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A new category of non-heart beating organ donor (controlled nhbd) refers to a patient who is in a vegetative state (not brain dead) who has life support withdrawn to allow cardiac arrest/death (doesn't always happen) to become a donor - Is it ethical?
http://www.lifeissues.net/writers/val/val_15organdonation.html
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=137443
http://query.nytimes.com/gst/fullpage.html?sec=health&res=980CEFDF1F3CF930A25757C0A961958260
http://sciwrite.org/sciwrite/sciwrite.weissarticle.html
The controversy lies in several issues:-
1. Proactive medical procedures eg. drugs, venous cutdowns, drips to prepare a patient performed without consent. These procedures are non-therapeutic and harmful to the already severely ill patient
2. Unethical because some patients who do not arrest have made full or partial recovery.
3. The limbo state of patients who unexpectedly do not arrest after ventilator is removed. Since the decision to stop life support is already taken, patient may simple be left without treatment.
4. NHBD is slippery slope of first expanding the definition of death(over brain death) then by allowing patients who are not in a permanent vegetative state (eg. poor prognosis) dependant on a ventilator to be nhbd.
Avicenna
06-17-2006, 19:09
This should go to the backroom.
To each their own, and unless the person states otherwise, I think the person's relatives should have the choice. Personally, I would want to donate above living as a vegetable, as there's no point whatsoever, you'll just consume resources and not be doing anything for ages. Your family will have a massive financial burden as well. If you believe in it, you'll get reborn later or go to heaven later, which can't be a good thing.
Ok. Can a mod pls move this to backroom?
To the Backroom and awaaaaaay!
(Oh, and don't cut out my kidneys without asking. Thank you bye.)
rory_20_uk
06-18-2006, 11:33
The controversy lies in several issues:-
1. Proactive medical procedures eg. drugs, venous cutdowns, drips to prepare a patient performed without consent. These procedures are non-therapeutic and harmful to the already severely ill patient
2. Unethical because some patients who do not arrest have made full or partial recovery.
3. The limbo state of patients who unexpectedly do not arrest after ventilator is removed. Since the decision to stop life support is already taken, patient may simple be left without treatment.
4. NHBD is slippery slope of first expanding the definition of death(over brain death) then by allowing patients who are not in a permanent vegetative state (eg. poor prognosis) dependant on a ventilator to be nhbd.
1) What proceedures are these non theraputic proceedures?
2) If they don't arrest then I thought there'd be no harvest.
3) If patients don't require ventilators they don't need one. It is a device that is not required, and does have its own mortality and morbidity. More tubes doesn't mean better treatment. So they're left. That's all the treatment they require.
4) That is a worry. Permanent vegetative state is a good cut off point though. Poor prognosis is much vaguer and is well on the slope.
I'm guardedly for it, but I'd like at least two consultants to make the choice, and probably some further oversight as well to ensure that everyone is above reproach.
~:smoking:
I had a another thread on the subject which disappeared.
What are your opinions on organ donation wrt presumed consent and non-heart beating donors? Italy/Spain have presumed consent while Canada and Britain are mulling on the idea. NHBD refers to a new method of increasing the donor pool.
http://www.lifeissues.net/writers/val/val_15organdonation.html
rory_20_uk
06-18-2006, 22:56
Look down the page slightly. You'll see it.
~:smoking:
1. Did you read the first link? The procedures as I said involved administering (possibly harmful) drugs like regitine/heparin which have no therapeutic value to the patient or witholding drugs which could interfere with the whole donation process.
Treating patients (before any request for consent) like containers of spare parts doesn't engender any trust from the public.
2. Basically Nancy Valko brought up troubling cases where patients were deemed hopeless(too soon according to established medical procedures) and set up for NHBD.
3. Valko says treatment is not resumed and simply left to die. I assume this is due to differing hospital standards on procedures after the unexpected happens.
Alexanderofmacedon
06-19-2006, 01:29
Oui, tis true.
Uesugi Kenshin
06-19-2006, 02:32
Presumes consent may anger some people, but I like the idea. Most people are pro-organ donation anyway, as are all major religions.
