U.S. policymakers really need to follow this model and focus more on flipping the defaults with respects to many aspects of end-of-life care. Since most people fail to opt out of the default, the default rule should maximize benefit. But currently, our defaults (e.g. aggressive curative focused treatment) are not what most people want. Therefore, we have a high error rate in that many people do not get the treatment they want.
Following Wales, we would do better to make the default what most people want and/or what maximizes social welfare. Yes, that might produce some false negatives (inferring no desire for life-sustaining treatment from the patient's failure to opt out). But it would eliminate far, far more false positives (assuming the patient's desire for life-sustaining treatment when there really is no such desire).
In view of the MISUSE of DNR Code Status to CAP unreimbursed medical care and to hide errors. etc. here in the USA, you don't think this would be dangerous for patients in the for-profit hospitals of the United States?
ReplyDeletePatients are "product" for profit in the United States and so are the organs of the dead. Yet, you want to remove "informed consent" for harvesting these organs?
I understand how some people have been campaigning for an opt-out presumed consent system. Sadly they are very mistaken;that would be immoral and possibly destroy the voluntary donation system. In practice clinicians are almost never prepared to take organs without the involvement and support of the patient's family. Even some recipients are very reluctant to accept organs if they think the organs were not given by a real donor , someone who knew about organ transplants and registered a decision to give. To take organs from someone who has no family is to exploit their vulnerability (if they are dying and barely conscious) ,their ignorance ( because they didn't know about the law to take organs without their consent) or their vulnerability ( as drug addicts, alcoholics, living rough or mentally incapable people) . These people should be excluded from organ donation or presumed consent . What you are left with then is those whose families do not consent, usually because they don't know their loved one's wishes. So why do you need to introduce a law which is draconian,authoritarian, anti-democratic ,potentially using the law and force to take organs against the family's wishes but actually won't do so? It doesn't make sense.
ReplyDeleteOf course more organs are needed. But the country which has the highest rate of organ transplants in the world is Spain , which never uses presumed consent , doesn't have an organ donor register, and always asks the family, (and doesn't take the organs if there is no family present at the bedside.). In practice the voluntary donor system is working well, having reached the national target of 50% increase over the last five years.” The Herald recently reported that the number of people donating organs after death has risen by 50 per cent since 2008.” In Plymouth the rate of organ donation is one of the highest in the country. We can copy that success to everywhere else and so raise the figure to 80 % .Northern Ireland has already done that.
.I Wales the organ waiting list is falling,the number dying while waiting for organs is going down, and the number of transplants is rising .But it can be still improved even more by voluntary methods such as prompted choice , and by better publicity especially on television. We've hardly started to make the most of voluntary donation ; please don't spoil it now.For further information please contact me on michael.thomas17@btinternet.com
I understand how some people have been campaigning for an opt-out presumed consent system. Sadly they are very mistaken;that would be immoral and possibly destroy the voluntary donation system. In practice clinicians are almost never prepared to take organs without the involvement and support of the patient's family. Even some recipients are very reluctant to accept organs if they think the organs were not given by a real donor , someone who knew about organ transplants and registered a decision to give. To take organs from someone who has no family is to exploit their vulnerability (if they are dying and barely conscious) ,their ignorance ( because they didn't know about the law to take organs without their consent) or their vulnerability ( as drug addicts, alcoholics, living rough or mentally incapable people) . These people should be excluded from organ donation or presumed consent . What you are left with then is those whose families do not consent, usually because they don't know their loved one's wishes. So why do you need to introduce a law which is draconian,authoritarian, anti-democratic ,potentially using the law and force to take organs against the family's wishes but won’t actually do so? It doesn't make sense.
ReplyDeleteOf course more organs are needed. But the country which has the highest rate of organ transplants in the world is Spain , which never uses presumed consent , doesn't have an organ donor register, and always asks the family, (and doesn't take the organs if there is no family present at the bedside.). In practice the voluntary donor system is working well, having reached the national target of 50% increase over the last five years.” The Herald recently reported that the number of people donating organs after death has risen by 50 per cent since 2008.” In Plymouth the rate of organ donation is one of the highest in the country. We can copy that success to everywhere else and so raise the figure to 80 % .Northern Ireland has already done that.
