A change of emphasis.: Interesting... - British Liver Trust

British Liver Trust

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A change of emphasis.

cityman62 profile image
48 Replies

Interesting article on the news tonight.Wales is about to enter a opt-out rather than opt-in system re:organ donors.Its been in place in Belgium for some years now and kidney availability alone has gone up by 85% over the period,presumably that applies to the other major organs too.Terrible as it would be to lose a child/brother/partner-I think I would find it some consolation to see hope come out of personal tragedy. I hope it will be adopted across the U.K. soon.

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cityman62 profile image
cityman62
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48 Replies
briccolone profile image
briccolone

yes I think it's a possible game changer

cityman62 profile image
cityman62

Yup,it's such a brilliantly simple idea,nothing coercive,if its not your scene,just opt out.When I was well,I used to keep a donor card in my wallet in case I mowed my leg off of fell out of a tree or whatever,but you lose them,or forget to get another one etc.Sadly,I fear nobody would touch them with a bargepole now!

Yes, it is a system to be applauded but it would still need support and an infrastructure to help ensure that donors' wishes were not overridden by relatives. Spain has the same system but still need a robust transplant coordination service.

cityman62 profile image
cityman62 in reply to

Yes,true,this seems to be the Welsh governments position-'

He said the Welsh government had failed to explain the new system clearly, “including the fact that under the new arrangements family members do not have the right to stop organs being removed, even if it is against their wishes.”

The role and rights of relatives is a delicate issue. Family and close friends cannot overrule their loved one if they register their position. They can inform medical staff if their loved one objected to organ donation but had not opted out. The Welsh government says that if this happens then donation will not go ahead. But it insists the objection has to be based on the views of the deceased'.

RodeoJoe profile image
RodeoJoe in reply to cityman62

When I had my transplant a consultant explained to me that it can be frustrating when the deceased has opted in but the family have refused. He said at this point they do nothing. I suppose it opens up such a big can of worms.

I imagine whatever 'rules' or would it be 'law' is decided this would still be the case.

cityman62 profile image
cityman62 in reply to RodeoJoe

See my post above re: Welsh opt in system.The donors views are paramount,and not be overriden-either way.Which in my humble opinion-is exactly as it should be,whatever the system in place.

cazer profile image
cazer

I hope yhe english government follow suit..

I think perhaps we should write yo mr cameron and explain some of these awful liver conditions etc .cazer

briccolone profile image
briccolone

I dont think relatives should be allowed to overide someones expressed wishes-this was the strength of the donor card. Assumed consent could well be challenged.

RodeoJoe profile image
RodeoJoe in reply to briccolone

See what I said above, the family's wishes are still very much considered even in opt-in system.

RodeoJoe profile image
RodeoJoe

That is fantastic news. About bloody time, and the rest of the UK should follow suit.

Makes you wonder how organs are currently shared between England, Scotland, and Wales. Will higher priority cases outside of Wales i.e. England, and Scotland get livers from Wales?

Interesting...

cityman62 profile image
cityman62 in reply to RodeoJoe

Interesting thought,one would hope it would be based on need whether you live in Llandudno or Liverpool.Then again, unless there is a 2 way reciprocal arrangement in place,things could get messy...However,I would be incredibly surprised if this doesn't go U.K-wide fairly shortly.

PCBnPBC profile image
PCBnPBC in reply to RodeoJoe

organ donation is split into regions.

there is an overall UK (and Europe) wide last resort "net"

priority is by need (urgency) after of course best fit analysis

so Welsh organs could end up anywhere.

carmik profile image
carmik

Definitely a great idea should have been done sooner.

Also they must stop relatives overruling the decision that was made whilst the person was alive.

Would they allow you to over ride a will?. No ,it would have to be contested in Court . Therefore overriding a decision upon death is a BIG NO NO.

PCBnPBC profile image
PCBnPBC in reply to carmik

To allay this important point that you raise (over ruling doror wishes) it is ever so important that potential donors (even under opt out) explain and discuss their wishes with relatives, then (hopefully) relatives would not go against wishes of donor.

Further, more discussion, more heightened awareness is likley to increase donors in opt in areas.

