Donating organs may be hazardous to your health? (New one to me)

[DRBUZZ0]

I am wondering if anyone has heard this belief before, which I'm quite sure is a myth. One of my friends and I were talking about something and I mentioned organ donation and that I had mentioned to my family that I figured I'd donate organs if I were knocked off, and I noted it on my drivers license. It seems like I may as well, since I won't be needing them at that point.

My friend's response was that it's a really bad idea to do that and I should definitely not note myself as an organ donor. She stated that organ donation is generous and good in theory except because there is a shortage of organs that it will lead to you not receiving the same lifesaving treatment in a medical accident.

If, for example, you come in to the hospital from a car accident and it could go either way (you may survive but it's iffy) they won't be as apt to fight to save your life if they know you are a donor, especially if doing so would possibly damage the organs.

She said, for example "If your heart stops do you think they're going to do CPR? Not if you're an organ donor because CPR could bruise your lungs or even crack and rib and puncture one. Those lungs are money so they'll let you go"


Obviously I highly doubt this, organ donors have to be in special circumstances, often when brain dead but kept alive so the organs can be removed in a controlled manner. Tissue donation may be possible after death, but organs aren't as easy. And since the question comes after they know you're gone, they probably won't even really be aware.

But has anyone else heard this belief? Is this a common belief amongst people?

[JoeEllison]

I have the feeling that more than a few people believe this... stupid people, but there are plenty of them to go around. How much of it is ignorance, and how much is rationalization for selfishness?

[Puppycow]

My google skillz were unable to find any science on this one way or the other.

Steven Novella (http://www.theness.com/neurologicablog/index.php) of the SGU podcast is a doctor and a skeptic. Maybe he could answer your question.

I'm sure they wouldn't give you worse care on purpose, but maybe for unexplainable subconscious reasons, they don't feel as motivated because they really want to save the recipient's life. I wouldn't rule it out a priori , but neither would I worry about it based on hearsay. It probably is an urban legend.

[Kaylee]

I have the feeling that more than a few people believe this... stupid people, but there are plenty of them to go around. How much of it is ignorance, and how much is rationalization for selfishness?Call me stupid then. Its why I haven't opted in.

If the default was for everyone to be an organ donor, and you had to choose to opt out, and if most people did not choose to opt out, and therefore there wasn't an organ shortage --- then I wouldn't opt out of organ donation in that situation either.

[Jensen]

Why would doctors risk going to jail in order to take organs from one stranger and give them to another? What could possibly motivate that?

[El Greco]

Such allegations are not uncommon at all (http://en.wikipedia.org/wiki/Organ_donation#Recent_controversy_in_Organ_Transpl antation_Case_in_California), and although I firmly believe that they must be nothing more than extremely rare cases, it's completely wrong to rule them out.

It's very very simple: There are people who will offer money to doctors to illegally find a transplant for them. There are doctors who not only will take the money, but also have the means to ensure preferential treatment for some patients.

[Ivor the Engineer]

I don't think it's stupid at all. It's quite a reasonable thought that if you being dead has some value then their is less net incentive to keep you alive.

Where I think this argument fails is it assumes the doctors treating you will have more reward from letting you die and whipping out your organs than keeping you alive. If they really were just out to make as much money as possible, keeping you alive in a hospital bed for years would guarantee a substantial income, especially in America.

Not only that, as far as I'm aware the doctors who treat you will not be the same ones who perform organ removal.

[Mojo]

To quote Monty Python (http://www.skepticfiles.org/en001/elephant.htm): "Is lack of donors a problem?"

"There just aren't enough accidents. It's unethical and time-consuming to go out and cause them, so we're having to rely on whatever comes to hand-- chairs, tables, floor-cleaning equipment, drying-out racks, pieces of pottery... and these do pose almost insurmountable surgical problems.

[wollery]

Whether or not your organs are viable (or a match for a potential recipient) can only be investigated after you are pronounced dead, and the doctors treating you have no idea where any organs you might donate will be going, so the idea that they'll let you die in order to help someone else, when they have no idea if you can, or who you will help is pretty darned silly really.

