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View Full Version : California, New York to change rules on organ donation


JSUCamel
05-10-2010, 08:23 AM
http://www.cnn.com/2010/HEALTH/05/10/organ.donation.jobs.laws/index.html?hpt=Sbin

The whole thing is too long to quote here, but I'm obviously interested in both bills and what the repercussions may be. California wants to create a living donor registry, the first in the nation, and New York wants to make organ donations opt-out (instead of opt-in, the way they are now).

What do you guys think?

Ishara
05-10-2010, 09:05 AM
Well, both ideas seem fabulous, on paper at least.

It's pretty well understood that you're going to get a bigger pool from anopt-out system than you would have from an opt-in system, if solely based on the fact that the lazy and uninformed wouldn't bother to opt-out.

And a living registry ...I'm not 100% sure how that would work, because don't you have to be functionally dead to be a donor?

Sei'taer
05-10-2010, 09:17 AM
I'm an organ donor so it doesn't really bother me either way.

Camel, if I wasn't on the registry and someone, say your brothers kid, needed a kidney, is it possible for me to only go into the pool for that particular person, or do you have to go into the wider pool of people? I'm just curious because some people might be against donating to strangers but ok with helping a friend out.

JSUCamel
05-10-2010, 11:15 AM
And a living registry ...I'm not 100% sure how that would work, because don't you have to be functionally dead to be a donor?

You can live with only one kidney, so it's possible to donate a kidney to someone while you're still alive. And you can donate up to 2/3rds of your liver to someone else while you're alive. The liver is the only organ in the human body that can regenerate itself (i.e. if you have 1/3rd of a liver, within a year or so it will grow back to a full-sized liver).

So to answer your question: no, you don't have to be dead.

Many hospitals don't do living donors (mine didn't) for psychological reasons. Think about it: if you donated one of your kidneys to your boyfriend, and he died on the operating table, how would you feel? Logically you would know that it wasn't your fault, but some part of you would feel guilty because your kidney wasn't good enough. Or what if you died on the table? He would feel terrible. So on, and so forth, and yadda yadda yadda.

The procedure is risky as all hell, even if you're perfectly healthy going into it, much less for the sick person who needs one. For that reason, many hospitals don't perform living donor transplants. Many do, however, especially those that specialize in kidney transplants.

JSUCamel
05-10-2010, 11:18 AM
I'm an organ donor so it doesn't really bother me either way.

Camel, if I wasn't on the registry and someone, say your brothers kid, needed a kidney, is it possible for me to only go into the pool for that particular person, or do you have to go into the wider pool of people? I'm just curious because some people might be against donating to strangers but ok with helping a friend out.

It is possible to donate your kidney to a specific person -- family members do it all the time. If you're a living donor, you have much more control over where your body parts go, but if you've died, then your organs go into a wider pool of people. I suppose it's possible that you could specify an individual in your will, but that would be kind of weird for obvious reasons.

Unrelated note: Don't let anyone fool you: nearly every major and minor religion out there sees organ donation as a gift of charity, and they're okay with it. There are very few, if any, that really think it's against their religion.

Basel Gill
05-10-2010, 11:34 AM
It is possible to donate your kidney to a specific person -- family members do it all the time. If you're a living donor, you have much more control over where your body parts go, but if you've died, then your organs go into a wider pool of people. I suppose it's possible that you could specify an individual in your will, but that would be kind of weird for obvious reasons.

Unrelated note: Don't let anyone fool you: nearly every major and minor religion out there sees organ donation as a gift of charity, and they're okay with it. There are very few, if any, that really think it's against their religion.

Only one I can think of that won't allow it (other than the ones who just don't use modern medicine at all) are Jehovah's Witness. I'm not entirely certain why, but I know they won't take blood transfusions or organs, etc. It's not a infection thing either, it's some sort of religious belief of theirs. That being said, modern medicine without blood/organs is all ok.

If there are any JH here or former ones, maybe enlighten me?

GonzoTheGreat
05-10-2010, 11:48 AM
From what I remember, the JW stance is based on this:
Leviticus|17:12 Therefore I said unto the children of Israel, No soul of you shall eat blood, neither shall any stranger that sojourneth among you eat blood.

And the lines around it, of course. They are sensible enough to read it in its context, even if they have a somewhat strange (to me, at least) interpretation of the verb "to eat".

Basel Gill
05-10-2010, 12:05 PM
That kinda sounds like the direction to eat kosher rather than exchange parts, but I never really did go to Sunday School regularly...

