UK: Organs from Drug Addicts Used in Transplantation--Excuse for "Presumed Consent"
This isn't good: In the UK some organs have been transplanted from drug addicts and cases of drug overdose because, allegedly, cases were desperate. And the answer to this disturbing bit of news? "Presumed consent" to organ donation. From the story:
Hundreds of below standard hearts, lungs and kidneys have been taken from drug addicts and transplanted into critically-ill patients, The Daily Telegraph has been told. Three per cent of the organs transplanted into patients in the past five years came from donors with a history of drug abuse--some of whom died from an overdose--figures obtained under the Freedom of Information Act have revealed.Yes, well there is a big problem with informed consent in a utilitarian, ageist, and health rationing milieu like they have in the UK. If you get seriously injured, particularly if you are not expected to regain full cognitive functioning, some doctors might look at you as if you were a mere collection of organs that others could make better use of than a patient with full equal moral worth. And, in the UK, they have futile care theory already in the law, which could profoundly add complications to the issue.
One transplant surgeon said doctors were "desperate" for organs and had to use some they would otherwise have rejected. The findings sparked renewed calls for a change in the law to presumed consent--in which everyone is included on the organ donor register unless they specifically opt out.
I debated this issue on the BBC a few months ago and the organ physician I was up against really did not want to talk about futile care as it applied to the issue. Time did not permit us to get into it deeply, but before this proposal gets through Parliament, which it will unless something is done, somebody had better bring it up!
Presumed consent might pass muster in the UK where people are less individualistic and there is a greater sense of the collective. But it would never wash here in the USA--at least if it were clearly discussed. Bioethicists and members of the medical intelligentsia know this, of course, and so they are already busily thinking up the euphemisms to use to get us to swallow presumed consent--as in this paper which spends much time urging that the term be changed to "specified refusal" as a tactic to help get presumed consent laws passed:
Having a policy that can potentially increase rates of organ donation is not enough in and of itself. These informants who are involved in the creation of health policy, suggest that semantics and marketing are just as important as efficacy in influencing political feasibility.Yes. When our betters among the intelligentsia want to sell us their snake oil, they know that telling the clear and candid truth tends to harm chances of their getting what they want. So, they change the terms. After all, the great unwashed are obstacles to be gotten around rather than constituents to be convinced by candid and honest advocacy.
posted by Wesley J. Smith @ 8:13 PM
1 Comments
1 Comments:
You would think that after the scandal in 1999 in which several British hospitals admitted having retained tissue from long-dead children, the authorities there would not be so quick to push anything even remotely similar to "presumed consent".
You are correct that "specified refusal" is a horrid euphemism for implied consent. Now that increasing numbers of people worldwide know about the global black market in human organs, the harvesting of prisoners' organs in China, and other abuses, I predict that fewer people will opt in to donation, which will lead to more attempts to mandate implied consent. After such a mandate, people will then opt out in increasing numbers, not just in the US, but in other countries where that is already policy.
Brazil had to backtrack on its presumed consent law and repeal it, so I understand, because of widespread distrust of the medical system there. News stories have been widespread in Central and South America including Brazil that allege kidnapping of children to harvest their organs for rich patients in industrialized countries, with one Mexican story several years back claiming that a number of children's corpses had been found not too far from the US border minus their organs. An American woman was attacked and gravely injured by a mob in one Central American country a few years ago because the crowd thought she was there to steal children for their organs. In that light, the policy change attempted in Brazil defied common sense. Whatever the truth of the allegations of harvesting from kidnapped children, they have irrevocably tainted donation in Latin America.
In the US elements of the population likewise have a mounting distrust of the medical profession and its motivations, which is a reason that some families will override the wishes of an organ donor and refuse to donate after the donor's death. Some states have passed laws to prevent such overrides if the donor's intent was clearly stated before death. But as you note, any push toward implied consent here will run into increasing hostility from those who distrust doctors and hospitals, and they are legion.
News stories here such as the sale of cadavers' parts in the northeastern US (thought to be mob-related) don't help the issue. The black market rears its ugly head even here. US hospitals were the ones obtaining the illicit body parts. This makes one wonder about their role in the black market for organs.
Also, a system that leaves 45 million Americans uninsured has no business trying to force organ donations. Presumed consent is not "consent", nor is it a "donation". It is forced. (This is the same logic that some school systems use in requiring high school students to work as a "volunteer".) Unfortunately, as Britain goes on trends like this, so typically will the US and other English-speaking countries eventually. Just prepare for the backlash when it happens.
I'm obese, though otherwise generally healthy, and was told some time back that my organs will probably not be considered suitable for transplant, so this debate is largely of academic interest for me. It won't be for others. I chose not to opt in anyway and will opt out if the rules change, as I don't want to feed the black market.
By the way, isn't it time to question just why so many people "need" organ transplants? It seems as if this particular little bit of medical stunt work has all too often become the first option instead of a last resort. That's at least for those with money or really good medical coverage; the rest of us must make do, it seems, without such "benefits". Just asking...
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