New UK Law Mandates Organ Donation by Default Unless Explicit Opt-Out (2020)
organdonation.nhs.uk
organdonation.nhs.uk
Want more info on the subject including a brief reason as to why visit (Spoiler: not enough donors) https://www.organdonation.nhs.uk/helping-you-to-decide/about...
The UK has been trying to push people more into being donors for a while. Back in 2011 (iirc) they added questions about your status as an organ donor to the driving license application. As the UK has about 75% of the adult population holding full licenses its was a good way of getting the question atleast asked to new drivers.
Also
> Will you automatically take my organs if I don't opt out?
> No. Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured.
EDIT: Also this is law in England. Wales has had a similar opt-out system in place since 2015 (Not checked Scotland or Northern Ireland)
[1]: https://www.gov.uk/government/news/opt-out-organ-donation-ma...
> it is clear that despite a massive amount of popular support the UK government fails to communicate effectively with its populace.
I have no idea where you get that opinion from... https://www.bbc.co.uk/news/uk-politics-56818750 (sarcasm tag, just in case :-p)
I think asking people this question when they apply for a passport would be a good middle ground, and/or maybe on the intake form for their GP, or other kinds of government interactions (voting registration might make sense in the UK specifically). People would still be able to opt-out of choosing at all, but this would catch the large group of people who just never bothered to register.
I am no fan of opt out since with the right opt-in they could get enough.
This already happens. When you apply for a driving licence, you are asked whether you would like to be put on the donor registry.
I live in the UK, I’ve been a registered organ donor for as long as I can remember.
I’ve opted out.
I’m not a bag of parts that belongs to an all powerful state.
It’s one thing to ask if they will help someone in need and another to say “we’re doing this are you going to stop us?”
By opting out, when I was previously on the donor list, I can spare them that.
You might say it will be handled more tactfully but there’s historical precedent that it won’t be.
This is an unpopular opinion but I feel compelled to express it; I think this law is wrong.
There should have been more debate and finesse used in the drafting of it.
Cremated, buried, put out to sea on a flaming raft, whatever. Who cares if the corpse I left behind is short an eyeball, a couple tendons, and a liver?
More importantly, if those body parts can be used to save someone else's life, I don't believe they should even have the right to care. People who are still alive and need an organ to survive are more important than whatever squeamishness and perception of agency my family might have.
The concern that doctors could theoretically let people die more easily to get their organs is another matter entirely, but that's not the topic in this sub-thread.
I suppose "organ donation" might be better phrased as "organ recovery" then?
You can't use it anymore, and it would go to waste... Hence it should be recovered. People might not have a right to have your own organs specifically, but it's society's duty to implement organ recovery.
Otherwise, we wouldn't be able to provide for everyone's human rights.
That being said, it cannot be used as an argument in a civilized discussion between adults.
> Death: Yes. As practice, you have to start out learning to believe the little lies.
> Susan: So we can believe the big ones?
> Death: Yes. Justice, mercy, duty. That sort of thing.
> Susan: They're not the same at all!
> Death: You think so? Then take the universe and grind it down to the finest powder and sieve it through the finest sieve and THEN show me one atom of justice, one molecule of mercy. And yet... you try to act as if there is some ideal order in the world. As if there is some... some rightness in the universe by which it may be judged.
Do we have agency over our own bodies or not?
How can I keep that agency and help someone under an opt-out system? That has been taken from me when better, workable opt-in solutions weren’t tried.
To take it to extremes, should the government be able to take “spare” kidneys from live donors?
Should criminals be forced to donate blood?
What about children that die in child birth, should they be harvested for organs too? ‘Cause the NHS were doing that at one time.[1]
Where does the line stop?
Right up until the point it's no longer your own body because you're dead, yes.
> To take it to extremes, should the government be able to take “spare” kidneys from live donors?
No, they're not dead.
> Should criminals be forced to donate blood?
No, but again, they're not dead.
> What about children that die in child birth should they be harvested for organs too?
The law only covers adults with the opt-out which would make this another no.
> Where does the line stop?
Pretty much exactly where the law says it does - "All adults in England will be considered as having agreed to donate their own organs when they die unless they record a decision not to donate (known as ‘opting out’) or are in one of the excluded groups."
[edit: Missed the A in "All"]
And it’s not like it is forced, especially with the family being able to “stop” it even when it happens. The status quo was a different tradeoff.
No, and that's the point. When you're dead you cannot have agency over your body even if you had the right to.
I find it weird how people compare this to the government treating them like a "bag of parts", as if they were more than a rotting corpse at that point. If you have a religious belief or some other reason that makes you think otherwise then go ahead and opt out, I don't have an issue with that.
> To take it to extremes, should the government be able to take “spare” kidneys from live donors?
Who ever asked for that? If the time came where the UK government started acting like the CCP the law today wouldn't matter either way.
