From: megadog	Date: July 18th, 2007 11:04 am (UTC)		(Link)

My mortal remains are not some sort of fleshy spare-parts-bin to be plundered by the State after my death.

OTOH I'd have no problems with Ebaying my parts post-mortem, with the funds so raised being utilised in accordance with terms & conditions defined in my will.

	From: vexen	Date: July 18th, 2007 05:58 pm (UTC)		(Link)

Death is the most pressing of problems, especially for those who wish to remain alive... there is no greater tragedy than the loss of life.

But once you are dead, your organs can help others live... your spare parts are not to be plundered, but they CAN be used to save life.

Indeed, I think that the morality of saving a life is great enough to override the once-existant moral concners of the recently deceased.

And hey, if you want to sell them in advance, so be it, sell them to an organ depository (none in the UK, though!), and get an exemption, and write on the back of your Not a Donor Card that your organs have been sold!

	From: spangle_kitten	Date: July 18th, 2007 11:17 am (UTC)		(Link)

I totally agree, I have a donor card but it got lost, but my next of kins all know I'd like to donate whatever they can find that still functions!

When I worked at the funeral parlours I was disguted at the low amount of people who donated organs. These are organs that will ultimatley get burned or buried, yet could save a life.

One woman donated her whole body and we buried what bits of her they sent back, which is a bit gross, but I'd be up for that level of donation too.

I get a bit anxious about the idea the government could have that amount of control over your body, but an opt out will sort out that area.

Otherwise we'll continue to have people die needlessly or organ failure and a disguting trade in imported body parts of murder victims.

The current system is crap - alcoholics who have had several new ones and refuse to get help to recover are given yet another liver because they're higher up on the list than people with liver cancer who have had none. That balance needs to be redressed.

	From: drreagan	Date: July 18th, 2007 11:53 am (UTC)		(Link)

http://www.uktransplant.org.uk/ukt/about_transplants/organ_allocation/liver/national_protocols_and_guidelines/protocols_and_guidelines/adults.jsp

"3.2.1 Alcohol-induced liver disease A history of excess alcohol is relevant in regard to potential or actual significant damage to cardiovascular and neurological tissue, or to the risk that patients might revert to alcohol abuse or might not comply with medication or follow up schedules and thus damage the new liver. A multi-disciplinary approach is required to select patients who are likely to comply with follow-up and not return to a damaging pattern of alcohol consumption after transplantation and may include psychological/psychiatric assessment. Appropriate follow-up strategies may be needed."

So it looks like they're assessed on a case-by-case basis - and anyone who has a history of alcohol replase would most likely not get given another new one as you suggest, especially if they'd already been given one transplant already, and then gone back to the drink.


With regards to the cancer - there's decent medical grounds for not transplanting with patients who suffer from certain types of cancer due to the large probability of it re-occurring - particularly in conjunction with immuno suppressant drugs.

"3.2.7 Malignancy Where potential liver allograft recipients have suffered from previous extrahepatic malignancy, the decision to proceed for liver transplantation should depend, in part, on the probability of malignancy recurring following liver transplantation. Some immunosuppressive agents may encourage the growth of malignancy. Patients should be considered in the light of section 2.2. With patients with primary hepatic malignancy, there are agreed criteria which predict a high probability of tumour persistence after transplantation: these include number of lesions, size of lesions, portal vein involvement and spread outside the liver capsule. Most data suggest that more than 3 liver tumours with a maximum diameter of 5 cm indicates that hapatocellular cancer is likely to persist following liver transplantation and the criteria in section 2.2. will not be met. However. These criteria are under regular review and a slight expansion, using the UCSF criteria, may be appropriate. The role of interventions that shrink the tumour (such as chemoembolisation) remains uncertain and extension of the conventional indications should be done in the context of agreed studies. In general, those known to have cholangiocarcinoma are not appropriate candidates for transplantation."

