Organ Donation Opt-in or Opt-Out That Is the Question

2 February 2017

Organ Donation Opt-in or opt-out that is the question This assignment will help us explore and understand the concepts of both the opt-in system of organ and tissue donation and the opt-out system, which I will compare and contrast through looking at both systems used in different countries throughout Europe. And also I will look at how they relate to beneficence and non-maleficence.

The opt-in system is based on the view that every person has a choice whether or not to go on the organ donation register, and in this system of donation in most cases the family or another person close of the person who is dying will have the last say whether or not any organs or tissues can be taken. There is then the opt-out system or presumed consent that works on the premise that unless you state that you do not want to donate tissues or solid organs, they can be taken without consent, in most European countries that have this system of donation the families are consulted before any organs or tissues are taken.We will also look at my views and beliefs on organ donation at the start of the essay and how I have come to have them; I probably have a very beneficencial view around the subject, as I would like to think when I die someone else may benefit from my gift of donation. With my old views taken into account I will then strongly critique them, and with an open mind look at the whole picture to see which system I think would be the best option in my opinion, my views may well stay the same as when I first started.Then when I have looked at both systems in depth and got a greater understanding of how they both work, I will try to offer a reflection on how my views, and if they have changed I will convey how this has come about. Whilst looking at the opt-in and the opt-out systems, we have to bear in mind that both are there for the same reason and that is the saving of lives through donation.The UK and other countries around Europe, Germany being one use the opt-in system, which uses the medium of advertising to entice and prick the conscience of people to join the organ donor register (ODR), and as this may be a very good way of attracting new members onto the (ODR) people still seem not to join, this may sometimes be put down to forgetfulness or just to the fact that a lot of people just do not want to think about dying.

Organ Donation Opt-in or Opt-Out That Is the Question Essay Example

This does seem to be a major stumbling block where getting people on the (ODR), is concerned.This does leave close relatives with big decisions to make at a very traumatic time. A survey was undertaken in 2007 in the UK and showed that 70% of people that were asked if when they died would give their organs or tissues for transplantation but only 20% were on the Organ Donor register (The Guardian). This seems to show that the opt-out system would probably work better in this country as it would not really matter if they forgot to join the register.In most countries that use this system, families or a close friend would still be informed and their opinion would be taken into account, Spain being a good example of a country that uses the so called soft opt-out system, there system lets the family play a big part in decision making at the time of death and their views are taken into account, this seems to work well for them as they have the highest number of donors with 33 deceased organ donors per million population.Eurobarometer European and Organ donation (2007), They have had this method of donation since 1979 and the director of national transplant organisation in Spain said the number of donors is not all down to the opt-out system, there was a large increase in donation in the 1990’s and this was down to the implementation of national procurement system. (NHSBT).

There are then countries like Austria that have a more hard line hard opt-out system, this is where the families do not get asked their opinion, the organs are taken unless the dying person has raised an objection and opted out. This can be a mine field because sometimes not being on the register can mean the diseased did not have a full understanding rather than being in total agreement with the policy put in place.At the beginning of this essay I had limited view around the subject of organ donation a lot would say a little blinkered, as my view is that when I had departed this earth my body could be used to help someone else, that meaning any of my organs or tissues could be used for donation, I was not on the (ODR) but have since joined it and have made my wishes 100% clear and now believe that if some accident was to happen to me, my wife would know what I wanted to happen to my body thereafter, but a more open conversation would probably be more appropriate with other family members and people close to me.As I am not a religious person, I have never even thought or took into account any other persons beliefs systems regarding the giving or receiving of another person’s organs into or out of their bodies, I now feel I must broaden my knowledge on this, there are numerous religions I have looked at in my research most of which do give consent for donation but have their own rules on how the procedure and for what reasons they can take place, here are a few. the Amish religion believe that they will only give consent for the donation of organs if the outcome was not in any way questionable, i. . meaning the outcome should be a success however a renowned authority on Amish law  John Hostetler contradicts this by saying “since God created the human body , it should be God who heals it”.