Ishara
05-10-2010, 12:24 PM
Thanks for clarifying. In that case, yes, I would fully support living donor lists, with the proviso that the eductaion piece should really be up to the individuals on the list.

Matoyak
05-10-2010, 01:57 PM
I'm an organ donor so it doesn't really bother me either way.This.

But I personally think both ideas would be ok, though the Opt-out versus Opt-in is a bit more questionable.

Sinistrum
05-10-2010, 02:00 PM
Yeah I'm not so sure about making it opt-out instead of opt-in. That could lead to complications were someone inattentive ended up having the organs donated against their wishes. I think opt-in is the more appropriate system.

Matoyak
05-10-2010, 02:25 PM
Yeah I'm not so sure about making it opt-out instead of opt-in. That could lead to complications were someone inattentive ended up having the organs donated against their wishes. I think opt-in is the more appropriate system.To be fair, though, that would be their fault. And really, your body is worthless to you after you die, might as well be useful to someone else.

<of course, I'm sure some religion out there disagrees. ah well>

Leanne
05-10-2010, 04:50 PM
[QUOTE=Matoyak;97435]To be fair, though, that would be their fault. And really, your body is worthless to you after you die, might as well be useful to someone else.
QUOTE]


I agree that your body is worthless to you after you die, which is why I am an organ donor myself. I didn't actually read about how they would have you "opt-out" and I am not sure if every state does this the same way. In Pennsylvania, we "opt-in" when we renew our driver's license. Now, not everyone has a driver's license, I wonder how they opt-in". Do they have to get some sort of state ID to be able to do this? I can see this presenting a problem beyond laziness for people to be required to opt-out. I'm not even sure, maybe there are other ways to opt-in besides the driver's license.

Jokeslayer
05-10-2010, 05:15 PM
<of course, I'm sure some religion out there disagrees. ah well>

Well then surely the members of that religion will just opt out?

Ishara
05-10-2010, 06:28 PM
I would think that regardless of that paper you sign when you get your license, you should make your wishes known to your family and they execute your wishes, whatever they are (in answer to Leanne's question).

Personally, I don't see anything questionable in an opt-out system, since a person's family would have the last say anyways.

JSUCamel
05-10-2010, 06:40 PM
To be fair, though, that would be their fault. And really, your body is worthless to you after you die, might as well be useful to someone else.



I agree that your body is worthless to you after you die, which is why I am an organ donor myself. I didn't actually read about how they would have you "opt-out" and I am not sure if every state does this the same way. In Pennsylvania, we "opt-in" when we renew our driver's license. Now, not everyone has a driver's license, I wonder how they opt-in". Do they have to get some sort of state ID to be able to do this? I can see this presenting a problem beyond laziness for people to be required to opt-out. I'm not even sure, maybe there are other ways to opt-in besides the driver's license.

There are other ways to opt-in. Most states have a donor registry of some kind that you can join without having a driver's license. In fact, in most states, the "Organ Donor" on your drivers license is useless, since your next-of-kin get to make the final call. In some states, such as Illinois, just joining the registry is enough, but in states like Alabama, your next of kin can say "No, you're not touching his body" and my wishes go unfulfilled.

Granted, I'm not allowed to donate anymore, but still..

The important thing is to register in the first place. You should all check out http://www.donatelife.net and sign the Donate Life registry in your state. They have all the facts, some nice testimonials, and even some pretty nifty schwag to go with it. I have a tshirt :)

And, of course, always talk to your loved ones about your decision so that if something were to happen, they can respect your wishes and not agonize over whether they're doing the right thing or not.

Matoyak
05-11-2010, 12:25 AM
Well then surely the members of that religion will just opt out?Yes, of course. What my religion comment was about was the "body being worthless after death" thing, not the opt out thing.

Frenzy
05-11-2010, 12:47 AM
What my religion comment was about was the "body being worthless after death" thing, not the opt out thing.

All the zombie-raising voodoo witch-doctors will be pissed.

Matoyak
05-11-2010, 03:32 AM
All the zombie-raising voodoo witch-doctors will be pissed.Yeah, I foresee a good many resolutions being proposed against this bill by their unopposed majority... ~sigh~ :(

GonzoTheGreat
05-11-2010, 04:39 AM
That kinda sounds like the direction to eat kosher rather than exchange parts, but I never really did go to Sunday School regularly...Most Jews, Christians and Muslims interpret it in that way. JWs (and some other, smaller, groups, I think) have a more stringent interpretation, though. That is based, at least in part, on a somewhat different translation than the one I gave, which may explain why it isn't entirely clear to you.

