Organ donors, where are you?

[Composite 2992]

Re: Organ donors, where are you?

this comment, along with scriv's earlier one, worries me. is the following scenario something some of you are concerned about? that you're, for whatever reason, in the emergency room with injuries so critical, it would take heroic efforts to save you. in another part of the hospital, there is a patient who will die in the next several days unless he gets a liver transplant. your emergency docs hesitate to give you the care you need in order to have a chance at living because they believe your liver is a perfect match for the other patient. while they don't exactly refuse to resuscitate you or whatever it is they need to do to save you, they linger so long at it that you die, thereby making your organs available for the other patient.

is this really something some of you worry about?

Personally, I got over the fear of death a long time ago. Everybody's gotta go sometime, and I have a vague notion that there's more to life than just life. In terms of pure physics, at our most elemental level we're really a complicated collection of particles, held together by magnetic fields. So is there more to us than just our physical bodies? If the laws of physics say you can't get something out of nothing, then what is the "something" that comprises human consciousness, and what happens to it afterward?

I haven't the slightest clue about any of this, but I decided I wasn't going to worry about it, because there's nothing I can do about it anyway. Instead, I'll concentrate on doing the right thing in this lifetime.

Also, I doubt that most emergency room doctors are looking for transplant organs. They're mostly interested in winning the game, which is getting the patient upgraded from critical, and eventually out of ICU. Fishermen want to catch fish. Baseball players want to hit homeruns. ICU doctors want to save lives.

In the movie "Zorro" there's a scene where Zorro's sidekick is hesitating jumping out of the window to the awning before. Zorro says, "Jump! Are you afraid you're going to die?"

And Zorro's sidekick (played by Cheech Marin) says, "No. I'm afraid I'm gonna break my neck and live."

I'd be more concerned with being rescusitated and ending up in a vegetative state. I'm also worried about my wife getting upset with the doubt that I might have been saved with a little extra effort or time. We've seen relatives and friends pull through some serious situations when doctors had thrown in the towel. But we've also seen situations where letting a loved one go is the better choice.

So, for me, if my wife is ok with turning off the ventilators and harvesting my organs, then it's ok with me. If someone can make good use of my heart and lungs (my lungs are unusually large, I found out) then that's good. If they can also make use of my pants, shoes and hats, then that's good, too!

And that's why "organ donor" is on my HDL.

[Leo Lakio]

Re: Organ donors, where are you?

The only thing stopping me from putting ORGAN DONOR on my driver's license is not being convinced that my organs won't be taken from me before I'm through with them. How and where can I get that assurance? Will my next of kin be allowed to give the green (or red) light, or will someone else be making that decision? These are questions I need answered before I'll sign my name to anything.

While I'm not in the same camp as you, these are very fair questions, and I hope you pursue answers (rather than just using them as excuses to not do something).

I renewed my driver's license to include organ donation. I've also willed my ol' bod to the UH. Heck, if any good can come from the use of it...why not!!!

I AM in this camp. Registered more than 25 years ago with the Univ. of Iowa (and affiliated schools across the country), so that (1) any useful organs are harvested first, then (2) medical schools can have the cadaver for any study, and lastly (3) they will dispose of the body by cremation and presentation of ashes to the family.

scriv--and the rest of you HTers who have not already done so--please get an advanced directive done.

Done; a fine reminder, thanks.

I don't think one story will help ...

...but thank you for sharing it anyway.

[cynsaligia]

Re: Organ donors, where are you?

Good suggestion. One thing I would add is that very careful thought be given to who you give durable power of attorney to. Of course it should be someone you closely trust. But don't just designate your spouse and leave it at that, as some folks thoughtlessly do. Why? Imagine if you are badly injured in a car wreck and your spouse is incapacitated/killed. Who will be there to carry out your will then? That's why it would be a good idea to also designate a backup decision-maker who is not likely to be traveling with you.

i cannot agree with this more. thank you for adding that.

may i take this opportunity to say that just because you saw it on ER or House, doesn't mean it actually happens in real hospitals? for example, it's a federal fine of $20,000 per incident if any healthcare provider releases your information without your permission. even police officers and other government officials have to go through some sort of authorization process before a hospital will confirm whether someone is/was a patient. if you walk into a hospital and tell a nurse passing by that your mom is a patient but you don't know what room she's in, she can't just blab it to you, even if just five minutes ago, she was putting an IV in your mom or something like that.

[Adri]

Re: Organ donors, where are you?

