Opt-out forms for organ 'robbery'
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when did i said that u r wrong in yr own opinion???Originally posted by fymk:Once the body is dead - the organs deteriorate rapidly - full shutdown so actually no you cannot say it is in death that they remove it . The body is then supported artificially or so it is claimed while they search for a proper recipient. Let me see - do they actually take the organs out while measuring the blood pressure and heartbeat of the donor? It is easy to find surgical procedures and processes on live patients but it is very difficult to find the organ harvesting procedure out in the open.
So can someone kindly educate me if I am wrong?
I am sure that MOH's the standard method of determining death is brain death . In the old days ,it was confirmed through ceased brain and cardiac functions . But in donor days, cessation of cardiac function means degeneration of organs - aka poor quality organs, so they pick brain death.
I would like to point out as well that none of us has ever crossed that barrier and returned to tell which is the right method of declaring a death. So I would not want to be at the end of the scalpel if it is not correct.
Yes I opted out. But I would like to see MOH and the doctors give full disclosure to their unsuspecting donors of what the transplant procedure entails . That is a principle I always have - informed consent to be taken in every single procedure. If you cannot agree with that but choose to argue with me on the moral high ground then really that's too bad - yes you backed a winner of saving lives but you are in fact apathic.
no one can said that he is right or wrong since we r all humans
u r just being defensive on what u think is right. -
Originally posted by fymk:
Since you mentioned me, I will have to respond. For those who are not acquainted, the Bolam test arises from a 1957 case 'Bolam v Friern Hospital Management Committee', in which Bolam sustained a fracture following electroconvulsive therapy. Mr Bolam claimed that the doctors were negligent in not giving him a muscle relaxant and he had not been warned of this possible side effect of treatment. The court ruling forms the standard for determining dereliction of duty in the tort of negligence.
Informed consent applies both ways to the living and the dead . The dead person should never be seen as a source of organs . That is my moral belief that the dead person used to be a living human being with loved ones . Doctors take full consent of surgeries and the risks involved - I am sure OM will be well aware of the Bollam Test when it comes down to informed consent. Likewise I want people to have the full disclosure of what happens when they harvest organs from them other than the usual practice of explaining that "your body will be treated with utmost respect". I am for informed consent. Like it or not.
Put simply, the standard of care expected is that of an ordinary workman who professes an ordinary level of skill. With regard to consent, one might consider if a side effect is of such minute significance that it does not have to be revealed eg. is it necessary to reveal to a patient that an operation carries a 1 in a million chance of a particular adverse effect? If other surgeons who perform the same operation do not reveal that minute level of risk routinely, the defendant can invoke the bolam test to argue that his practice is acceptable.
In the present issue, I am not sure why fymk has raised the issue of consent. We have legislation that facilitates an opt out system of consent. If you do not consent to have your organs donated in the event that you become brain dead, you can register your objection and opt out. If you do nothing, the law makes it legal to assume that you have consented.
The law therefore makes it unnecessary to invoke the bolam test in any dispute about consent for organ donation. It is unnecessary for the doctors to obtain consent from the next of kin with regard to a brain dead victim. All it requires is to check the register of those who have opted out.
As for your statement that 'the dead person should never be seen as a source of organs', your view may well be a minority opinion. According to you then, there will not be any cadaveric transplants and thousands of patients with organ failures are doomed to die along with those who are already dead.
I agree with informed consent but i maintain that the law does not necessarily take it away, provided there is adequate dissemination of information. I do agree that Singaporeans should be aware of the law and its implications, something the recent case in SGH has highlighted. However, the law itself is fine. -
We die in bits and pieces, not all at once. If deprived of oxygen for 3 minutes, the brain becomes damaged irreversibly and dies very quickly. However, other organs can survive longer. If the brain is severely damaged as a result of a stroke or physical insult such as head injury, parts of the brain may shut down and die but the heart and lungs can continue to function, keeping the other organs alive.Originally posted by fymk:Once the body is dead - the organs deteriorate rapidly - full shutdown so actually no you cannot say it is in death that they remove it . The body is then supported artificially or so it is claimed while they search for a proper recipient. Let me see - do they actually take the organs out while measuring the blood pressure and heartbeat of the donor? It is easy to find surgical procedures and processes on live patients but it is very difficult to find the organ harvesting procedure out in the open.
So can someone kindly educate me if I am wrong?
The brain is a complex organ with many parts. The part of the brain that maintains vital functions such as the heart and lungs are in the brain stem. So if the brain stem dies, the heart and lungs will stop eventually, but there is a period during which the brain stem is dead but the heart/lungs are still working. This is the window for cadaveric transplant.
The organs are harvested quickly and perfused with cold University of Winsconsin (UW) solution. As long as the transplant is done quickly after the blood supply is cut off, there is a good chance of success.
