My Research Paper

Two Steps to Success

Twenty-one people will die today waiting for organ transplants that will never come.  These people are not nameless faceless strangers, they are children, mothers, fathers, sisters, brothers, grandparents and friends.  There is a severe shortage of organs for transplant in the United States and all over the world.  This shortage is not because people are not dying, but because the system is not structured properly and the general public is not knowledgeable about the process of donation.  Because of this, the system does not work as effectively as it could and should.  A surprising “90% of Americans say they support donation, but only 30% know the essential steps to take to be a donor” (Donate).  As a result, perfectly good hearts, kidneys, lungs, and other organs are being buried or cremated, instead of being used to save lives, and the people who desperately need them are dying. There are currently two ways to become an organ donor, you can either register to be a donor at the MVA or you can register online.  While most people are in favor of organ donation, some people are opposed for personal reasons, and in these cases it should be made clear, no one should be forced to donate an organ. However, it is our responsibility as Americans to educate ourselves and to take responsibility for our bodies and our beliefs.  We need to pass an opt-out law coupled with increased education about organ donation.  This will increase organ donations and save lives, dispel the fears and false myths that often accompany the issue, and expedite and ease the donation process for all involved.

There is a severe shortage of organs available for donation in the United States. It may seem as though the process is working when we hear statistics that tell us, “In 2013 there were 14,257 organ donors resulting in 28,953 organ transplants” (Donate).  While this sounds like a large number, it does not come close to meeting the needs of the over 123,000 people who currently need lifesaving organ transplants.  With so many people suffering and dying on a daily basis, it is clear that something must change.  The opt-out law states that, “it is assumed that the deceased had no objection to donation unless such objections had been expressly registered prior to death” (Akyol 3).  This would be a main component to increasing organ donation because it would include people who are indifferent or neutral on the topic.  People who have no objection to organ donation but who may not necessarily make a point of registering at the MVA or going out of their way to look up the correct website and register online.  It would change people’s perspective on the issue.  Being an organ donor would be considered the norm and become more of an assumed expectation rather than something out of the ordinary.  This legislation is already in effect in many countries such as Spain, Chile, Austria, Finland, Greece, Hungary, Italy, Norway, Poland, Portugal, Sweden, and Argentina.  And so far, “There is evidence that supports the association between presumed consent and increased donation rates and that countries with opt-out laws have rates 25 to 30% higher than those in countries requiring explicit consent” (Zúñiga-Fajuri 199). Implementing this legislation would be a huge step forward for the United States because we have already seen proof that it can and has worked in many other countries.

These positive results in other countries are due only in part to the change in legislation.   Interestingly enough, “Opt-out legislation has been enacted in some countries with the highest donation rates, and also, paradoxically, by many of the worst performing countries” (Oh 13).  The difference between the successful and the unsuccessful countries is that the countries that actually saw an increase in donation were also increasing education on donation, not only to the general public, but to their medical personnel as well.  Those countries that do not focus on increasing education have significantly lower rates.  Education, or lack thereof, makes a huge difference.  In the case of Chile, implementing the opt-out law without increasing education and information actually caused a decline in organ donation.  Changing the legislation without any sort of informative process frightened many people and caused a lack of trust between the general public and the government.  As a result there was a wave of people scrambling to register against donation.  Fixing our system should be a two part process; neither education nor legislation can fix our system on its own.  We have the advantage to learn from the successes and mistakes of other countries.  From this it is clearly evident that a legislative change is the first step towards saving more lives, but it is essential that it be accompanied by increased education or the results will never reach their highest potential.     

Education is a key component to increasing organ donation because there are many misconceptions about the process. People wonder, if I am an organ donor will paramedics really try to save me or let me die just to use my organs?  If I am too old or have been sick no one will want my organs anyway.  I am not eighteen or older, I am not allowed to be an organ donor. What if I am still alive when they try to take my organs?  Some people may not mind donating a kidney or liver but they do not feel comfortable donating their heart or corneas; however, they do not donate because they believe it is an all or nothing deal.  Many people fear organ donation is against their religion.  This lack of education provides just a few of the reasons that people are failing to become registered donors or are avoiding the issue altogether. 

With more education people would learn about this process.  They would learn that the first and foremost priority of paramedics and doctors is to care for and save the life of their patient.  They are not aware of a patient’s organ donor status when they first arrive on the scene of an accident and are trained to do whatever it takes to save the patient.  Age and health are factors in determining donor eligibility, but they are not absolute standards.  Just because someone has a bad heart does not mean they cannot donate a liver or kidney.  Someone who has been told they have three days to live does not care about the age of the person whose heart they are receiving. People under the age of eighteen are in fact able to become donors, they simply need parental consent.  To put aside the fears of people who are afraid they may still be alive when their organs are removed, “people who have agreed to organ donation are given more tests (at no charge to their families) to determine that they’re truly dead than those who haven’t agreed to organ donation” (Mayo Clinic Staff).  Donation is not an all or nothing process, you can choose to donate your entire body to science, or you can select only a few organs you would like to donate.  Many religions actually approve of donation and some, like Judaism and Catholicism, even encourage it.   Judaism states that it, “is a moral obligation. Saving human life supersedes maintaining the sanctity of the human body after death” (“What Faith”).  Catholicism states that donations are an, “act of charity” (“What Faith”).  It is perfectly natural to have these questions and concerns, but before we dismiss an issue or form an opinion on it, we should educate ourselves.

