Up until now here in Germany we had a “system” that was a paper(!) card you put in your wallet if you were ok with donating your organs. That’s obvioisly not an ideal system and Germany has far to few donors. We now moved to an online system and being Germany it’s (as far as I’ve heard, I haven’t tried it yet - which might be a sign that this is not going to be a great solution) is super complicated and convoluted. So basically even worse than the piece of paper in your wallet (seems impossible but for Germany business as usual when it comes to anything digital).
Personally this would be one of the very few things were I would be ok with something being opt-out instead of opt-in but I don’t see that happening.
Apparently the paper card is still valid, there’s the online thing and you can also put it in you advance directive(? that sounds made up, I mean "Patient*innenverfügung):
https://www.organspende-info.de/organspendeausweis-ja-oder-nein/
How weird that it’s so different just over the border. Here in the Netherlands it’s opt-out and afaik it was quite easy to enroll when it was still opt-in.
Well, I can’t take them with me…
Here in Belgium everyone is a donor unless you register that you don’t want to donate your organs.
Same default settings in France, although your organs can only be used for transplant. Using them for teaching and practicing in medical school still needs your explicit (prior) consent.
No. Religious reasons
Just as a pro-tip, “No.” is a complete answer. You don’t need religious reasons.
I worked as a transplant coordinator, and we talked to a lot of different people from a lot of different religions. This is something I wish I could have said to everyone who ever told me no because of religious reasons: I really hope you don’t feel like you have to make up a reason.
We can start with, no organized religions specifically prohibit organ donation.
There are some religions, like Jehovah’s Witnesses, that probibit receiving blood transfusions, but organ donation doesn’t require blood transfusion, and the decision is left to the individual.
There are also some religions and folklore that believe the body must remain intact after death, but those beliefs are not consistent or particularly widespread. Some Shinto believers refuse donation to avoid angering the spirits of the dead, but that’s also an individual choice rather than an official position.
So when we would discuss how to approach people of varying faiths, it was important to understand the underlying reasons for objections to donations. It’s also important to recognize that, despite what is on your license, it’s really not up to you. The transplant coordinator is talking to your next of kin, and they will be the one making the final decision. If I’m talking to you about donation, it’s because someone close to you has died, and we’re not discussing your beliefs. We will discuss what they would have wanted.
Nine times out of ten, when someone would cite religious objections, they were not members of an obscure Roma group or Shinto practitioners. We do have a significant number of Jehovah’s Witnesses in our region, and our consent rates were roughly the same for those families. That might be different depending on where you live.
Far more likely for our region, people were using “religious reasons” as a social trump card that gives them an out without looking selfish. Donation is an uncomfortable concept for a lot of people, and you’re talking to them at one of the worst times in their lives. Not everyone is up for having that conversation, and any transplant coordinator will understand when someone says “no.” Still, a lot of people think they will get pressured to do something they aren’t confortable with, and will make arguments they think “win” the discussion in the shortest amount of time.
The key is, I’m not going to tell you what you believe. I’m not your spiritual advisor or religious leader. I can help navigate those waters if asked, but if you say you have religious objections, I don’t need to know what they are. You don’t want to donate.
When I spoke with families, I was advocating for the people waiting for a transplant. There are people living better lives today because I was able to persuade donor families to overcome their objections. My second priority was making the process as comfortable for the families as possible. It made no difference to me whether those objections were religious or personal. If someone wanted to talk about it, we’d talk about it. If they couldn’t, we didn’t.
Others have mentioned in this thread that donors are exceptionally rare. Few people die in a way that makes donation possible. So when they do, their families are presented a unique situation where they are in a position to help others. Most people will help other people when they can, but the ones that don’t aren’t lesser humans. It isn’t selfish to say that it’s too much, too painful, too disturbing to think about. Because it is. You’re in the acute phase of a significant loss. You do not need to justify your feelings, and you should not feel defensive about what you want for your loved one.
If you don’t want to talk to someone about donation, you can just say “No.”
That’s a shitty religion then
I think we can be a little more respectful in our disagreement no?
Just stating the obvious. If it’s really religion banning donating organs, not only do they take bodily autonomy from you but also the chance to help save someone else’s life. That would be a shitty religion
The religion can’t “ban” you, they don’t have governmental authority or a police force. The person chooses to participate and chooses not to donate. Unless they live in a particularly authoritarian theocracy it is likely this is a choice.
I disagree entirely with their decision but it’s important to not wildly mischaracterize it as not a decision. They can be an organ donor if they want and live their lives if they choose.
