I have to go off on a rant about organ donation.

[TheWraith]

Call it a delayed action rant, after the posting of the nonsense 1999 Wall Street Journal article posted the other day. I really didn't think it was necessary, but some of the reactions in that thread boggled my mind.

I am an organ donor. I'm signed up so that if I ever bite it, my parts will be put to good use. And frankly, this is such an incredibly simple decision that I cannot imagine why anyone chooses NOT to do so except for medical reasons like having a communicable disease.

Okay, that's not quite true--I can imagine some reasons people would choose that. Unfortunately, most of them are wrong, and thus doing harm to the public health. Like the perception that someone who's rich and powerful is more likely to get a transplant if they need one than someone who's not. That's wrong. Organ transplants are done based on the compatibility of the organ, and the need of the patient. That's it. No amount of money will buy you a new pair of lungs if you need them, at least not in the US where it's a federal crime to sell human organs.

Nor does being an organ donor mean the doctors will put in less than their full effort to keep you alive if you come in in an accident. Organ donation is only considered after death; doctors aren't pirates hanging around the ER looking for someone they can chop useful parts out of like some kind of horror movie. If you can be saved, they'll save you.

And if you can't be, you might be able to save someone else.

For every donor, doctors are able to get an average of 3 transplantable organs. You don't have to have perfect organs or be in perfect health to be a donor. And most of those organs end up saving people's lives: hearts, lungs, kidneys, livers. Some of them, like corneas, "merely" end up helping blind people to see again and the like.

That's the long and short of it: being an organ donor costs you nothing, ever, and it makes it possible that someday you're going to save the lives of three people, and send them back home to their families where they might have otherwise died. I really can't imagine why anyone chooses not to do that, but they do: only 1 in 4 people in the United States is signed up to be an organ donor.

[Robeysays]

1. i too am a donor. easy decision.

maybe mitt can buy some new lungs?

[11 Bravo]

2. Agreed. Why would anyone NOT be an organ donor?

[Deep13]

3. How do you know?

How do you know that in borderline cases, doctors will not turn their attention to saving the organs rather than saving the person? How do you know that the math--how many can we save with transplants--will not be weighing on their minds. Frankly, that's the impression I got when my Dad was dying. He had a stroke that rendered him unconscious, but not brain dead. Seemed like the recovery team was questioning me before we even knew it was hopeless.

[Logical]

4. I worry about this also.

[nobodyspecial]

15. They have to move quickly

If there's even a possibility that organs may be available, they have to be tested, put in the database, matched and the recipient needs to get to the hospital. All of this takes time. If they wait until a person dies, it may be too late to do the most good.

Just wondering what the outcome of your situation was. If you did lose your father, I'm sorry.

[Deep13]

24. Yeah, he died in perfect health 13 years ago.

Seriously, he was in better shape at age 51 than I have ever been in.

It may--I do not know, of course--have been a failure to communicate. The neurosurgeon--damn his defensiveness--refused to say that it was hopeless until my father was actually dead. The other docs may have known, but from my perspective, he had even odds of recovery when the transplant team came around asking about whether he smoked or drank. Seemed like they were browsing before there was a reason to think they would be needed.

[nobodyspecial]

46. My guess is the doctor told the transplant team the truth

and not the family. The team would never approach without the doctor initiating it and knowing the likely outcome. Given your father's health, it must have been quite a shock. That's why I've communicated my wishes to be a donor on my license and with family members. They will be certain that it's what I want, even in a time of crisis.

[Deep13]

53. We knew he want to be an organ donor...

...we just did not know that it was time to start thinking about that. It's like that Monty Python skit. "Can we have your liver?" We thought that meant when he was dead.

[w8liftinglady]

54. I know how hard that moment is for your family

Like I've said- I cared for donors...both before and after they were declared brain-dead.It's never a "good" time to break the news to families.I did at least try to get the discussion started with my family members...I still do that,even with patients you wouldn't necessarily consider donors.Most people,when talked to,would like to see a piece of their loved one live on.I hope it's some comfort for you to know that there are many people alive today thanks to the generosity of your dad and your family.