I believe the answer is somewhere in-between. We certainly don't have full agency over our own bodies. Can't take the drugs you want or need without asking permission, you're highly encouraged to stay healthy, vaccinations are mandatory, suicide is highly discouraged.
As always, it's a trade-off between the individual self and the society we live in.
Rejection is horrifying and can be deadly. Donated organs can introduce deadly infections. If all goes well, you will be on anti rejection meds the rest of your life.
It's not the magic cure all with no downside that people often seem to imagine.
I don't think anyone gets a liver transplant because of an article in Goop. I imagine that in most cases, they do it because they're going to die without it.
You might want to look into the definition of odds.
But I think it's time for me to walk away from this discussion.
And organ “printing” is simply not there yet.
Aside from the fact that this statement is wrong - the state can conscript you if there's a war, or imprison you - I'm wondering what actual objection you have to donating parts of your body after you are dead? Personally speaking once I'm dead, I'm not going to care in the slightest.
I think the idea that someone might see with my eyes after my death to be a beautiful one and I’ve been a lifelong card carrying organ donor.
I object to presumed consent.
A gift is not a gift if it’s not freely given.
My aim was simply to answer the parent’s claim that I might have an issue with organ transplant and that’s not the case.
> because it’s the right thing
“What gets us into trouble is not what we don't know. It's what we know for sure that just ain't so”
This rule has been decided by elected leaders after many discussions. As a citizen you opt in by default into many things that have been different in the older times. School, health care, the BBC, etc. some of which you even cannot opt out at all. Why should organ donation be treated differently?
It is however strange to me that rather than to communicate clearly with its populace, improve/innovate in terms of recruitment methods, and generally “educate” the populace, a government reaches for an option that I would consider morally dubious and potentially harmful to the overall opinion on organ donation further down the line whenever that inevitable case comes up when a donation is carried out without properly seeking consent. I say inevitable here, because out of the three countries (Sweden, Japan, and the UK) I have lived in long enough to form an opinion, the UK government is by far the worst and its institutions the most poorly managed.
As for “elected”, the UK has a very large expat community and many of us are well over the 12-month limit and are being “volunteered” as donors without being close to having the right to vote for the political body that enacted this legislation. Make of that what you will.
This is nonsense, because this is the standard fallacy of any survey. You take a sample and extrapolate out to the general population. If your sample is not representative, then the statement is false.
In fact, I would go so far as to say that we should mandate a law whereby nobody can claim "% of X agree to Y" unless it is specifically stated "% of X surveyed out of a sample size of N agree to Y. Here's a link to the methodology and questions."
Organ donation is good and important, but default opt-in is a bad decision, and the reasoning listed for it is worse.
https://www.organdonation.nhs.uk/get-involved/news/hundreds-...
But alas, no methodology and questions on that page.
As an analogy, it's like healthcare/insurance taxes - you pay them regularly in the hope that if you ever need it, they'll pay for you.
Why would you expect to receive an organ if you're not willing to offer yours?
Anyone can receive a donated organ. But those that do are permanently opted in to donate.
Well, I actually don't think that. People can legitimately change their views and philosophies. The "wedginess" of this rule would probably do more harm to society than the marginal increase in organ availability.
I think it's perfectly fine and respectable for someone who opts out of donation to decide for themselves, when the issue faces them, that they won't take a life saving organ.
That's very different from mandating and coercing organ donation in order to be eligible.
Right now, organ donations go to those with the greatest need. You are saying, well no it shouldn't go to people who aren't moral according to my philosophy.
I think you have to consider how that could go wrong, and who might be considered the wrong sorts of people, the sort of people who don't deserve to be treated.
Who might prominent political figures decide are immoral, abnormal, unproductive, unworthy, or unpatriotic?
Here in Germany I stand in the minority where donation is opt-in, the result being that better not need an organ transplant over here, as it has one of the lowest contribution rates across Europe.
One of the people in the interview is a medical student who does dialysis at night, and it negatively affects his studies and health.
I am a dual US|EU (Croatian) citizen. I also have lived with type 1 diabetes (autoimmune and insulin-dependent) for almost 30 years now. While I have been fortunate that my kidneys have been fine, if I were to need a kidney transplant, I would absolutely live in Croatia long-term (where I live currently) if I needed a donor kidney.
Croatia has an opt-out system, like Portugal.
Croatia has one of the highest kidney transplant rates in the developed world, and in Europe it competes with Spain and Portugal. You really do not have to wait that long for a kidney transplant in Croatia compared to other developed countries. Here is a good writeup on the Croatian transplant system and how it works: https://cdn.intechopen.com/pdfs/27728/InTech-Action_taken_to...
Anyway, all the best everything stays safe.