Also, ER doctors do things by numbers, all of which are recorded in detail, in case of malpractice suits. These require CPR for a set amount of time, set amounts of drugs for a given body mass, etc.. So if they don't give you the same efforts as someone who hasn't indicated that they want to donate their organs they can get into very serious trouble, up to and including having their medical licence revoked.

ETA. And of course, they can go to jail for a long time if they're selling the organs.

[Soapy Sam]

Buzz, I have heard the same belief expressed in the UK.
I don't give it any credence myself.

[wollery]

Also, I believe the UK has now gone over to harvesting organs unless specified otherwise.

[El Greco]

Whether or not your organs are viable (or a match for a potential recipient) can only be investigated after you are pronounced dead, and the doctors treating you have no idea where any organs you might donate will be going, so the idea that they'll let you die in order to help someone else, when they have no idea if you can, or who you will help is pretty darned silly really.

Also, ER doctors do things by numbers, all of which are recorded in detail, in case of malpractice suits. These require CPR for a set amount of time, set amounts of drugs for a given body mass, etc.. So if they don't give you the same efforts as someone who hasn't indicated that they want to donate their organs they can get into very serious trouble, up to and including having their medical licence revoked.

ETA. And of course, they can go to jail for a long time if they're selling the organs.

I personally know (as opposed to have heard) of too many stories about blatant violations of medical deontology, including selling of babies, unnecessary operations, preferring certain methods of operating because the involved companies give higher commission, cover-up of medical malpractice etc. I guess it helps that I am a pharmacist with a large friendly circle of medical doctors (many of them surgeons).

You may think that modern medicine is like mathematics where 1+1=2, that there is only one optimal method of treatment, and that the medical institution is impermeable to corruption. This may be true in the US & UK (I strongly doubt that), but it certainly isn't the case here.

BTW, here's the World Medical Association Statement on Human Organ Donation and Transplantation (http://www.wma.net/e/policy/wma.htm). It seems to me that throughout the statement it is recognized that financial motives can be a great problem.

[Furi]

wow, I can understand that some people would believe that, after all some people believe the moon landing was hoaxed,

(UK Centric VP don't know about other countries Health workers)
As for the organs having a value, how do they know if there is a recipient till you have been tissue matched, also no organs for sale (Legally) in the UK,

I also do not think any Doctor / Nurse worthy of the respect given to their profession would even entertain the thought, and propagators of this cocktardary should feel disgusted at their actions, unless of course you would prefer to receive the homeopathic version of a blood transfusion or kidney or from me should you need one.

[fls]

I am wondering if anyone has heard this belief before, which I'm quite sure is a myth. One of my friends and I were talking about something and I mentioned organ donation and that I had mentioned to my family that I figured I'd donate organs if I were knocked off, and I noted it on my drivers license. It seems like I may as well, since I won't be needing them at that point.

My friend's response was that it's a really bad idea to do that and I should definitely not note myself as an organ donor. She stated that organ donation is generous and good in theory except because there is a shortage of organs that it will lead to you not receiving the same lifesaving treatment in a medical accident.

If, for example, you come in to the hospital from a car accident and it could go either way (you may survive but it's iffy) they won't be as apt to fight to save your life if they know you are a donor, especially if doing so would possibly damage the organs.

She said, for example "If your heart stops do you think they're going to do CPR? Not if you're an organ donor because CPR could bruise your lungs or even crack and rib and puncture one. Those lungs are money so they'll let you go"


Obviously I highly doubt this, organ donors have to be in special circumstances, often when brain dead but kept alive so the organs can be removed in a controlled manner. Tissue donation may be possible after death, but organs aren't as easy. And since the question comes after they know you're gone, they probably won't even really be aware.

But has anyone else heard this belief? Is this a common belief amongst people?

I've heard several people claim to believe this. As you point out, it is the opposite that is probably true. Since you need to be alive, but brain dead, they are going to try harder to keep your heart beating when it otherwise appears hopeless. The decision to consider organ donation from someone who is not brain dead, but who is unlikely to survive their injuries is an unusual situation. Most of the time, the organs cannot be used when they eventually die, anyway (therefore no incentive to let them die for that reason). There are a handful of centres (acting under strict guidelines) who will retrieve organs from someone who no longer has a beating heart, but only under very special circumstances (someone who is 'iffy' is definitely not one of them). It is not a decision that can be made in the field by a paramedic, or in an ER room in the heat of the moment. It is a decision that has to involve the transplant team who must be in place before the heart stops beating. That is, even if you did encounter someone who was so lost to ethical considerations that they ignored their duty of care to you, acting alone would get them nowhere.

