Mykaihla Sternick

Dr. Freymiller

CAS138T

10 April 2016

Organ Donation

Everybody wants to change the world. You can ask a child what they want to do when

they grow up and inevitably, they will have an idea thats larger than life. Dreams can be tainted

when a child is diagnosed with the need for an organ transplant where the ratio of needs to

availability of donors is unnecessarily uneven. But, by being an organ donor, the ability to

change the world becomes possible. By changing possibly eight lives the legacy that is left

behind is beyond any other gift that can be given. America should follow the lead of countries

abroad by changing the policy for organ donation from opt-in, to opt-out, and by doing this, the

rates of organ donation will increase, and the lives that will be saved, will be forever impacted.

By presenting the facts of organ donation, debunking the myths that accompany the idea, and

explaining the results that countries who have successfully implemented the opt in program, the

realization to become proactive with this policy should become apparent.

According to the United Network for Organ Sharings online database that is updated by

the minute, at this time, there are 118,073 eligible people waiting for a transplant, and 75,847 of

them are actively on the waiting list. That is quite a significant number, because many of those

people are in critical condition, and on average, 22 people die daily waiting for an organ

(UNOS). That number becomes even more outstanding when you discover that only 45% of

Americans are donors. Every ten minutes someone is added to the list to wait. Every year 8,000
people die waiting (Donate Life). But, we have the power to change that. 33,600 patients were

given life from an organ transplant in 2016. That is just the patients. That number is in the

millions if you just think about the moms and dads, brothers and daughters, friends,

acquaintances, doctors and teachers that are impacted by one donation. That is one donation, and

every person has the potential to donate 8 organs.

The process of organ donation begins with registration of an organ donor. Here, is where

the problem lies. According to statistics from the US Department of Health and Human Services,

95% of Americans support organ donation, but on 48% of people are registered organ donors

(USDHHS). That number is alarming in respect to integrity of American people. The process in

America is easy, but alas, it is a program that requires you to take the action. There are three

ways to become an organ donor. First and most common is at the local Department of Motor

Vehicles. All that you need to do is check a box to become an organ donor, and this decision is

recognized on state IDs and drivers licenses. Another way is by going to any of the government

recognized websites such as organdonor.gov, dmv.org, or donatelife.net. The final way is by

mail, which is the least common. Once you make the decision to be a donor, its as simple as that.

From there, there aren't many limiting factors. So the question is, who can actually donate? The

U.S Government Information on Organ Donation and Transplantation states that only 3 in 1,000

deceased patients who are registered organ donors are actually available to donate. The process

goes like this; A patient would come to a medical facility with injuries such as an accident with a

brain trauma or a stroke. They will be put on life sustaining machines to continue to pump blood

and oxygen through the body. The team of doctors would not even consider if the patient was a

donor at this point, and a good doctor would always do everything in their power to keep their
patient alive. At this time, if the patient has died, despite the doctors best efforts, they will

conduct brain death testing. Only then, they will consider organ donations. The list of possible

organs and tissues to be donated are heart and heart valves, lungs, kidneys, liver, intestines,

pancreas, Femoral and Saphenous veins, as well as tissues such as bone, skin, tendons, and the

corneas. At that point, the government becomes part of the picture, when the medical team

contacts the local Organ Procurement Organization, who would send someone to evaluate the

situation and give legal consent for donation. If it is authorized, but the person were not an organ

donor, the next of kin would be asked to consider organ donation. From here, the transplant list is

consulted to find suitable matches, that are within a close enough radius (US Dept. of Health and

Human Serives). Time is of the utmost importance. The approximate maximum time for organs

and tissues are; Lungs and heart, 4-6 hours, Liver-24 hours, Pancreas-24 hours, Kidney- 72

hours, Corneas- 14 days, Bone- 5 years, Skin- 5 years, and Heart valves- 10 years (DCI Donor

Services). The surgical team recovers the organs and tissues, and they are transported by a team

via ambulance, helicopter or commercial airplanes to wherever is deemed fit.

It seems like it is simple to become an organ donor, but many people have misconceptions with

the process. First of all, live donors can donate a kidney, part of a liver, lung, pancreas, intestine,

and some tissues, so it doesn't always deal with deceased. Second, many people think that it is

against their religion, but almost all major religions recognized in the US have given public

statements in support of organ donation. Most see them as an act of charity, and sharing Gods

love. This includes Catholicism, Episcopal, Islam, Judaism, Mormon, and Baptist, among others

(US Dept. of Health and Human Services). Next, age does not play a huge part in quality of
organs. There is no cut off of too old and with consent of parents, children under 18 can be

donors as well. This also ties into the fact that donors of all ethnicities are needed. 65.5% of

donors in 2015 were caucasian, 16.3% African American, 13.6% Hispanic and 2.5% Asian

(USDHHS). The final few common misconceptions are almost insulting to doctors. One of the

most widely used excuses is that if I am an organ donor, my doctors wont work as hard to save

me if I was in an accident. That is very untrue. A doctor should do anything in their power to

save your life. They want to save you. People also say that they might not really be completely

dead, but as mentioned earlier, there is testing done to see if there is any brain activity in the

patient. Citizens of Australia determined in a survey that if their family members heart was still

beating, even if they were brain dead, they would not opt to cease life sustaining care. The final

and most mediocre myth of organ donation is that you cannot have an open casket funeral. This

myth is so selfish in the fact that you want to throw away your organs because you need to have

an open casket. Even if you were to donate organs, tissues, and corneas, you can still have an

open casket, if it really means that much. There is no cost, there is no priority based on financial

or social status, and there is no price on the lives that could be saved.

