England to assume consent for organ donation

[The New California Republic]

So without reading anyone else's replies, that's all kinds of messed up. I understand that the need for organ donations is huge, but just assuming that someone is completely willing to give away parts of themselves even after death is a pretty big assumption on the part of the British government. Does this apply to the entire UK, or is this just England?

Wales has already had this system in place for 3 years.

It is just going to be England and Wales for the time being.

There is an opt-out system. The person can opt out, or the family member can opt them out after their death. It's a simple 2 minute process: https://www.organdonation.nhs.uk/regist ... paign=2804

[Estanglia]

Did you not read the definition of compulsory you cited? because, by your definition, organ donation is not compulsory as you can opt out or your family can say 'no'.



Ironically, that is what you're doing; stating that the proposed system is compulsory, despite it being not by your definition.

I think he knows that perfectly well. Just let him play his little games, he clearly gets a kick out of it.

I get a kick out of laughing at arguments that make no sense or is clearly ill informed.
It's even better when the evidence given contradicts the argument instead of supporting it, as in this case.

[New Elesar]

So without reading anyone else's replies, that's all kinds of messed up. I understand that the need for organ donations is huge, but just assuming that someone is completely willing to give away parts of themselves even after death is a pretty big assumption on the part of the British government. Does this apply to the entire UK, or is this just England?

This would only apply to England. Wales adopted an opt-out system in 2015, and Scotland and Northern Ireland are considering following suit.

Alright, that makes a bit more sense now. I know that in the US we have an opt-out system as well, and I guess I just assumed the rest of the world did the same.

So without reading anyone else's replies, that's all kinds of messed up. I understand that the need for organ donations is huge, but just assuming that someone is completely willing to give away parts of themselves even after death is a pretty big assumption on the part of the British government. Does this apply to the entire UK, or is this just England?

Wales has already had this system in place for 3 years.

It is just going to be England and Wales for the time being.

There is an opt-out system. The person can opt out, or the family member can opt them out after their death. It's a simple 2 minute process: https://www.organdonation.nhs.uk/regist ... paign=2804

It's still not ok to just assume consent on issues like this.

[The New California Republic]

Wales has already had this system in place for 3 years.

It is just going to be England and Wales for the time being.

There is an opt-out system. The person can opt out, or the family member can opt them out after their death. It's a simple 2 minute process: https://www.organdonation.nhs.uk/regist ... paign=2804

It's still not ok to just assume consent on issues like this.

Why's that? Even with robust opt-out system in place?

[New Elesar]

It's still not ok to just assume consent on issues like this.

Why's that? Even with robust opt-out system in place?

Some people are just put off by the idea of donating organs, for one :/

Not to mention the possibility of disease transmission, though I assume that would be picked up in screening if that's what you call it

But what do I know? I'm not exactly an authority on the issue

[Ifreann]

This would only apply to England. Wales adopted an opt-out system in 2015, and Scotland and Northern Ireland are considering following suit.

Alright, that makes a bit more sense now. I know that in the US we have an opt-out system as well, and I guess I just assumed the rest of the world did the same.

By "opt-out" system I mean that anyone who dies in Wales, who has lived there for at least 12 months, and who has not registered that they do not wish to donate their organs is assumed to consent to donating their organs. Exactly the system that is going to be established in England, and eventually all of the UK, probably.

[The New California Republic]

Why's that? Even with robust opt-out system in place?

Some people are just put off by the idea of donating organs, for one :/

You won't be alive to experience it. And you can opt-out if you don't like it.

Not to mention the possibility of disease transmission, though I assume that would be picked up in screening if that's what you call it

All organs get screened as part of their processing, so disease isn't really an issue. The far bigger risk for organ recipients is organ rejection by their own immune system, hence why they need to take immunosuppressants for the rest of their lives in most cases.

[Pollona]

Because some people don't care either way and this will allow their organs to be used.

The question I'm posing is about consent, and whether it is respected. The people who do not care are not relevant to that question -- they would have consented either way.

At the end of the day, the law as proposed modifies (or potentially destroys) the legal definition of consent. Violating a patients right to consent to post-mortem choices is being done in the name of medical expediency: saving lives. For some people that subtle change goes unnoticed because, well, we are supposedly saving lives.

Previously for EOL organ donation, in law a person either expressly gave their approval (a will or a registry), or delegated to proxy, relatives who knew some expression of their wishes. Similar practices across medicine.

Now the state takes on the presumption that Patient A wanted X, because A didn't expressly say they didn't want X. Human nature trends towards apathy. Those who would not have consented but did not inform the state lose out. And this precedent could impact a lot of medical law.

At the end of the day, could the state apply this version of consent for harvesting organs from someone alive? A lot of patients need kidneys, and we all have 2. Look at the dead, we already presume they wanted their organs used for the good of society.

Burial is slightly different (laws legally require disposal of a body) but still operates the same principle. Could the state presume consent for someome to be cremated? Public health can be improved if we just assume you wanted to turn to ash!

