Opt In ? Opt Out?

 The Ukrainian Village has had a facelift his morning. coops have been cleaned and fumigated, nest boxes cleared out and feed bowls disinfected. It's a dirty but satisfying mundane job, that you can lose yourself in somewhat.
Today as I was shovelling shit, I found myself thinking about the Welsh Assembly's historic decision to change the present organ donor system.
From as soon as 2015 Wales will be the first UK nation to introduce a system where people are presumed to have consented to become donors unless they opt out. 
I am not in favour of this
An opt out system , I think gives the illusion that everyone involved has made an informed consent decision about organ donation. I think that this is wrong as doing nothing about documenting your wish to opt out is very different indeed from actually being fully informed about the whole process of organ donation per se.
True, the public can research the whole subject to its nth degree, but human nature being what it is, I honestly think that few will fully appreciate the ramifications of the organ donation process when they bumble along leading ordinary lives.
Informed Consent is a tricky subject to get right .
To me, the opt in system is  simply more ethical.
Am I wrong?
We will see
L


54 comments:

  1. a rather deep thought to have whilst shovelling shit and straw !..... if someone is willing to have my organs after my demise then to be honest I couldn't really give a flying rats arse.....if I am dead then they weren't really doing their job properly anyway......how they could be of any use to someone who is "not very well themselves" is beyond me ....think they would be better served just sticking with the dodgy one they already have rather than taking an even worse one from my corpse !

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    1. Well as the village " pin up" jason..... A few old ladies would be glad of your organ(s)

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  2. If it's an eye or an ear they want from me, good luck to them. I can't half see and I have selective hearing which only I know the password to disable it. ;-)

    A lot of companies have programs you have to opt out of, or be charged on a continuous basis. Perhaps, this is what the UK is up to. That, and opting out would appear to be more on the heartless side. (was that a pun?)

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  3. Anonymous3:23 pm

    If anyone wants whats left of my sorry old carcass they can have it...I've already signed my donor card. I do think though that the choice given is the wrong one. TOLD that I am an organ donor would probably put my back up and I would refuse.

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  4. I like the 'opt in' choice better, just one more thing we have to put on our to do list, otherwise we are whizzed away into the land of government Oz, without a second thought.
    ~Jo

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  5. tough one bc studies have shown that people who do wish to donate never do bc they forget and the usual busy rigmarole so the system loses out on plenty of good intentioned people who have intended to donate but never do. If it is an issue they reckon people will make more of an effort to opt out if they have an issue with it which is just human nature I suppose...

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  6. Although I've had a donor card for years, I am not in favor of the new opt-out system. A person should have the sovereignty over their body. Period. The opt-out system just has this connotation of somebody already owning your body unless you tell them otherwise. The opt-in system is a much better idea.

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  7. It seems to me that it's the family of the dead who often stand in the way of donation which wouldn't change anyway according to 'Today' this morning. If the family objects, the organs stay put. It will be interesting to see how much the figures rise in the next few years.

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    1. I think that in the welsh system the family can only object if they " know" that the person involved did not want to donate... They cannot stop the process if THEY feel the donation is wrong

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  8. I recently decided to start carrying a donor card...my decision, informed or not. I do fervently believe that my body and all its' constituent parts, and whether they are given to someone else, is my choice, and mine alone. The Boy's mother was a donor and it's a comfort that a number of people have benefited after her death. I am sure they are happier knowing it was her choice rather than something the state just did

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  9. I agree with you, I favor opt in, and in fact I did opt in on my driver's license. We do better with the choice, otherwise the state thinks they own your body. My two cents worth from California.

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  10. ..... not the sort of thing I think about while mucking out a henhouse, usually much more along the lines of ....bl**dy hell what HAVE they been eating!!"

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  11. I do not believe that exchanging people's parts, like buying new tires for your car, is an effective way to deal with things. The opt out system, no matter what it applies to, is just another way to manipulate what is seen as a stupid populace down your own preferred path. I think this all started back with the Columbia Record Club years and years ago. You'd join the club and get 6 records for free, and then they would keep sending you records and charging you for them until you opted out. Opting out was not easy, and those were days when consumers were protected considerably more than they are today. I'm getting so tired of being seen as just a sucker that any clever company (or government) is free to fleece.

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  12. I have my donor card and no family to put the brakes on them whipping my organs out so to me it makes no difference. I guess these are the lengths they have to go to when people are desperately waiting for organs.
    I posted your crafty parcel yesterday btw. Hope they arrive soon :o)

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  13. I had an op last year. The anaesthetist sat with me and filled in a form. At the end she said "Is there anything else I should know?". Yes, I said, I am an organ donor. She looked a bit horrified."Hopefully it won't come to that!" she exclaimed.