The problem is, what can be done to fix the lack of donors that America is facing? AS

mentioned, we perform organ donations on an opt-in program, meaning that you must consent to

become an organ donor. In many countries in Europe they are seeing much success with the opt-

out program, also called deemed consent. In December of 2015, Wales became one of the first

countries to do this. Vaughan Gething, Cabinet Secretary for Health, Wellbeing and Sport in

Wales explained in an article for the Guardian that The path to organ donation is a complex

one, but consent is the stage at which most donations are lost. I am extremely proud that Wales
now leads the way by being the first nation in the UK to move to a soft opt-out system of

consent. I fully expect that the new system will create a step change in consent for organ

donation in Wales. The early indications are that this certainly is the case (Morris). 60 organs

were transplanted between December and June, the beginnings of this plan. Half of the organs

had come from patients whose consent had been deemed. The organs were from 31 people, and

10 of them had not explicitly confirmed they would be donors (Morris).

Richard H. Thaler explains in an article Oping in vs. Opting out for the New York

Times, that nationwide, there are about 12,000-15,000 people declared brain dead and being kept

alive temporarily, but only half of them will become organ donors. If there was an average of 3

organs viable per each person, an if just 1,000 more of them would consent, thats already 3,000

more organs to be donated (Thaler). In two bordering European countries, Germany and Austria,

there are major differences in organ donation rates due to the different policies. Germany, with

the opt-in program has a 12% rate of donation, while Austria has 99% donation rate with the opt-

out program. France has joined the opt out movement on January 1, 2017, and has already seen

improvements. Laura June writes in an article for The Outline, that a survey in France has shown

that up to 80% of the population was in favor of donating their own organs, but 40% of families

refuse when presented the opportunity to choose. In France, they created a national refusal

registry, where about 150,000 of France's 66 million had signed up already (June). Imagine the

impacts that could be made if this would be established in American society. Karen Hill, a

graduate of Fordham University wrote a powerful article for CNN shortly after being diagnosed

with Cardio Myopathy and being notified that she would be in need of a heart transplant. The

article is titled Would you opt out of saving a life like mine. Would you opt out of saving a life
like mine? After reading a story such as hers, it would be heartless to say no. She considered

herself lucky when a donor match was found (Hill). Some people argue that an opt out program

would take away rights and the ability to make choices, but on contrary, it would actually make

people more aware of the decision they are making to opt-out, if they had a reason.

Common heart transplants are done on babies with heart defects or adults and children

suffering with heart failure. Most liver transplants are given to those with liver cancer or other

causes of liver failure. Kidneys are the most commonly transplanted organ, with 82% of patients

waiting for a kidney right now (Donate Life), and most of them are dealing with kidney failure.

Lung transplants save children and adults with severe illnesses such as COPD (chronic

obstructive pulmonary disease) and Cystic Fibrosis. A pancreas will save someone who is insulin

dependent dealing with type I diabetes. Skin transplants for burn victims and tendon transplants

for traumas causing nerve damage give people the chance for restoration of their normal lives,

and 1 persons corneas can give two people the ability to see again (Live on NY). One healthy

person can give all of that.

Organ donation is a part of our everyday lives. The stories of kids having a chance to

create their own lives and adults getting a second chance to do the same should be more

plentiful. Kin requesting contact information to organ and tissue recipients of their loved ones is

brings immeasurable comfort for a moment. A mother hearing her sons heart beat in another

boys chest is knowing that there is still a part of him left in this world. Its a legacy. Its a gift.

Its larger than life, and it changes the world.

 Works Cited

Data. United Network for Organ Sharing, 2015, unos.org. Accessed 10 Apr. 2017.

Frequently Asked Questions. DCI Donor Services Inc, 2017, dcids.org. Accessed 10 Apr.

2017.

Hill, Karen. Would you Opt out of Saving a life like mine? CNN, 29 Dec. 2015, cnn.com.

Accessed 10 Apr. 2017.

June, Laura. France Beings Opt Out Organ Donation. the Outline, 2 Jan. 2017. method,

theoutline.com. Accessed 10 Apr. 2017.

Morris, Stephen. Dozens saved in six months by Welsh deemed consent organ donation

system. the guardian, 14 June 2016, the guardian.com. Accessed 10 Apr. 2017.

Organ, Eye and Tissue Donation Statistics. Donate Life America, 2017, donatelife.net.

Accessed 10 Apr. 2017.

Thaler, Richard H. Opt in vs. Opt out. The New York Times, 6 Sept. 2009, nytimes.com.

Accessed 10 Apr. 2017.

US Department of Health and Human Services. U.S. Government Information on Organ

Donation and Transplantation. organdonor.gov, 2017, organdonor.gov. Accessed 10 Apr. 2017.

What Organs Can be Donated? Live on NY, liveonny.org. Accessed 10 Apr. 2017.