Oh, and one particularly local aspect to a reluctance by some to indicate a willingness to donate organs is that it is "bachi" or bad luck ~ that somehow by indicating a willingness to donate organs, one may cause bad circumstances to arise that will result in one donating one's organs. This may be separate from Scrivner's apparent concern that someone may hasten one's death in order to get one's organs if one indicates a willingness to donate organs.

Scrivner: I don't mean to be unsympathetic but if you really are concerned that someone may steal your organs or may hasten your death in order to take your organs, then what would stop those people from doing the same even if you do not have an advance directive or an indication that you wish to donate your organs on your driver's license? Unless they took something really noticable like skin, what are the chances that anyone would know if any of your internal organs were gone after you died? We're relying upon the integrity of our health care providers and the health care system every time we use them.

eta: To be clear, I am not deriding your right to not donate your organs. It is a deeply personal choice and I really do not want it to stop being a choice.

I don't think one story will help satisfy your concerns but I feel compelled to say anyway that a family member felt strongly about donating his organs and he died unexpectedly. The family struggled over the idea of donating his organs even though it was clearly his wish that it be done. Part of it was an unwillingness to accept that he was going to die, part of it was grief, part of it was a psychological barrier to someone taking parts of him and putting them into someone else, and a whole lot more. But he had talked to his own children about the importance of organ donation more than once and eventually his family decided to honor his wishes. I don't want to unfairly describe the organ donation process (and I'm not saying I think the process should change ~ I don't think it should cut any corners in determining when organs should be donated) but one aspect of it that was really hard for us in real life application was the prolonged checking to see if he was "legally" dead. They can't take donated organs under those conditions unless the person is legally dead. It was sort of a "was he dead enough" feeling that I know none of the health care providers intended but it felt that way to me sometimes. They had said that he was essentially dead due to massive brain damage but they had to keep checking to make sure there was no brain activity. They checked several times over a period of a couple of days and each time there was some brain wave activitity that wasn't conscious coherent thought, according to the doctors, but it meant they had to wait and check again later. It was hard because each time they checked, we had to prepare ourselves for it to be the final announcement of his death. And when it came, dammit, it was hard to watch them wheel him away to take his organs. But he was gone and it was what he wished. I'm not saying it was or is ever easy for his widow and children but they eventually got a letter describing the people who were helped by his organs. Not by name, but with enough detail so that it was clear how much the donated organs helped other people. That provided a lot of comfort to the family. But my point to this long rambling story is that the health care providers in this case did not rush to kill the patient just because other people were waiting for organs. They did not rush the process at all even when it seemed at some points that it might be easier on our family if they did just get it over with if he was essentially dead and he was never going to recover. The doctors made very very sure that he was actually brain dead and had absolutely no chance of recovering before going on to take his organs.

[cynsaligia]

Re: Organ donors, where are you?

Yes, I've heard a lot of this before, and I'm inclined to believe it, but part of me is still not sure, and I can't make a decision like this without some amount of sureness. You say "trust me," but as much as I love and respect you, why should I if you don't give me a reason to, such as credentials or...something? I'm not trusting a nameless, faceless person I met on the Internet with a thing like this.


It may sound irrational or the result of watching too much television, but yes, this is part of it. I refuse to be PC about this; it's too easy to sign a name on a piece of paper and to have my driver's license stamped without knowing what's really going to happen. I'm not afraid to admit that I'm afraid of dying before my time. Can you assure me that I won't? I'll take a look at those links, later, but for now I won't be goaded by the likes of Ron Whitfield into signing away something this important just because someone accuses me of having "no aloha."

scriv, i will PM you shortly with the details you request. i can understand why you feel the way you do. i'm honored to have your love and respect and hope you know i feel the same for you.

i've said before that eric and i prefer to remain relatively anonymous here on HT for several reasons (mostly professional, some personal--and really, we're not inclined to be OUT THERE on the internets. we purposely don't twitter and we don't facebook, for example). some HTers already know who we are in real life and have kept their word that they will keep such info to themselves. if any of you are truly conflicted about organ donorship and details of who i am/what i do for a living (which is related to this subject) will help you make a better, informed decision, feel free to PM me. all i ask is that you do not give my personal information out to anyone, HTer or not, without my express permission.

[Frankie's Market]

Re: Organ donors, where are you?

hubby and I are registered organ donors. Eldest daughter opted not to. We had talked about it when she got her driver's license and the thought heebs her out. I bring it up every once in a while, hoping to change her mind. She reacts as if I am trying to kill her.