Linda

[El Greco]

BTW, to see whether such allegations have any merit, we should consider each of the following statements may be true. If we can 100% rule out at least one of them, then it's ok to assume that such terrible things never happen.

1. There are people who will offer money for a trasnplant
2. There are doctors who will "speed-up" the death of a terminal patient for financial gain
3. The waiting lists can be circumvented

[wollery]

BTW, to see whether such allegations have any merit, we should consider each of the following statements may be true. If we can 100% rule out at least one of them, then it's ok to assume that such terrible things never happen.

1. There are people who will offer money for a trasnplantOf course there are, but how many doctors would take it? That's a much more important question.
2. There are doctors who will "speed-up" the death of a terminal patient for financial gainWe aren't talking about terminal patients, where there will have been time to discuss the matter and take tissue types, etc. We're discussing accident victims, where no such considerations exist, and it's far harder to find a way to cover up any wrongdoing.
3. The waiting lists can be circumventedYes, they can, but it isn't easy, and is illegal (in most countries), so most doctors would not have anything to do with it.

Let me make it clear, I'm not saying that such things don't happen, but the chances of it happening to any individual are practically zero, so as a consideration of whether or not to indicate that you want to be a donor it is worthless.

Also, I'm sure there are countries where the laws are less strict and the punishments far lighter, and it's easier to find police, administrators etc. who are willing to look the other way for a cut of the profits, and it happens more often in these countries. But in the US and UK I don't believe it would be anything other than an extreme rarity.

[fls]

BTW, to see whether such allegations have any merit, we should consider each of the following statements may be true. If we can 100% rule out at least one of them, then it's ok to assume that such terrible things never happen.

1. There are people who will offer money for a trasnplant
2. There are doctors who will "speed-up" the death of a terminal patient for financial gain
3. The waiting lists can be circumvented

I think there are better ways to avoid becoming a victim of fraud than ticking off a box on your driver's license (would that even make a difference?).

Linda

[El Greco]

This is what I already said in my first post in this page:

I firmly believe that they must be nothing more than extremely rare cases

[Cuddles]

I can just about understand how people could believe this somewhere like the US, but in the UK it's just stupid. Doctors are on a salary. It doesn't matter what happens with any individual patient, they get paid exactly the same amount anyway. There is no possible benefit for them to let someone die on purpose and there are some serious downsides, such as being struck off, being sued for millions and spending a fair bit of time in jail.

Edit: Also, think how many people would need to be in on it. You don't have one doctor by themselves in a darkened room, you have a whole team of people - probably more than one doctor, nurses, anaesthetists, theatre assistants, various other support staff, administrative staff, porters and probably various others. All of whom will notice any deviation from normal procedure, all of whom could overhear a decesion to kill someone, and many of whom are qualified enough to notice any malpractice. Just as with all conspircay theories, it just isn't anywhere near plausible.

Also, I believe the UK has now gone over to harvesting organs unless specified otherwise.

There's been debate about it, but I don't think we've switched to an opt out system yet. Hopefully we will soon though.

[ohms]

Also, I believe the UK has now gone over to harvesting organs unless specified otherwise.


Not yet but it is under discussion.

Link (http://news.bbc.co.uk/1/hi/health/7183559.stm)

[sophia8]

Also, I believe the UK has now gone over to harvesting organs unless specified otherwise.No. Although there's been some noises about changing to an opt-out system here, it hasn't happened yet. You still have to carry an organ donor card.

ETA: Beaten to it.

[sol invictus]

Donating organs may be hazardous to your health?

I am wondering if anyone has heard this belief before, which I'm quite sure is a myth.

I strongly recommend against trying it, particularly at home.

