Thursday, August 07, 2008

Presume Nothing But Trouble

Recently, the Ontario government announced plans to increase organ donation in Ontario. Currently, you have to give your consent in writing prior to them taking your organs upon your death.

Problem is, most people don’t sign their organ donor cards. There are many potential reasons, the most likely is people just don’t want to be organ donors – and I can’t blame them.

Though what the current provincial government in Ontario is proposing is a far cry from a voluntary organ donation system which we have now – they are proposing presumed consent.

What that means is essentially everyone is automatically assumed to be an organ donor in Ontario, unless you opt out of it by signing the opt out card. That is, it unless you sign the little piece of paper which you normally ignore anyways, it is presumed that you are willing to be an organ donor.

This reminds me when many companies were using automatic renewals to keep people on their contracts – Rogers Cable was one of the biggies back in the day. You’d sign up for, say a three-year deal, and in the fine print, it said if you didn’t cancel within a certain number of days prior to your contract ending, it automatically renewed for another three-years.

Rogers doesn’t do this anymore, as most companies don’t – they learned by public outcry that presumed consent wasn’t always right.

The same hold true for organ donation – or anything else. Just because someone doesn’t remember to sign something, is no excuse to interpret that as they knowingly accept and acknowledge some hidden outcome.

Besides, can you imagine the ethical, legal and political battles which presumed consent for organ donation can cause?

What happens when little Johnny, a shell of his former self thanks to a horrific car crash, is kept on life support against his parent’s wishes, so that his organs can be harvested for another kid, who hasn’t made it into the hospital yet?

How would you feel if your son or daughter were clinically brain dead, and the doctors told you there is nothing more that can be done, but we’re keeping him or her on life support until we can remove his heart for someone else? Wouldn’t you just want to get it over with – could you imagine watching your dead kid being kept alive, just to benefit some stranger?

Granted, organ donation is a good thing to do – it does save lives. But keeping someone alive just for that purpose prolongs the pain and suffering of the next of kin – and that is wrong.

There are many other issues too – what about those who just forgot to sign their card. I know, it’s a weak excuse, but it’ll happen. By forgetting to sign your card under a presumed consent system, it is assumed that you are okay donating your kidneys, liver, heart or whatever else is needed at the time of your death.

Organ donation is a very personal thing – probably the most personal thing there is, as it deals with the ultimate of private property – our own bodies. It only makes sense then, that organ donation should be an informed, educated consent, not a presumed consent.

There is quite a bit of information already out there on organ donation, and whenever you renew your driver’s license, you are given the organ donor card to sign, or not to sign – the choice is up to you. As it should be.


  1. You have covered many of the concerns I have. However, I have a few more. I wonder what sort of unsavory illegal practices could slip into the system undetected. I wouldn't suggest that most doctors would do this certainly, but is it just possible that an unscrupulous doctor could be bribed by a wealthy person waiting for an organ, with the intent that the doctor should hasten or even cause someone's death with the object of obtaining the organ for that wealthy patient.
    There are waiting lists for people needing organs but wealthy people's names might mysteriously and unaccountalbly sneak up the list. Organs might "go missing". Mistakes might happen. A person's name on the OPTING OUT registry might be overlooked. Our present system while not perfect is far superior to presumed concent.

  2. Actually that's not true, statistics show the majority of the population support organ donation and wish to donate but have not signed the register so most of the people not signed up wish to but have never got round to it/dont know how to or have forgotten.
    There are also many people who are apathetic about the sue of their body after death and it is these people as well as those who forget to sign up that the system is designed for. Those peoples organs will be saving lives.

    Those who don't wish to donate just have to sign something, it's very simple and if you are so against your organs being donated you will remember.

    Also, those who do donate are saving lives after death, why should they be the ones to have to do the signing?

    I think the presumed consent is a good system that could save many lives if preparations werer made so it could be put into place properly.

  3. I realise this was posted a long time ago but just to answer that, the doctors looking after someone who is dying have nothing to do with organ donation.

    There is a seperate organ donation team who come in when the person is beyond help and deal with the subject of organ donation.

    There are seperate transplant hospitals and staff so the doctors are unlikely to be dealing with the people waiting. Plus surgeons remove the organs anyway.

    I do not understand why people are so suspicious of Doctors, being a doctor is an extremely difficult, time consuming and unless you are a GP, often underpaid job. I don't see why anyone would go through all of that if not because it is a caring profession and because they enjoy helping people.