Also, there are issues with forensics. Organ harvesting, from what I hear, is more likely to be followed by cremation than embalming, which makes it impossible to re-examine remains at a later date. Again, given the “tradition” of cover-ups that most nation-states carry, it seems like a dangerous slope.
2) one rational argument for opting out is that if you are in a bad state, it might be rational for a doctor to let you die rather than save you, since your organs might be saving multiple people’s lives. I know I was a doctor and I had a 50 year old person in a car crash and I had 3 twentysomethings waiting for a heart liver and lungs I might want to hurry that 50 year old off this mortal coil. It would be the ethical thing to do. But if I was the 50 year old I wouldn’t like it.
And I’m not sure whether you meant that you were a doctor, or was it just a hypothetical, but usually car crash victims are not operated on by organ transplant specialists, so the doctor’s patients will not intersect, making your point purely theoretical.
And while there are bad, even borderline evil doctors out there, I think statistically you are much more likely to find a morally corrupt politician than a doctor, especially in countries with public healthcare.
And while it may seem like the trolley problem, it is not, because there is a huge indirection in whether those organs can be used at all, are required at this time and whether they will truly save someone else. So instead of the still morally questionable 1-3 trolley problem you instead have one where you can either direct the trolley on a track with one person in sight or another with noone on it. And at the distance, both tracks branch randomly and most of them go through 3 young person, and maybe slightly less kills them in the second case.
Most people specify what to be done by issuing a will, but there is not unlimited freedom there. For example, in some countries it is difficult to completely disinherit someone. If there is no will, your property is split in some way among your relatives. The default option, if there are no heirs, is that the inheritance falls to the state.
After death your organs likely won't be able to benefit your relatives, unless they are currently in a life-threatening condition themselves. Dunno how long organs can be kept around, but I doubt that there is no expiry date after which they have to be tossed out. In that case, the organ would have gone to waste by sitting in a freezer.
Therefore, treating your dead body's organs similar to inheritance would make it moral to pursue the default option in most cases, which is donation to the health system. Still, there is the possibility to opt out, which is an extra effort similar to (but way less involved) than issuing a will.
You have the freedom to specify what exactly should be done with your stuff when you die. Whether those wishes will be legally enforced will depend heavily on what they say.
To test this thesis, go to a lawyer in your jurisdiction and ask them about whether it would be possible to split the proceeds of your estate in equal shares with every man in the Greater London area who wears brown shoes on a Thursday, and prepare for a short explanation of administratively workablity.
Then ask about whether you could posthumously fund some international terrorist organisations. Actually, maybe don't.
On the other hand if most people are donors by default there should be sufficient supply, easing this pressure.
> You might be in a critical state and someone else really needs an organ from someone like you.
How often does it actually happen that an organ recipient and a matching potential donor who is in critical condition are in the exact same hospital at the same time? Is the concern for skewing the incentives real? I’m not even sure where the incentive is in your example—it’s just trading off one life for another. The hospital still wouldn’t be avoiding the potential death of a patient either way.
The issue is that the patient needing the organ might die before the potential donor.
Edit: this is under the assumption that the potential donor is very likely to die of their current condition.
The default-to-being—an-organ-donor/presumed consent approach has proven benefits when it comes to outcomes in medical situations that require organ donors [0][1][2]. The thing that I personally dislike about defaults like these is that it allows people to move through their life ignorant of the good that they are able to do for others and the good that others are able to do for them.
In the case of an organ donation question on a driving license, I would personally like there to only be two options that are both not default: opt-in to being an organ donor and being able to receive organ donations, and opt-out to not being an organ donor and then be unable to receive donations. An answer to this question would be required (opt-in or opt-out), and not making a selection would the equivalent of submitting an incomplete driver’s license application such that the application would be rejected.
[0] https://en.wikipedia.org/wiki/Default_effect#Default_setting...
[1] https://sparq.stanford.edu/solutions/opt-out-policies-increa...
[2] https://www8.gsb.columbia.edu/sites/decisionsciences/files/f...
What if, before somebody gets their ID (or another process everyone goes through), we ask them "do you want to be an organ donor" and they have to say either say yes / no?
In the U.S. 33% of organ donation come from motor vehicle accident. Reduced driving due to Covid put a dent on organ donation. Long term, as cars go more autonomous, vehicular related fatalities would decrease drastically.
The U.S will have to follow the same model.
https://en.m.wiktionary.org/wiki/donorcycle#:~:text=donorcyc....
They should then pay something to the organ donors family... Even if it's just twice what a decent funeral costs...
Wife's uncle had his eyes harvested nobody told her aunt and she had a horrible surprise at the funeral when he was highly disfigured...
She probably wouldn't have cared if she'd known... But I feel like there's a black market for organs...
Maybe more ppl would be okay with donation of they knew it'd help their family some.
Life is hard enough as it is, but let’s make it harder by forcing people to have to opt out of choices they never made!
