Presumed Consent

How have I derailed anything PECS? I stayed on topic. I was just drawing a possible parallel between what was being said here and what has been said in a different context.

The reality is that the same arguments are often applied in many situations.

Funnily enough I have just been giving my opinion on a few posters ( although you didnt come into my thoughts at that time - you have just aligned yourself there) who seem to think that they must control the thoughts of others by whatever means .

It puts people off. We all have a right to our opinions and last time I looked we all had a right to make choices concerning our own bodies without having to justify it. To try and sideline something because you do not agree is not nice. I do tend to say what I think.

I do not though demand that others agree , just that they are open minded enough to hear other views without the classic shutdown you have just used. .

ie " Go away and write somewhere else " ..... because that is what you have said effectively.

Back to the topic. I still will not donate my organs and in my opinion, opt out is one step to far and is without safeguards.

There are other threads for Brexit fury Abbey ..go to those rather than derail a different topic.

When you renew your driving licence online at 70, you have to complete a choice of two in order to get your licence.

The choice: I will agree to donate my organs after my death

or

I will agree to think about it later. There is no option to opt out completely.

Box9exchange - When did you renew your licence? I am not 70 but I had to renew mine nearly two years ago. There wasnt a couple of boxes like you suggest, just one to opt in or leave blank.

Is your experience more recent? Is it because you are over 70?

I am absolutely appalled that there is no option to say "No".
I had enough difficulty because I refused to tick the donation box ( got asked three times if I had made a mistake) but to put you in a position where effectively you cannot opt out is one step beyond in my opinion.

But I wasnt aware of this change at all.

that is why I think the choice a person makes when alive, and in sound mind, should trump next of kin or state wishes. So maybe not either / or but a definite choice either way needs to be registered.

I agree with that. I would also add that we need a system where there are checks to ensure your wishes are adhered to and respected.

Neither do I think people need to be asked for their reasons. It might be cultural or religious or it might just be a personal choice. Why does one have to justify a personal choice? What next? I am too thick, too uneducated, too stupid to know what I signed and I couldn't have really meant it?

In a country that can have a vote to leave the EU and then it can be overturned by MP's and those who didnt agree, what chance an individuals wishes when registered if someone wants something from them badly enough?

Unless of course you are suggesting by asking again and again that they have no right to make that choice unless it is the "right choice" - ie one you, the government and others in power agree with.

janea that is why I think the choice a person makes when alive, and in sound mind, should trump next of kin or state wishes. So maybe not either / or but a definite choice either way needs to be registered.

But neither do my relatives "own" my body post mortem so ,by that token should not , if I am over 18, be asked if my body parts can be used, especially if I have registered yes under the original system or am carrying a donar card
PECS I agree that your relatives don’t own your body, but if your relatives don’t own your body, then the State certainly doesn’t.
But no one is saying that relatives own your body.
When they are asked for permission to remove organs, they are acting as your proxy, in just the same way that if you were in a coma, they might be asked for your consent to discontinue life-support.
There is no guarantee in any situation that relatives will adhere to someone’s wishes.

I seem to have missed out in the above - next of kin has no legal status in this country, thats another thing that makes this move very dangerous - with the only safeguard in a soft opt out system being asking relatives.

But cynical me - any move that gets loads more organs is a good move whether the donor wants it or not isn't it? Whatever it takes in this country these days. I hope you enjoy the organs you get knowing they might have been taken without any consent at all. ( call me emotive if you like).

PECS - I have made it clear to all my relatives what my feelings are. I am fortunate in that most ( if not all) share the same view. Certainly those who should be asked as " Next of Kin" know. However, my experience of the NHS is that they look for the first person around and rarely ask if that person is next of kin and has any right to make a decision.

This is why I really do not like the idea of presumed consent at all. Unlike others who might say, well I am opting out but it doesnt really matter to me ( ie I am doing it on principle) , it really does matter to me. I dont want to be a donor ( even by accident).

An opt out system allows for far more accidents ( no one being found to ask, just not being asked and a glitch in a computer system where someone doesnt see a name are all issues with this.