RodeoJoe profile image
RodeoJoe in reply to PCBnPBC

Again I think education is the best method of encouraging this kind of discussion. Could this subject matter be on the school curriculum, in subjects such as life studies (6th form perhaps)? It would benefit both camps who either want to let family members know either way. It's also a subject that in my view is educational and thought provoking in itself.

Like other's have mentioned in other posts, the whole decision needs to be backed up with a fully thought out process to minimise conflict and encourage people to make the right decisions for themselves and relatives.

blackbeef profile image
blackbeef

A potential minefield, politically, ethically, religiously and legally explosive. Does the dead person still have Human Rights?

Thank my god I will not be the one to cause such likely dilema.

RodeoJoe profile image
RodeoJoe in reply to blackbeef

What do you mean? They can opt out if they strongly oppose the idea.

What do you mean human rights for a dead person? I don't think the dead are covered by the human rights act. If you mean does the dead body get treated with respect, well of course it would.

"Thank my god I will not be the one to cause such likely dilema." - What do you mean?

blackbeef profile image
blackbeef in reply to RodeoJoe

Let's say i am just playing devils advocate here. As far as me and my god are concerned, i can not have a transplant so it will not be an issue for any one else.

RodeoJoe profile image
RodeoJoe in reply to blackbeef

OK I understand. If you're not considering ever having a transplant you need not worry about the ethics.

blackbeef profile image
blackbeef in reply to RodeoJoe

No you do not understand! Firstly I am not able to have a liver transplant, it is not about my choice in the matter Secondly as for not worrying about the ethics, that is just like saying that as a man, I should not care about the ethics of abortion just because I can not become pregnant. I suggest that you put your brain into gear before engaging your finger!

RodeoJoe profile image
RodeoJoe in reply to blackbeef

Hmm, I see. Actually sorry no I don't, but I'm sorry if I offended you.

PCBnPBC profile image
PCBnPBC in reply to RodeoJoe

BlackBeef, I have no clue what you are saying. I am NOT being offensive when I say please can you explain what you are saying, it might be of interest as it appears to be a different slant on the subject, but I simply do not have a clue what you are trying to say......

cityman62 profile image
cityman62 in reply to blackbeef

I see no minefield Frankly.Respect the donors wishes/As a potential donor make your wishes known amongst your family.If you have an ethical objection-opt out.

PCBnPBC profile image
PCBnPBC

The message here in Wales (I believe) is clear, it is important to discuss with your next of kin, inform them you are up for donation if you are indeed in favour of being a donor. No one wants to RIP the organs out of a deceased person just because there is an opt out system in place, some decorum is applied!

Belgium has a rate of 27 doners per million (opt out system) Spain has 33 doners per million (opt out) UK has 13 doners per million (opt in)

see ibtimes.co.uk/organ-donatio...

Croatia have the most incredible success in about changing their organ donation from 3 doners per million to 33 doners per million in 10 years !!

See ncbi.nlm.nih.gov/pmc/articl...

I hope the Welsh opt out makes a difference and assuming it does that UK follows enmasse.

As Croatia demonstrates, it is more than passing a law, it requires public support and effort from the health service too.

We need to do our bit! do not be complacant join the facebook campaigns, and everywhere else that you can, together we can make a difference!

RodeoJoe profile image
RodeoJoe in reply to PCBnPBC

Yes completely agree. I think education also has an important part to play. Assuring people that their bodies will be treated with the respect it deserves if they decide to donate their organs.

cityman62 profile image
cityman62 in reply to PCBnPBC

While you can plainly see the (roughly)50% improvement in the figures you quote,I must confess I'm shocked at how low the figures are under both systems,best,Andy.

jules45 profile image
jules45

Hi cityman, I live in Wales and being a cirhossis sufferer I find the change a good one.

My ex partner wants to opt out though. Its up to the individual at the end of the day.

Just because my liver is not acceptable to donate, it means that other parts of me can help others so its helpful to me as I would like to donate.

Best wishes

jules

cityman62 profile image
cityman62 in reply to jules45

Hi,Jules,of course it's a personal thing.For myself I would find it almost impossible to come up with a reason Not to reuse my organs,but that's just me.I think it's similar to explaining to your folks what you want to happen in the event of you ending up in some sort of ghastly hopeless unending coma in intensive care with no real hope of resuming consciousness. I think the Welsh decision on consent is about right.The potential donor decides and their wishes must not be overridden.Best,Andy.

jules45 profile image
jules45 in reply to cityman62

Hi Andy, I agree with every word you said to me. My liver is unusable but my kidneys are fine so anything I can give I will give if the worse happens.