This isn't like changing your corporate pension plan from an opt in to an opt out program. It's all a series of logical next questions, and a legislature or judge will be thinking about these precedents. It opens the door for the state to take on many more legal priorities once left to patients or their proxies.

Maybe it's fine that the state's policy towards post-mortem rights is now "screw'em" but that is the effect.

[Ifreann]

At the end of the day, could the state apply this version of consent for harvesting organs from someone alive?

You must not know many alive people.

[Platypus Bureaucracy]

The question I'm posing is about consent, and whether it is respected. The people who do not care are not relevant to that question -- they would have consented either way.

At the end of the day, the law as proposed modifies (or potentially destroys) the legal definition of consent. Violating a patients right to consent to post-mortem choices is being done in the name of medical expediency: saving lives. For some people that subtle change goes unnoticed because, well, we are supposedly saving lives.

Do we have a legal definition of consent?

[The New California Republic]

At the end of the day, could the state apply this version of consent for harvesting organs from someone alive?

What...? How could they assume consent and harvest organs from someone alive...?

[Fartsniffage]

At the end of the day, could the state apply this version of consent for harvesting organs from someone alive?

What...? How could they assume consent and harvest organs from someone alive...?

https://www.youtube.com/watch?v=Sp-pU8TFsg0

[The New California Republic]

What...? How could they assume consent and harvest organs from someone alive...?

https://www.youtube.com/watch?v=Sp-pU8TFsg0

Oh jeez

[Prekonate]

This law supposes that some people who have not consented to organ removal will also not have opted out. It allows consent to be imputed to them on the basis that there is social benefit in doing so. The exceptions to this rule -- that people who have explicitly refused, and people whose families refuse on their behalf are allowed to keep their organs -- are not based on the law's animating principle. They are based on a much older principle that consent should be a free choice. But why should this principle survive much longer? Why should a family selfishly refuse to give up their son's organs for the good of someone else? We have already accepted that consent to bodily invasion may be overridden for the social good, and the logical endgame is that these exemptions must eventually be eliminated.

I posit that the social utility of removing organs from healthy people could be enormous.

[Platypus Bureaucracy]

What...? How could they assume consent and harvest organs from someone alive...?

https://www.youtube.com/watch?v=Sp-pU8TFsg0

Actual training video for NHS staff.

[Fartsniffage]

https://www.youtube.com/watch?v=Sp-pU8TFsg0

Actual training video for NHS staff.

Well the guy doing the extraction was a fully qualified British doctor.

[Pollona]

At the end of the day, the law as proposed modifies (or potentially destroys) the legal definition of consent. Violating a patients right to consent to post-mortem choices is being done in the name of medical expediency: saving lives. For some people that subtle change goes unnoticed because, well, we are supposedly saving lives.

Do we have a legal definition of consent?

Several in fact. In a lot of cases the legal definition of consent is much like the dictionary version: "give permission for something to happen."

But don't want to sound pedantic and flippant about this, so let's take one common medical definition/practice: "informed consent." A physician tells a patient about a surgical/medical procedure or treatment which, strictly speaking, would violate their bodily integrity. After being informed, the physician must obtain a patient's written affirmation that they agree to the procedure. Here consent is quite simple: the patient makes a reasonable decision regarding what treatment they want, and under their own free will declare they are willing to let the doctor go forward.

The key here is that nothing is "implied." The physician cannot simply start treatment assuming the patient agrees to the procedure.

At the end of the day, could the state apply this version of consent for harvesting organs from someone alive?

What...? How could they assume consent and harvest organs from someone alive...?

Quite painfully I'd imagine, or through a medically induced coma. And of course once your heart is removed you can't live long on artificial blood circulation.

The principle remains the same. If we can legally presume the dead would want us to harvest their organs, why not apply the same principle for the living?

Why should a family selfishly refuse to give up their son's organs for the good of someone else? We have already accepted that consent to bodily invasion may be overridden for the social good, and the logical endgame is that these exemptions must eventually be eliminated.

I posit that the social utility of removing organs from healthy people could be enormous.

This entirely.

[Platypus Bureaucracy]

Do we have a legal definition of consent?

Several in fact. In a lot of cases the legal definition of consent is much like the dictionary version: "give permission for something to happen."

But don't want to sound pedantic and flippant about this, so let's take one common medical definition/practice: "informed consent." A physician tells a patient about a surgical/medical procedure or treatment which, strictly speaking, would violate their bodily integrity. After being informed, the physician must obtain a patient's written affirmation that they agree to the procedure. Here consent is quite simple: the patient makes a reasonable decision regarding what treatment they want, and under their own free will declare they are willing to let the doctor go forward.

The key here is that nothing is "implied." The physician cannot simply start treatment assuming the patient agrees to the procedure.

Sources, darling. If it's a legal definition it must be written down somewhere, so let's have the text, verbatim. One legal definition for consent, that's what you implied, and that's what I expect. If there are several, then a single change can't destroy the legal definition; it just changes the way we do it in that one area.

[Fartsniffage]

Quite painfully I'd imagine, or through a medically induced coma. And of course once your heart is removed you can't live long on artificial blood circulation.

