Question to my Peeps

[Okla-homey]

Okay, here goes. You folks are smart and you probably understand that when you die, the hopsital can't harvest any of your organs for transplantation into a person who needs them without your express consent, in writing, obviously before you die.

Now, some places in the world flip that around and have what we call "presumptive consent." Put another way, unless you expressly state "do not harvest my transplantable organs" in writing before you die, hospital personnel are allowed to do so.

I kinda think we should have "presumptive consent" here in Oklahoma. Just seems kind of wasteful to have perfectly good transplantable organs, desperately sought by folks who need them to live, get injected with embalming fluid and buried or burned in a crematorium. What do you guys think?

:pop:

[royalfan5]

I don't understand why anybody would be opposed to being parted out, but I don't think it would be unreasonable to require people to opt out instead of opting in.

[gaylordfan1]

It's kind of a tricky transaction that takes place. This usually occurs before death per say. For instance, say someone has a heart attack and is down without oxygen for a while but is revived and is able to maintain a heartbeat... or someone has some kind of trauma that makes them brain dead... If these people can are maintained "alive" on life support and have been considered "brain dead" by EEG the next step is to notify Organ Sharing of Oklahoma no matter what. If they are a candidate by their lengthy standards then they come to the hospital and work up the patient. All this is done whether the patient has documentation of being or not being a organ donor. It's pretty rare that a family refuses this right, esp if the donor is a young adult with all organs being viable for transplant other than the reason of brain death.

Anyways, it seems to me that the laws surrounding this are very vague. It used to be that if the family said no to the process then it stopped right there. But now Organ Sharing has to be notified immediately after the diagnoses of brain death has been made and are usually there to talk to the family within 5-7 hours. But, no organs are taken without the family knowing about whats going on. It takes a long time from the time of brain death and the patient being on the table for the organs to be retrieved. Usually around 6-12 hours.

Now, when a patient dies at the hospital the same steps apply to notifying Organ Sharing. Only now there are limited organs that can be harvested after the heart has stopped beating. Namely skin and corneas.

[olevetonahill]

Im all for it Homester, Course they aint gonna be anything of me worth harvesting , I think Ive bout used it all up:D

[JohnnyMack]

I'm not an organ donor and don't plan on becoming one. Just my personal preference.

[olevetonahill]

JM, any particular reason ?

[Boomer.....]

I don't understand why anybody would be opposed to being parted out, but I don't think it would be unreasonable to require people to opt out instead of opting in.

I agree.

[Ike]

On the one hand, I can see the argument for presumptive consent being a good thing. People should think about whether or not they want to be an organ donor and actively make the choice, and presumptive consent certainly encourages people to do just that. However, there is another side that worries me about it. And that would be those cases where an individual is brought to the hospital in a near-death state, and while it would be possible to revive the patient, it would require very expensive and time consuming procedures (about which the hospital may or may not have an idea with regards to the patients ability to pay for). In such an instance, if the patients organs might be in a harvestable condition, there is an opportunity for powerful incentives to influence a potentially bad decision.

I'm not saying that such incentives will or won't influence a decision, but doctors are human beings like the rest of us, and in such a situation, where time matters, things aren't always crystal clear as to what should be done.

[yermom]

i'd say what Ike said, with a little more cynical overtones :D

[sooner_born_1960]

They can have my organs when they pry them from my cold, dead...
Wait.

[Frozen Sooner]

Okay, here goes. You folks are smart and you probably understand that when you die, the hopsital can't harvest any of your organs for transplantation into a person who needs them without your express consent, in writing, obviously before you die.

Now, some places in the world flip that around and have what we call "presumptive consent." Put another way, unless you expressly state "do not harvest my transplantable organs" in writing before you die, hospital personnel are allowed to do so.

I kinda think we should have "presumptive consent" here in Oklahoma. Just seems kind of wasteful to have perfectly good transplantable organs, desperately sought by folks who need them to live, get injected with embalming fluid and buried or burned in a crematorium. What do you guys think?

:pop:

I recognize your point on the societal waste involved with a presumption of non-consent. As a matter of social policy , I have an issue with the state seizing your estate's chattels without hearing or opportunity to redeem. Plenty of people out there with religious objections to being parted out.

[homerSimpsonsBrain]

In my experience, its a lot harder to donate organs even if you want to than most people think. You can be profoundly brain damaged to the extent you are on life support and if taken off support will die but you are not brain dead. So you are not a donor candidate.


Homey, have you been listening to NPR again? They're going to revoke your "true conservative" card if you get your information from non approved media.

[Okla-homey]

Homey, have you been listening to NPR again? They're going to revoke your "true conservative" card if you get your information from non approved media.

I think we've already established I'm not a "true conservative" because I don't mindlessly subscribe to the entire conservative manifesto. While it's generally unfair and inaccurate to label people, except for BHO whom I agree is a "radical socialist,";) I'd probably describe myself as a right of center guy on social issues. I'm pretty keen on personal liberty issues, except for abortion rights, because they involve two human lives in being, only one of which is able to express her preference.