[jeff47]

18. Because they're different doctors

The doctors trying to save you aren't the transplant doctors.

[Deep13]

25. I know that, but they are all collegues who work with each other regularly...

...while the patient is a stranger.

[Sgent]

36. There are very few transplant teams in the country

with just a few doctors doing it. Donations come from almost all hospitals throughout the nation -- many of which don't have a transplant team within 50-100 miles, even then they often work at different hospitals or in different departments completely.

[riderinthestorm]

42. Exactly. I just posted about my sisters very, very recent experience with transplants downthread.

Thanks for weighing in.

[jeff47]

45. The organ recipient is also a stranger

The organ donor and organ recipient are equally unknown to the doctors.

(assuming the doctors are following ethics and not treating their own family members / others that they know well)

[TheWraith]

30. One reason I know is because I'm not paranoid.

I no more believe that the doctors are conspiring to harvest my organs than I believe that they're conspiring to withhold a cure for cancer.

Frankly, all things being equal, I'm inclined to trust the medical professionals understanding of the situation over yours. They may have known it was hopeless long before the family did. Are there bad doctors? Incompetent doctors? Hell yes. But I'm less worried about bad doctors than I am about bad drivers. There's an element of risk involved any time that you step outside of your front door. On my threat assessment, being prematurely harvested for my organs ranks far below being attacked by an angry housecat.

[riderinthestorm]

41. My sister just received a kidney and a liver via the transplant program at CPMC in San Francisco

just two weeks ago. So I am fully immersed in this right now. Please feel free to ask me any questions. Here's what happened to us (her of course really, but to us as her family).

My sister had two "false alarms" before her actual surgery, where she was prepped and ready to get the anesthesia when the organs arrived. In both instances, once the transplant team saw them and tested them, they decided against the transplant. The organs just weren't suitable.

That process left us with a lot of questions. Why didn't they know before she was prepped that the organs weren't suitable?

Because the transplant team is completely different. Neither of the donors from the first two attempts were from San Francisco. They passed away at other hospitals elsewhere. They wouldn't tell us anything about the donors other than to say they hadn't died there. This was important to us because my sister lives 2 hours away from San Francisco and had rushed to the hospital to ensure she was there within the 6 hour window of viability. We wondered why they hadn't been able to evaluate the organs before that very last moment. Now we know. The donors didn't die there. We were told that they haven't had a donor at the hospital for a recipient at the same hospital, ever.

So two different teams of doctors are making the evaluations: your doctor is evaluating you at the end of your life. The transplant team is evaluating the organs in a whole separate procedure.

I hope this helps with some of your worry about that. I am so sorry about your Dad.

[LanternWaste]

58. After this therefore because of this...?

"Seemed like the recovery team was questioning me before we even knew it was hopeless..."

After this therefore because of this...? Or, in Latin, post hoc ergo prompter hoc?

[Voice for Peace]

5. also an organ donor

but understand the willies about it. I used to have a terror
of being buried alive. I'd prefer not to have my organs harvested
while I was still alive. Although some days waking up without a
brain would be nice.

[dixiegrrrrl]

22. that would make you a Republican, would it not?

[thesquanderer]

56. I have a friend who thinks the opposite

re: "I used to have a terror of being buried alive. I'd prefer not to have my organs harvested while I was still alive."

I have a friend with a fear of bring buried alive. She signed up to be a donor, because that way she figures it will be 100% certain that she will be dead before they put what's left of her in the box.

[Voice for Peace]

57. people used to sit with the dead unembalmed body for two days or so, until

the skin became greenish and a foulish scent began to make
it absolutely clear that the body was dead and decomposing,
and the person wouldn't be back. Then the body was disposed
of. Of course there wasn't organ sharing back then.

I've heard a story of someone waking at his own funeral, I don't
know where this happened; but everyone thought it was a demon,
when he sat up in his coffin, so they stoned the poor guy to death.

