The need for opt-out organ donation in England

[Shaker]

Dozens of lives saved in Wales in six months following the introduction of opt-out scheme: https://goo.gl/S7LwXa

Who'll put this on the agenda for England?

[floo]

Dozens of lives saved in Wales in six months following the introduction of opt-out scheme: https://goo.gl/S7LwXa

Who'll put this on the agenda for England?

Good for WALES! The whole of the UK should follow their example.

[Shaker]

Absolutely!

... critics including the Church in Wales are sceptical, arguing that the new system could be confusing, may alienate relatives of potential donors and could tarnish the image of organ donation.

Needless to say

[Hope]

Whilst I'm all for the opt-out system, I do find the Guardian's headline somewhat laughable.  Whilst 60 is literally 'dozens', the term 'dozens' is more usually used to refer to more than 5 dozen.

[Nearly Sane]

Whilst I'm all for the opt-out system, I do find the Guardian's headline somewhat laughable.  Whilst 60 is literally 'dozens', the term 'dozens' is more usually used to refer to more than 5 dozen.

Surely that is contextual? If I said I had dozens of things to do today, that wouldn't mean more than 5 dozen. It might not even mean an actual dozen.

Here where it is describing an actual number as opposed to 'lots' contextually, seems reasonable to me.

[Udayana]

hmm .. it's not even 60 ...

"Of the 60 organs transplanted in Wales between December and June, half came from people whose consent had been deemed. The organs were provided from 31 people, 10 of whom had not explicitly confirmed that they wanted to become donors."

And what about all the figures not mentioned - did the relatives  of those "deemed" donors also consent or were they not asked or overruled? How many potential donors were not used because relatives objected. How many potential donors were not used for other reasons? What are the figures for people already registered as donors or registered as not consenting? What are the figures for relatives of potential donors being asked for consent or not consenting prior to the new system?

 This is propaganda, not information!

[john]

If opt out donation led to only one dozen or even one life being saved. It would be worth doing. Bring it on.... NOW

[Shaker]

Well well well ... https://goo.gl/BScZnk

[Owlswing]

Whilst I'm all for the opt-out system, I do find the Guardian's headline somewhat laughable.  Whilst 60 is literally 'dozens', the term 'dozens' is more usually used to refer to more than 5 dozen.

Typical Hope pedantry, saved for times when he has nothing worthwhile to quote from his extensive friend and worldwide travel experience bases.

[Owlswing]

hmm .. it's not even 60 ...

"Of the 60 organs transplanted in Wales between December and June, half came from people whose consent had been deemed. The organs were provided from 31 people, 10 of whom had not explicitly confirmed that they wanted to become donors."

And what about all the figures not mentioned - did the relatives  of those "deemed" donors also consent or were they not asked or overruled? How many potential donors were not used because relatives objected. How many potential donors were not used for other reasons? What are the figures for people already registered as donors or registered as not consenting? What are the figures for relatives of potential donors being asked for consent or not consenting prior to the new system?

This is propaganda, not information!

A quote culled from the link - https://goo.gl/BScZnk - provided by Shaker

Thirty-one people who died in Wales between the start of December and the end of May donated 60 organs between them. Of these, 10 had their consent presumed because they had neither opted out nor joined the organ donor register. (That figure was up from 23 donors in the same six months the year before.) Of the 60 organs, 32 came from the 10 people whose consent was presumed under the new set-up.

I think this answers your question Udayana.

My guess is that you belong to one of the fatalist beilef groups.

[Udayana]

ha . no it doesn't provide any details of how the system is working or is helping. Ambiguously written to boot. There are all sorts of factors that could affect how well the donation system works.

Really, I'm getting fed up with how this country is run based on soundbites. Soon will be giving up  parliament, courts and universities and just rely on twitter 

Gave up on the Guardian years ago because every story is wrapped in woolly thinking!

What is a fatalist belief group?

My own inclination is that the state should not presume rights over individuals without good reason. Civil society depends on people freely cooperating positively.