[godless dave]

Sounds like nonsense to me. Not because there's no such thing as corrupt EMTs or doctors (of course there are), but because it just wouldn't be practical. As has been stated, you don't know if I'm a tissue match until after I'm dead.

[X]

Aside from the fact that having my heart removed would very definitely be hazardous to my health, I cannot fathom the logic behind saying "doctors will let a person die so that they can take an organ and save someone else".
Surely it defeats the purpose?

[ponderingturtle]

Why would doctors risk going to jail in order to take organs from one stranger and give them to another? What could possibly motivate that?

Ask Amit Kumar (http://abclocal.go.com/kabc/story?section=news/world_news&id=5946938)

But I suspect it was money.

[ponderingturtle]

Edit: Also, think how many people would need to be in on it. You don't have one doctor by themselves in a darkened room, you have a whole team of people - probably more than one doctor, nurses, anaesthetists, theatre assistants, various other support staff, administrative staff, porters and probably various others. All of whom will notice any deviation from normal procedure, all of whom could overhear a decesion to kill someone, and many of whom are qualified enough to notice any malpractice. Just as with all conspircay theories, it just isn't anywhere near plausible.


What just becuase it involves paranoid conspiracies(a rather large number of doctors on the take, and targeting you) you make it sound all irrational.

[Demigorgon]

I am wondering if anyone has heard this belief before, which I'm quite sure is a myth. One of my friends and I were talking about something and I mentioned organ donation and that I had mentioned to my family that I figured I'd donate organs if I were knocked off, and I noted it on my drivers license. It seems like I may as well, since I won't be needing them at that point.

My friend's response was that it's a really bad idea to do that and I should definitely not note myself as an organ donor. She stated that organ donation is generous and good in theory except because there is a shortage of organs that it will lead to you not receiving the same lifesaving treatment in a medical accident.

If, for example, you come in to the hospital from a car accident and it could go either way (you may survive but it's iffy) they won't be as apt to fight to save your life if they know you are a donor, especially if doing so would possibly damage the organs.

She said, for example "If your heart stops do you think they're going to do CPR? Not if you're an organ donor because CPR could bruise your lungs or even crack and rib and puncture one. Those lungs are money so they'll let you go"


Obviously I highly doubt this, organ donors have to be in special circumstances, often when brain dead but kept alive so the organs can be removed in a controlled manner. Tissue donation may be possible after death, but organs aren't as easy. And since the question comes after they know you're gone, they probably won't even really be aware.

But has anyone else heard this belief? Is this a common belief amongst people?

Having a wife who works on the transplant team in a hospital, this is absolutely in no way true what so ever. Complete rubbish. It's myths like this which prohibit donations when they are so badly in need. Sign yourself up, your freinds and family too. Tell your friend that I hope she or (if she has children) are never in need of a life saving transplant.

Ask Amit Kumar (http://abclocal.go.com/kabc/story?section=news/world_news&id=5946938)

But I suspect it was money.

This isn't Nepal....

[madurobob]

If, for example, you come in to the hospital from a car accident and it could go either way (you may survive but it's iffy) they won't be as apt to fight to save your life if they know you are a donor, especially if doing so would possibly damage the organs.

I actually had an almost opposite experience.

My wife was an organ donor and due to a blood disorder and a confluence of unfortunate events she died after giving birth. She had a massive cerebral hemorrhage and died almost instantly.

But, the organ donor supervisor came to me and asked if I agreed with my wife's organ donation plan and told me they would obviously honor MY wishes rather than the paperwork my wife had on file. Once I said I agreed she asked if it would be OK for them to initiate extraordinary measures (six hours of brain surgery) that had a very slim chance of saving my wife's life, but would also keep her body functioning long enough to ensure her organs could be used. Thats right - the organ donor program tried to save her life. The organ donor program paid for all of this.

The nice part about it for me is her heart is beating today just 100 miles east of here. Her liver saved another life, and her corneas helped others to see. Although she died she made several other lives possible, not the least of which is our now 8 year old son.

You better believe I have that organ donor heart on my driver's license!

[ponderingturtle]

This isn't Nepal....

His crimes where committed in India, he was extradited from Nepal.

[luchog]

I've always thought it was complete nonsense, nothing more than an irrational paranoia-based urban legend; and have been an organ doner since I got my first driver's license.