It could be that the topic of death is something she finds morbid and would rather not think about or contemplate. I don't know if there's any way to convince her, as this is a personal decision that everybody has to make for themselves. What convinced to be an organ donor was my wife telling me that it is a way for a part of me to physically live on in someone else.

Hubby and I also want to be cremated and fed to the fishes, be composted, recycled. Same daughter swears that she won't let that happen. I have snapped many times saying she is to abide by our wishes. She says when we are dead, we are dead and cannot argue; she intends to box us up in the ground.

It's a stumper for me, to be sure. Hopefully she will mature some by the time we need to act on these decisions.

If you don't trust your child to carry out your will and you feel strongly about how your remains are to be handled, you can have a will drawn up. Then an attorney will see to it that your wishes are carried out, even over your daughter's objections.

[Barry]

Re: Organ donors, where are you?

I've got a card which I carry in my wallet >to donate my organs. Yet by the time I've finished with them, they will be no use to anybody.

[Frankie's Market]

Re: Organ donors, where are you?

scriv--and the rest of you HTers who have not already done so--please get an advanced directive done. an advanced directive (also known as a living will) is a legal document in which you declare before witnesses or a notary public what actions you want taken should you be mentally and physically unable to make your desires known. for example, if you become brain dead and doctors say that it's highly unlikely that you will recover consciousness, would you want your life prolonged? whom of your family/friends do you designate as your healthcare decision maker should you not be able to voice your desires?

Good suggestion. One thing I would add is that very careful thought be given to who you give durable power of attorney to. Of course it should be someone you closely trust. But don't just designate your spouse and leave it at that, as some folks thoughtlessly do. Why? Imagine if you are badly injured in a car wreck and your spouse is incapacitated/killed. Who will be there to carry out your will then? That's why it would be a good idea to also designate a backup decision-maker who is not likely to be traveling with you.

[Pua'i Mana'o]

Re: Organ donors, where are you?

hubby and I are registered organ donors. Eldest daughter opted not to. We had talked about it when she got her driver's license and the thought heebs her out. I bring it up every once in a while, hoping to change her mind. She reacts as if I am trying to kill her.

Hubby and I also want to be cremated and fed to the fishes, be composted, recycled. Same daughter swears that she won't let that happen. I have snapped many times saying she is to abide by our wishes. She says when we are dead, we are dead and cannot argue; she intends to box us up in the ground.

It's a stumper for me, to be sure. Hopefully she will mature some by the time we need to act on these decisions.

[scrivener]

Re: Organ donors, where are you?

I wonder if the "no breathing" policy is based on sound medical evidence, or if the Red Cross just caved in to evade concerns about transmission of infectious bodily fluids.

An article I read (don't remember where) says evidence points to the chest-compressions alone being just as effective (not more or less, I believe) as with the included breaths.

it's highly unlikely that your organs would be taken from you, as you say, before you're done with them. hospitals are already highly regulated; transplantation is even more closely scrutinized. unless you designate yourself as DNR (do not resuscitate), hospital staff are required to do their absolute best to keep you alive and save your life. additionally, no one could harvest your organs without your next of kin giving permission once you die. trust me, organ procurement in the united states is very closely watched.

Yes, I've heard a lot of this before, and I'm inclined to believe it, but part of me is still not sure, and I can't make a decision like this without some amount of sureness. You say "trust me," but as much as I love and respect you, why should I if you don't give me a reason to, such as credentials or...something? I'm not trusting a nameless, faceless person I met on the Internet with a thing like this.

this comment, along with scriv's earlier one, worries me. is the following scenario something some of you are concerned about? that you're, for whatever reason, in the emergency room with injuries so critical, it would take heroic efforts to save you. in another part of the hospital, there is a patient who will die in the next several days unless he gets a liver transplant. your emergency docs hesitate to give you the care you need in order to have a chance at living because they believe your liver is a perfect match for the other patient. while they don't exactly refuse to resuscitate you or whatever it is they need to do to save you, they linger so long at it that you die, thereby making your organs available for the other patient.

is this really something some of you worry about?

It may sound irrational or the result of watching too much television, but yes, this is part of it. I refuse to be PC about this; it's too easy to sign a name on a piece of paper and to have my driver's license stamped without knowing what's really going to happen. I'm not afraid to admit that I'm afraid of dying before my time. Can you assure me that I won't? I'll take a look at those links, later, but for now I won't be goaded by the likes of Ron Whitfield into signing away something this important just because someone accuses me of having "no aloha."

[Amati]

Re: Organ donors, where are you?

This is outrageous! Talk about no Aloha...