[Shaker]

What is it, specifically, about an opt-out system (i.e. don't like it = say no thanks) that you think interferes with anybody's rights?

[Rhiannon]

I'm not a fan of the Graun articles. They really aren't clear at all and I don't think that helps in getting people on board.

Doesn't change the fact that the opt out system is the way to go. Both individuals and bereaved families have that right, which is the co-operation you want, Uday.

[Udayana]

What is it, specifically, about an opt-out system (i.e. don't like it = say no thanks) that you think interferes with anybody's rights?

It's the "presumption". I also want to understand why, assuming no compulsion, the opt-out system is better than the opt-in system.

It does reflect on rights, just as much as an ID system does or vaccination or fluoridation, for example. It's an interaction between an individual, or in this case their family, and the state.

[Shaker]

It's the "presumption". I also want to understand why, assuming no compulsion, the opt-out system is better than the opt-in system.

Because it drastically enlarges the pool of available organs for transplantation. That's the point of it, and it works.

It does reflect on rights, just as much as an ID system does or vaccination or fluoridation, for example. It's an interaction between an individual, or in this case their family, and the state.

An ID card system is imposed on everyone with no ability to opt out, so I really don't see how you think there's a comparison of any kind. Young people who need to prove their age can already choose - you'll note the word - to carry an ID card of sorts. The point however is that this isn't a national scheme of the kind proposed a few years ago; you can choose one way or the other. All those opposed to ID cards when they were mooted some years back - me, for one - had no issue with any system that allows for anyone to say "No thanks, not for me." That's the system we already have, after all.

An opt out donation system allows for this, so why pretend that it doesn't?

[Udayana]

Because it drastically enlarges the pool of available organs for transplantation. That's the point of it, and it works.

But why not just ask the family anyway? If the consent of the deceased is important why not just have a  register of OK, Not OK, or Don't Care for each person?

An ID card system is imposed on everyone with no ability to opt out, so I really don't see how you think there's a comparison of any kind. Young people who need to prove their age can already choose - you'll note the word - to carry an ID card. The point however is that you can choose one way or the other. All those opposed to ID cards when they were mooted some years ago - me, for one - had no issue with any system that allows for anyone to say "No thanks, not for me." That's the system we already have, after all.

An opt out donation system allows for this, so why pretend that it doesn't?

Why don't we have an opt-out ID/DNA system then?

[Shaker]

But why not just ask the family anyway?

Because it's not a decision which family should be able to make. Family refusal rates run to something like 50%, I gather, and it's unconscionable that any other party - including family; especially family - can overrule the express wishes of someone who has chosen to donate. Donation is donation; once somebody has made that decision it should stand.

If the consent of the deceased is important why not just have a  register of OK, Not OK, or Don't Care for each person?

Superfluous. Under an opt-out system not opting out is a don't care, I'd have thought. If you have every opportunity to opt out - potentially by something as simple as ticking a box on a sheet of paper - but don't, what does that say about how important it is to you?

Why don't we have an opt-out ID/DNA system then?

ID - we already do. You can carry an ID card right now, if you choose to - I see the sticker on the windows of shops all the time. In practice, a passport and a driver's licence even more so amount to the same thing. They're things you have to choose to get, though.

Not sure what you mean about a DNA system.

[Udayana]

Because it's not a decision which family should be able to make. Family refusal rates run to something like 50%, I gather, and it's unconscionable that any other party - including family; especially family - can overrule the express wishes of someone who has chosen to donate. Donation is donation; once somebody has made that decision it should stand.

So under the opt-out system, consent from the family is not requested/obtained?

Superfluous. Under an opt-out system not opting out is a don't care, I'd have thought.ID - we already do. You can carry an ID card right now, if you choose to - I see the sticker on the windows of shops all the time. In practice, a passport and a driver's licence even more so amount to the same thing. They're things you have to choose to get, though.

But why not an opt-out DNA or biometric data based system with the known advantages of such?

[Shaker]

So under the opt-out system, consent from the family is not requested/obtained?