[w8liftinglady]

6. I have cared for both organ donors and recipients

Organ donors are treated extremely aggressively.Doctors have a hard time "letting go" of a patient.If your family is approached for a possible donation,trust me- the docs have done everything.

I have cared for heart,kidney,liver and lung transplant patients both pre-op and post-op.The changes in their lives,their family's lives are indescribable.If you need reassurance that your decision is making an impact,just know that a lung transplant extends the life of a teenager at least 5 years,a heart transplant extends the life at least 25 years.

I saw cystic fibrosis kids graduate high school thanks to their lung transplants (we had to check them periodically for rejection).These kids were literally dying in front of their family's eyes pre-op.

I have signed my donor card.

[nobodyspecial]

16. Thank you for your insight

and care of these patients.

[Rex]

7. I doubt a lot of people even take the time

to read the back of their drivers licence/I.D. If there was a concentrated effort nationally to bring awareness to this cause, then I could see more people signing up. Otherwise, it is just another small thing in the life of most people imo. They don't think about anything that you listed in your OP, it is just not something important enough to be brought to the forefront of their brains imo.

[Poll_Blind]

8. I didn't like that article either and posted a link to the actual guidelines. But your...

...statement, specifically, that a person who's rich isn't any more likely to receive an organ transplant is simply not accurate.

While it is illegal to sell human organs in the United States, for a person of means the odds are dramatically tipped in their favor.

This article, How Did Steve Jobs Get His Liver?, lays it out clearly in the case of Steve Jobs. Don't go fooling yourself that if Bill Gates needs a new liver that he's going to die while on a waiting list.

PB

[w8liftinglady]

10. Yeah, David Crosby got one,too.

That being said...none of the hundreds of patients I broched and biopsied at UTSW was famous.Most were dangling on a thread because of the illness their family has incurred. There is always going to be graft in medicine.You can only tip organ donations so much in your favor.(blood type,antibodies,etc)

[Gemini Cat]

13. Exactly.

I know many transplant patients and not one of them are rich or famous, but they are all alive thanks to someone signing their donor card.

[Texasgal]

38. They must have insurance.

Organ transplants are NOT free.

[w8liftinglady]

44. Good point... PNHP made a comment on this

http://pnhp.org/organ_donors/Transplants.pdf

[frazzled]

9. Organ donor here, too

This business about doctors not putting in a full effort to save you seems ridiculous. I think too many people have been watching reruns of ER and Grey's Anatomy. Hospitals aren't soap operas, in which the guy in the next room is in need of a lung the moment you are brought in by Medivac from a gruesome accident.

I hope someone puts my organs to use better than I have been able to do

[Politicalboi]

11. I'm a donor

They should do it the opposite way when you get your license. You should have to tell them that you DO NOT want to donate. Or maybe they could charge donors less with their car registration. Or they should compensate the living family for the funeral for the organs they use. And if your religion clashes, tough shit. Religion is a choice, and if your religion doesn't allow for donations, then maybe your church will compensate for the higher registration or burial.

[jeff47]

19. What you do on your driver's license really doesn't matter

They have to get permission from your next-of-kin no matter what you put on your Driver's License.

[RebelOne]

21. But at least your driver's license is half price.

That's why I became an organ donor.

[TheWraith]

28. That's actually how they do it in parts of Europe.

They have an opt-out system instead of an opt-in system. In Belgium, for example, where you have to specifically say you don't want to be a donor, their participation rate is closer to 3 out of 4, instead of the 1 out of 4 you find here in the US.

