Dear TIPsters, Thank you all for your replies to my post about my daughter and my thoughts on organ donation--you can't imagine how a little psychological support helps and I appreciate your responses. I have actually reread them several times and I plan to look more closely at the social issues surrounding organ donation (possibly it helps take my mind off of other things).
Anyway, I've learned a great deal in the last few months, and if it helps any of you explain things for your students, here are some things I've learned. The organ donation procedure is very safeguarded to protect the donor as well as the recipient. There are several teams that work both ends, and each team's responsibility lies with their own patient (donor as well as recipient). The procurement team is called into action if and when a verified organ donor becomes a candidate. Many tests are performed to ensure that the donor cannot otherwise survive and that his or her organs are useable. There are age restrictions as well as prior history factors that come into play. First and foremost is the possibility of the patient's (donor's) survival at that time; quality of life isn't even an issue--just survivability. Then the patient's wishes are discussed with the family, and then--only then--is the procurement team called in. At that point, the testing of the potential donor begins. So, it's not a quick and dirty decision like you might see on TV. And as the procurement testing begins, the recipient's team has still not been notified. Once the testing of the potential donor has progressed enough for tissue typing and viability to be completed, the information is put into a database utilized by UNOS (the United Netword for Organ Sharing system). A computer analyzes the data for the best match, and then the potential recipient's team is notified. At the same time, a transport team has to be mobilized because the heart can only survive for about 4 hours outside the body. There has been some recent debate (within the last few years) because of the way transplant recipient selection occurs--it isn't just the sickest who get the heart first. Factors such as the match between donor-heart body size, tissue matching, and proximity are as important as the degree of the recipient's illness. There are plenty of other things that come into play, but the point I've been trying to make is that there is absolutely no collusion between the donor's team and the recipient's team, thus nobody has a stake in seeing an organ donor die. Ambulance drivers obtaining financial gain from letting someone die seems like movie fodder to me. Especially given the narrow window of time between death, harvesting the organ, and keeping it viable enough to transplant. One last thing I will say though, is that there IS a basis in 3rd world countries for this fear. In some countries, there are people who are desperate enough to sell their organs (that extra kidney is unnecessary when you have no food), and those vital organs that don't come in pairs (such as the heart or liver) may be contracted for future use. Those are sociopolitical issues that don't occur in the United States and UNOS is taking every possible step to make sure that such issues can't possibly arise. Despite such prudence, there ARE people in this world (and the US is no exception) that will try to circumvent any and all moral issues for their own financial gain. I hope I've given you enough information to help allay the fears of some of your students. And of course I'm looking at it from a biased perspective, but I trust this system completely. I just hope it works in time for us. Carol
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