You actually can’t choose your beliefs. Either something convinces you or it doesn’t. They could choose to not live in accordance with their beliefs, or course, but that would be intellectually dishonest.
I didn’t say you can choose your beliefs. This person can decide if they want to adhere to the rules of a religious apparatus or not. Millions of religious people around the world do this every day. Most people even under the banner of a religious institution choose to ignore or downplay key elements constantly. See: Catholics who support a woman’s access to abortion. They are not in line with the church. They know this and choose not to be while still attending church and believing in most of the church’s teaching.
Most people do not adhere to 100% every rule and regulation of their faith. Believe it or not religious people are capable of nuance.
Did you not read my second sentence then?
Yeah I mean of course they (usually) can’t force you, but you’d go with religion’s guidelines because you trust on the authority and peer pressure, potentially also threatened with eternal damnation of some sort.
Didn’t say it was a fair fight
The religion bans desecrating corpses, which includes dissection. Donating organs while alive is Ok
I stand with my original statement, if the religion favors dead over the living.
I am curious, what are your religious beliefs on this? And would you be willing to accept a donated organ to save your life?
I am not sure why you are getting downvoted for answering the question. Yes, lemmy tends to have fewer religious people, but it’s upsetting that others are quick to downvote anyone expressing their religious beliefs. Personally I am agnostic, however I respect that everyone has the right to their beliefs.
I am - in the UK - and I think that it should be opt out rather than opt in.
It is, they changed it a while back.
I’d go so far as to say there should be no choice available to opt out
Wtf? The state doesn’t own our bodies.
Neither do you, once you’re dead.
How does it matter though once we’re dead? It’s only gonna help others in need
I think the vast majority of people who, even if they have some discomfort around the idea, would not care enough to opt out. The only effect of not allowing opt out, I think, would be to cause considerable distress to those who do care a lot about not donating. I don’t agree with their stance but I don’t think they should be forced to donate, especially if we can get enough organs just from making it opt out instead of opt in
No, I’m one of those weird people that because my family moved to the UK when I was little in the late 80s for work for a year I’m under risk of mad cow disease and none of us can donate blood or organs. Learned that the sad way when trying to give blood in college, like half a dozen random things that can disqualify you that you might not realize.
FYI, in Australia they scrapped the rule a couple years ago and you would’ve been able to donate now (at least blood, not sure about organs).
Wherever you are, maybe check again if they’ve relaxed the rule.
Unfortunately I am in United States of Freedom. Good to know though, thanks.
It looks like they lifted the ban in the USA too? If you’re still keen, do give them a ring.
You can donate your organs, if you die of a head injury. You cannot donate tissues like bone, skin, or corneas, because those are considered “life enhancing.” Donated tissue has a similar restriction to donated blood, so you’re right about that bit.
Organs like the kidneys, liver, heart, lung, pancreas, and stomach are “life saving” and don’t have any restrictions. When you die, you’ll be evaluated for any potential donation, and if you are a candidate for donating organs, someone will come talk to your family about it. Talk to your family about what you would want.
Jesus, that’s awful
Yes. Probably been registered for more than 10 years now. I’m in Sweden and it was a super easy online form to fill in.
If I die there’s probably someone else who needs my organs more than me.
I am not. HOWEVER, it is simply because my spouse will be the one to make the decision. Not that I don’t trust doctors, but it’s a decision my spouse and I talked about.
Your spouse or next of kin is always the one making that decision. Doctors don’t transplant organs unless the family is on board with the decision, regardless of what you put on your license.
Yes because why not. I doubt they will be of much use, but feel free to harvest anything you want. It would be the most useful I’ve been in my existence.
As a very strong believer in Danny DeVito’s quote, “When I’m dead, just throw me in the trash!”, if any medical party is even remotely interested in dumpster diving for my parts when I’m done with them, they can have 'em. Better than throwing them in a box and taking up land in a cemetary. The less of my remains uselessly taking up space on this planet after death, the better. If I get my way upon my demise, anything they don’t take is going into the incinerator anyway.
Sounds like a Frank Reynolds quote!
No. There are too many people on this planet.
- of course.
- i’ll be dead and won’t need them while others might. how selfish of me not to give them over
Yes. I’d like to donate my body to science too, but I want to see if there’s a way to do it non-profit. I’m not interested in helping make someone rich.
Lots of medical schools have programs.
Just so everyone knows, you can’t really transplant dead organs (at least not as safely or with the success of live organs).
They can only use your organs if you die in a hospital setting. They will keep pumping blood to your organs after you die to keep them “fresh” and “alive.”
Post-death organ transfer exists but is way more risky than an organ that was recently in a living, functioning body.