[pitohui]

12. i'm glad being an organ donor is guaranteed to cost you nothing

i did without health insurance for 15 years, i know from personal experience that more care DOES go to the people with money, so there is no use in telling me stories about how you think it otherwise (and you offer no proof that the rich don't go first just your assertion without evidence or any cite from a disinterested party) -- fact is, money does buy better care, and better care does make it more likely that you'll be rated strong enough to undergo procedures, where is the hole in the logic here?

i don't criticize people who want to donate organs, but nor do i feel any special inclination to criticize those who don't -- i wonder how many of those 3 out of 4 who don't care to be organ donors are underprivileged or have other damn good reasons to be suspicious of the system

as for the claim that there is no charge to the family after the plug is pulled, i would say that's an easy claim for you to make, the bill won't go to the invisible wraith on the internet if you're wrong, the bill goes to my survivors at the time they can afford it the least so forgive me if i don't take your word for it, i have to believe what everybody IRL tells me, which is that they'll bill your family and your insurance for every little thing they can dream up, from $130 aspirins until the bill is over six figures! and the final day is the most expensive by many thousands of dollars! it's insane!!!

if organ donors had a complete forgiveness of their final hospital bill you'd see plenty of us older folks signing up, that's for sure, but instead big medicine wants to play on guilt and grab something for nothing, screw that

[TheWraith]

29. There's so much wrong with your post I don't know where to begin.

First off, it's not "my assertion" that having money doesn't buy you a transplant--it's federal law. Transplant decisions are made medically, not on the basis of how much you can pay. If you're unwilling to look at a Google search to learn that, ask the Mayo Clinic:

http://www.mayoclinic.com/health/organ-donation/FL00077

As they point out, "celebrity" transplants are actually AUTOMATICALLY audited by the authorities to insure that nothing inappropriate took place.

as for the claim that there is no charge to the family after the plug is pulled, i would say that's an easy claim for you to make, the bill won't go to the invisible wraith on the internet if you're wrong, the bill goes to my survivors at the time they can afford it the least

Again, this isn't some nebulous claim of mine, it is FEDERAL LAW. All costs for organ donation are free to the donor and their family. If you receive a bill in error, you are legally entitled to waive it. Period.

but instead big medicine wants to play on guilt and grab something for nothing, screw that

It's extremely disturbing to me that you decide to be paranoid about "big medicine" and someone supposedly "stealing" your organs rather than take the few minutes needed to review the facts, including getting a handle on the fact that we're talking about saving the lives of hurt, sick people in need, not the supposed nefarious evil of some kind of conglomerate bent on... saving lives? Try educating yourself on the subject.

[Texasgal]

37. The organ may be "free"

getting it in the patient is not.

It costs thousands and thousands of dollars. Receiving a transplant is VERY expensive.

[LadyHawkAZ]

14. I'm a donor

The likelihood of me dying in a motorcycle wreck is high- that's why we call them donorcycles. They are welcome to anything useful they can salvage, and good luck to them.

[RiffRandell]

17. Reminds me of a movie "Never Let Me Go"

which I highly recommend-- it's about people who are bred for the sole purpose of donating their organs to people that need them; it's based on a book. I am an organ donor myself.

[ZombieHorde]

20. I think some people don't donate organs because they fear they will anger their god. nt

[LanternWaste]

59. That's quite a premise you've place your faith in...

That's quite a premise you've place your faith in...

[TheWraith]

62. Truth is, most religions actually strongly favor organ donation.

Most Christian denominations, Judaism including Orthodox Judaism, Islam, most eastern traditions, are all either accepting or strongly supportive. Catholicism considers it an act of charity, Orthodox Judaism considers it obligatory to save a life, and Buddhism considers it an act of merit. Just about the only organized religions which really frown on organ donation in any sigificant way are Shinto (because a body after death is considered impure) and Jehovah's Witnesses (because they believe the bible forbids blood transfusion).

[ZombieHorde]

66. I don't see how that condradicts what I wrote. nt

[TheWraith]

67. Did I say it contradicted anything?

I was making a comment.

[ZombieHorde]

69. Where I live, that is what the phrase, "truth is..," usually means.

Sorry that I misinterpreted your post.

[Demonaut]

23. I like to think that part of me is still alive after I've passed

[Hoyt]

26. Agree Completely. Make sure family knows your wishes.

I agree completely, and am singed up as an organ donor.