	From: spangle_kitten	Date: July 18th, 2007 12:38 pm (UTC)		(Link)

I think it's another one of those systems that work one way in theory and in writing and another in practice...

Mum comes across patients in the hospice every day who have been refused livers (many not cancer, wrong about that bit) yet also sees chronic alcoholics who are on thier 3rd or 4th transplant. I put this down as much to the fact that alcoholism support in this country is truly appalling, as much as the state of the transplant system though.

	From: drreagan	Date: July 18th, 2007 03:29 pm (UTC)		(Link)

Actually, it wouldn't terribly surprise me if those guidelines were ignored in practice, if the rest of the NHS is anything to go by.

	From: hiddenpaw	Date: July 18th, 2007 01:05 pm (UTC)		(Link)

I would not like to see this bought in as a european measure because it is at it's heart a very spiritual question and for europe to go in to that area in such a way would give so much properganda to the Anti-euro lobby as to blow it apart. It would be good to see all countries choose for them selves to impliment an "Opt out" donation sceme.

I would though very much object to your second paragraph. I do not concider my physical body to be the property of anyone other than myself and I concider that to be the case even after my death. Power over myself is the one thing I concider myself to have a total right to and for me it would be a step to far for the government to take that away. It would be one liburty to far. I do not mind it being assumed I want to donate unless I say otherwise. That way I still have the choice and for what it's worth I have already chosen to donate and opted in, but I concider that choice my right and mine alone and concider that everyone else also has that right.

	From: purplegril	Date: July 18th, 2007 02:41 pm (UTC)		(Link)

Yep. And I think masses of people would have a problem with having to opt out too. However, I think an opt-out system would be far better than the one we have.

You can't remove the opt-out though. People have to be able to make their own choices about some things, and their own bodies is one of them.

	From: vexen	Date: July 18th, 2007 06:06 pm (UTC)		(Link)

I think that concern for the living should override the now-irrelevent physical self-concerns of the dead!

Imagine if a religion became popular that caused its adherents to shun burial? They could use the same argument ('their own bodies' etc), and it would simply have an unacceptable effect on the living. I think the case of organ donation is the same; organs can save lives, and I think that is more of a moral concern than any attachment dead people think they might have with their dead bodies.

After all, as we cremate more people than we bury, surely there can't be that much opposition to reducing the ash pile, and allowing others to live?

I would be morally opposed to anyones' moral oppositions! I can't see how there can be a valid justification to cause one person a day to die whilst on organ donation waiting lists, when the solution costs nothing, and even means less carbon oxides released into the air (as less corpse mass is burned)!

	From: purplegril	Date: July 18th, 2007 07:11 pm (UTC)		(Link)

Well don't have a go at me. I agree with you. Just don't think there would be the kind of consensus to get it passed, that's all.

	From: vexen	Date: July 20th, 2007 12:46 pm (UTC)		(Link)

Wasn't having a go at you... just debating-out-loud at the issues! (And, I won't have-a-go when people disagree, I am a hard debater but arguments are not personal)!

	From: hiddenpaw	Date: July 18th, 2007 07:29 pm (UTC)		(Link)

What ever thier Moral Justification and weather you agree with it or not I think it gross arogance to claim more right over thier body than they themselves have.

The logical conclusion to that is that if the only suitable match for an organ transplant is another living person and the pserson needing the transplant was of more use to socioty then the current owner of the organ should be put to death and butchered for his parts.

Our bodies are the one thing that is most essentualy our own. If the government persumes ownership of thoes bodies either before or after death then personal freedom is effectively a thing of the past.

Incidently there are plenty of people neither burned or buried in this world due to thier religous beliefs. This is why the dramatic decline of the indian population of vultures is causing great concern in that country.

In short the thing you have totaly failed to apreciate is that peoples feelings matter. If we were to live in a world where sentimentality (and the desier to control the ultimate destination of ones body is a most fundimental sentimentality) was so ignored and derided and set aside then I would suggest that one the things that most makes being human worth the effort would have been struck down. There comes a point where you can take cold logic to far.