Thanks for your reply

jules

Very interesting thanks for posting. I am in US and we are very very far from such a policy, although advocates are talking about it.

cityman62 profile image
cityman62 in reply to

Thanks for responding,and Heres to a more enlightened New Year for us all! :-)

VanessaH profile image
VanessaH

I agree - British liver trust had a really good piece on radio 5 on this

Bermuda1 profile image
Bermuda1

I am possibly the devils advocate here. I have cirrhosis, and my father had 3 cadaver kidneys. I would probably opt out. Its a very personal issue, there is neither a right or a wrong here. I do however believe next of kin should still have some rights in this decision making process. You do not have to be religious, or against your culture to not which for any transplantation from a loved one. My son wishes for his organs to be used , I would not consent to this. Transplants are not always wonderful, and only the positive ones tend to be highlighted. There whole transplantation experience is very stressful on all the donor family, it is not an easy option. I too have very mixed feelings about ever needing a transplanted organ if it was needed. I am neither right or wrong, I know many who have had both ' successful' liver and kidney transplants and of course always hope it works out , and this option extends their life and the quality of it.

RodeoJoe profile image
RodeoJoe in reply to Bermuda1

What about if your son needed a transplant? Where would you stand on that? Would you let him know your view?

I don't know how old your son is but lets say he was dependant on you, would you then consider a transplant?

In my mind it's the same as politics, you have to consider yourself in every scenario and always have the same answer before you can make a decision on something like this.

Bermuda1 profile image
Bermuda1

I have a very open relationship with my son , and he knows my views. If he needed a transplant , I would discuss with him the pros and cons too.

Yes you have to consider each scenario, yet no one really knows how they would really react or their actual thought processes at the time until you are in that situation. That is why I think legislation needs opt outs and also to be over ridden in certain scenarios. I do not believe this ' great about time attitude' is not sensitive to all , each situation is different , and each person has their right to their own feelings. Is it really wrong for a loved one at a time of such intense grief to be unable to accept the transplantation of a part of the person they loved ? I said I would be devils advocate , well I see both sides and have indeed been very close to both sides. Therefore I have no right to stand in judgement of others. I am not in any way religious or influenced culturally in this either.

RodeoJoe profile image
RodeoJoe in reply to Bermuda1

But if religion and culture are not an influence what are the cons?

"and each person has their right to their own feelings" what about the right of the deceased?

I'm not trying to be confrontational, just trying to consider all sides. If you said religion then although I think you're making a mistake I'd fully understand your reasons. If you felt that after death it actually made a difference to the deceased, I'd get it.

RodeoJoe profile image
RodeoJoe in reply to Bermuda1

You see ultimately it is a decision that only you can make. However many people on this forum have made that decision, and have received a transplant or are waiting for one, or have a loved one doing the same. It's a subject most of us have had to consider and ultimately realise that should they need to receive or able to donate then of course that is what they would do.

I think it's an easy decision for the majority of us on this forum however my admiration of those that when a loved has died, takes that opportunity to make such a selfless act at such a personal time is amazing.

Bermuda1 profile image
Bermuda1 in reply to RodeoJoe

I too have great admiration for the many who do chose to have a close person or relatives organs etc to be transplanted. I am aware of many who have that choice from an alternative forum. I am also aware of those who will never be able to have a transplant for various reasons, and some who have chosen that is not the route they wish to take. I too if I am ever in need of one , which could happen , although my liver is presently stable, am undecided about what my personal choice would be . Not all people do think the same , and no I don't think you are being confrontational.

cityman62 profile image
cityman62

Woo,I hear what your saying,but,and its a big but,your sons body belongs to your son-not you.I cannot see-whatever your relationship to someone close to you,blood relationship or not,how you could even contemplate 'taking ownership'over their very being and bodily structure-if you follow that logic through,I think we go down a deeply troubling road,best,Cityman.

cityman62 profile image
cityman62

And really,following my thoughts through.If my son-or your son made it plain that in the event of a hopeless brain/bodily trauma that they wished to be switched off,and I/you betrayed that huge trust,that indeed,would be the ultimate betrayal of someone you love-placing selfish considerations before their wishes.