"Aloha"? Are you showing "aloha" by chastising others for not following your belief about the appropriateness of being an organ donor? Being a donor is a very personal decision, and those who choose not to donate can hardly be labeled as being "ourtrageous" or not showing "aloha".

[cynsaligia]

Re: Organ donors, where are you?

There's a tough balancing act: Saving the lives of 16 people who need organs. And possibly prematurely ending the lives of 16 people when gathering organs.

this comment, along with scriv's earlier one, worries me. is the following scenario something some of you are concerned about? that you're, for whatever reason, in the emergency room with injuries so critical, it would take heroic efforts to save you. in another part of the hospital, there is a patient who will die in the next several days unless he gets a liver transplant. your emergency docs hesitate to give you the care you need in order to have a chance at living because they believe your liver is a perfect match for the other patient. while they don't exactly refuse to resuscitate you or whatever it is they need to do to save you, they linger so long at it that you die, thereby making your organs available for the other patient.

is this really something some of you worry about?

[Composite 2992]

Re: Organ donors, where are you?

There's a tough balancing act: Saving the lives of 16 people who need organs. And possibly prematurely ending the lives of 16 people when gathering organs.

With Obama opening up the possibility of resuming stem cell research, this need to harvest organs might be reduced once we're able to repair or replace organs -- or components of organs -- with someone's own tissue.

As for me, I have "organ donor" on my driver's license. I don't know what good that will be since I only have a guitar in the closet.

[cynsaligia]

Re: Organ donors, where are you?

It seems kinda of silly to chastise the living. There's nothing anyone reading this thread could have done to save those 16 lives. I would think berating the living would be counter-productive to your cause.

I am trained in CPR, and have been certified several times, but it has been quite a few years since I've had a valid card; as Gecko Geek points out, I wouldn't be among the 5% but that doesn't mean I couldn't or wouldn't get right to it when called upon.

At the moment, I am not an organ donor, 'though my family is aware of my wishes (I should probably do something about that, legally). If there is even the smallest chance that I might recover, I want that chance. I love life and am not willing to let go without a fight, and mock me for believing in miracles if you will, but I do believe in miracles. The only thing stopping me from putting ORGAN DONOR on my driver's license is not being convinced that my organs won't be taken from me before I'm through with them. How and where can I get that assurance? Will my next of kin be allowed to give the green (or red) light, or will someone else be making that decision? These are questions I need answered before I'll sign my name to anything.

scriv--and the rest of you HTers who have not already done so--please get an advanced directive done. an advanced directive (also known as a living will) is a legal document in which you declare before witnesses or a notary public what actions you want taken should you be mentally and physically unable to make your desires known. for example, if you become brain dead and doctors say that it's highly unlikely that you will recover consciousness, would you want your life prolonged? whom of your family/friends do you designate as your healthcare decision maker should you not be able to voice your desires?would you want nutrition to keep you alive? would you want pain medication? do you want your organs to be made available for donation? which ones?

i believe there are free advanced directives available online. if i can download one from work and post it here on tuesday, i will do so.

it's highly unlikely that your organs would be taken from you, as you say, before you're done with them. hospitals are already highly regulated; transplantation is even more closely scrutinized. unless you designate yourself as DNR (do not resuscitate), hospital staff are required to do their absolute best to keep you alive and save your life. additionally, no one could harvest your organs without your next of kin giving permission once you die. trust me, organ procurement in the united states is very closely watched.

as for the lack of donors or available organs and what factors there might be for that: yes, religion is a factor. many believe in the sanctity of the body and would not consider organ donorship. yes, there are those who want to donate but would not be suitable (alcoholism, certain diseases, drug use would disqualify certain of your organs for being viable). also, there are many factors that come in to play when determining whether an organ can be matched with a recipient (histocompatibility). lastly, just because a kidney becomes available that matches a potential recipient, does not mean that recipient can get that organ because of how long the organ is viable after it's removed from the donor and far away the recipient is.

some links where you can learn more:

united network for organ sharing (UNOS): the national organization that oversees all transplantation in the united states.

donate life america: an organization that works to educate the public about organ donorship

[Adri]

Re: Organ donors, where are you?

I agree that it would be a good thing for people to donate organs after death and to make their wishes regarding organ donations known by driver's license, advance health-care directive and talking to their family and close friends. However, Hawaii has a high rate of heart and/or kidney disease. Part of the low rate of organ donations may have something to do with a high(er) rate of people with organs that cannot be transplanted. I've heard a number of people decline to indicate that they wish to be organ donors because they are convinced that they have no organs that anyone would want for any purpose. and Gecko Geek is right about the religious aspect as well.