So if you’ve ever considered it, keep in mind that you have to die at a hospital for it to happen, and even then, they’re still technically forcing your body to be alive to keep these organs alive.
Source: Friend who lost his leg to amputation during a COVID-coma. They didn’t think he would make it. He woke up in the donor ward.
I worked as a transplant coordinator for a few years, and you’re mostly right, but there qre a few points I would clarify.
Dead is dead. All transplants are post death.
All of your organs need oxygen to keep functioning. When they don’t have oxygen, the cells die and the organ stops working, but you can be dead and have functioning organs.
When your brain is deprived of oxygen, the neurons stop firing and you’re gone. Dead is the irreversible cessation of brain activity. Sometimes organs can heal, but once your brain is gone, you’re dead.
Sometimes that happens because your heart stops beating. The muscle in your heart can also die, and it will stop pumping blood. This heart failure deprives your brain of blood, and then you die. When your heart is failing, you can stimulate the heart to keep beating and continue to live. But if your heart stops beating and you die, that is called a cardiovascular death.
You may also lose oxygen due to a failure of the lungs. Lungs put oxygen in your blood, and if your lungs fail, you don’t get oxygen to your brain and you die. This could be related to the lungs, the vasculature between the heart and lungs, or any combination of the three.
The liver and the kidneys work to filter the blood. If either of these fail, your blood can become toxic and poison your heart, your lungs, and/or your brain. The liver and kidneys also need oxygen to live, so if your heart stops beating or your lungs stop providing oxygen, then they will begin to die at the same time as your heart.
Like your organs, your muscles, skin, and nerves also need oxygen to live, and if you have trouble getting oxygen to your peripheral systems, your limbs can begin to die and become necrotic. Necrotic tissue creates a feedback loop of decay in your blood stream, and often requires amputation.
Covid affects both the lungs and the heart. Lung damage reduces oxygen in the blood, and heart failure reduces the flow of blood to the extremities.
Now, in the event of a traumatic brain injury, like a motorcycle accident, the brain can be killed before the other organs begin to die. The heart has a special mechanism that allows it to continue beating without input from the brain. These are ideal circumstances for organ donation, because the donor has died but their transplantable organs are in good condition.
It might be different in other countries, but in the USA, there is a network of transplant professionals that work together to procure and distribute transplants. They work with the hospitals to identify potential donors and talk to the families about donation options.
The hospital would call the local organ procurement organization every time any patient had a traumatic brain injury, even before they died. Patients would continue to receive treatment in the same area of the hospital by the same doctors and nurses. There is no “donor ward” and the only difference in treatment is that additional efforts will be made to keep the transplantable organs alive.
The patient’s doctor wants to keep their brain alive along with everything else, and they only stop trying when it becomes impossible to succeed.
So, while I’m sure that your friend really did experience the loss of a limb, and I’m certain the OPO had dispatched a transplant coordinator to evaluate your friend for donation, there’s no way the family was approached for possible donation without a dire prognosis (or maybe they asked). The approach would have been in the same conversation where they discuss withdrawing care because there is no hope.
The doctors and the family may have mentioned that they had discussed donation to demonstrate how dire the situation seemed, and how close to death your friend was, but they would not have altered his care at all or moved him to a special section for donors.
ICU PA here who frequently deals with all of this. Amazing information, thank you.
Would just like to add to the conversation that tissue like corneas can still be donated in even circumstances where other more sensitive organs are nonviable. Please correct me if I’m wrong!
You’re right, same with bone and skin.
Hey that’s something! Maybe all this moisturising will pay off
Now, in the event of a traumatic brain injury, like a motorcycle accident, the brain can be killed before the other organs begin to die. The heart has a special mechanism that allows it to continue beating without input from the brain. These are ideal circumstances for organ donation, because the donor has died but their transplantable organs are in good condition.
This is why they call them donor-cycles! Also why early summer is peak donation time. Yay!
His parents both died of COVID while he was in the coma. While I’m sure you’re very correct in everything you’re saying, he was basically a “ward of the State” at that point, considering his “family” was now deceased. He was already on SSI when this happened, and his parents dying kind of fucked up a lot of things because suddenly he had an inheritance and Social Security cut off his SSI funding because now he had technically too much money to qualify.
That’s fucked up. It must have been horrible to wake up to all of that.
As a ward of the state, he would have been assigned a case worker who would have been in charge of his care and end of life decisions. The TCs would have still tried to find next of kin or any family that could provide consent (and a medical and social history). Besides the legal implications, there’s also a PR consideration. Transplant organizations are keenly aware of the public perception, and they will go to any lengths to avoid the narrative that the state killed someone to steal their organs. If there was a third cousin in Germany, they would have gotten a phone call before decisions were made.
