HSE organ donation opt-out register

TomEdison said:
Minister could defer making the commencement order for as long as was necessary to complete the project
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Provided that the legislation was also deferred.

As of now, we are in a position where everyone is assumed to give consent to organ donation & the register to opt out is not functioning.

Don't quote the next of kin thing to me - first of all "next of kin" does not have a clear legal meaning. Secondly can family members be contacted quickly enough and finally, familes frequently disagree.
 
DannyBoyD said:
Don't quote the next of kin thing to me - first of all "next of kin" does not have a clear legal meaning. Secondly can family members be contacted quickly enough and finally, familes frequently disagree.
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The legislation doesn't use the term "next of kin". It has the concept of "designated family member", which is defined with a long list — spouse, cohabitant, child, parent, brother, sister, etc.

And, if those family members can't be contacted, the organs can't be taken. Even if there is deemed consent (because the deceased didn't opt out) they still have to contact a designated family member — not just any designated family member, but one with whom the doctors have had "real and substantial contact" in relation to the care and treatment. So, basically, the family member they were dealing with in relation to your medical treatment? That's the family member they deal with in relation to taking your organs after you die. If there was no pre-death care or treatment — e.g. if you are brought in dead from a road accident — then it has to be the family member at the top of the list — your spouse or cohabitant, but if you don't have a spouse or cohabitant then your (adult) child, but if you don't have an adult child then one of your parents, but if you don't have a living parent then a brother or sister, etc, etc.

So there's no lack of clarity about who they need to talk to.

And, even though there is deemed consent, the organs can't be taken unless the designated family member that they talk to confirms, in writing, in the presence of witnesses, that they do not object. If they object, or if they just fail to confirm that they don't object, the organs can't be taken.

In a case where there isn't deemed consent, then the rules are actually pretty similar — they have to talk to the same designated family member, and the transplantation activities can't proceed unless that person gives "appropriate consent" (in writing, witnesses, no duress or coercion, etc, etc.).

So, in fact, whether there is "deemed consent" or not, what happens in practice will be pretty similar. They talk to the family member that they were talking to in relation to your care or, if they didn't talk to anyone in relation to your care, to the family member who is highest on the list. They can't carry out transplantation activities unless that family member confirms that they don't object (if there is deemed consent) or gives their approval (if there is no deemed consent).

(My guess is that this is more or less what happens already. The legislation is simply giving clear statutory backing to covnentions that have already been developed and refined by transplant teams and have been used in practice for some time.)

So what's the relevance of deemed consent or not? In practice, I think, only this — if there's no deemed consent because you opted out, then the transplant team may take their cue from that and not approach your designated family member at all. And, if they do approach them, your family member may be likely to withhold approval, because they know from the fact that you opted out that you didn't want your organs to be transplanted. So what this legislation may actually do is provide a mechanism for people who object to having their organs donated to record the fact, and have it taken into account when the time comes.

DannyBoyD said:
familes frequently disagree.
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Yes, and of course you have this problem already in relation to organ donation.

Under the new legislation if, say, you have no spouse, but two living parents, your two parents are your designated family members, and the transplant team can proceed with approval/confirmation of no objection from either of them.

In practice, I suspect, they would be slow to proceed without approval/confirmation from both, and they would certainly be reluctant to proceed if they knew that one definitely objected.
 
TomEdison said:
So what's the relevance of deemed consent or not?.....
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This is something I've been wondering about over the last couple of days
If a person "opts out" is that the end of the matter, no organ donation at all
Or can a surviving family member override that decision and opt them back in??
 
DannyBoyD said:
I don't share your confidence in hospital administration.
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Logically, that should be a concern you have right now. I don't think the legislation authorises the medics to do anything that they aren't already doing.
Cervelo said:
If a person "opts out" is that the end of the matter, no organ donation at all
Or can a surviving family member override that decision and opt them back in??
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As I read the legislation, your designated family member can give approval for transplant activities even if you opted out.

But, in practice, I think transplant teams are much less likely to approach the family members of people who have actively opted out. And, if they do approach them, the family members are much more likely to say "no".

On edit: Gippiman is correct, and I am wrong. Under s. 33(5) of the Act, if you register your objection to organ donation they (unless you later withdraw your registration) it is forbidden to take your organs.

(Note that there;s a class of people who aren't deemed to have consented, even if they don't register an objection — e.g. children. In those cases organs may be removed with the approval of the designated family member.)
 
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can the family member check if person has opted out at hospital?
what i mean is if the surgeon tell the family member that the person opted in but actually opted out ,family member may not be aware of person choice .hope this makes sense?
someone mentioned politicians son above
a guy down the road medical card hip problem years waiting for hip operation
another guy i knew private 3 weeks hip done ,this is what would bug me, organs going to someone private not in immediate need as opposed to someone really in need
 
johnwilliams said:
a guy down the road medical card hip problem years waiting for hip operation
another guy i knew private 3 weeks hip done
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Huh? Hips aren't covered by the organ donation scheme. And some people get things done quicker privately than on the public system. So what? You really think that the state or medical professionals are doing to start harvesting organs from people who haven't given permission?
 
johnwilliams said:
organs going to someone private not in immediate need as opposed to someone really in need
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There’s no private access to organs for transplantation outside the HSE/National Transplant Programme. Transplant costs are not covered by health insurance, nor are transplant services offered by private hospitals privately. All costs of transplantation are covered by the Government/taxpayer including the (very) high on-going costs of immunosuppressive drugs required to sustain the recipient.
 
DannyBoyD said:
@TomEdison - I don't share your confidence in hospital administration.
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Either do I, and the more I see of medical and healthcare employees the less confidence I have in them also. I'd be more worried about that when in their care before there was a need for a discussion on this topic.
 
Given their track record of ineptitude and incompetence why would you expect them to do this thing correctly?
 
DannyBoyD said:
autonomy over one's body is a key freedom.
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Fundamental rights under the Irish Constitution

The Irish Constitution recognises and declares that you have certain fundamental personal rights. These are confirmed and protected by the Constitution.
www.citizensinformation.ie
The Irish Constitution recognises and declares that people living in Ireland have certain fundamental personal rights.
...

Bodily integrity​

You have a right not to have your body or person unjustifiably interfered with. ...
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IANAL...
 
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DannyBoyD said:
Its not our place to judge.
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Would totally agree with you here in relation to this subject but I will say one thing if my understanding of the law change is correct
and it's something that I've not really seen mentioned or referenced too in any great detail and that is,
it's vital for this to work that you have a conversation with your next of kin as their the ones that will be giving the real consent

If you haven't opted out and your next of kin can't be contacted then I believe no donation happens
and I would suspect if your next of kin don't know your wishes they might not give consent for any number of reasons personal to themselves
So if you haven't, have the conversation and make your wishes known
 
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