Opt in at least forces the medics to find someone to ask or to check they have permission. But it is a waste of time arguing it. The state now own your body. Its been done.

I found out the other day that presumed consent has been removed from the statutes in Brazil after they had a lot of trouble and a lot of complaints.

But neither do my relatives "own" my body post mortem so ,by that token should not , if I am over 18, be asked if my body parts can be used, especially if I have registered yes under the original system or am carrying a donar card.
It is important that families/ friends talk about their wishes & make them clear when alivev so that in any traumatic situation bereaved are not having to make decisions for someone else.

On the issue of written consent though, I have a colleague who has had " I do not consent to organ donation" tattooed across his chest - seriously. he jokes about it and shows it off. But he says, he hopes that before they cut him open, they would see it.

NOT allow organ donation, so I forsee a lot of trouble if organs are taken without written permission

I can see a possibility of this too. I for one would kick up a hell of a stink if the organs of a loved one ( I cannot say myself of course as I would have been deemed dead) were taken because their name was not on some opt out register and the medical services managed to miss the fact there was a next of kin or asked the wrong person.....

Of course, it is moot because they will have got the organs and all that might be said is a (half hearted?) sorry.

Thats one thing that concerns me on a practical level. No opt out cards to carry, having to fight virtually to ensure the box was not ticked on my driving licence - I left it blank but someone else was so keen to have it ticked she asked me three times if I understood what I had done..... thats another concern, how many might cave in un der the pressure of being asked so many times or in a way that they feel they cannot refuse? Its pressure.

The who notion of presumed consent is in fact no consent at all. Consent is an active process - the act of saying yes (or no) if you have a system where the notion of saying nothing becomes consent, then you undermine the meaning of consent. There are many reasons one may stay silent. It doesnt mean they agree with something .

Some of the poster here seem to think hospital staff would see a living, sick person as just a collection of parts to be harvested. Do you really have so little faith in the compassion of nurses and doctors that a donor card or the presumption of permission) would mean you received poor quality care?

Well you see this is why I have a number of misgivings. Unlike some others here, I have had some very bad experiences with the NHS staff. Its not based on one experience, but experiences that exceed the fingers and thubs on both hands now. It has left me rather skeptical about any of it to say the least. But it has also left me worried and anxious about any contact with the NHS.

People do not go into nursing for the money, long holidays or glory but because it's a vocation and (to me) that indicates a caring nature, even if they do occasionally get grumpy - as do we all.

I know doctors and nurses are above criticism ( unlike teachers, police and politicians) but I would question this.
For some I think it might be just a job. I have met a number of younger people who have trained as nurses because it seemed like a good career move for them and have said so. Nothing to do with compassion.

I understand there are various religious and cultural groups who absolutely will NOT allow organ donation, so I forsee a lot of trouble if organs are taken without written permission

Some of the poster here seem to think hospital staff would see a living, sick person as just a collection of parts to be harvested. Do you really have so little faith in the compassion of nurses and doctors that a donor card or the presumption of permission) would mean you received poor quality care?

People do not go into nursing for the money, long holidays or glory but because it's a vocation and (to me) that indicates a caring nature, even if they do occasionally get grumpy - as do we all.

janeainsworth you are absolutely right.
It's the principle.
Opt-in is a better than opt-out.

No Abbey I do not have an agenda, but I do have some experience. And I also have feelings which you have disregarded in your broadside.

Of course, you presume I have no experience and no feelings? You are wrong.

Surely if you have reservations about organ donor consent you can just opt out, but the presumed consent means that many more people may benefit from a replacement part and enjoy better health and a longer life. I know that two people were able to see again, and two had heart repairs that enabled them to live a better life, all because a police officer asked if my husband had carried a donor card. In the shock of my husband's death on a road accident I was not thinking clearly and I would have felt very sad that l had not been able to fulfill his wish. When we lose someone dear it is a devastating time, so much better that presumed consent allows donation, none of us know when we may need a donation of a body part of some kind.

I don't feel that the state should feel it automatically has the right to take my organs unless I've trawled the internet and found a website to register my concerns (if any) . I don't see opt out cards in shops or surgeries.