In the translation used by the english Bible which I have on my computer, it says "eat blood". However, the original is Hebrew, as you no doubt know, and the JWs use a translation that is more like "take blood into your own body". With that translation, objecting to blood transplants (and organ transplants, which always amount to at least some blood being transplanted) does make sense.

Ishara
05-11-2010, 08:11 AM
And, of course, always talk to your loved ones about your decision so that if something were to happen, they can respect your wishes and not agonize over whether they're doing the right thing or not.

This.

Zaela Sedai
05-12-2010, 11:56 AM
Was there any clarification on whether the donor list was allowed to be a specific person, or would youo not go on the list at that point?

For me I have to keep my organs for my family. My side has a 50/50 shot of having polycystic kidney disease, my granma father and aunt have it and only my Aunt hasn't had the transplant yet. Both donators were from the family as we are all O+ as well. So i cant give my kidney out as there is a chance I may have to give it to one of my 5 siblings or my cousins if they need it. That is of course, if I don't have the disease myself, which I will find out about within the next couple years.

Obviously we work with Live Donor Hospitals. (Philly, PA)

JSUCamel
05-12-2010, 12:22 PM
Was there any clarification on whether the donor list was allowed to be a specific person, or would youo not go on the list at that point?

For me I have to keep my organs for my family. My side has a 50/50 shot of having polycystic kidney disease, my granma father and aunt have it and only my Aunt hasn't had the transplant yet. Both donators were from the family as we are all O+ as well. So i cant give my kidney out as there is a chance I may have to give it to one of my 5 siblings or my cousins if they need it. That is of course, if I don't have the disease myself, which I will find out about within the next couple years.

Obviously we work with Live Donor Hospitals. (Philly, PA)

I'm not sure about California's new bill, but in general, if you're a living donor, you have a choice about who gets your organs. In your case, you would be able to say "I'll donate my organs to my family".

As far as cadaverous donors, you don't have a choice because your organs aren't viable for very long, so they give them to the people who need it the most. Your family members may not need your kidney at the time of your death, and so they wouldn't receive it. You can, of course, tell your family not to donate your organs if it doesn't go to them, but that seems like a waste.

I'm surprised that your family is allowed to donate to each other, considering the history of kidney disease. For instance, as far as I know, a donor whose family has a history of liver cancer would probably be denied as a donor, even if the donor herself has no signs of cancer. Then again, I don't really know much about kidney transplants and the rules for that. My knowledge is primarily focused on liver transplants.

Sarevok
05-12-2010, 01:27 PM
I'm surprised that your family is allowed to donate to each other, considering the history of kidney disease. For instance, as far as I know, a donor whose family has a history of liver cancer would probably be denied as a donor, even if the donor herself has no signs of cancer. Then again, I don't really know much about kidney transplants and the rules for that. My knowledge is primarily focused on liver transplants.
From Zae's post, I would guess that the disease she's talking about is congenital? i.e. you'd only have it or you don't, and if you don't you've no chance of getting it?

Zaela Sedai
05-12-2010, 06:07 PM
From Zae's post, I would guess that the disease she's talking about is congenital? i.e. you'd only have it or you don't, and if you don't you've no chance of getting it?

Correct, Polycystic kidney disease is congenital, If i don't have it I will not pass it to my children, my father has it so there's a 50% chance his kids do (6 of us and 3 for my aunt) Our strain is the less aggressive, and you'll notice it by 30 via ultrasound and not need the transplant until you are over 50 most likely. My cousin from my Uncle had it (my uncle is clean, he donated to my Grandmother) from his mothers side which was the aggresive side...he had his trransplant around 30 a couple years ago. His kidneys weighed 8 lbs a piece and looked like brains...he had a member from his church donate as he has a weird blood type that noone matched. My step mother gave to my father.


ANYWHO I am an organ donor if i die. I just meant if I'm living i will not donate my kidneys to anyone but family since they may very well need one.

Another question... can you redonate your liver after it grows back?

JSUCamel
05-12-2010, 09:03 PM
Another question... can you redonate your liver after it grows back?

I'm gonna go out on a limb and say no, but I really don't know for sure. The surgery is incredibly risky, whether you're the recipient or the donor, and both physically and mentally. I seriously doubt any competent transplant surgeon would allow it.

In order to become a donor or recipient, you have to undergo extensive testing, both physical and mental, to determine whether you're eligible... and I'm not sure you would pass a second time.

But again, I don't really know for sure.

Zaela Sedai
05-12-2010, 09:14 PM
Yeah, I doubt it too... just popped into my head.

Ishara
05-13-2010, 09:00 AM
Stupid maybe, but I had no idea that your liver could grow back. Cool and freaky, all at the same time!

