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Sunday, March 18, 2012

How to Safely Increase Organ Donations for all Countries.

Organ donation has always had an unintended sinister aspect to it. How long does the hospital wait before harvesting the organs of an organ donor who may be on life support? Hospitals from all over the country anxiously watch for organ availability and viability, and the pressure to save multiple lives today could over ride the desire to give  an organ donor on life support extra time before harvesting their organs.

Responsible people who agree to be organ donors could find themselves the victim of a numbers game. Perhaps their chance of recovery is less than 1%, but at that same moment in time there could be 5 different people waiting for organs that that donor may be able to supply.

What are the doctors to do?  Save the lives of five people in desperate need of an organ, or keep someone on life support even if their chance of recovery is less than 1%?  

If you were an organ donor, and you had a .5% chance of recovery, would you want the organ donor system to give up on you and end your life after a few days to a couple of weeks so that others could be saved?
There probably is a solution to the organ donor dilemma that could increase the overall supply of organ donors. 
What if an organ donation protocol were established in which ALL ORGAN DONORS were entitled to 30 days of life support treatment, plus an additional evaluation and another 10 days before their organs were harvested?

The initial reaction of, "What good is it going to do if every donor gets up to a 40 day extension?" is a knee jerk response that misses the  actual benefits of such a program. I think it is possible that if a 40 day organ donation waiting period were established, the number of organ donors could go up significantly once organ donors knew they would not be cast aside because of a numbers game before it was truly known if they may or may not make a recovery.

Harry's Law had an episode on organ donation and organ trafficking and I don't believe the scenario I am proposing was explored. More and more I am troubled by the lack of a "float" being used to solve societal problems.

The refusal to pass on any significant reparations to the middle class for the loss of several trillion dollars in home equity due to home securitization fraud is a typical example of refusing to let the "float" solve an issue.

Helping homeowners now would have eventually created a financial windfall that could have replaced investment funds that would have had to accept part of their losses now, but possibly get reimbursed later on.

Instead everyone keeps passing the buck and kicking the problem down the road while demanding they get all of theirs, NOW! Organ donation is in the same predicament.  

A study needs to be done to see if the amount of total organ donors would go up if the donor was guaranteed 30 plus 10 days of life support and that there would be significant attempts made to bring them out of a coma for up to forty days.

If there was an overall increase in organ donation, then nobody would feel pressured to "pull the plug" on somebody who had recently become comatose because there would already someone else on life support about to come off after 40 days, and there in lies the "float".

A perfect example of this process would be Sarah Burke.  I disagree with the medical conclusion that was reached about her having irreversible brain damage.

The reason I disagree is that Ms. Burke was injured in very cold weather. I'm not a medical expert but I have read that the cold can slow down damage to organs and the brain.

Burke was in the prime of her life and in great cardiovascular shape. Why the rush to take her off of life support after only 20 days? If she wasn't an organ donor, they should have given her more time. If she was an organ donor, then she should have gotten her 40 days on life support and then a final evaluation would have been done.

The 40 days rule takes away the possibility of a desperate doctor or ultra efficient hospital administrator possibly manipulating a family into agreeing to a premature organ donation. 
If an honest and reasonably lengthy attempt is made at reviving a person, would that not INCREASE the amount of people who would agree to be organ donors?
Do the organs atrophy during the 40 days of life support? I don't know, but assuming that the life support is working properly, and the person is being nourished, would that not mean the organs remain viable?

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