Also I would add that it would be of no practical use to make opting out impossible as just creating an opt out baszed system would leave us with far more organs than we have the surgons to make use of or I would guess patients who could benifit from them.

	From: vexen	Date: July 20th, 2007 12:41 pm (UTC)		(Link)

Again, the only rational approach is for organs that are no longer needed, to be used to save lives, by default... you yourself said "peoples feelings matter"... and people who are alive having feelings; therefore, if feelings matter, organs from dead bodies can and should be used to save those who have feelings.

I support an opt-out system because I cannot think of a single moral reason why you'd want to intentionally restrict the saving of other peoples' lives; what kind of objection could be of such concern that human suffering and death is less important? I can't think of any!

	From: hiddenpaw	Date: July 20th, 2007 01:37 pm (UTC)		(Link)

Where in this thread have I disagreed with the priciple of an opt out system? THe answer is that I have not. My argument is against your acersion that at some point in the future the option to opt out should be removed just as soon as oppersition to such a move can be reduced suffiecently.

Your recent style of debate seems to mirror more and more the habbit of the british press to accuse anyone with veiws opposed to thier own of having not only those veiws but those views taken to a rediculas exstream.

Debate is not about winning. it is about analizing a proposal or proposition.

	From: vexen	Date: July 20th, 2007 04:16 pm (UTC)		(Link)

Well I know that an opt-out system is inevitable, and I recommend it because of the politics involved means that more suffering is saved by passing an opt-out version in the short term (wheras, none would be saved by trying to pass a doomed no-opt-out-version).

But, I am morally opposed to opt-out schemes... saving organs, to save lifes, is to me more important than any of the arguments I've seen against donation.

Combining the two reasons above, means that I will support an opt-out system because it is the second-best to rote saving of organs, but will still press for the recognition that opt-outs aren't justifiable.

	From: hiddenpaw	Date: July 20th, 2007 07:06 pm (UTC)		(Link)

What is the point of life is it is not without freedom? What is freedom if not the right to choose?

It is my opinion that the choice of what happens to one's physical body even after death is one of the most fundimental of choices and should be to as greater exstent as practicable a choice for the person who's body it is.

	From: vexen	Date: July 21st, 2007 03:10 am (UTC)		(Link)

(1) People are not free in all areas. We are not free to murder other people, to poison water wells, and legally at least, we are not free to stand as a bystander whilst an arrestable offence (such as murder) is being committed. On all these points, we are not free to choose. Yet, our 'freedom' is only impinged in order to give other people their own freedom. The overall level of freedom increases in a stable society where murder and accidental death is reduced.

Following on:

(2) We are not free to let our bodies decompose in public, because it threatens life, by causing disease. This is a precedent for our wishes towards our bodies, when we are dead, being overriden by the public good. In other words, we have to be buried or cremated. There are many freedoms here that are suppressed.

If freedom is valuable, then, once I am dead and I cannot use my body in order to act freely, it makes sense that my soon-to-be-useless organs are in fact used to allow other people to live longer and enjoy their freedom.

I should not be free to deny them life, just like I'm not free to chose to let my body decay in a field: in both cases, the public good and general freedom are both increased by making certain acts illegal/compulsory.

	From: hiddenpaw	Date: July 18th, 2007 07:03 pm (UTC)		(Link)

Indeed I think we are already seeing the arguments wheeled out against an opt out system. and they don't seem to hold water in my oppinion. I have heard one tory politician say "Opting out is no choice at all" and go on to claim that most would be to scared to opt out for fear of what people would say, but is they don't care enough to fill in a form or what ever is the system then I would suggest that they obviously don't care that much about what will happen to them after they die.

My one concern is that the system must be orgaised enough that when people die if they have opted out thier body parts are not taken by mistake. I am quite sure such a system can be organised, but it is important for peoples belief in thier own liburty that robust and sensible system is built in to the legislation to enact an opt out system.