Presumed consent in organ donation

[S.A.M.]

Such a system would require the force of law. Without it, any doctor or facility honoring the opt-out exclusion would be subject to malpractice and civil rights lawsuits. If that lawsuit resulted in no fault on the part of the doctor and hospital, the program would become at that moment a matter of public policy, backed by the force of law.

Is a DNR any different?

Those who ignore DNRs—except under genuinely extraordinary circumstances—shouldn't be doctors.

And we're back again to the Hippocratic oath and patients who want to die for religious or other reasons.

I'm not sure what to make of this statement because, to the one, there is an aspect about it that is absolutely correct, yet to the other there are frightening implications. In the case of ignoring DNRs, some resuscitations will lead to extended existence in pain. Still, the phrase, "protect the doctors from their tendencies to want to abide by the Hippocratic oath", is ... well, I can see how it could be controversial. Throw that one into the abortion debate and see if we can find heads and tails, for instance.

Doctors usually see the human body in a detached way - they'd have to, to be objective - for them, the subjective aspects are less important than what they can do to prolong life and alleviate disease. The kind of doctors who ignore DNRs are the kind who don't give up on their patients and the notion that they can recover and once again, enjoy what life has to give. In my opinion and experience, those are the best kind of doctors.

 

[phlogistician]

That's a great idea! Kinda like making people who have unpopular ethnic/religious identities walk around a Star Of David on their clothing!

Being willing to donate organs post mortem should be one of the qualifications for living in civilisation. Don't want to donate, don't get civilisation. They can go live in a cave.

 

[iceaura]

The kind of doctors who ignore DNRs are the kind who don't give up on their patients and the notion that they can recover and once again, enjoy what life has to give. In my opinion and experience, those are the best kind of doctors.

Not for me or those I care about.

A doctor who abets and prolongs and intensifies the suffering of the dying against their will is in the same moral and ethical category as a medieval witchburner, purifying the soul of the witch through fire - for their own good, of course.

The arrogance involved is a species of insanity. That kind of decision is not theirs to make.

The fact that people cannot always trust doctors to abide by DNRs and the like, is one of the factors in people's reluctance to agree in advance to donate their organs. They are signing over control of the fate of their body to people they can't trust.

 

[S.A.M.]

Not for me or those I care about.

A doctor who abets and prolongs and intensifies the suffering of the dying against their will is in the same moral and ethical category as a medieval witchburner, purifying the soul of the witch through fire - for their own good, of course.

The arrogance involved is a species of insanity. That kind of decision is not theirs to make.

The fact that people cannot always trust doctors to abide by DNRs and the like, is one of the factors in people's reluctance to agree in advance to donate their organs. They are signing over control of the fate of their body to people they can't trust.

I generally expect a doctor to abide by the Hippocratic oath, ie do no harm. Trust issues I think are a general problem in American society. Not just with healthcare but also governance and law enforcement. Its a problem in the society itself, I think.

 

[Tiassa]

Fundamental differences

Is a DNR any different?

A DNR, as we both know, refers to "Do Not Resuscitate". I'm asking you to look at that last word. Resuscitate. Do not jump start the flat line.

This is the opposite of opt out, which orders a doctor to not maintain the bouncy ball.

However, in terms of the section of my post you quoted, that is the response to the specific question: "How is opting out of an organ donation [to/for] a matter of public policy?"

The kind of doctors who ignore DNRs are the kind who don't give up on their patients and the notion that they can recover and once again, enjoy what life has to give. In my opinion and experience, those are the best kind of doctors.

They also include folks like Dr. Bill Frist, also formerly known as Senator Bill Frist. As in the guy who was completely capable of misdiagnosing Terry Schiavo from a videotape in order to stage a completely useless and embarrassing federal intervention over human self-determination.

It's a mixed bag. But in the long run, I see the DNR in fundamentally terms than the opt-out/exclusion scheme.

 

[Cowboy]

Being willing to donate organs post mortem should be one of the qualifications for living in civilisation. Don't want to donate, don't get civilisation. They can go live in a cave.

So your idea of civilization is based on the notion that, when push comes to shove, "society" owns your body? I might prefer the cave...if it was given full political autonomy.