The topic of organ donation can be an extremely emotional and stressful one, especially for the family of the deceased.  It can also be a time sensitive issue.  The donation process can take long enough by itself assuming the deceased is a registered organ donor. In the event that the deceased has not made prior arrangements regarding organ donation, the decision is left to the immediate family.  This is a process that can take a considerable amount of time, time people waiting for organ transplants do not have. The decision of whether or not to be an organ donor should rest solely with the individual.  If this proposal were adopted, you would either be an organ donor, or you would not.  The choice would be yours.  As simple as that.  This difficult question would be removed from the equation for families of the deceased altogether because the answer would be in place prior to their loved ones death.  It would relieve the families from feeling the guilt and pressure of making such a decision in their time of grief. 

Education would hopefully help to ease the minds of the families of the deceased.  Understanding the process, removing the foreign ambiguity of it all, would take some of the fear and horror out of the situation.  While nothing will fix or erase the loss they are feeling, “Many donor families say that knowing other lives have been saved helps them cope with their tragic loss” (Health Resources).  Hopefully they will be able to find a small amount of solace in the knowledge that their loved ones donation gave up to eight people a second chance at life.

People opposed to this law may argue that you simply cannot take away an individual’s right to choose what happens to their body, even after death.  They are absolutely correct.  No one would be forced into donation.  Anyone who wanted to opt out of donation would be free to do so at any time, for any reason, with no cost or consequence.  People may argue, what if I am strongly against organ donation but simply don’t have time to register before the law goes into effect?  This would not be an overnight change.  There should be public announcements and ample information made available prior to the change in legislation.  Information would be distributed through the MVA, websites, non-profit organizations, doctor’s offices, and anywhere else it was deemed necessary.  There would then be a transitional period of time, over several months to a year, when the law first took effect that would stipulate that even for presumed donors consent must be obtained by an immediate family member before the donation could take place.  This would ensure that even if someone had been unable to register, their wishes and rights would not be denied.  After a period of time the transitional period would end and the full law would be in effect.

This law would also address the issue of children under the age of eighteen, especially those who fall between the ages of sixteen and eighteen.  These children are just getting their driver’s license, they are making adult decisions, but by our current laws, they are not yet adults.  These children would not be included in the presumed consent category.  They would have the right to register at whatever age they chose to and there would be a designated place or website for them to register, but only with parental consent.  Any child under the age of eighteen who wanted to be a donor, but whose parents disagreed would have to wait until the age of eighteen when they would become a presumed donor. At that time they would have the choice to remain a donor or register as a non-donor.  The only exception to this would be if the child were emancipated.  Then he or she would have the power to choose freely and register themselves. 

Another important issue is funding.  Where does the funding for the support and education on this topic come from?  The answer to this problem is right in front of us.  There are already many non-profit organizations, such as The Colby Foundation, Donate Life, One Legacy, and The American Transplant Foundation, working to educate the general public and raise money for this important issue.  This law would generate support and renewed interest in these groups and as the education and interest increased so would donations.  Children are already taught about organ donation in school and in Drivers Education classes, we simply need to build on that and make it more of a focus, not simply a side note.

Today in America people enjoy many freedoms and choices.  These rights are a privilege.  We have the power to shape the future of the world we live in, but this power comes with responsibility.  In order to continue enjoying the rights and freedoms that we do, we must take responsibility for educating ourselves, seeking out, and putting into action the changes we want to see in the world.  We can no longer prevent progress by claiming ignorance.  This proposal is in no way designed to force people to do something they do not want to do or to attempt to change their beliefs. It is designed to help a system that performs miracles daily to become even greater and function more effectively. If there is something you disagree with, learn about it, it may make you change your mind, or it may add more strength to your argument against it.  Either way, education is the best weapon with which you can arm yourself in any fight.  If there is a way to save more lives and improve the quality of life for so many, we must take the necessary steps to do so.  Combining a change in legislation with increased education is our best option to save thousands of lives a year.  This is something that each and every one of us can do to make a difference.  By investing in this proposal we are investing in our future. 

Works Cited

Akyol, Murat, and Victor L. Tswen Wen. "Organ Retrieval Logistics." Abdominal Organ Retrieval and Transplantation Bench Surgery. Ed. John Forsythe, John Fung, and Gabriel Oniscu. Somerset: John Wiley & Sons, 2013. 3. ProQuest. Web. 22 Apr. 2015.

Donate Life Maryland. "Donate Life Maryland." Donate Life Maryland. Donate Life Maryland, 2015. Web. 22 Apr. 2015.

Health Resources and Services Administration. "Donate the Gift of Life." OrganDonor.gov. US Department of Health and Human Services, n.d. Web. 27 Apr. 2015.

Mayo Clinic Staff. "Mayo Clinic." Mayo Clinic. Mayo Foundation for Medical Education and Research, 3 May 2013. Web. 13 Apr. 2015.

Oh, T. "Organ Donation: How to Increase the Donor Pool." Editorial. Anaesthesia & Intensive Care 43.1 (2015): 12-13. Academic Search Premier. Web. 13 Apr. 2015.

"What Faith Says About Organ Donation." Curriculum Review 43 (2003): 5. Academic Search Premier. Web. 22 Apr. 2015.

Zúñiga-Fajuri, Alejandra. "Increasing Organ Donation by Presumed Consent and Allocation Priority: Chile." Bulletin (2015): 199-202. World Health Organization. Web. 27 Apr. 2015.