[blutoski]

There's a bit of convoluted reasoning here, too: if the harvesters in question are corrupt, then it certainly doesn't matter if you've signed an organ donor's card.

We had a high-profile case recently where organs were being sold overseas through a black market network. They certainly didn't care whether the victims had given permission or not.

Ultimately, giving permission does not decrease the chance of trauma survival. Based on the operations of organ transplant organizations, it's likely to actually help survival, and of course, there's the reality that if you die, it may provide benefit to others.

[LostAngeles]

His crimes where committed in India, he was extradited from Nepal.

OK, well this still isn't India. What's your point?

In fact, where I sit, this is not any country that is not the United States of America. YMMV.

[CFLarsen]

Can we 'ave your liver, then?

It's all for the good of the country. (http://arago4.tnw.utwente.nl/stonedead/movies/meaning-of-life/11-live-organ-transplants.html)

[Kaylee]

Why would doctors risk going to jail in order to take organs from one stranger and give them to another? What could possibly motivate that?

I’m not envisioning a scenario a la Robin Cook or Hollywood where organs fresh from the cadaver are plopped into that of the wealthy crooked patient or the patient whose best friends are major players in the local hospitals.

Why (at least in some parts of the country or hospitals) wouldn’t a hospital’s political environment be such that doctors would be under strong pressure to steer deceased patients to organ donation programs?

In today’s environment where the average medical appt. is very rushed and hurried, that alone is enough to deter me from opting-in.

[Kaylee]

Can we 'ave your liver, then?

It's all for the good of the country. (http://arago4.tnw.utwente.nl/stonedead/movies/meaning-of-life/11-live-organ-transplants.html)
Great movie! :D

[godless dave]

Why (at least in some parts of the country or hospitals) wouldn’t a hospital’s political environment be such that doctors would be under strong pressure to steer deceased patients to organ donation programs?


Patients dying would be worse for their reputation than patients surviving. Doctors would be under stronger pressure not to let their patients die. I don't think hospitals get any PR or monetary benefits from supplying organs.

Remember, the next person on the recipient list isn't likely to be at the hospital whose ER you got taken to after an accident.

[Kaylee]

Patients dying would be worse for their reputation than patients surviving. Doctors would be under stronger pressure not to let their patients die.
Good point. But what about a case where a medical team thinks that its unlikey that two of their patients in ICU will survive, no matter what steps are taken? And the hospital just happens to be behind in their informal quota of deceased patients funneled to the organ pool? (Assuming that such a quota exists.)

Might that not affect what steps they decide to take if its thought that some steps might injure organs that could otherwise be donated to the national pool?

I think as others have said, these scenarios might rarely occur, but could they not occur?

I don't think hospitals get any PR or monetary benefits from supplying organs.
No, but perhaps hospitals are under informal pressure to funnel "contributions" to the organ pool? Could the number of organs contributed to the national pool through a particular hospital affect that hospital's patients standing on the recipients waiting list?

Remember, the next person on the recipient list isn't likely to be at the hospital whose ER you got taken to after an accident.
I'm aware of that.


ETA: I think it would be interesting to try to correlate a person's liklihood of being an organ donor to their perception of the quality of medical care they have received over their lifetime.

[Molinaro]

Sounds like heavy duty insane paranoia is more common than I thought.

[Kaylee]

Sounds like heavy duty insane paranoia is more common than I thought.
Your wit is absolutely awe inspiring. And if you believe that ...

[fls]

Good point. But what about a case where a medical team thinks that its unlikey that two of their patients in ICU will survive, no matter what steps are taken? And the hospital just happens to be behind in their informal quota of deceased patients funneled to the organ pool? (Assuming that such a quota exists.)

There is no quota. It would be a remarkably silly thing to have.

Might that not affect what steps they decide to take if its thought that some steps might injure organs that could otherwise be donated to the national pool?

No. As I mentioned earlier, if a patient needs CPR but it is withheld, the lungs cannot be used for donation anyways. Which means that whether or not the organs would be damaged is completely irrelevant.

I think as others have said, these scenarios might rarely occur, but could they not occur?

