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When Are You Dead?
Hugh Pickens writes "Dick Teresi writes in the WSJ that becoming an organ donor seems like a noble act, but what doctors won't tell you is that checking yourself off as an organ donor when you renew your driver's license means you are giving up your right to informed consent, and that you may suffer for it, especially if you happen to become a victim of head trauma. Even though they comprise only 1% of deaths, victims of head trauma are the most likely organ donors. Patients who can be ruled brain dead usually have good organs, while organs from people who die from heart failure, circulation, or breathing deteriorate quickly. But here's the weird part. In at least two studies before the 1981 Uniform Determination of Death Act, some 'brain-dead' patients were found to be emitting brain waves, and at least one doctor has reported a case in which a patient with severe head trauma began breathing spontaneously after being declared brain dead. Organ transplantation — from procurement of organs to transplant to the first year of postoperative care — is a $20 billion per year business, with average recipients charged $750,000 for a transplant. At an average of 3.3 donated organs per donor, that is more than $2 million per body. 'In order to be dead enough to bury but alive enough to be a donor, you must be irreversibly brain dead. If it's reversible, you're no longer dead; you're a patient,' writes David Crippen, M.D. 'And once you start messing around with this definition, you're on a slippery slope, and the question then becomes: How dead do you want patients to be before you start taking their organs?'"
... and I'm surprised that anyone is surprised by any of this. Frankly... If I'm braindead, or even slightly above braindead so that I can breathe myself, just kill me, mm'kay? There is no way in hell that I'll ever be "me" again. The "me" is dead, and that zombie-corpse-thing is not "me" anymore. Help others, save the financial cost and emotional burden to my family (even though I live in Europe, I expect the financial cost to be low... )... Take them, help someone. I am dead if my neocortex is not functioning correctly anymore.
Ahhh...the great dumpster continuum. Many a free computer will be found there. -- sowth (748135)
My wife is a physician and she is not an organ donor and when we got married she made me opt out of organ donation.
She did a rotation in one of the largest and most respected shock-trauma units in the country (University of Maryland) as part of her residency and says that as soon as they wheel somebody in with head injury trauma the team goes to work to save them but at the same time one member of the team starts typing the organs for possible transplant.
She says she won't sign the card because she doesn't want somebody trying to "save" her when there are hundreds of thousands of dollars involved if it goes the other way.
Two days after I proposed to my wife, she was t-boned on a major street. She broke both clavicles, cracked a couple ribs, and fractured her sacrum. Unconscious, she was airlifted to the hospital.
When she came to, her first mumbled words were, "Not dead yet!"
P.S. She recovered completely.
Okay, read that in whatever punny way you like but after seeing the prices organ donors' organs fetch, I want to be an organ donor but I want to be paid for it NOW.
The only one who doesn't benefit is the donor!! How wrong is that?! If I am going to be a donor and the medical industry is going to benefit from it, then they need to share that benefit with me. Sure. Put me on a health plan and require me to live within certain healthy standards. I don't drink that much anyway. I don't do drugs. I don't smoke. I don't run around having casual sex either... (not my choice really... I think I would if I could.) I'm a pretty healthy candidate all in all.
I know by my asking for this I'm setting myself up for one of the opening scenes from Monty Python, but I'm certainly not going to volunteer myself while other profit from it.
Seems more likely that there are medical reasons rather than cost reasons, perhaps wanting the harvested bits to be as free from anything that might cause complications in their next home as possible.
Boffoonery - downloadable Comedy Benefit for Bletchley Park
Meanwhile, if you don't have a card, costs are limited to the effort of bringing you back. In the event of the worst happening, they can keep you on life support and ask your next of kin about harvesting. Sucks for the people on waiting lists, but it's not like they aren't already cooling their heels.
Back when dialysis was first perfected, the machines were extremely expensive and only rich people could afford to be treated. And since that's effectively a death sentence to the very large numbers of people in end stage renal disease (ESRD), there was a huge fuss. In the end, Medicare was extended to cover the cost of treatment for anyone with ESRD. No age restrictions, nothing.
When kidney transplants became feasible they were also covered. So the notion that you have to be rich or have excellent insurance to get a transplant is just plain wrong.
This is not to say that the system isn't borked, but that happens long after the transplant. Specifically, once you have a undergone a successful transplant you no longer have ESRD, so Medicare coverage stops. But your need for anti-rejection medication does not, and it's expensive. That's a separate thing, and the guidelines for it were set back when transplants rarely lasted for more than a few years. So the rules say that Medicare pays for the medication for 36 months, then coverage ends.
As a result a not-insignificant number of people with transplanted kidneys are forced to stop taking the necessary medication because they cannot afford it. Their transplants fail, and once that happens they're back in ESRD and on dialysis. And their Medicare coverage resumes. Oh, and did I mention that the medications are expensive, they're still significantly cheaper than dialysis? So this is truly a case of penny-wise, pound-foolish.
One final note. The coverage issue was addressed by the health care reform bill, but that particular provision doesn't kick in until 2014.
Only those people who cannot be brought back to a fully conscious life. That, to me, seems to be a safe and conservative boundary. The life is lost anyway.
The same can be said about the old guy, the poor guy and about political undesirables. Hell, the same is said about young children with a mild mental handicap. (and that's not the only paper advocating such a viewpoint)
The other people on the waiting list will be very grateful.
This sentence mostly shows just how little you know about transplantation. The problem is not the amount of organs, but whether a donor can be found with a compatible immune system. For any given recipient, it is extremely rare that there is more than 1 good donor, likewise most available organs are never used for anything. This would be true even if everybody donated organs.
It is frightening how strong an opinion people can have when being ill-informed to such a degree.
So no, nobody on the list will be grateful in the least. If there is an organ that would match me, chances that it will match someone else needing an organ are tiny. So nobody will be grateful.
If you were terminally ill and could only be saved with an organ from the victim of a traffic accident, would you refuse? If not, then stop being a hypocrite.
Oh great, hyperbole. If you were terminally ill and could get better if you just had the doctors kill some unknown homeless person, would you ? Some mentally retarded kid ? Some usually comatose old guy ? A black woman perhaps ? An infidel ? A republican ? A communist ? There's plenty of people who argue those lives to be less than worthwhile. "If not, then stop discussing."
And for the record, if I was not sure about the circumstances in which said organ was taken, yes, I would refuse. For one thing, why would my life be worth more to the doctor than that of the guy they cut open for the organ in question ?