JSUCamel
05-13-2010, 10:15 AM
Stupid maybe, but I had no idea that your liver could grow back. Cool and freaky, all at the same time!

Yep. Generally in a living donor liver transplant, the recipient receives 2/3rds of the donors liver. Usually, the donor is worse off following the transplant than the donor (going from healthy -> (temporarily) sick is worse than going from super sick -> healthier).

More info: http://en.wikipedia.org/wiki/Liver#Regeneration

Davian93
05-13-2010, 10:56 AM
I like both laws.

I do forsee the inevitable "But I didnt KNOW that if I didn't opt out, they'd take my organs"...of course it'd be from next of kin anyway as the donor is off to bigger and better things at that point.

The only objections I could see other than JW (odd ducks them) is any remaining followers of Ra and Anubis as they tend to like having their organs buried next to them in nice little alabaster jars.

Zaela Sedai
05-13-2010, 12:39 PM
Yep. Generally in a living donor liver transplant, the recipient receives 2/3rds of the donors liver. Usually, the donor is worse off following the transplant than the donor (going from healthy -> (temporarily) sick is worse than going from super sick -> healthier).

More info: http://en.wikipedia.org/wiki/Liver#Regeneration


That was exactly the case in my Stepmithers donation too my father. She's still recovering and it was last winter, he felt 100x better the next day.

Sarevok
05-13-2010, 04:33 PM
I like both laws.

I do forsee the inevitable "But I didnt KNOW that if I didn't opt out, they'd take my organs"...of course it'd be from next of kin anyway as the donor is off to bigger and better things at that point.

Actually, I think the bigger discussion will be "But he said he opted-out!", while the official registration say he didn't.
I suspect there might be one or more court cases over that.

JSUCamel
05-13-2010, 05:18 PM
I like both laws.

I do forsee the inevitable "But I didnt KNOW that if I didn't opt out, they'd take my organs"...of course it'd be from next of kin anyway as the donor is off to bigger and better things at that point.

I love the California law. Not crazy about the New York law. I'd much rather they do some other incentive program to get people to become organ donors... Cut your drivers' license renewal fee in half if you opt-in, or something along those lines.

I'd much rather see more people opting in than make people opt-out.

The issue I see with organ donation right now is that the next of kin doesn't know. They don't know what their loved ones' wishes were. And if they say yes, then they agonize over that decision, and if they say no, then they agonize over that instead. The only way they know they're making the right choice is if their loved one made their wishes known before they died.

And having everyone automatically on the list doesn't help that scenario at all.

Leanne
05-13-2010, 07:19 PM
There are other ways to opt-in. Most states have a donor registry of some kind that you can join without having a driver's license. In fact, in most states, the "Organ Donor" on your drivers license is useless, since your next-of-kin get to make the final call. In some states, such as Illinois, just joining the registry is enough, but in states like Alabama, your next of kin can say "No, you're not touching his body" and my wishes go unfulfilled.

And, of course, always talk to your loved ones about your decision so that if something were to happen, they can respect your wishes and not agonize over whether they're doing the right thing or not.

So, the whole discussion of whether there should be an opt-in or opt-out law is almost pointless, as long as there is next of kin/family to overrule your decision. I guess I just want that bright green "organ donor" with my signature on my license to mean something! They even let me redo my signature because it was good the first time.

Let's say, for sake of argument, I am in a car crash in New Mexico. I am not going to make it. There just happens to be someone at that same hospital that needs a heart. They are not able to get in contact with family in time for the heart to be transplanted (I have no idea how long it can be "kept" for). Would they see my license and give this person my heart, assuming it would possibly work?

JSUCamel
05-13-2010, 10:49 PM
Let's say, for sake of argument, I am in a car crash in New Mexico. I am not going to make it. There just happens to be someone at that same hospital that needs a heart. They are not able to get in contact with family in time for the heart to be transplanted (I have no idea how long it can be "kept" for). Would they see my license and give this person my heart, assuming it would possibly work?

I'm pretty sure that if your license says you're an organ donor and/or you're registered with the registry, if they can't find your next-of-kin within a reasonable time, then I think you'd become a donor anyway.... but I'm not positive on that, and that may vary from state to state.

The next-of-kin override varies on a state-by-state basis. In Illinois, for example, if you've signed the organ donor registry, that's it -- you're a donor upon death. In Alabama, the next-of-kin gets final say. I believe that's true in Georgia, as well. I can't speak for other states.

Regardless, it's best to let your family members know, not so much because of the above situations, but because it helps them deal with the decision.