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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)
The real question is how fast will this thread deteriorate into a Monty Python quote fest?
Learning HOW to think is more important than learning WHAT to think.
"Even though they compromise only 1% of deaths [...]"
Comprise. The word is 'comprise'.
Spelling mistakes, grammatical errors, and stupid comments are intentional.
Interesting article, but I'm going to categorize it under scare-mongering. I'll accept the next to nothing possibility of being still alive while they take my organs, if that means saving other's lives.
"Computers are useless. They can only give you answers." - Pablo Picasso
Yessss! When my brain no longer works, I want to be asked if it is broken enough to consider me dead! Or, better, have my stupid relatives decide that!
Out of all the alternatives, I would rather rely on a doctor's decision.
Contrary to the popular belief, there indeed is no God.
At least one of the cases described in the linked article should be grounds for legal action, at the very least dismissal of these surgeons from their jobs. Case #2 seems a collection of mistakes and errors: was permission granted by or even asked from the family? Dismissing objections of one of the teammembers? Designated target dies before even receiving liver and the donor dies as well? I mean... this sounds like a case for a law school, not for medical school.
However... most donations are rigged with very careful procedures precisely because of all the legal pitfalls. Given the good it does to help with the mourning process of the family of the donor, and the good it does on the other side, there is a powerful drive to make sure we improve this procedure.
And also: more research on stem cells is desperately needed.
Therefore, by the (faulty) logic you're using, you're just a cow with a keyboard - osu-neko (2604)
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.
When you stop pounding at the inside of your coffin.
It's a very dark ride.
No it says A doctor does so, not ALL doctors do so.
I have a cousin who years ago was in a massive car accident and thrown through the windshield. Full coma and braindead. His family kept hope for a while and then had the plug pulled. Shockingly he kept breathing which seemed to give everyone hope. Here we are 15 years later and he is just as much brain dead as he was then but his direct family has been absoluetly through the ringer and his parents are absoutely broke. Looking back on what that has done to his family and what his quality of life is, I would absolutely say go ahead with the donation and make someone else's life better.
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.
"He's feeling much better."
"Flyin' in just a sweet place,
Never been known to fail..."
If on the DMV form you have an exclude checkbox for organ donation, 98% of population will donate their organs by default. So much for human psychology... as a society we are at a stage where we need make some conscious choices if supply is low we need to understand all possible root cause and try to fix them.
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.
They can have my organs when they pry them from my cold, dead... oh wait.
DUH! When Netcraft confirms it.
That's a lie in the article fabricated to shock. The cost of a transplant is $750,000, but they don't mention what that is, and then imply that's the cost of the organ. That's the cost of the doctors and drugs and tests and such to put an organ into someone, assuming the organ is free. Add $50,000 for the organ, and it'd move the cost to $800,000. Moving organs is expensive, and the article is written by an anti-transplant person trying to dissuade others from donating.
Learn to love Alaska
You sure? there seem to be a few brain dead posters still around...
That's the best explanation I've ever heard. "Dead" is simply the expectation that you're never going to be what we call "alive" again. Sometimes we're more certain than others. Run over by a steamroller? Yeah, we're pretty certain you're dead. Brain dead? We're pretty certain you're dead, just ever so slightly less so. Heart stopped? Ok, you're not dead, but you're definitely in danger of it if we don't get it started Very Soon Now.
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.
During the French Revolution, betting on how far a headless noble would get was a popular gambler's game.
"The ability to delude yourself may be an important survival tool" - Jane Wagner -
While you're right that the OP is probably a religious asshat trying to get his wacky agenda some air time, you can't deny the huge incentive hospitals have to declare someone "brain dead" who maybe is or maybe isn't or is maybe on the cusp, because they make $750K PER ORGAN harvested.
...
What nonsense. Organ transplants COST $750,000 to perform because they are difficult, elaborate, high-tech, risky procedures -- it can't be done for $5 grand by Dr. Nick. That money goes to a lot of expenses the hospital doing the transplant has pay for, large amounts of medical supplies, a lot of highly trained human labor, etc. And you realize, I hope, that this is not some profitable side-line a hospital adds on to fatten its bank balance. Transplants requires special certified, highly qualified teams that must pass rigorous certification. Many transplants are done in regional centers that specialize in doing them because it makes the transplants more successful (practice makes perfect) - these centers aren't medical casinos raking in dough.
Second class citizen of the New Gilded Age
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 ?