No. As I mentioned earlier, nobody would be interested in using the organs in the scenarios you have proposed - they would be useless because they have a high failure rate under those circumstances.

No, but perhaps hospitals are under informal pressure to funnel "contributions" to the organ pool? Could the number of organs contributed to the national pool through a particular hospital affect that hospital's patients standing on the recipients waiting list?

That is not how the system works.

I sincerely hope that you make an attempt not to let naivety be your guide on this issue. It's too important.

Linda

[JoeTheJuggler]

No. As I mentioned earlier, if a patient needs CPR but it is withheld, the lungs cannot be used for donation anyways. Which means that whether or not the organs would be damaged is completely irrelevant.
I know this is running off on a tangent, but that reminds me of a recent House episode where his patient needing a liver was told no by the committee (I forget why), and meanwhile a patient who was dying or brain dead and being kept alive on machines was deemed to have an unusable liver due to some STD. House, the maverick that he is, first had to diagnose the "donor" (he did, but not in time to cure the infection). The patient's life was saved by the transplant, but he had to begin treatment for the infection.


My question is, do things like that really happen? I don't mean violating rules and all that House stuff, but do organs that might reasonably save a life get thrown out for bad reasons? (If my choice is death in two days or a transient and treatable infection, I think it's obvious.)

I'm signed up for one of the for-profit organ donation places. They allow organ gifts (like the back-of-the-driver's-license program) to harvest organs for transplant first, then they'll take whatever's left. (I think they sell stuff to research labs.) For me the biggest plus is that they pay transportation costs and even provide two death certificates to the family. (My parents donated their bodies to a medical school which requires no organ donation and they have to shoulder the cost of transportation--which is outrageously expensive.)

[fls]

My question is, do things like that really happen? I don't mean violating rules and all that House stuff, but do organs that might reasonably save a life get thrown out for bad reasons? (If my choice is death in two days or a transient and treatable infection, I think it's obvious.)

That is part of the decision process. Questionable organs will be considered for transplantation when the only other choice is imminent death.

Linda

[LostAngeles]

...


ETA: I think it would be interesting to try to correlate a person's liklihood of being an organ donor to their perception of the quality of medical care they have received over their lifetime.

You'd have to weed out the under and un-insured for one. I don't think you'd get much, if anything, out of the correlation.

I cannot recall if I've ever been asked, when seeking ER treatment, if I am an organ donor.

I am an organ donor and I have it in one of those legal documents that I am since my mom is skeeved out by the whole process and I am adamant about having my organs donated.

I'd be dead and not using them and since I'd have to be brain-dead, I'm really dead and I'm really not using them.

[Kaylee]

I personally know (as opposed to have heard) of too many stories about blatant violations of medical deontology, including <SNIP>, unnecessary operations, preferring certain methods of operating because the involved companies give higher commission, cover-up of medical malpractice etc. I guess it helps that I am a pharmacist with a large friendly circle of medical doctors (many of them surgeons).

To a certain degree that has also been true in the USA.

Reports of unnecessary hysterectomies being performed instead of just removing the fibroid, and surgical biopsies instead of fine-needle biopsies are some of the ones that I’m aware of.

Also, while these are on a far lower scale of “wrongs” – they are being committed by the same “system”:

* Outrageous billing mistakes – the extent and degree of occurence makes many believe that this is some hospitals' standard and intentional operating policy.

* Doctors and hospital staff covering up malpractice

* Putting the "system" first over individual patients:
** Its still standard practice in many American hospitals to put patients under the care of sleep deprived interns (on 30+ hours shifts). This leads to increased serious mistakes and even deaths. There is resistance by the medical practice on changing this practice. The attitude seems to be “Well, I did it and the next generation of doctors are going to do it too.”

http://www.news.harvard.edu/gazette/2006/09.14/99-sleepyinterns.html

** Giving patients duplicate medical procedures to evaluate the effectiveness of a new procedure – but not telling them that is the reason.

These type of practices have got to have an impact on many people’s level of trust. IMHO, you need to have a strong environment of trust for a majority of people to check off the organ donation box on the back of their driver’s license.