As a side note I have an organ donar card that gives up all of my organs should I buy the farm.
scooter_the_shooter
06-19-2006, 02:41
I have no problem with it....but I prefer to go into the ground whole thank you~;) call me selfish all you want, but when it comes down to it, it's my body
doc_bean
06-19-2006, 09:45
Here every person is a 'voluntary' organ donor, unless they get a special legal note saying they aren't iirc. Which probably has to be renewed every year :laugh4:
Also, I think we kill of our veggies a lot sooner than the merkins do it, I remember a lot of doctors here saying that Shiavo would have been terminated years ago if she had been 'threated' here.
rory_20_uk
06-19-2006, 11:44
American doctors get paid by the treatment, not treating. Veggies are ideal patients - little hastle, and can keep a bed for sometimes years. Oh, and require frequent scans, ECGs, blood tests etc etc just in case... :deal:
~:smoking:
Duke John
06-19-2006, 11:51
Perhaps interesting to discuss: should people who do not want to donate their own organs have the right to receive organs? Or is this already included when they have a note that they are not a organ donor?
Presumes consent may anger some people, but I like the idea. Most people are pro-organ donation anyway, as are all major religions.
As a side note I have an organ donar card that gives up all of my organs should I buy the farm.
I think two out of four of the worlds' major religions are only neutral on the issue of organ donation and probably all of them do not support presumed consent.
rory_20_uk
06-19-2006, 16:18
I think that a system where to get one has got to give is a good idea. Some countries already do this with such things as blood donation: to receive blood your family need to donate some for others.
I think two out of four of the worlds' major religions are only neutral on the issue of organ donation and probably all of them do not support presumed consent.
Well, they can go to their maker early, as they'd not be entitled to spares from doners.
~:smoking:
doc_bean
06-19-2006, 17:17
Perhaps interesting to discuss: should people who do not want to donate their own organs have the right to receive organs? Or is this already included when they have a note that they are not a organ donor?
Well, it wouldn't be really ethical for a society imho. That said, **** em, if you're not willing to part with your organs when your dead, you shouldn't expect someone else to do that for you.
Besides, I don't think any hospital here pays much attention to this 'card', when they get fresh meat and need to be quick to harvest, they're not going to wait for clearance...
:2thumbsup:
Perhaps interesting to discuss: should people who do not want to donate their own organs have the right to receive organs? Or is this already included when they have a note that they are not a organ donor?
They probably deserve a lower priority but cadaver bodyparts are also used in procedures for cosmetic reasons (eg. cosmetic augmentations). Should those recipients be bone/tissue donors as well?
Duke John
06-19-2006, 18:10
Yes, if you want a pretty face when the only thing left for you to do is lying in a coffin to rot, then you shouldn't be expect another person to make that "sacrifice" for you.
Of course that might result in people changing their donor status just before the operation, but at least it gives the right signal; society is not a one way system.
Uesugi Kenshin
06-19-2006, 18:43
I think two out of four of the worlds' major religions are only neutral on the issue of organ donation and probably all of them do not support presumed consent.
Well I doubt they support presumed consent, but I am pretty sure the major religions all support organ donation. I know I saw that somewhere....Then again that may have been on the organ donor recruiting poster, so it may not be the least biased source available.
Well I doubt they support presumed consent, but I am pretty sure the major religions all support organ donation. I know I saw that somewhere....Then again that may have been on the organ donor recruiting poster, so it may not be the least biased source available.
Muslims do not have a unanimous view on the issue although those in the west would probably support it. To Hindus, it is up to the individual's conscience. Buddhism has a similar stance.
Uesugi Kenshin
06-20-2006, 04:58
Comes close enough for me....And I bet the spiritual leaders would encourage it anyway. But I'm not going to pretend to know enough about that to debate it intelligently.
Anyway, I think it'd be better to have people get non-organ donor cards rather than organ donor cards.
scooter_the_shooter
06-20-2006, 05:13
Well, it wouldn't be really ethical for a society imho. That said, **** em, if you're not willing to part with your organs when your dead, you shouldn't expect someone else to do that for you.
I might consider it if I knew who would get it, but am not giving my kidneys to a stranger.
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