[Tulsa_Fireman]

Plenty of people out there with religious objections to being parted out.

Better listen to him, Flounder. He's pre-med.

[Okla-homey]

Plenty of people out there with religious objections to being parted out.

Who are they? Ancient Egyptians? They all died and were mummified thousands of years ago.

But srsly, I'm not aware of any organized religion that has a published policy against organ transplantation except for JW's...and they're whack-os. All we'd have to do to enact presumptive consent is give JW's adequate notice before the law went into effect and a means of expressing their disagreement/non-consent.

[Serge Ibaka]

All we'd have to do to enact presumptive consent is give JW's adequate notice before the law went into effect and a means of expressing their disagreement/non-consent.

Yep. The objectors would be just fine. An opt-out system makes 100x more sense.

[Frozen Sooner]

Who are they? Ancient Egyptians? They all died and were mummified thousands of years ago.

But srsly, I'm not aware of any organized religion that has a published policy against organ transplantation except for JW's...and they're whack-os. All we'd have to do to enact presumptive consent is give JW's adequate notice before the law went into effect and a means of expressing their disagreement/non-consent.

Yeah, the JWs haven't litigated First Amendment issues pretty extensively at all. ;)

Some Jews have a problem with it, I think. I want to say I remember that the Hasidic Jews forbade the practice. Probably wrong, though.

Not really sure that the advance notice and opportunity to opt out cures a possible Free Exercise violation. I guess under Oregon v. Smith it's not even a FE burden so doesn't need to be cured, but then I wasn't necessarily talking about things from a constitutional basis. Dunno. I'm just a little uncomfortable with the transfer of a non-fungible chattel from the estate to the government.

[Tulsa_Fireman]

My old man has mentioned it. He's catholic, but I don't know if that's a personal issue or one of the Church.

[C&CDean]

I'm not an organ donor and don't plan on becoming one. Just my personal preference.

That's right, this way ALL of you can burn in hell for eternity heathen boy.

[olevetonahill]

Hell Ima already willin my parts away
Boomer..... done asked fer my Liver,So he gets that. Anyone need some Strong Kidneys ?

[GKeeper316]

I don't understand why anybody would be opposed to being parted out.

catholics believe that the body must be whole in order to be resurrected.

[olevetonahill]

catholics believe that the body must be whole in order to be resurrected.

Are You catholic? or are you just makin **** up ?

If this is true what happens to the dude who dies in a Car crash and some pieces are never found ?

[Okla-homey]

catholics believe that the body must be whole in order to be resurrected.

Too bad for the countless thousands of Catholics blown to bits by aerial bombardment or artillery in the wars of the 20th century. Oh well. I'm sure Rome has its reasons for such a policy.

[Frozen Sooner]

He's incorrect. JPII authorized organ donation. However, the church requires that for someone to accept a donation, the donee must have given informed consent.

[Flagstaffsooner]

Vet's liver will be used as an anchor on a very large ship.

[JohnnyMack]

I'm actually worried about reincarnation and how it will affect my future standing if I end up without my entire body being intact.

[C&CDean]

I'm actually worried about reincarnation and how it will affect my future standing if I end up without my entire body being intact.

Freak.

[olevetonahill]

I'm actually worried about reincarnation and how it will affect my future standing if I end up without my entire body being intact.

Maybe if we aint all there we wont HAVE to come back. WIN

[Okla-homey]

Dunno. I'm just a little uncomfortable with the transfer of a non-fungible chattel from the estate to the government.

It's not like the organs have any intrinsic pecuniary value. It's illegal to sell or traffic in them in the US. And who said anything about them becoming the property of the government? I merely favor a statutory presumption of consent so licensed heath care facilities where deaths occur are free to harvest viable organs of people who are declared dead by a licensed physician and make them available to whomever needs them.

[Jello Biafra]

where do i sign up to sell my parts?

[Frozen Sooner]

It's not like the organs have any intrinsic pecuniary value. It's illegal to sell or traffic in them in the US. And who said anything about them becoming the property of the government? I merely favor a statutory presumption of consent so licensed heath care facilities where deaths occur are free to harvest viable organs of people who are declared dead by a licensed physician and make them available to whomever needs them.

No legal pecuniary value, of course, but intrinsic emotional value.

If the government can direct the disposal of the body for the public good, sounds to me like they took title.

[Boomer.....]

Hell Ima already willin my parts away
Boomer..... done asked fer my Liver,So he gets that. Anyone need some Strong Kidneys ?

Score!


:D

[olevetonahill]

No legal pecuniary value, of course, but intrinsic emotional value.

If the government can direct the disposal of the body for the public good, sounds to me like they took title.

Mike Im :confused: , If its an Opt out thing and the Doctors are making the decisions , How is the Government involved ?

[Frozen Sooner]

Mike Im :confused: , If its an Opt out thing and the Doctors are making the decisions , How is the Government involved ?