Burnard & Chapman There is then the Jehovah’s Witnesses who do not as a whole give consent for donation but would rather leave it down to the individuals own conscience, they do say though that if one of their followers do donate or receive an organ all the blood must be first drained out of it, as being a Jehovah’s witness blood transfusions are forbidden this is part of their law. Thetransplant network). There was one religion that totally refuses the give consent for either the removal or implantation of organs this was the Shinto religion, they believe that once the person is diseased their body is considered to be impure and dangerous and to take or receive an organ would be considered very bad luck, even dissection for medical education is classed as injuring the body and would not be allowed in this ancient Japanese religion. (BBC Religions).We can see through looking at other belief systems, that other people’s opinions and views have to be taken in account and looked into where organ donation is talked about, and it is not as straight cut as it can at a glance seem, my view as said above have been that of the utilitarian or beneficencial one and if my organs can help numerous people after my death that would be my wish, as if I was in need of an organ I would hope there was one there for me.I obviously wouldn’t want my organs to be wasted so a system that could speed things up at the time of death would probably be a better option, this seems to be the hard opt-out system, but at the moment there is no chance of this system being brought into the UK.Although the more family friendly soft opt-out system may become legislation in Wales shortly, ex-Prime Minister Gordon Brown stated in 2008 that it would be a good idea for the UK to use the opt-out system as the waiting lists are just getting longer under the current system, and as a number of other countries in Europe already use the opt-out system and we have seen the number of donors increase it would be an all-round better system for the UK ( BBC News Chanel).

Beneficence By definition the word beneficence meaning to do an act that would benefit thers, in the medical sense of the word, and especially when dealing with organ donation to act in a beneficencial way would be to donate an organ or tissue by having a donor card and after death the gift of donation could take place, or to donate while still alive, Kidneys are donated from live donors on a regular basis and both donor to donor can live a normal life. Non-Maleficence Non-maleficence means to “do no harm”, so non-maleficence in the respect of organ donation means that the outcomes of any procedure undertaken have to be of greater benefit to the person receiving them than damage that may occur.In the case of Mr and Mrs Srinivas, who were operated on by professor Nigel Heaton team of Kings college London, the experience of their son Mr AV Srinivas was that his father had been diagnosed with liver disease in 2002 and transplantation took place in April 2003 at the Global Hospital, a private hospital in Hyderabad India, the donor was his mother to which he had no problem, as all the information that had been given said that there should be no out of the ordinary risks or problems, they were not alerted to the lower success rates between adult to adult live donors, and that there is a higher success rates in adult to child donors.On the day of the transplant both were said to be fit to operate on, but within 48 hours of the operation his mother had a cardiac arrest and resuscitation took too some time leading to brain damage and now she is in a permanent vegetative state, then his father’s situation got worst and he died within two weeks of the operation, the death certificate said the cause of death was multi-organ failure due to fungal septicaemia.This shows non-maleficence is not always the case and “to do no harm” does fail sometimes it also shows that if the Doctors had given all the correct information that they should have to Mr &Mrs Srinivas or the rest of the family, it could of lead to different decision being made, thus leading to the death of one and permanent vegetation of another.This shows that even though the Doctors started out with the all good intentions and “no harm” was intended, things can go wrong, ethically the Doctors were wrong not to give full and easy to understand information should have been given so the families could have come to the right decision for them . ( Living donor liver transplantation.

Indian Medical Ethics Journal). ReflectionMy views at the beginning of the essay, was that I definitely wanted to donate my organs and this has stayed the same, the only change I would make is, that I would change the system we use in the UK to the opt-out system, as I think the opt-out system would help free up more organs for donation, I would use the soft opt-out system though as I think ethically it would be a good idea to ask the family about their views at the time of death.Conclusion This assignment has help me explore and understand the concepts of both the opt-in system of organ and tissue donation and the opt-out system, which I have compared and contrasted through looking at both systems used in different countries throughout Europe. And also I have looked at how they relate to beneficence and non-maleficence.As we have seen the opt-in system is based on the view that every person has a choice whether or not to go on the organ donation register, and in this system of donation in most cases, and that the family or another person close of the person who is dying will have the last say whether or not any organs or tissues can be taken.I then looked at the opt-out system or presumed consent that works on the premise that unless you state that you do not want to donate tissues or organs, they can then be taken without consent, in most European countries I found that the countries that use this system of donation the families are consulted before any organs or tissues are taken. I also looked at my views and beliefs on organ donation at the start of the essay and how I have come to have them.

With my views taken into account I then strongly critiqued them, and with an open mind looked at the whole picture to see which system I think would be the best option in my opinion, my view has stayed the same as when I started the essay as I think the opt-out system would help free up more organs for donation. Then when I have looked at both systems in depth and got a greater understanding of how they both work, I will try to offer a reflection on how my views, and if they have changed I will convey how this has come about. References

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