Because the brain stem is dead, there is no hope of recovery. The person can be deemed to be dead and soon the traditional signs of death, such as the cessation of heart beat, will come about. Whilst the heart and lungs are still functioning, however, the other organs are kept alive. With modern medicine, we can continue to ventilate the lungs mechanically and keep the other organs alive until such time when the heart stops beating. This is the small window of opportunity during which we can harvest the organs for transplantation.
All the major religions of the world have accepted the concept of brain death and the good of cadaveric transplants. Obviously there may be others who believe otherwise. Those who object to it can opt out in Singapore, whilst the majority who do not are allowed to help others have a second lease of life. -
Like I said , the information is not adequate. But thank you for your answer about the transplant procedure. I am the minority who has actually seen something that terrifies me about organ transplant .Originally posted by oxford mushroom:Since you mentioned me, I will have to respond. For those who are not acquainted, the Bolam test arises from a 1957 case 'Bolam v Friern Hospital Management Committee', in which Bolam sustained a fracture following electroconvulsive therapy. Mr Bolam claimed that the doctors were negligent in not giving him a muscle relaxant and he had not been warned of this possible side effect of treatment. The court ruling forms the standard for determining dereliction of duty in the tort of negligence.
In the present issue, I am not sure why fymk has raised the issue of consent. We have legislation that facilitates an opt out system of consent. If you do not consent to have your organs donated in the event that you become brain dead, you can register your objection and opt out. If you do nothing, the law makes it legal to assume that you have consented.
The law therefore makes it unnecessary to invoke the bolam test in any dispute about consent for organ donation. It is unnecessary for the doctors to obtain consent from the next of kin with regard to a brain dead victim. All it requires is to check the register of those who have opted out.
As for your statement that 'the dead person should never be seen as a source of organs', your view may well be a minority opinion. According to you then, there will not be any cadaveric transplants and thousands of patients with organ failures are doomed to die along with those who are already dead.
I agree with informed consent but i maintain that the law does not necessarily take it away, provided there is adequate dissemination of information. I do agree that Singaporeans should be aware of the law and its implications, something the recent case in SGH has highlighted. However, the law itself is fine.
Informed consent should let people know about what they expect about how they might look after death and what happens when they donate their organs if they wish to know. All I ever get is " you will be treated with respect and dignity" PERIOD.
Do they use anaesthetics or paralytic agents in removal then? Full disclosure of what drugs they use to paralyse the body if the "reflexes" aka "convulsions" play up . If they do feel that it is not acceptable , they can fully withdraw from opting in or they can request that their body gets an adequate amount of anaesthesia to treat their dead body with the same respect of a live body If they feel that the information is adequate - then they can continue opting in.
Brain death is a concept which major religions might accept but not everyone. I am also the minority who refuses to believe in death or that the soul has fully left the body (I do believe in afterlife) until all vital functions has finally ceased. -
Maybe you should really check up on what I say - I didn't say I want the person rotting. Check cardiac death and check brain death.Originally posted by Kenashi:too bad u live in singapore, they r the government, they will act on it, law by law.
at least this time, u got the option of opt out rather than the HDB blunder
so u going to hang on to a person who is declared brain dead until u see her rot and start decomposing then u will finally admit that she is dead huh??
if u can't even believe the doctor who sworn an oath to help every patient, i don't really know who u can believe anymore???
What's wrong with having a brain and cardiac death to declare a person dead? Some religions do believe that as long as the heart is still beating and the blood still flows - the person is alive regardless of a brain function. It has a spiritual meaning to them.
It only results in poorer quality organs but nevertheless organs.
LOL as for the last statement , I worked in hospitals . I seen major fuckups so don't ever try and even question me on this one again. Doctors are only humans who can make mistakes . Medical science is only at the tip of the iceberg . Science does not equate other spiritual beliefs and science does not have answers for everything. -
quote:Originally posted by gLc:Firstly, I dont see why they should take our organs out for the benefit of others, call me selfish, whatever. How many people, esp the older generations actually heard of this auto opt in thing, dont we have rights to our own body?
In actual fact, imho, I sincerely dont think the gov has done enough to educate the people on how this whole system works. As you said, if i want to choose what I want to do with my body, who are they to take it out without the actual consent. There are cases whereby after a few years where the "victim" is declared brain dead, the "victim" just wakes up suddenly, with no brain/body defects. What if one day, your wife is so called declared brain-dead and they wanna remove her organs, then maybe only until then you'll get what im saying. Im entitled to my opinion as well.
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quote:Originally posted by fymk:Maybe you should really check up on what I say - I didn't say I want the person rotting. Check cardiac death and check brain death.
What's wrong with having a brain and cardiac death to declare a person dead? Some religions do believe that as long as the heart is still beating and the blood still flows - the person is alive regardless of a brain function. It has a spiritual meaning to them.
It only results in poorer quality organs but nevertheless organs.
LOL as for the last statement , I worked in hospitals . I seen major fuckups so don't ever try and even question me on this one again. Doctors are only humans who can make mistakes . Medical science is only at the tip of the iceberg . Science does not equate other spiritual beliefs and science does not have answers for everything.
