UK suggests ethically controversial strategies to increase organ donations
Katherine
2012/08/10 01:16:04
LONDON, August 1, 2012 -- The UK’s National Health Service (NHS) has launched a survey asking health professionals and the public to weigh in on several ethically controversial strategies to increase organ donations. Among the most contentious is the suggestion of “elective ventilation,” whereby patients considered to be close to “brain death” would be started on ventilation and kept alive by artificial means with the specific intention of facilitating organ harvesting.
The survey asks if the NHS should “review the ethical, legal and professional acceptability of so-called elective ventilation, i.e. intubation and ventilation of a gravely ill patient whose death is inevitable in order to promote donation after brainstem death.”
The criterion of “brain death” itself is controversial. Dr. David Albert Jones, director of the UK-based Anscombe Bioethics Centre, a British Catholic institute that tackles moral questions arising in clinical practice and biomedical research, has pointed out that the dubious criterion of “brain death” was “invented” in 1968 to accommodate the need to acquire vital organs in their “freshest” state from a donor who some would argue is still very much alive.
Dr. Jones has said there are many ethical questions that must be answered before we can know if someone is really dead. “Most donation after death in the whole of the western world happens when the heart is still beating, the so-called beating heart cadavers,” Dr. Jones explained, “so it is very important for people, that this body that doesn’t look like a typical dead body, to be sure it really is dead. Because if it isn’t dead, and you take the organs out, then you might be killing someone.”
Other proposals in the NHS survey include registered organ donors receiving preferential treatment if they themselves need an organ transplant, a presumption of consent for organ harvesting unless people have specifically opted out, and higher financial payments to hospitals for every organ they harvest. According to the Guardian, UK hospitals currently receive about £2,000 for every organ they provide, which the NHS compares with the €7,000 (£5,500) paid in Croatia.
The survey asks if the NHS should look again at presumed consent, in which people must opt out of being donors rather than opting in, or if the idea of “mandated choice” should be considered, where people are required to make a choice one way or the other.
In 2008, then prime minister Gordon Brown told the Guardian in an interview that despite experts rejecting the idea of “presumed consent,” he believed the law on organ donation could be changed to allow this. With regard to registered organ donors being given preferential treatment the NHS survey asks, “Do you agree that a person who has signed up to the Organ Donation Register should be a priority recipient for an organ if they subsequently require a transplant?”
The survey offers the example of Israel where in 2009 registered organ donors, and their partners and close relatives, were given the legal right to priority treatment if they should require an organ transplant. At that time Dr Vivienne Nathanson of the British Medical Association criticized the move, saying, in Britain, “We would have serious concerns about a system that would move away from treating patients on the basis of clinical need.”
However, in considering the current survey, the NHS’s director of organ donation and transplantation, Sally Johnson, told the Guardian, “It always seemed to me that fairness is quite a fundamental British value but we have never put that in the context of organ donation.” The NHS Blood and Transplant “Post-2013 Organ Donation Strategy” survey is available here, with an accompanying “Portfolio of Evidence” available here. The deadline for responding to the survey is September 24, 2012.
1) Not getting the chance before getting injured. Wonder how slow the paperwork would be. Wonder what the rule is on children.
2) Brain death determination is unsound and unreliable. They still don't know when to make these calls and often harvest organs while people are still alive. Most of the time patients wake up as doctors are removing the organs. In the case of Russia's homeless, they argue that the person is going to die eventually anyway.
3) Organ donation is already corrupted by doctors and hospitals that convince patients to not get life saving treatments so the hospital can sell the organs and make money. It would be even worse when government runs health care, then gets to determine when to give up on trying to save your life with a system that automatically makes everyone a donor until they can run as fast as they can and apply to be left out.
4) It's unConstitutional and makes your body the property of government first, almost like you're guilty until proven innocent..... You shouldn't need to get their approval to not have the government divvy up your body parts or harvest your organs.
5) Forces citizens to check in with government. You can't be free and independent or else, if something happens to you, they'll chop you into bits. A clever little head count.
There's more that I'm forgetting.
3) I am not aware enough of the UK medical system to comment, as in america organs are not supposed to be sold, by hospitals or otherwise, as it is illegal.
4) OPTN is not a government agency, per say.
5) youi have to check in with the governemnt to get a driver"s license too, and to get social security and medicare.
2) Where is 2?
3) It's happened here.
3) Your point?
4) People can live without those and do. As a matter of fact, before the 1960's, civilization lasted thousands upon thousands of years. If you're an Atheist, billions. But to prevent yourself from being cut into pieces if you die, since you won't be able to prevent it once you're dead, you would have to give up your anonymity. It's unconstitutional here. You're innocent until proven guilty, you don't have to opt out. It's your body, your temple, so to speak. If they want it, they have to ask you first.