Maybe it’s just the phrasing, but unless there is a proper shift away from a given default expectation, lots of people will be blind sided by this.
So organ harvesting without consent happens in the US too
So, I wonder how stuff like that factors in. That doesn't appear to be addressed.
I looked into signing up to be a bone marrow donor when my corporate employer was giving some kind of incentive. I don't qualify. Period.
You cannot tell by looking at me that my DNA is miscoded but it significantly impacts organ function, and not in a good way. My ID card doesn't state I have a genetic disorder.
Genetic disorders among donora is not a legitimate concern here.
> On 7 February surgeon James Jaggers had almost completed the operation when he learnt that the organs came from a donor with type A blood, incompatible with Jesica's type O. The story became front page news. Jesica was kept on life support systems while a second transplant was sought—and, astonishingly, found. Despite the second transplant, Jesica died from irreversible brain damage on 22 February.
Quite the testing they did there.
Humans are fallible and mistakes happen. It's a tragedy of course, but it is not evidence of a widespread problem.
https://www.cdc.gov/transplantsafety/protecting-patient/scre...
It just so happens people with my condition receive a lot of organ transplants and the organs they receive then don't have the genetic defect. Not exactly a cure, but I'm pretty darn sure it would run the other way and if someone got one if my organs, they would have my genetic disorder in that organ. And they would likely not be happy campers.
So I doubt your statement is entirely accurate.
Edit: I will add that genetic testing takes time and organs aren't viable for transplant for very long. Transplant happens pretty quickly following death of the donor, so genetic testing is unlikely to enter the mix anytime soon, I think.
The U.K. does not have a good track record here.
https://en.m.wikipedia.org/wiki/Contaminated_blood_scandal_i...
Those excluded will be people under 18, those who lack the mental capacity to understand the new arrangements and take the necessary action; people who have lived in England for less than 12 months or who are not living here voluntarily and those who have nominated someone else to make the decision on their behalf.
It says nothing at all about "people with dread diseases that are genetic in origin that you wouldn't wish on your worst enemy."
In the US, where it is fully possible that you will simply not receive an organ if you can't pay, I think it makes sense to also do the opposite and simply not offer an organ for transplant if it can't be paid for. I am interested in speaking to anyone who has had experience bypassing current "donation" laws.
2. Opt-out is not the same as forcing people
3. Dead people can't be forced to do anything, they are dead
2. I said "begging/forcing". Opt-out is forcing those who don't know, and begging those who do. Opt-in is begging. And you know, we've started with begging (not even opt-in), then added opt-in, now we're onto opt-out, which might make one wonder: what's the next step? The obvious answer is that if we continue on this path we won't even get to opt out (force).
3. Nonsense. The next of kin of a dead person gets to decide burial options, and much more. And there's no reason a living person couldn't have the right to decide what is to be done with their body after death.
Does the State own you, or do you own yourself? If the latter, you get to sell your dead body; if the former, you don't get to sell your dead body.
That, plus organ sales wouldn't stop at kidneys and the "trade your life for money to your family" thing doesn't sit well with most people, even if it's voluntary.
Kidneys and half-livers would all that would be legal to sell before death, but I'm talking about donations at death.
If my hospital bill for a single night stay is 50k, they can pay me 50k for my organ. I’m certain hospitals can pay far more than that, with the amount of insurance fraud they commit.
Why shouldn't the estate of the deceased get rewarded for the deceased's generosity?
(Of course, I fully expect this added cost to just get passed on to the recipient, which isn't a great outcome.)
It seems to me that the medical profession is financially imbalanced with respect to the rest of society. In the US, they are propped up by mandatory health insurance requirements and are all but guaranteed income, whether it’s from private insurance companies, taxpayer dollars (a la Medicaid/Medicare), or some poor unfortunate soul’s lifelong medical debt payments.
As long as people are being born, medical problems will be a dime a dozen, and wealth earned by medical practitioners will scale with the size of the population.
At the very least, the default should be that your estate and/or your family takes ownership of your remains. Otherwise we're heading into territory where the state can say: "Why should you have a grave so your body can rot in there. It's not like we're going around killing you for your biological matter, so it's okay if we just take your body and decompose it into fertilizer to help rejuvenate the farm fields!" or "We've determined that you don't need 10% of the blood that you generate every day, so please make sure to go daily to your local "Blood donation centre" for your "voluntary donation""!
The way people are cheering this "donation" on is frankly very disturbing. Yes, I know it saves lives, but so would abolishing cars to stop car accidents and so would banning all knives and having people use feeding tubes instead!
They are absolutely not infallible of course, but they are the best formation we managed to come up with. So we have governments at the present time, and let’s say a power grab were to happen. Then does it really matter that we had such a law now? They can then do whatever they want with or without laws, so your fear is baseless. It is a good decision that will save lives and is basically without price.