.I Wales the organ waiting list is falling,the number dying while waiting for organs is going down, and the number of transplants is rising .But it can be still improved even more by voluntary methods such as prompted choice , and by better publicity especially on television. We've hardly started to make the most of voluntary donation ; please don't spoil it now.For further information please contact me on michael.thomas17@btinternet.com
I understand how some people have been campaigning for an opt-out presumed consent system. Sadly they are very mistaken;that would be immoral and possibly destroy the voluntary donation system. In practice clinicians are almost never prepared to take organs without the involvement and support of the patient's family. Even some recipients are very reluctant to accept organs if they think the organs were not given by a real donor , someone who knew about organ transplants and registered a decision to give. To take organs from someone who has no family is to exploit their vulnerability (if they are dying and barely conscious) ,their ignorance ( because they didn't know about the law to take organs without their consent) or their vulnerability ( as drug addicts, alcoholics, living rough or mentally incapable people) . These people should be excluded from organ donation or presumed consent . What you are left with then is those whose families do not consent, usually because they don't know their loved one's wishes. So why do you need to introduce a law which is draconian,authoritarian, anti-democratic ,potentially using the law and force to take organs against the family's wishes but won’t actually do so? It doesn't make sense.
ReplyDeleteOf course more organs are needed. But the country which has the highest rate of organ transplants in the world is Spain , which never uses presumed consent , doesn't have an organ donor register, and always asks the family, (and doesn't take the organs if there is no family present at the bedside.). In practice the voluntary donor system is working well, having reached the national target of 50% increase over the last five years.” The Herald recently reported that the number of people donating organs after death has risen by 50 per cent since 2008.” In Plymouth the rate of organ donation is one of the highest in the country. We can copy that success to everywhere else and so raise the figure to 80 % .Northern Ireland has already done that.
.In Wales the organ waiting list is falling,the number dying while waiting for organs is going down, and the number of transplants is rising .But it can be still improved even more by voluntary methods such as prompted choice , and by better publicity especially on television. We've hardly started to make the most of voluntary donation ; please don't spoil it now.For further information please contact me on michael.thomas17@btinternet.com
I understand how some people have been campaigning for an opt-out presumed consent system. Sadly they are very mistaken;that would be immoral and possibly destroy the voluntary donation system. In practice clinicians are almost never prepared to take organs without the involvement and support of the patient's family. Even some recipients are very reluctant to accept organs if they think the organs were not given by a real donor , someone who knew about organ transplants and registered a decision to give. To take organs from someone who has no family is to exploit their vulnerability (if they are dying and barely conscious) ,their ignorance ( because they didn't know about the law to take organs without their consent) or their vulnerability ( as drug addicts, alcoholics, living rough or mentally incapable people) . These people should be excluded from organ donation or presumed consent . What you are left with then is those whose families do not consent, usually because they don't know their loved one's wishes. So why do you need to introduce a law which is draconian,authoritarian, anti-democratic ,potentially using the law and force to take organs against the family's wishes but won’t actually do so? It doesn't make sense.
ReplyDeleteOf course more organs are needed. But the country which has the highest rate of organ transplants in the world is Spain , which never uses presumed consent , doesn't have an organ donor register, and always asks the family, (and doesn't take the organs if there is no family present at the bedside.). In practice the voluntary donor system is working well, having reached the national target of 50% increase over the last five years.” The Herald recently reported that the number of people donating organs after death has risen by 50 per cent since 2008.” In Plymouth the rate of organ donation is one of the highest in the country. We can copy that success to everywhere else and so raise the figure to 80 % .Northern Ireland has already done that.
.I Wales the organ waiting list is falling,the number dying while waiting for organs is going down, and the number of transplants is rising .But it can be still improved even more by voluntary methods such as prompted choice , and by better publicity especially on television. We've hardly started to make the most of voluntary donation ; please don't spoil it now.For further information please contact me on michael.thomas17@btinternet.com