h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

http://news.bbc.co.uk/1/hi/health/4762923.stm

I'm shocked that the rate is so low - only 12 people per million that die permit (or their families permit) their organs to be used for transplantation Why is this so low? Do people still not like the idea of it for themselves? It seems that many families are refusing in spite of any wishes expressed by the deceased.

Can anything be done to improve this? Is it time to seriously push an opt-out system rather than an opt-in one for organ donation?

I remember writing a paper on this at university in my final year. I was trying to way up the ethics of using a hypothetical genetic engineering of pigs to harvest organs to supplement an opt-out policy for organ donation

I thought then and I think now that an opt-out is the way to go but I am not convinced that will provide the supply to cover the demand for such a succesful surgical invention given especially, as was in the news recently regarding bone marrow transfers in in ethinic minorities, the variations in population for compatability.

I suspect there will never be enough doners so alternative resources must eventually also be considered.

It's not per million that die it's per million of population. I have no idea why they count it that way though.


It'd be useful to know if it's the rate of people that consent to donate if they die, or the rate that actually get used (the former will be higher).

In the UK can family refuse consent if someone has given consent before death?

*fails to understand what the numbers actually mean* Very odd way of counting it indeed.

In the UK a family can say no, even if the deceased had an organ donation card or was registered on the dontaion website.

>>>>
"The study looked at the possible number of donations from deaths in 284 hospitals throughout the UK.

The maximum achievable potential donor rate during the two-year study period was 23.2 donations per million population per year.

"Intensive care units are extremely good in considering possible organ donation from suitable patients," the researchers said.

During the study, families of 94% of patients who could have been organ donors were approached for consent to donation.

Relatives' reasons

A total of 41% of the families denied consent. "
<<<<<

It doesn't say how many of the 41% were going against the wished of the deceased person.

There must be some people that die in ways (or with dieseases) that prevent them from being candidates for donation, but for the rest, an opt-out system would help.

Should families be allow to overrule an expressed wish?

They measure it like that because the actual measured statistic was that 41% of families asked refuse consent for the use of their deceased relative's organs.

12 per million of population sounds a lot more hysteria and news worthy than 6 out of 10.

It isn't 6 out of ten though, it is six out of ten that were eligible which might only be one out of ten (or less) that actually die.

There should not be an opt-out system. It is my goddamned body, and I decide what will be done with it.

>>>
There must be some people that die in ways (or with dieseases) that prevent them from being candidates for donation, but for the rest, an opt-out system would help.
<<<

I don't believe everything I see on TV but on an episode of House the other night the rate of unusable donors was surprisingly high (something like 60% of hearts get biffed because there is something wrong with them).

It'd be useful to see the rate of donation, the rate of useful organs, and the rate of family non-consent, it we want to make sense of it all.

>>>During the study, families of 94% of patients who could have been organ donors were approached for consent to donation.

>>>A total of 41% of the families denied consent.

Now, when you look at those stats the 'X in a million' tagline seems a little sensationalist!

So, 59% of all possible deaths are generating organs.

Ok, could be higher, but I'm not sure there's much you could do to _greatly_ increase it without legislating - and that'd be a seriously bad move.

oops, delayed simulpost there

How about a system whereby you wouldn't be entitled to an organ, if you hadn't been a registered donor for the last five years, at the point when you need one?

This would give an incentive to opt-in, allow for a prioritisation of organs on as fair a basis as any other, and still allow those who feel very strongly about opting out to do so.

Would that change your mind, Xanatic?

sprout

"It isn't 6 out of ten though, it is six out of ten that were eligible which might only be one out of ten (or less) that actually die."

No, it is 6 out of ten families who were asked gave consent. It isn't about the patient as much as the consent given.

The 6 out of 10 is the comparable statistic to the 12 per million population. 6 out of ten is what was measured.

Presumably, a lot of the people that die are old and have organs that are worn out so not suitable to be transplanted, similarly, the younger but diseased are also excluded. This means that the pool of possible donators is quite small so doing anything that will increase the numbers that go ahead is a good thing - I agree with Clive that alternatives should also be sought though (doesn't that slide over to the realms of the animal testing thread ?).

I think that 12 per million of population measure is pretty much meaningless because it doesn't tell you how many per million were eligible (and how many were not).

Some additional stats would be useful to inform the debate, but as I said before if 60% is still quite a small number of donatable organs then trying to increase that nearer to 100% is a good idea.

The article also says that for ethnic minorities the refusal rate rises to 70%, does anything specific need to be done to improve that?

Not all cultures have the same values around death, illness, bodies etc as the British.

The 12 per million is indeed a meaningless measure, which is why I mentioned this in my original posting saying *why* they used that particular measure and not the clearer one I mentioned.

I seem to recall various one-off calls for ethnic minority donors when some specific case gets highlighted. But in general the media gives the impression that the Donor card and concept still has a lot of inroads to make, especially in minority communities.

kea: not even all the British have the same values around death, illness and bodies.

If it changes my mind? I'd say I would agree with such a move. But I would still oppose an opt-out system as mentioned earlier. The state does not own my body.

And as regards using animal organs, I think that idea has more or less been scrapped. I think they are too worried about diseases crossing over the species-barrier.

Fair enough Ictoan

Although the term 'ethnic minority' does encourage the use of generalisations about the British (I probably should have used 'anglo-saxon')

So what are the predominant values around death, illness and bodies amongst the anglo-saxon British?


What I'm seeing here from some people is the assumption that organ donation is always good and that refusal to donate organs is somehow morally deficient. If we are then going to start disussing other ethnicities I think we need to understand our own first.