Bermuda1 profile image
Bermuda1

As I said I have no right to judge others on this , but nor do you. Its highly personal , and a loss such as this and the grief is a terrible thing.

I have succeeding then in playing devils advocate , and as you see there are indeed judgements made, which no one has any right to do so.

What I would actually do , I will never know until I am faced with that reality, but I am willing to keep an open mind , are you ?

cityman62 profile image
cityman62 in reply to Bermuda1

Unfortunately,your opening words rather betray you-'I have no right to judge others on this',I assume this includes your Son.....

Bermuda1 profile image
Bermuda1 in reply to cityman62

Remember I am not doing anything rather than challenging you . As I stated no one knows what they would do , nor do you, unless its your reality. Again city man you are standing in judgement. Your use of the word "betray" shows this.

I think we should leave it here , or would you rather continue ? Your choice , who am I to judge.

cityman62 profile image
cityman62 in reply to Bermuda1

As it happens,yes,I have been in that place,and yes I have had to decide,on someone I loved very deeply rather limited future,so to me me its not an issue for an 'interesting philosophical debate',God forfend,you will ever decide to deny your child a transplant,and also deny your child giving someone else a life. I find your arguments deeply flawed,also controlling-to your kith and kin,and you may be just having 'fun',but in your own way rubbish like this-ethical/moral/religious spurious arguments explain why a '123'choice,becomes a '123456789' choice-and then people die.Good luck to you-and your son.

cityman62 profile image
cityman62

No,I am not,my body belongs to ME,and your/my sons body belongs to THEM,your wishes,selfish concerns,are to me-and them,(given they have clearly communicated their wishes to you/me)are totally irrelevant-and worse,a sign that you don't care/respect their life/opinions/beliefs,so to me-therefore,if that's your idea of love,Frankly,I'd prefer to be an orphan.I'm not sure are you pursuing an indefensible argument on an intellectual level,or just arguing because its fun.This is what muddies the waters-its not rocket science is it?Donate/Don't donate/opt out.Simple?

cityman62 profile image
cityman62

Excuse the rant-leaving aside the bleeding obvious organ donor1/2/3 choice, let's go back,your nearest and dearest-oh,look,another 1/2/3 argument-worms eat their organs/you burn their organs/or their organs allow several other people a hugely enhanced life experience-you choose.But no,that's FAR too simplistic for some,ukking fell. Xx

A good read 😘😘 many of you will be to young but many years ago there was a programme called 'that's life' with Esther rantzen - I was quite young but they showed the story of a baby called Ben - he needed a liver transplant 😓😓 he unfortunately didn't survive - it was such a massive thing for me that I told my parents I will give anything when I am dead !!! And I have carried a donor card since/signed up etc - so just that one programme and story changed my feelings for life !!!!! Ironic that my husband would end up needing one 😅

Totally agree with whoever above said education of the kids - obviously our boys want to give everything !!! Because they know how important it is - as a nurse the majority would donate but not eyes ??? But for whatever reason don't get around to signing up etc xx

Just putting this out there - Rob had 6 offers from Aug to May - 3 in one week !!! Perhaps because of poor lifestyle choices nowadays organs aren't as useful ?? Maybe this brings down numbers ??? Also with uk being a diverse multicultural whatever - religions prevent from donating ??? I did a Facebook 'beg' before robs transplant and got over 20 new sign ups - but they knew our story 🤔🤔🤔🤔 perhaps a national 'story' telling like 'Ben' would work ???! And if anyone asks - they can have anything they want of mine when I am gone - I won't be needing it ❤️❤️❤️❤️❤️

PCBnPBC profile image
PCBnPBC

Gosh, Devils advocate...... I think the point where someone believes they own the rights of another individual is where the matter moves from a discussion on transplant and into another area.

Once 18 and a free man (or woman) no one else but me has the right to interfere with my right and legal choices.

My parents and children are included here.

If I want to opt in or out, and I am concerned my relatives might interfere with that descison I guess I need to attempt to ensure they understand my wishes, and I would hope they would accept my wishes.

I leave it up to each individual to come to their own choice.

I (as I guess most here) would be of the mind those organs are of no use to me once dead, but if they can save a life for someone else, please enjoy my organs, please look after them, cherish them, and I donate them with my love.

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