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  14. As I am planning on reaching the 100 mark, they are welcome to take any bits they want when I eventually kick the bucket. That's if there is anything worth taking.

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  15. I don't believe we have that here yet, BUT many of the credit cards are like that. You have to jump through hoops to get out of their *Bleep* *Bleep* *Bleep*!

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  16. Not enough people opt in. We all have though x

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  17. I, too, prefer opting in. I am a donor, and it's been made easier in the US in many (not sure if all) states by being able to register when you get or renew your driver's licence. I don't care if they take body parts or blood, i shall not be needing them insofar as i can tell. I did put the proviso though, that they can't have my brain. Yes, i'm sure it's a control issue, but so be it. If my heart, lungs, liver, kidneys, or eyes can help someone out who's here after i'm gone, i'm all for it.

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  18. Yes John, I know what you mean about cleaning and mucking out - it is hard and dirty work but when it is all done and everything smells clean and all the clean straw is down you do feel good about it.

    I am already a donor so have not taken an awful lot of notice of the Welsh idea - my own personal feeling is that everyone should have their organs taken after death if they are of any use to anyone - but perhaps this goes against some religious views, I don't know.

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    1. In my experience the thought and the experience of organ donation are miles apart.......that's why I feel the way I feel

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  19. I'm uncomfortable with the 'opt out' scenario but feel a bit ashamed to admit it.
    Anyhoo. I only want my brain to go to someone with big shoes and a bolt through his neck.....

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  20. when we renew our driver license in this state, we are asked if we want to become part of the organ donor registry. your choice is marked on your license. spouse and I are both donors.

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  21. I have a friend whose husband was put on the Liverpool Pathway without her knowledge or permission. The current issues appearing in the NHS shows you couldn't trust them further than you could throw them

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  22. Anonymous8:49 pm

    There are never enough organs for transplant here and an opt out system has been suggested at times. I think it is a good idea, as long as rels still have veto. I will be dead, so I won't care what happens to me. One of our best friends had a heart transplant in her mid-forties and so I think it is one of the most wonderful things you can do, and it costs you not time nor effort.

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    1. I have no problem with organ donation andrew
      I have carried a donation card since I was 18
      I do however have a problem with the informed consent aspect of it all

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  23. I feel very nervous about the prospect of our bodies being up for grabs unless we happen to remember to say no.
    It just doesn't seem right.
    Almost like the body snatchers all over again.
    They're actually welcome to any bits of my anatomy that they like - I won't be around to see it, but it's my other half who's not comfortable with it. Surely we also have to respect the wishes of those who are left to grieve and pick up the pieces of their lives.
    It's a compex and emotive issue.

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  24. Do you mean to say that when in Wales, I would not be able to refuse your organ if offered?

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    1. i would take john's organs... if they came with their own lifetime supply of scotch eggs...

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  25. Bill & I both have "opted" to donate our bodies to the closest medical school for scientific study (when we kick off, of course)... I've already had some "problems" such that they no longer want any of my organs put in anyone else... so... what happens to a person (like me) who dies, "they" don't know my history because I left my card at home the day I met fate and they use my organs in someone... the poor medical students get a carcass that is only half loaded.... oh what the heck... I live in the US... it might be a while before this situation hits home....

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  26. i think im going to now preface all my comments with "Today as I was shovelling shit, I found myself thinking about ____________ " ...

    moving on to your topic - I think everyone has the right to make an educated decision - an opting out program puts the burden on the person to find out, versus the program itself educating...

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  27. I agree with you John.

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  28. I agree with you John.

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  29. I have an organ donor card. I sent them my Hammond. Seriously, the idea of presumption is neither to my liking.

    Take care and shovel some more shit, my friend.

    Gary

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  30. A body is just a receptacle for a human life. When that life has gone, what is left behind doesn't matter so if different parts of us can enhance or extend other people's lives I say go for it! Three cheers for The Welsh Assembly!

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  31. Mr O's uncle donated his body to Medical Research. They all toddled off to a service with no coffin -or body- but sort of a commemoration of a very brave man. In WW2 he was a Chindit. Anyway, about 18 months later, the medical people said, OK, we've done with him now, Mrs Widow, here are his bits for you to get rid off. For me, this was wrong on so many levels. However, I am not donating my temple (body!) to medical research, as they would need a whole department devoted to my idiosyncracies and I could not ask any Government to sanction such expense. But I do have a donor card should anyone need whatever I have left that functions when I have shuffled off this mortal coil. And as functions seem to be on and off these days (update on hospital appointment for minor surgery to follow if anyone is interested) maybe that is more of a threat than a promise!