[Kaylee]

You'd have to weed out the under and un-insured for one. I don't think you'd get much, if anything, out of the correlation.
Why? If such a study could be done, I'd think it would be valuable to have it reflect all the demographics.

I would expect a high correlation. I would expect that people that have received excellant care and had a good relationship with every health care provider they had ever encountered to be more likely to check off the box on the back of the driver's license. I think the only thing that would throw off this correlation would be if they were religous and their religion's beliefs (big guy in the sky wants you intact) and/or religion's customs (open coffin at the funeral) had the effect of making them adverse to organ donations.

I cannot recall if I've ever been asked, when seeking ER treatment, if I am an organ donor.
Dome to think of it, I don't think I've been asked either. Then again, fortunately for me, my most serious medical problem has been wisdom teeth that wanted to grow in the wrong direction and very badly designed knees. I vaguely recall having to give some ID (esp. the health insurance card!), but I don't recall if I was asked to give any picture ID or a driver's license.

I am an organ donor and I have it in one of those legal documents that I am since my mom is skeeved out by the whole process and I am adamant about having my organs donated.

I'd be dead and not using them and since I'd have to be brain-dead, I'm really dead and I'm really not using them.

After I'm brain dead I'm OK with having my organs donated to others also. I just want the whole process monitored by a very good friend and not someone whose only connection to me is that they happened to have read the back of my driver's license -- which is why I haven't checked off that box.

[LostAngeles]

Why? If such a study could be done, I'd think it would be valuable to have it reflect all the demographics.
...

Because when I was under-insured or un-insured, I found that I received lousy care as opposed to when I was insured. As an example, I was told to take large amounts of NSAIDs for my headaches. UCLA Medical Center found a pineal cyst (asymptomatic) and migraines. However, that might be attributed to UCLA Medical Center being among the best hospitals in the country.

On the other hand, I know that slingblade tells a similar tale.

On the other hand again, that's an n=2 sample.

You need to remove as many other explanations for poor (or good) quality of care. State of insurance is just one of the ones I thought of. Isolate your variables as much as possible. You could compare care and organ donation among people with the same level of insurance to control for that as an example.

[Kaylee]

Because when I was under-insured or un-insured, I found that I received lousy care as opposed to when I was insured.

You need to remove as many other explanations for poor (or good) quality of care. State of insurance is just one of the ones I thought of. Isolate your variables as much as possible. You could compare care and organ donation among people with the same level of insurance to control for that as an example.

I don't want to remove people that are under-insured or have other reasons to have received substandard care. This would have an adverse effect on my attempt to prove this correlation:

The more positively someone evaluates the medical care they have received and the more positively they describe their relationships with all of their health care providers, the more likely that have checked off the organ donor box on the back of the drivers license, or have made similar provisions through a medical will.

The more negatively someone evaluates the medical care they have received and the more negatively they describe their relationships with all of their health care providers, the more the likely that they have not checked off the organ donor box on the back of the drivers license, or made similar provisions through a medical will.


CUT AND PASTED OUT OF ORDER
As an example, I was told to take large amounts of NSAIDs for my headaches. UCLA Medical Center found a pineal cyst (asymptomatic) and migraines. However, that might be attributed to UCLA Medical Center being among the best hospitals in the country.

On the other hand, I know that slingblade tells a similar tale.

On the other hand again, that's an n=2 sample.

I'm sorry to hear that you and slingblade have had bad experiences in health care. It must have been a very frustrating and even scary situation.

[LostAngeles]

I don't want to remove people that are under-insured or have other reasons to have received substandard care. This would have an adverse effect on my attempt to prove this correlation:

The more positively someone evaluates the medical care they have received and the more positively they describe their relationships with all of their health care providers, the more likely that have checked off the organ donor box on the back of the drivers license, or have made similar provisions through a medical will.

The more negatively someone evaluates the medical care they have received and the more negatively they describe their relationships with all of their health care providers, the more the likely that they have not checked off the organ donor box on the back of the drivers license, or made similar provisions through a medical will.

OK, that makes much more sense. In that case, you'd have to control somehow for religious/spiritual reasoning (JW for example), but you're right, that would be interesting to see.