I will relay my experience when my wife -- Jane -- passed away three years ago unexpectedly at home.

When I got home the organ donor agency called to ask my wishes. It was the nicest lady whose angelic voice I still remember. She explained that since Jane did not die in a hospital, some of the organs weren't useable -- heart, etc.

But, she said, they had a big need for other organs. I was fine when she asked about donating the cornea. Then, when she asked about all the skin off my wife's back and the "long bones of the legs," I had to ask her how long I had to think about that. I knew what I was likely to do, but just needed to think about it -- it had been a tough day. She said something like an hour, two at most, because they had to transfer her to several places to have those removed and prepared.

Anyway, I told the lady to call me back in 45 minutes. I thought about it and called a few of my wife's friends. They said they were sure Jane would want to do it. So, in 45 minutes I said OK.

Almost every month for a year, I received at least one nice letter from the donor organization -- I mean really nice letters that made me feel good about the whole thing. They also sent a few books about mourning the passing of a loved one. They even had counseling meetings I could attend and some kind of celebration for all those families who participated during that year. While I did not participate in those, I am sure it helped those who did.

Considering the circumstances, the donation part was a wonderful experience. I think some people truly benefited -- so, in a sense, Jane's life was meaningful even after death.

I never had a regret and have told those who will likely make those decisions for me to do the same.

I suspect it is even tougher for those who have to make the decision while their loved ones are still clinging to life. My thoughts are with them, and all those who make this choice.

[Iggo]

27. Someone get me the percentage of doctors who are organ donors.

Then we can talk.

I realize it may only be an urban legend that doctors aren't donors, but it still scares the crap out of me.

[Sgent]

39. The only physicians I know

who aren't donors have religious objections (some types of Judaism, probably others). Now, I don't ask everyone, but I have 5 doctors that are close relatives and worked in the industry for a long time.

[YellowRubberDuckie]

31. The only problem I have with it...

...is the MILLIONS of dollars they're making off my DONATION. I'm saving someone's life, sure. That's worth it, but the hospital is making a ton of money on someone else's life or death. THAT makes me wanna vomit.

[TheWraith]

33. Organ transplants are not a profit center.

Particularly since all the costs for harvesting organs are assumed by the hospitals.

[YellowRubberDuckie]

63. You know they are making up for it somewhere.

I don't buy that they're losing money harvesting.

[joshcryer]

32. I'm signed up for cryonics, if I could trust the system to respect my wishes...

...I would happily sign up for organ donation, but the risk is too great for them to properly deal with my body.

[Texasgal]

34. Not entirely true.

You have to have the means to pay for a transplant before you even hit the federal transplant list. You either must have the funds or insurance (private or medicade/medicare) in place BEFORE you are even considered.

Many folks don't have the insurance or don't qualify for MC.

Those who do not don't get the transplants period. Unless you have a quite ample stash of money. Otherwise screw you, you die.

I agree with organ donation everyone should do it.

[Junkdrawer]

35. The system can and is gamed for VIPs. It's not as bad as, say, the legal system....

But there are ways of bumping a person up the list to some extent. (Overstating current illness, making the person a multiple organ candidate when they should not be, etc. etc.)

[HopeHoops]

40. Some do have religious reasons for not doing it. I have no such reasons.

It's so easy in most states - just check a box on your driver's license renewal.

[riderinthestorm]

43. Thank you to everyone who is an organ donor. My sister just got a kidney and liver 2 weeks ago

in San Francisco.

Please feel free to pm me or ask me any questions. I've tried to clear up some misconceptions upthread but if there are any other concerns....

[nobodyspecial]

47. I'm glad someone's gift was able to help your sister

I the deceased's family and friends find some comfort in that.

[w8liftinglady]

48. bless your sister... and her donors

I felt the same way when I prepped a patient to donate organs...and when I prepped my CF patients to receive them.Now I take care of post-liver and kidney transplants.I am PMing you

[riderinthestorm]

49. Wow!! Can't wait to hear from you!! My sister has had a terrific experience in San Fran

Her doctors were great but of course it's the nurses who really are the stars for post-transplant patients.

