By Cara Matthews •Albany Bureau • June 19, 2010, 7:20 pm
ALBANY -- A proposal to flip New York's organ-donation system on its head by presuming people are donors unless they indicate otherwise has the state Legislature buzzing.
Polls have found that the majority of New Yorkers would like to be donors, yet just 13 percent of residents 18 and older are on the state Donate Life Registry. More than 9,600 people in the state need organ transplants, according to the New York Organ Donor Network. Last year, there were just 423 deceased organ donors in New York.
"What we have in New York is a completely failed system," said Assemblyman Richard Brodsky, D-Greenburgh, whose daughter is a two-time kidney transplant recipient and who proposed the legislation.
"People are dying in New York this week because we have failed to create a system that maximizes the opportunities to keep them alive," Brodsky said.
Brodsky said his bills to implement "presumed consent" and prohibit family members from overriding donors' wishes have sparked a lot of interest. People approach him about it everywhere he goes, and individuals and religious groups have raised legitimate concerns.
Because of that, he's not pushing the proposal this session, he said.
"What I've said to anybody, whether they like it or they don't like it, we can't sustain the current system," said Brodsky, whose daughter, Julianne "Willie," received her second transplant four years ago and has become an advocate for changing the system.
He is working on other reforms on organ donations, such as requiring the state Department of Motor Vehicles to provide information on organ donations and creating an organ donation tax credit.
Brodsky, a candidate for state attorney general, co-sponsored legislation this session that would let people consent for giving an anatomical gift through an electronic signature. It passed both houses and goes to Gov. David Paterson for his consideration. Forty-five states allow electronic signatures for donor registries, the New York Organ Donor Network said.
Other states with low donor-registration rates are Texas (an estimated 2 percent), South Carolina (9 percent) and New Hampshire (10 percent), compared to 73 percent in Alaska, an April Donate Life America report found.
No states have "presumed consent" laws, although there have been attempts in several of them, including Maryland and Pennsylvania. Legislation is under consideration in Illinois. A bill was introduced in the Delaware Legislature two years ago.
A number of European nations, including France, Austria and Spain, have this kind of system in place, and they have seen an increase in organ availability, said Arthur Caplan, a bioethics professor at the University of Pennsylvania School of Medicine.
Polla have found that the majority of New Yorkers and Americans want to donate organs and tissues when they die, so the burden should be on the minority to opt out, Caplan said. A recent survey by the New York Alliance for Donation found 67 percent of state residents strongly support organ and tissue donation.
The use of the term "presumed consent" can make some people angry because they don't want presumptions made about what happens to their bodies after they die, Caplan said. He prefers to call it "default to donation."
To get traction in this country, "It's going to take one state to sort of jump out there and show that it works," said Caplan, who has been working on the issue since 1983.
Organ-donation groups report that common objections to presumed consent are a belief that physicians may not work as hard to save them and the government and health care systems would have too much power.
The Long Island Coalition for Life Inc. opposes Brodsky's legislation, which is sponsored in the Senate by Senate Health Committee Chairman Thomas Duane, D-Manhattan.
"This legislation opens up the door to abuse via hastened death of vulnerable people and overriding of family concerns," Jerome Higgins, chairman of the coalition, wrote in a memo to lawmakers. "It also goes a step further toward turning human organs into commodities. The sick and disabled need to be protected, not exploited for their body parts."
The Rev. Jason McGuire of New Yorkers for Constitutional Freedoms, an evangelical Christian group, said organ donation should be voluntary. There are personal-privacy and big-government issues involved. In general, evangelical Christians don't oppose organ donations, although they are not permitted in certain religions, he said.
It's "bizarre" to think presumed consent would go over well with ordinary Americans, said Mary Ann Baily, a fellow of the Hastings Center, a bioethics research group in Garrison, Putnam County, and a graduate faculty member at Sarah Lawrence College in Yonkers. They are frustrated with taxes, and the idea that government would have control over their organs likely is even less popular with them.
"The problem is it's quite easy not to even notice that box that says, 'I don't want to donate my organs,"' she said, referring to a driver's license form. "You should only presume consent when it really is clear that everybody would consent if they thought about it."
One of the major reasons for not having enough organs is people have to die in a certain way and in a hospital for their organs to be viable for use by others. Most families will give consent if they are asked in the right way, said Baily, who once sat on an Institute of Medicine committee that looked at how to boost organ donations.
But even if all available organs were taken, it wouldn't eliminate waiting lists, Baily said. Hospitals may not get the maximum number of organs possible if they and organ banks aren't well organized, she said.
"This law, it seems to me ... is going to stir everybody up and probably not increase organ donations," she said.
Physicians who conduct transplants "don't hope for somebody to die to be a donor," said Dr. Luca Cicalese, chairman and director of the Texas Transplant Center and surgery professor at the University of Texas Medical Branch.
"The reality of the system is that we don't have anything to do with donors," he said.
Transplant staff don't talk to the family of someone who is dying, Cicalese said. That's done by organ-bank staff members, he said.
"There is a system that is very careful in keeping things separate and avoiding conflicts of interest," he said.
Under presumed consent, the family would still be asked whether they wanted the relative's organs to be donated, Cicalese said.
"I think the education is very important. Many people don't understand that one donor can actually save many, many people's lives," he said.
http://www.pressconnects.com/article/20100619/NEWS01/6190348/1112/-Presumed-consent--legislative-proposal-for-organ-donations-sparks-debate
No comments:
Post a Comment