out option the best, where consent is assumed and the relatives are consulted and supported throughout the discussions'

I don't see why the opinion of relatives is even relevant. If the person does not elect to not donate, then that's final. The organs are of no use to the relatives if left in the body, and if they want a viewing at the funeral, the removal of organs would not be visible. I can't even grasp any kind of emotional connection. Now, it's one thing to want a body to bury, and another thing entirely to insist that organs that could be put to good use be thrown in the ground and left to the worms.

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[info]augustine
2008-01-15 10:51 pm UTC (link)
"...Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity..."

Catechism of the Catholic Church #2296

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[info]ikobob
2008-01-22 05:45 am UTC (link)
"I cannot think of a single logical reason why someone would not wish to donate their organs after their death."

Just wanted to comment on this real quick. I'm very much for organ donation, and don't understand why people don't do it more often either, but some people, like myself, have medical conditions that could make it dangerous for the people receiving an organ donation. Getting Lyme from my organs is probably the last thing someone that sick needs. I don't know how many people won't do it because of reasons like that, but yeah.

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[info]axver
2008-01-22 12:27 pm UTC (link)
That's not an issue, luckily enough. A person's medical history is checked, and if there are issues - such as Lyme - then the organs would not be removed or used. In almost all cases, a person has to die in a narrow and specific way for their organs to be successfully harvested, and less than 1% of people who die in Australia can actually donate in the first place. So anybody who actually dies of a medical condition that affects their organs would be unable to donate in the first place.

I do wonder, though, if organs from people with medical conditions are useful for donation to science for research and study though? It may not save a life directly, but it might help enhance knowledge and save lives indirectly. I intend to stipulate that if my organs cannot be donated for use on others, then I want them to go to science.

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[info]ikobob
2008-01-22 05:46 pm UTC (link)
Huh, I never knew that. I'm reading the organ donor site now, and it actually does look like this is something I can do. I knew I couldn't donate blood, because I've heard that's an easy way to spread the disease, but it never occurred to me that organ donation would be any different. Thanks!

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[info]axver
2008-01-23 11:10 am UTC (link)
Well, that's cool! And I'm definitely going to have to look into how to donate to science, rather than to another person - as it's rather unlikely I'll be one of the 1% who can donate organs to somebody else, I'd still like them to go to good use if at all possible. So hopefully there's some handy register like with this. It just seems like such a waste to be tossed in a hole in the ground!

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