Boosting Organ Donation

[okarol]

June 19, 2008 at 23:39:43

Boosting Organ Donation

by Robert Cogan   

http://www.opednews.com

Almost 100,000 Americans are waiting for organ transplant. Up to 60% will die before an organ becomes available. Yet Americans overwhelmingly support organ donation and most express willingness to donate. (See the book “Nudge: Improving Decisions about Health, Wealth and Happiness,” by Thaler and Sunstein, Ch 11.) What's wrong? It's the way states legally structure choice: a person has to take one or more active steps to opt into donation, e.g., by checking the box for donating on the drivers license renewal camera card form. One survey showed that of those who expressed a personal desire to donate, only 64% had that marked on their license and only 34% carried donor cards.

Many more lives can be saved by simple changes in anatomical gift laws from active opt-in to active opt-out or “presumed consent” (PC.) Under PC persons are presumed to give consent for donation unless they actively opt-out. Public education that this will occur, plus just a few words added to documents like the camera card indicating that if you do not wish to be a donor, have the “non-organ donor” designation put on your license would do it.

Each donor can help seven or maybe more people. And there is already partial presumed consent in some other states law for corneas derived from autopsy and analogies in our law about dying without a will (see “Presumed Consent for Organ Donation in Pennsylvania” 107 Dickinson Law Review 935 , Spring 2003.)

It's shameful that there are any Americans without resources to get needed transplants. But to at least stimulate more voluntary organ donation people can take an intermediate step of enlightened self-interest. “Lifesharers” is an organization that enables you to express a preference in donation of your organs to other members of Lifesharers. The United Network for Organ Sharing while not favoring this, apparently gives some weight to it in seeking a suitable Lifesharers recipient, if available, over what might be their “best match.” I'm persuaded that in current circumstances there are more ethical pros than cons to choosing Lifesharers. And after that, one can join Medcures, with which you agree to donate the remains of your body for science and education, in return for free cremation and return of your cremains to loved ones about three weeks after your body is picked up. Check out Lifesharers and Medcures on the Internet.

I am a humanist. I want to help as many other people as I can and have no place of sorrowful remembrance. No amount of money and things I can leave to relatives and charity will come close to equaling the gift of my organs and body.

Take action -- click here to contact your local newspaper or congress people:
Enact Presumed Consent for Organ Donation in State Legislatures http://www.usalone.net/cgi-bin/oen.cgi?qnum=4364

The author is a 67 year old, white male American retired college professor of philosophy. He is a long-time minor activist in the civil rights, anti-war, profeminism movements and taught critical thinking and social philosophy. He has been a unionist, on the Board of Directors of a food coop, an ACLU chapter president, a CASA, and is currently an elected Green Party member nearing, with relief, the end of a 4-year term as a Borough Councilman in his small hometown. He is happily married, for 37 years, to a woman significantly responsible for his modest success in life, the couple have two great kids.

http://www.opednews.com/articles/Boosting-Organ-Donation-by-Robert-Cogan-080617-595.html

[Hemodoc]

It is interesting to see the changes in ethics from when I went to medical school in the late 1980's which for some seems like ancient times, but I assure you it is not.  In medical school we had many classes, lectures and discussions on a wide variety of issues of which I used this framework of learning many times in my own medical practice.  The over riding element of ethics discussed in this time period was that of autonomy and substituted judgement which came forth as a result of proving the autonomous decision of patients when they were unable to proceed by witness statements.  The current ethics domain is that of altruism of which presumed consent comes forth.  We must know and understand that autonomy and altruism at times may have conflicting outcomes of which the prevailing arguments today are going towards altruism over riding that of individual autonomy.  Of the "greater good" of increasing organ donation, we should and I feel must keep account of the ethical costs of supplanting individual autonomy for the greater altruistic good of systems such as presumed consent.

I personally find this a very dangerous precedent where the government over rides personal choices and autonomy no matter how "good" the outcome of increasing organ donation by presumed consent.  Whose organs are they? The person's or the states?  Yes, organ donation is a GIFT that saves lives.   My organs do not belong at all to the government but under the presumed consent laws, the state would indeed control and in a sense own my organs.

In China, until recently, they had a booming business with condemned convicts that were killed at the time of an organ recipient coming to China, and paying for the transplant.  In fact, the slippery slope of China which is universally condemned stems from a perversion of altruism and state  rights over individual autonomy even after death.  Yes, we are indeed heading into many of the slippery slopes of ethics that I learned about and was warned about in my medical school classes that today are the leading attributes of many medical decisions.  How far is it from presumed consent to killing convicts for organs even here in America?

We should study the ethical choices of times past especially like that of Nazi Germany where the ethical decisions of the medical profession lead into the justification of the Nazi killing machines.  Yes, the medical ethics of the 1930's in Germany was the manner in which Hitler brought the death camps into position.  Those that forget history are doomed to repeat it.

Thus, as a renal transplant candidate, I uniformly reject personally receiving any kidney that was not categorically a gift from one individual to another.  The state has no right to take a dead person's organ's no matter how many will benefit.  Yes, we are on a slippery slope that we may not be able to return once we start to slide.  I previously commented on this issue on Bill's page previously.

http://www.billpeckham.com/from_the_sharp_end_of_the/2008/05/presumed-consen.html

May the Lord guide us and direct us to the right decisions on all of these issues.

Peter

[Sunny]

As a renal patient on a transplant list, I too, would have to agree organ donation should be expressly agreed upon by a deceased donor prior to their demise. I also believe
consent from relatives is appropriate if the deceased did not have a consent on file. None of this "presumed consent" for me! I think it could lead to dangerous precedence.
We do NOT have the right to other people's organs. We should refrain from passing laws that take organs from people. Organ donation should be a gift, not a requirement.