Thats a really good point actually. Right now you can carry a donor card, have it put onto your drivers licence and if you trawl the internet you can opt in to organ donation. But as you say, the opposite has not been true.

There are no opt out cards.

You have to make a point of ensuring someone doesn't tick a box on your driving licence . I know about this because I was nearly "had" by it when I renewed my licence recently at the Post Office . The woman behind the counter asked me not once but three times if I was sure I did not want to tick the box to be a donor.

and .... when it does happen ( the legislation in England comes into force in 2020), you will indeed have to trawl the internet to opt out. This concerns me because it is all too easy for someone to miss a name, have a computer glitch and your wishes are ignored pronto. Of course if ( or maybe when ) found out they will always be sorry and lessons will be learned but your organs will have been taken by then.

Its not a good system. I would indeed get a " I will not be a donor" card if one were available. Yes, I know nearly all of you feel the opposite .

I could carry on and on explaining the principles of the thing , not to mention my own views but I will leave it at that.

I have no argument with that janea but the wishes of the donor card must remain paramount and grieving relatives should not be allowed to overrule that consent as has been known to happen.
Such decisions need to be taken in a calm and considered way as few grieving partners/children/parents are going to be in a frame of mind to take that decision, nor should they be obliged to.
However, (and this is not directed at you) hysterical old wives’ tales or urban myths about doctors not doing their best for a patient because they want their organs must be firmly banged on the head. As indeed comparison with holocaust victims, gold teeth, jewellery or other “Brave New World flights of fantasy.
It is a serious subject and deserves rational discussion.
I for one trust our NHS and comparisons with Mexico or Third World countries are never helpful.

PECS as jane10 keeps saying, it’s not about organ donation and whether it will or will not increase donation rates. It’s not about staff working in transplant units and how they feel about the issue.
It’s a simple matter of principle - who owns our bodies.
It should not be assumed that just because consent has not been withheld, ie someone has not opted out, that consent has been given.
It’s as simple as that.

Janea Happy to be wrong on this but I understood that one of the reasons for 'opt out' rather than 'opt in' was because those with experience of working in trauma departments and those working in organ donation felt it would be a more humane way to work, not less!

In other words research had led them to believe that most people would be happy donate and fewer would opt out. But people just never got round to opting in because they did not feel strongly that it would never apply to them anyway. Whereas by actively saying NO when alive made it easier for medical professionals to know when to /not to approach families for permission. I did not understand that ultimate permission was being removed.

No janeainsworth it doesn't. Ah well. It seems that you can't make people understand a point of principle.
Wonder what will be done next by the state 'for our own good'? . People can't say they weren't warned.

People’s wishes will be respected though, if you care enough then you will have opted out, the patients wishes are not respected at the moment as family can veto it or indeed agree to it against the patients stated wishes.
That family may have had nothing to do with the person in life and indeed be estranged from them but have the final say on donation.
Surely everyone can see that this has to be wrong?

jane10 that brick wall doesn’t get any softer, does it? Your head must be aching by now.
I agree with you anyway.
I don’t want to opt out. I think organ donation is a good thing.
But I don’t understand how when medical staff have to go to great lengths to get valid, informed, written consent for even minor procedures like having a tooth out, suddenly, because someone is dead that all doesn’t count any more and the person’s wishes and those of their next of kin don’t have to be respected.

My point is again that it is surely more positive to opt in than opt out! I don't feel that the state should feel it automatically has the right to take my organs unless I've trawled the internet and found a website to register my concerns (if any) . I don't see opt out cards in shops or surgeries.
I just don't like it. Its the principle of it I'm uncomfortable with.

But as long as the "opt out" option is made very clear and is well publicised before it is introduced there will not be presumption. People will have opted out.

By better information and more dedicated staff (as I said earlier) donations have risen in the UK without this legislation. And conversely, in Wales, where it has been adopted, no such increase has been shown. It is only showing where staff are pro-active and specially trained.
If you want to increase the gifting of organs you obviously don't do it by legislation, you do it by having more trained specialist nurses.
This seems to be a win win.