I don't know if in practice it is in those countries that already operate the opt out system; I'm saying it shouldn't be. The decision to donate organs is pure altruism and rests with and only with the temporary caretaker of said organs. Nobody else gets a say. Sorry, but that's how it should be. If families think that decomposition or roasting of organs is preferable to giving several other people a chance of sight or even of life itself ... well fuck them, frankly.

If that seems harsh, well done on your perspicacity: it is. Hard? Yes. But life is hard and so is death - welcome to the universe. Some people, recently bereaved, find that the whole business is made easier by knowing that the person they've loved and just lost was large-hearted enough to want to do an unalloyed and unambiguous good for complete strangers. If you say to me, while still living, that you prefer not to help others, or relatives say the same of a loved one, I put you and them in the same category as the farmer who would rather see a crop rot in the ground than feed people with it. (This is already the case with supermarkets). I have no option but to accept that decision, but I am under no obligation to respect it or regard it as anything other than contemptible.

I don't really expend tremendous effort to disguise my utter scorn and contempt for stupid, ignorant and irrational beliefs, and to me, believing that it's better to deny people a chance - any chance - of better eyesight or of living an extended (or even a normal) lifespan is right up there in the ranks of nauseating ignorance  not to mention equally sick-making selfishness. (What corpse needs internal organs, and what for?). Especially in the name of religion, pretty well all religions supposedly being predicated on the idea of good will and charity to others, whether mandated by a god, two gods, many gods or no gods.

But then religion is usually best at talking a good game rather than actually delivering good where it counts - with real live people actually living in the world. That's why overwhelmingly we find a certain type of person more interested in stem cells and embryos than somebody who goes ouch if you pinch them.

But why not an opt-out DNA or biometric data based system with the known advantages of such?

If it genuinely is opt out, then fine.

There are also known disadvantages, of course.

[Hope]

I don't really expend tremendous effort to disguise my utter scorn and contempt for stupid, ignorant and irrational beliefs, and to me, believing that it's better to deny people a chance - any chance - of better eyesight or of living an extended (or even a normal) lifespan is right up there in the ranks of nauseating ignorance  not to mention equally sick-making selfishness. (What corpse needs internal organs, and what for?). Especially in the name of religion, pretty well all religions supposedly being predicated on the idea of good will and charity to others, whether mandated by a god, two gods, many gods or no gods.

Is ensuring that 'everyone has a chance' as you put it, necessarily the best thing, Shaker?  I sometimes think that society is so afraid of death that it seeks to put the inevitable off for as long as possible, even if those being kept alive might rather not be.

But then religion is usually best at talking a good game rather than actually delivering good where it counts - with real live people actually living in the world. That's why overwhelmingly we find a certain type of person more interested in stem cells and embryos than somebody who goes ouch if you pinch them.If it genuinely is opt out, then fine.

That, of course, assumes that religion doesn't deliver good where it counts - which is not the case in my experience.

Regarding whether to opt-in or opt-out, a person's family is almost always consulted whichever the system.  It allows the medics to double check medical records that aren't always accurate.  For instance, I suffered from acute nephritis back in 1982 (from which I was declared clear within 6 months) but because it occurred abroad it doesn't appear in my records here - despite my pointing it out every time I have a major consultation with the doctors.

[Udayana]

I don't know if in practice it is in those countries that already operate the opt out system; I'm saying it shouldn't be. The decision to donate organs is pure altruism and rests with and only with the temporary caretaker of said organs. Nobody else gets a say. Sorry, but that's how it should be. If families think that decomposition or roasting of organs is preferable to giving several other people a chance of sight or even of life itself ... well fuck them, frankly.

If that seems harsh, well done on your perspicacity: it is. Hard? Yes. But life is hard and so is death - welcome to the universe. Some people, recently bereaved, find that the whole business is made easier by knowing that the person they've loved and just lost was large-hearted enough to want to do an unalloyed and unambiguous good for complete strangers. If you say to me, while still living, that you prefer not to help others, or relatives say the same of a loved one, I put you and them in the same category as the farmer who would rather see a crop rot in the ground than feed people with it. (This is already the case with supermarkets). I have no option but to accept that decision, but I am under no obligation to respect it or regard it as anything other than contemptible.