The principle remains the same. If we can legally presume the dead would want us to harvest their organs, why not apply the same principle for the living?

We set fire to dead people, bury them in airtight boxes and pump them full of toxic chemicals. Why shouldn't we be able to do these things to the living without their consent?

[Prekonate]

Several in fact. In a lot of cases the legal definition of consent is much like the dictionary version: "give permission for something to happen."

But don't want to sound pedantic and flippant about this, so let's take one common medical definition/practice: "informed consent." A physician tells a patient about a surgical/medical procedure or treatment which, strictly speaking, would violate their bodily integrity. After being informed, the physician must obtain a patient's written affirmation that they agree to the procedure. Here consent is quite simple: the patient makes a reasonable decision regarding what treatment they want, and under their own free will declare they are willing to let the doctor go forward.

The key here is that nothing is "implied." The physician cannot simply start treatment assuming the patient agrees to the procedure.

Sources, darling. If it's a legal definition it must be written down somewhere, so let's have the text, verbatim. One legal definition for consent, that's what you implied, and that's what I expect. If there are several, then a single change can't destroy the legal definition; it just changes the way we do it in that one area.

"Consent" is a recognized concept within medical law. The exact definition will vary by jurisdiction. In England, as in the rest of the common law world, a patient must give active informed consent to be touched by a doctor, or the touching constitutes a battery. The only time a doctor may infer consent is when the person cannot give active consent, e.g. when the person is incapacitated. For reasons I discussed earlier this doctrine could not coherently be extended to dead people.

Legal concepts, like consent, are underpinned by principle. Consent is underpinned by the idea of self-determination and free choice; that is why a patient may refuse to consent to a medical procedure even if it is necessary or beneficial for him. The danger of this law is that it is animated by a very alien principle: that of imputing consent when it is socially useful to do so. Introducing this principle may very well change the way the law conceptualizes consent, as I suggested above.

[The New California Republic]

Quite painfully I'd imagine, or through a medically induced coma. And of course once your heart is removed you can't live long on artificial blood circulation.

The principle remains the same. If we can legally presume the dead would want us to harvest their organs, why not apply the same principle for the living?

We set fire to dead people, bury them in airtight boxes and pump them full of toxic chemicals. Why shouldn't we be able to do these things to the living without their consent?

[Prekonate]

The selective responses are telling

[Pollona]

Several in fact. In a lot of cases the legal definition of consent is much like the dictionary version: "give permission for something to happen."

But don't want to sound pedantic and flippant about this, so let's take one common medical definition/practice: "informed consent." A physician tells a patient about a surgical/medical procedure or treatment which, strictly speaking, would violate their bodily integrity. After being informed, the physician must obtain a patient's written affirmation that they agree to the procedure. Here consent is quite simple: the patient makes a reasonable decision regarding what treatment they want, and under their own free will declare they are willing to let the doctor go forward.

The key here is that nothing is "implied." The physician cannot simply start treatment assuming the patient agrees to the procedure.

Sources, darling. If it's a legal definition it must be written down somewhere, so let's have the text, verbatim. One legal definition for consent, that's what you implied, and that's what I expect. If there are several, then a single change can't destroy the legal definition; it just changes the way we do it in that one area.

I accept all terms of endearment.

Sources? Sure, the first quote I provided is from Webster's Dictionary. It was very easy to Google. Won't presume you are from a common law jurisdiction, so I will elaborate why I offered that as one legal definition. In common law jurisdictions (Commonwealth countries, the US), law is developed not only by statute but also by case precedent from judges. There is a long history, built upon stare decisis, that unless otherwise specified by statute, a word legally takes on its common public meaning in law. In cases, this often comes down to if a statute explicitly gives a definition of a word, if not then use the common public meaning. Judges often interpret an idea like "common public meaning" to sources like the dictionary. So if someone was to 'consent' to a contract, a judge would turn to a dictionary to understand what that word means.

Admittedly I hesitated and said there are many legal definitions of consent, because (for example) there may be different bars for what qualifies as someone granting their approval. I was thinking about the recent movements to set a different legal bar for sexual relations. I'm not up to date on my legal jurisprudence from California or the Canadian Supreme Court, but give me several months and I'll get back to you.

In the medical field, the principle of "informed consent" in law is so pervasive I could simply quote state legal codes or the AMA.

(I see Prekonate has answered my question on what the English medical definition is)

But in law, consent is underlined by the notion of granting some form of permission (without coercion) for something. This statute converts the system to implying (rather than explicitly granting) approval because it is socially useful to do so. If I can be crude, the law seeks to ask forgiveness (if wronged) rather than seek permission. Thus, the principle of consent in law may change (as I described above about the common law).

[The New California Republic]

The selective responses are telling

Not really. If there is a glaring contradiction then folk will tend to focus on it.

[Des-Bal]

All for it. If this matters enough to bitch about just opt out.

What...? How could they assume consent and harvest organs from someone alive...?

After death you have between 4 and 6 hours to perform the transplant surgery. A lot of these transplants are from someone who is being kept breathing specifically to allow the transplant.