With an opt-out, the body presumptively becomes the property of the state at death, and the state transfers the body to the doctors. The doctors would have the right to enforce that transfer over the objections of the estate.

With an opt-in, the person transfers his body to the doctors willingly without a taking. The estate has no objection, as the deceased's will is known.

[GKeeper316]

He's incorrect. JPII authorized organ donation. However, the church requires that for someone to accept a donation, the donee must have given informed consent.

ah... its been a while since ive been a practicing catholic. pope may have changed the rules since then.

[Okla-homey]

With an opt-out, the body presumptively becomes the property of the state at death, and the state transfers the body to the doctors. The doctors would have the right to enforce that transfer over the objections of the estate.

With an opt-in, the person transfers his body to the doctors willingly without a taking. The estate has no objection, as the deceased's will is known.

THE BODY DOES'NT BECOME THE PROPERTY OF ANYONE! No one has a property interest in humans, dead or alive. Read the flippin' XIII Amendment again for crying-out-loud. All presumptive consent does is make it more likely that transplantable organs will be put to good use. This does not involve real property to which title must always attach to a living person or the state.

[Tulsa_Fireman]

Honest question.

In the pre-hospital environment there's such a thing as implied consent, as in the consent to treat the unconscious/unresponsive under the premise that should they be conscious, it is implied that they would consent to treatment and transport to advanced medical care. So with establishment of presumptive consent for organ donation would/could this overlap with the implied consent of the pre-hospital setting (and the extension of practice for pre-hospital providers being through the licensure of a physician) and set a "conflict of consent" for lack of a better term?

Example being, emergency response to an arrest. Patient is discovered unconscious and asystolic. Under implied consent, we treat and transport. Under presumed consent we would not? That the patient has given consent to harvest their organs? Advance that under treatment protocol established by the physician providing licensure and provide a appropriate quality of care, when does "presumed consent" establish itself? Are organs after an appropriate level of care is given even viable?

It is my opinion that organ harvesting is a good thing that saves lives. But outside of a hospital environment, it seems that acquiring said organs while keeping within pre-hospital treatment standards and existing law is amazingly hard to do. And that presumptive consent would actually NOT affect harvesting rates specifically in the pre-hospital environment. But that's why I pose the question.

Which takes precedent? Implied consent to treat or presumptive consent to harvest?

[bluedogok]

Better listen to him, Flounder. He's pre-med.
I thought he was pre-law.....

[olevetonahill]

I thought he was pre-law.....

Naw , Mike Is in Full fledged Law Skool in Bammer :P

[Frozen Sooner]

THE BODY DOES'NT BECOME THE PROPERTY OF ANYONE! No one has a property interest in humans, dead or alive. Read the flippin' XIII Amendment again for crying-out-loud. All presumptive consent does is make it more likely that transplantable organs will be put to good use. This does not involve real property to which title must always attach to a living person or the state.

Yes, Homey, I understand it's not literally property. The situation is analogous. The next of kin have an interest in the dead body, subject to the will of the deceased. Feel free to attempt an intellectual leap or don't, I don't really give a flip.

[Okla-homey]

Honest question.

In the pre-hospital environment there's such a thing as implied consent, as in the consent to treat the unconscious/unresponsive under the premise that should they be conscious, it is implied that they would consent to treatment and transport to advanced medical care. So with establishment of presumptive consent for organ donation would/could this overlap with the implied consent of the pre-hospital setting (and the extension of practice for pre-hospital providers being through the licensure of a physician) and set a "conflict of consent" for lack of a better term?

Example being, emergency response to an arrest. Patient is discovered unconscious and asystolic. Under implied consent, we treat and transport. Under presumed consent we would not? That the patient has given consent to harvest their organs? Advance that under treatment protocol established by the physician providing licensure and provide a appropriate quality of care, when does "presumed consent" establish itself? Are organs after an appropriate level of care is given even viable?

It is my opinion that organ harvesting is a good thing that saves lives. But outside of a hospital environment, it seems that acquiring said organs while keeping within pre-hospital treatment standards and existing law is amazingly hard to do. And that presumptive consent would actually NOT affect harvesting rates specifically in the pre-hospital environment. But that's why I pose the question.

Which takes precedent? Implied consent to treat or presumptive consent to harvest?

Perhaps you're thinking this too hard. The presumptive consent wouldn't trigger until the attending physician concludes there is no hope of saving the patient and it has been determined the patient has not affirmatively opted out. I don't think anyone favors first-responders making the call outside of a hospital environment.

[AlbqSooner]

When I was working in the medical field in the Air Force and at OUHSC, surgeons did a lot of "exploratory laparotomies", which involves opening from the xiphoid process to the pubis. (Chest bone to the - well, pubis). This was the state of the art diagnostic tool at the time, due to the lack of anything beyond X-ray.
They were conscientous in some people to make an incision around the belly button so as to preserve it intact. There was a cultural belief that one could not enter heaven without the belly button (which originally attached them to their mother).
My guess is there are other, similar, cultural beliefs that would be compromised in the absence of explicit consent.