Sorry to hear about your friend.
I don’t think knowing this fact should discourage anyone from choosing to be a donor, though. It just means that yeah, it’s unlikely that you’ll be in a position where they can use your organs when you die, but it doesn’t hurt to be put on the list just in case.
Iirc, I think a lot of organ donations end up being from people in motor vehicle accidents.
I did get to see one case where they harvested the person’s bones instead of their organs. Didn’t even know that was a thing. I’m not sure if they died in a hospital setting or not. Might be you get more time to harvest bones as opposed to organs?
Oh yeah, I hope I don’t dissuade anyone. I just hadn’t ever really deeply thought about it before, despite being a registered organ donor. It’s an interesting conundrum to me, because you need fresh, live organs, but you can’t reasonably take those from fresh, live people most of the time, so you need people who are literally on death’s door, who aren’t going to make it, to have their bodies kept artificially alive for the purpose of organ transfer. COVID was just a fucked up situation all around with not enough beds and so many people dying. My friend had a rough experience, but it’s hardly the norm.
Yeah I’m so glad that we’re not still in that disaster. I mean, I know COVID is still out there, but thankfully in much smaller numbers and we have a much greater capacity to treat it nowadays… especially without hospitals being overwhelmed.
I’ve seen cases where patients actually ended up getting lung transplants in an attempt to save them with COVID. I handled the diseased lungs and they were so bizarre looking.
Wow, I didn’t know about the covid lung transplants. If you don’t mind me asking, could you describe the covid lungs/how they looked different to healthy lungs? Just morbidly curious
Sure thing. It’s been a while and I’ve only seen a few, but I’ll do my best.
So normal lungs are puffy enough, and smooth and glistening on the outside. On the inside, they resemble a kitchen sponge. They are soft and pliable, and able to easily contract and expand to inhale and exhale air.
In these COVID lungs, the outside was very ragged and shaggy. They were distorted with a lot of contracted areas. When you cut into it, there was some residual spongy areas, but a lot of it was white, firm, and solid. Think of how you might get a gnarly scar on your arm from a bit cut. Except instead of just being a single scar, almost the entirely of the lungs are scarred and firm. They aren’t able to contract and expand easily anymore because of how firm and rigid they’ve become. And because they no longer have the spongy architecture, it means many of the airspaces are lost and there is far less areas for potential gas exchange.
So I’m not positive, but I’m fairly sure these COVID lung transplant attempts are primarily performed on younger patients after their body was able to clear the virus. It’s just that in these individuals, although they no longer had COVID, the resulting scar tissue absolutely destroyed their lungs. It doesn’t happen in every case thankfully…or even most cases, but when it does it’s a bit scary.
I remember one of my cases being a young pregnant woman who had to be put on an ECMO machine (artificially oxygenates the blood when your heart and/or lungs cannot). I don’t know whatever came of her, but I hoped she was able to go on and lead a relatively normal life.
You can read a bit more about this sort of thing here: https://en.wikipedia.org/wiki/Interstitial_lung_disease
Wow, that was really interesting. Thanks for typing that up
What does it even look like when you wake up in a donor ward? Was he a write-off and the doctors were just like ‘oh shit, he’s awake’? Do non-donors simply get disposed of instead of being brought there?
He’s older and it’s been tough to get explicit details from him, but yeah it sounds like because it was during COVID and beds for bodies were so scarce, on top of the fact that they didn’t have high hopes for him surviving (so many people his age with COVID just never made it), that they were keeping in there for simplicity’s sake. Anyway, it spurred me to begin looking into organ donation actually functions, and I mean, it makes sense, I just hadn’t really thought about it before that you technically have to have your body being kept alive to be able to donate the organs. A rotting organ probably isn’t very useful. That’s why it usually happens with terminal patients where the outcome is 100% they are gonna die. During COVID, with bodies piling up, and lack of open beds in hospitals, it at least makes sense to me that he would have ended up there, in case he didn’t wake up. It was pandemonium, at the time. Sadly, it seems to have kind of messed with his head to wake up in that situation, he’s a lot less trustful of doctors now.
If I’d walk up from coma with one leg less, I might lose my trust in doctors too…
It’s not the leg amputation, I believe, they considered him “as good as dead” when he went into coma. He knew he was getting an amputation. What he didn’t expect was that he would wake up to a nightmare of being prepped for his other organs to be removed.
I am and I hope to have everything unsalvageable cremated