I'm sorry to hear that you and slingblade have had bad experiences in health care. It must have been a very frustrating and even scary situation.

Thank you. Honestly, a lot more scary hearing about the cyst, but the care I've received has been fantastic. :D

[Skibum]

I cannot recall if I've ever been asked, when seeking ER treatment, if I am an organ donor.



Good point.

In my experience as an EMS provider, the only time I've heard the issue brought up is after everything else has been tried and the only options are organ donation or morgue.

[Demigorgon]

Sitting at work I just wanted to share an email I received this morning from my lovely wife (unedited except where noted):



Good morning I trust you got to work ok. I am having a GREAT day doing an organ retrieval!!!!! I have not done one in so long and it is of course sad but at the same time this pt will give the gift of life to a child here at [edited out] a new liver which is desperately needed - the recipient is on deaths door, and two kidneys will get two lucky people off of dialysis and heart valves to study and two corneas to give two people the gift of sight :) :) just amazing!!!! truly these parents are hero's!



I know it doesn't do much to move the discussion for or against the crazy theory in the OP, but I thought maybe some real world perspective here might be enlightening.

And like another poster said, it is only after all other measures fail do they consider doing organ retrival. In which case they must keep the patient alive LONGER than they would have prior.

[DRBUZZ0]

The one time where I could see this being a possibility would be in the circumstance where a person is fatally injured and will die without intervention, but even with intervention will still only have a less than 50% chance of survival and where the intervention might damage the organs.

I can understand the logic too because if I only had a 25% chance of survival I would not want to be left to die. I'd still want the medical staff to peruse that 25% chance with all approperate effort.

One could see the rational of "he's probably going to die anyway, but if we try to save him chances are we won't and the organs won't be viable then"


However, this is at best a limited thing, because in most cases, the patient needs to be kept alive until the time when the organs are to be removed. Most resuscitation would not harm the organs, but perhaps certain trauma surgery might run that risk. In most cases, resuscitation would increase the odds of the organs being viable.

And aside from that I doubt that in such an emergency the medical staff would have the opportunity to stop and evaluate the odds of your survival and question the impact of attempting to save your life.

[fls]

The one time where I could see this being a possibility would be in the circumstance where a person is fatally injured and will die without intervention, but even with intervention will still only have a less than 50% chance of survival and where the intervention might damage the organs.

I can understand the logic too because if I only had a 25% chance of survival I would not want to be left to die. I'd still want the medical staff to peruse that 25% chance with all approperate effort.

Twenty-five percent is a huge chance! Nobody's going to stop working on you for that! Realistically, in a young, healthy guy, they're going to keep going until your heart stops (and they can't get it going again).

Linda

[godless dave]

It should be noted that in the US there are a LOT of ethical regulations and laws regarding organ donation. It was recognized early on as an area where corruption and unethical behavior was a possibility. The science fiction author Larry Niven wrote a lot of stories about a future society that handled organ donation in a much less ethical way.

So the fears aren't unfounded - and it's because of those fears that we have such a strong system in place to prevent abuses.

[blutoski]

Twenty-five percent is a huge chance! Nobody's going to stop working on you for that! Realistically, in a young, healthy guy, they're going to keep going until your heart stops (and they can't get it going again).

Linda

The other thing that doesn't make sense is: who is this they?

I spent years as a lifeguard doing CPR until the victim is declared. That's a pretty common first aid scenario.

I'm not sure why somebody would think that the teenager at the pool with whistle would be in cahoots with an international organ harvesting conspiracy.

For most victims, survival odd are in place long before they get anywhere near EMS.

And, as pointed out, for most victims, the trauma team will finish their role long before the victim is identified, much less determined whether there's a match waiting somewhere for their exact HLS.

Look at my situation: I've been a registerd donor for 25 years, and only once has somebody in North America a) required bone marrow and b) been a match.

Nobody's going to snuff a patient on spec, hoping that the planets will all line up at the right time with a patient waiting for just this exact victim's HLS or MHC matchup.

[Agular]

Sometimes it happens:
Doctor accused of hastening death for patient's organs

http://www.cnn.com/2008/CRIME/03/03/transplant.trial/index.html?eref=rss_topstories