I just got back on Wednesday after being there 2 weeks. She has to stay in San Francisco for at least a month post-transplant for very close observation so I got to do the fun stuff! Find an apartment and get it ready while she recuperated at the hospital. Then bring her "home" for the rest of her recuperation. What a trip!

You are an angel if you are part of a post-transplant team

[w8liftinglady]

51. Our fresh transplants were challenging!

I still run into them and their parents sometimes. We always hug!

[riderinthestorm]

55. Yup, always a hug and most likely tears I presume (sniffles for me here).

Scott, our (okay, hers but honestly we ARE her support group!) transplant coordinator RN, is also a member of a donor family. As he was going over the details for our departure from the hospital, he got to the part about writing to the donor family. I got teary and so did he! 2 years post transplant for his family....

Of course the prednisone has my sister in tears daily. Heh. But it's just this big dramatic event, for everyone... there really aren't words for it all. A real life changer.

[liberalhistorian]

50. You "can't imagine why anyone would choose not to do so"?

I totally agree that it's the right thing to do, that the paranoid fears surrounding it are urban legend bullshit, and I very happily not only am a listed organ donor on my driver's license, I've also made my wishes very clear to my husband and family, since they will be the ones who will ultimately make such a decision should it come to that.

HOWEVER, it is NOT up to you what someone else should do in that regard. People have the right to do as they wish with their own body and if they choose not to do so then that is their choice and their right and they should not be judged or, worse, punished or ostracized because of it, nor should they be subjected to sanctimonious lecturing. That NEVER works for anything. An educational campaign explaining the myriad benefits, showing how recipient's lives can be saved and forever changed, explaining that too many people who could be saved die while waiting for organs due to a lack of donors, and debunking all the urban myth bullshit surrounding organ donation would do far more good and have a far strong effect. But no one should EVER be forced or required to be a donor. It is and should be ultimately their decision.

[TheWraith]

65. Maybe you should respond to what I actually SAID?

Would you care to point out exactly where I suggested forcing people to be organ donors? Or would you rather apologize for imagining I said that?

[Dawson Leery]

52. As long as the system is

opt-in.

[The2ndWheel]

60. Their body, their choice

[davsand]

61. I am an organ donor and I have been very outspoken with my family about it.

If I'm at the point where the docs don't think I'm viable any more, then, by all means, give away anything I have left that is still gonna be of use to somebody. I can't think of any better memorial for anyone than to be remembered for the gift of corneas, kidneys, heart, lungs, skin, bone--the list goes on...

I had a family member who suffered a heart attack that severely damaged his heart. His only options were a transplant or a coffin. He got lucky because a donor match came up in time. Harold was a retired fire chief (he'd been Fire Chief at an Air Force Base) as well as the local volunteer fire dept. Chief. As a result of his transplant, he and his wife enjoyed 17 more years together. He lived long enough to see one of his his grand daughters graduate from college and start to work in medical research (ironically enough in transplant technology) and the other in pre-law.

How could anybody deny that kind of gift?



Laura

[geardaddy]

64. As an organ recipient, I appreciate your post.

Granted I got a living-related organ, but there is no reason to not be a donor, unless, like you said, there is a communicable disease involved.

[Demonaut]

68. calling dibs

[dotymed]

70. What about the fact that people are charged

huge amounts of money for an organ that was donated, free of charge? The organ procurement business is a huge, for profit business. Let's say that a kidney that you donated, goes to a patient in dire need. That patient is charged tens of thousands of dollars for that "free" kidney. At current rates, I believe a donated (or harvested, not donated) cadaver is worth about $500,000. That is definitely not the cost of removing the usable parts. that is why so many funeral homes and/or crematoriums are caught selling body parts. Bones, tendons, etc..at horrendous prices to medical procurement business'. That is why I am not a donor. If I knew that I could help someone without enriching a ghoul, it would be different.