I don't really expend tremendous effort to disguise my utter scorn and contempt for stupid, ignorant and irrational beliefs, and to me, believing that it's better to deny people a chance - any chance - of better eyesight or of living an extended (or even a normal) lifespan is right up there in the ranks of nauseating ignorance  not to mention equally sick-making selfishness. (What corpse needs internal organs, and what for?). Especially in the name of religion, pretty well all religions supposedly being predicated on the idea of good will and charity to others, whether mandated by a god, two gods, many gods or no gods.

But then religion is usually best at talking a good game rather than actually delivering good where it counts - with real live people actually living in the world. That's why overwhelmingly we find a certain type of person more interested in stem cells and embryos than somebody who goes ouch if you pinch them...

But there's a distinct lack of consistency here. If the relatives feelings are not to be considered, then the deceased wishes prior to death are also irrelevant; they are no longer sentient after all. You might as well go for compulsory use of body parts however the authorities see fit to use them.

I suspect that the reason for insufficient donors in the current system is because relatives are not asked - in those few cases where transplants are feasible - in turn, probably because of taboos around discussing death. In some cases families may withhold consent, essentially because of the same taboos.

ETA: Am failing to see how anyone can come to a correct understanding of peoples attitudes and decisions on such issues without the basic facts on the operation of the current systems.

[Étienne d'Angleterre]

Is ensuring that 'everyone has a chance' as you put it, necessarily the best thing, Shaker?

Yes. If people want and organ transplanted and there is a willing donor.

I am an organ donor. If my family vetoed it, AND, there is an afterlife, then they had better watch  out!

[Étienne d'Angleterre]

But there's a distinct lack of consistency here. If the relatives feelings are not to be considered, then the deceased wishes prior to death are also irrelevant; they are no longer sentient after all. You might as well go for compulsory use of body parts however the authorities see fit to use them.

So, you think that a person's will should not be respected? I don't see the difference. One is an asset and the other is organs. It is what the person wanted. I have made a will but didn't consult my relatives (other than my wife and the custodians for the children - it is a joint will). Have I done wrong? Should it be able to be simply rejected by relatives because they don't like it (other than if they suspect fraud of some sort)?

The only other consideration I would give is that (IMO) you should need to be above an age of consent before the question is asked. I would suggest 16-18, but after that be able to opt-out at any point. Like most things there is no hard and fast line but I think you should be able to consider a position before you agree to it, wherever possible.

.

[Shaker]

Is ensuring that 'everyone has a chance' as you put it, necessarily the best thing, Shaker?

Yes, it is.

I sometimes think that society is so afraid of death that it seeks to put the inevitable off for as long as possible, even if those being kept alive might rather not be.

Organ transplants are about people who want to be given a chance to live not those who wish to die, but it surprises nobody that you pick an utterly irrelevant example of something else entirely.

Premature death through organ failure (and therefore the need for a new organ) is frequently avoidable. It's a problem in need of a solution, and we know what the solution is.

That, of course, assumes that religion doesn't deliver good where it counts - which is not the case in my experience.

Which of course is long and incredibly wide-ranging. Isn't it always?

[Owlswing]

Yes, it is.Organ transplants are about people who want to be given a chance to live not those who wish to die, but it surprises nobody that you pick an utterly irrelevant example of something else entirely.

Premature death through organ failure (and therefore the need for a new organ) is frequently avoidable. It's a problem in need of a solution, and we know what the solution is.Which of course is long and incredibly wide-ranging. Isn't it always?

Shaker

Please keep up the good work of pointing out the terminal unpleasantness of the views of Hope and Udayana on this subject, their willingness to deny life where it can be given as a gift when, in Hope's case, it is being taken away by the will of his shit-head of a God (if we are to believe what he says of his God)  - you are well aware of the volatility of my temper when faced with this kind shit and if I try typing what I think about their views I will be banned permanently in a instant.

Go Shaker!