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    1. Oh, Janet, that's terrible! If he donated his body to medical research, the least the team could do when they were done was to bury the rest.

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  32. The thought of any government taking body parts after death...unless one has remembered to 'opt out'...sends shivers down my back. What a horrible idea. And what a marvelous opportunity for graft and corruption to blossom within a governmental agency dealing with spare body parts.

    I've had an organ donor card for years. They can take whatever guts they might need when I'm dead. But I just can't imagine having body parts removed...just because I didn't fill out the form correctly. Gah! Now you've gone and gotten me all worked and feisty John.

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  33. There are simply not enough organ donors here. People die waiting. I don't know what the solution is, but would like one found.

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  34. The point is you are not actually dead when the organs are taken. I'm sure that most of us would not care after death. It's the before bit that worries me.

    I removed my wonderful 92 year old mother from hospital when the consultant said she had two or three days left at most. They had stopped feeding her because she had lost her swallow reflex and advised that it was not in her interest (!) to give artificial feeding as she was dying anyway. I nursed her at home ( with terrific support from community nurses and carers) and her reflex quickly returned. We fed her with soft foods and soups and chocolate mousse. And the occasional whisky. I counted her calorie intake and she revived to joke and chat with my brother and sisters. I had nearly three weeks with her before a sudden succession of tiny strokes finally took her away. Probably too old for organ donation and certainly too late but she died properly and with dignity.

    I don't disagree with organ donation per se but it is not as straightforward as it might seem. Having seen at first hand the way that a surgical consultant regarded 'near' death I'm not convinced that I would believe his opinion in a younger person who appeared to have 'brain death'. Though of course the results of traumatic injury can be devastating and not recoverable.

    My other worry is that, as I understand it, freely and generously donated organs through the organ donor system can be given for private patients who have not contributed to the NHS or have used the private system to gain priority on surgeons lists at the expense of regular NHS patients. Or even for foreign patients who come to the UK specifically to use this service. (John please advise if this is not true.

    Then again if it was my child or grandchild who needed the organ...though I believe it's just a matter of time before new organs can be grown from our own body cells. Originally a faulty mitral valve in the heart was replaced with valve from a pig. I trained in the hospital that pioneered that heart surgery. Hopefully donor surgery will be a flash in the pan.

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    1. That's not always the case
      Many harvesting of organs occurs literally seconds after death occurs

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  35. That is scary!

    We have our consent posted on our Driver's license.

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  36. Gee, as much as I wish that more people would opt in to donate their organs, I find the opt out to be just wrong.

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  37. Who would want my old decrepit parts anyway?

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  38. Both my French, and my English, donor cards hang from the rear-view mirror of my car. Wherever I am; my car is! They're welcome to any reusable bits.

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  39. I like the idea of the opt out option but am worried that people may be allowed to die who could have been saved. I carry a card as do my eldest two children (19 & 17). My daughter got herself a card at 16 and was very proud to do so having spent a morning on the interwebs researching it. So in reality I'm on the fence.

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  40. I'm quite happy for my organs to be used for someone else's benefit after I die, and if the opt-out system avoids all the time-wasting and distressing consultations with relatives, I'm all for it.

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  41. Unfortunately nick...I suspect this will not be the case

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  42. Very interesting discussion - I have mixed feelings about this. It might help if the verb "harvest" hadn't come into use in this context. It reminds me of the film "Soylent Green".

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    1. Nilly
      Harvesting is exactly what they do sometimes
      And it is the term which is used

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  43. An issue in sharp focus for me today... a friends daughter just got a kidney transplant at the weekend :-)

    I think I agree with you that I am a little disturbed by the "presumed consent" decision. Given only 30% sign up that is a leap to get to "everyone is in".

    Personally I'd prefer to see sustained national campaigns that bombard people about signing up... or (uneasy feeling I may be heading in a direction unpopular...) what about... if you haven't been on the donor register you can't go on a list for a transplant. Yes that sounds wrong but I often hear arguments that alcoholics, drug addicts and smokers should be denied life saving transplants and treatments as they have made a "life style choice" (rubbish if you have any understanding of addiction as a disease) but if people think that why not?

    *Ducks under table to avoid the hate mail to follow...* :-)

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    1. Here here graham
      Opt out is somewhat of a knee jerk reaction me thinks

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