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i think u should read up on my post n those that i quoted instead of jumping into your own conclusion.
u r such a selective looker as i have said b4.
i wasn't replying to yr post unless u r glc.
even if u seen major mistakes, r u going to deny the fact that it is the minority, most operations r successful, there will always be mistakes in life made by humans cos we r all just humans. u r just looking at mistakes only, u condemn ppl based on their mistake made in life, a lifetime is a long journey, u should oso see the merits as well or do u believe that ppl don't deserve a 2 chance?? u r always so defensive that u believe that everyone is wrong n u r right. what does that make u??? non-human?
ps. please read carefully b4 posting, otherwise don't post at all. -
Not really. You are just plainly dismissing the other side of the argument on organ donations lightly and taking the convenient and patronising moral high ground with me. Emotional argument - that is what you are using too as much as you like to think otherwise.
Dismissing? That is a rather weak attempt at trying to define your opponent's positionÂ… and as anyone who has read my posts will see, a failed attempt to do so as well.
Let me point out that NONE of you have ACTUALLY tried to rebuff about harvesting organs from functioning bodies except for one who seems to think that accidents happen and " too bad " if it happens , and one absolutely absurd allegation that I am USING it to discourage people. How the heck do they keep organs from deteriorating - ask yourself this. That is why I prefer to have people KNOW the FULL disclosure of how transplants are ran and then make the decision themselves.
For the record, I for myself do not dismiss the issue of people being accidentally harvested for their organs. In fact by my reckoning these deaths are every bit as tragic as those who die because organs are needlessly wasted. The DIFFERENCE between you and me is that I do not rely overtly, irrationally, and in an unbalanced way on either side of the argument to make my caseÂ… which is really more then I can say for you.
Also if you didnÂ’t note, the reason why nobody tried to REBUFF you is simply because you have left such a big hole in your own arguments could other people not help but exploit it before moving on to more balanced debate?
Does anybody here think that the risk of being accidentally harvested is an acceptable cost as long as thereÂ’s a supply of organs? I doubt so, and I think they can put up a lot more elequoent, reasonable, and honest arguments against such practices then you should it come to it.
IÂ’m afraid you attempting to see your opponents as being dismissive of the other side comes more from your desire to equate them and SOLVENT GREEN then actually and proper correlation in reality.
The truth is most reasonable people in here know we should be striving towards a system that is as zero-error and works for as many different beliefs as possible, where no organs are wasted and nobody accidentally (or maliciously) harvested. What we are however making clear is that the mistakes we are making not should not discourage us from working towards correcting and rectifying the entire thing.
It’s like one person saying “you like having your vegetables moderately fresh… why not have them totally fresh instead.” And another who goes “let’s throw out the loaf and eat bricks and centipedes instead.”. I think it’s quite clear who’s who.
And the point remainsÂ… at least most of your opponents have proper, solid ideas on how to improve the system while reducing the number of lives lost to organs wastedÂ… what has yours possibly been except stating out some rather commonsensical improvements but declaring quite proudly that you are happy to take a course of action counterproductive, or even outright contradictory to the very thing you suggest?
At the risk of using weasel words, I have plenty of friends who work in healthcare, seen plenty of death, the screw ups and what have you not. They however, seem to have a far more balanced view of organ donation then you do. -
Selective looker is more applied to you. I suggest that you read up on the definition of brain death before calling me a selective looker.Originally posted by Kenashi:quote:
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i think u should read up on my post n those that i quoted instead of jumping into your own conclusion.
u r such a selective looker as i have said b4.
i wasn't replying to yr post unless u r glc.
even if u seen major mistakes, r u going to deny the fact that it is the minority, most operations r successful, there will always be mistakes in life made by humans cos we r all just humans. u r just looking at mistakes only, u condemn ppl based on their mistake made in life, a lifetime is a long journey, u should oso see the merits as well or do u believe that ppl don't deserve a 2 chance?? u r always so defensive that u believe that everyone is wrong n u r right. what does that make u??? non-human?
ps. please read carefully b4 posting, otherwise don't post at all.
I am stating that no one ever know what the proper declaration of death is especially pertaining to consciousness in a brain dead ...wait brainstem dead patient. Never mind that the higher functions could be possibly existing in a brain stem dead patient or that a person with a form of neurological disease may not be responding to the clinical assessment criteria and therefore declared as dead wrongly. Note that they said the advanced tests like EEG are just "complementary"
I am not stating that people don't deserve a second chance. I am very paranoid of the current definition of death in favor of organ harvesting. Once brain death occur , I believe that the body should be allowed to shut down. Cardiac death always follow brain death.
In my opinion, that is the only way to declare a person fully and properly dead but it will never be done because they want better quality organs . That in my opinion , is viewing a person as a potential source of spare parts even before they are fully dead.There are cases whereby after a few years where the "victim" is declared brain dead, the "victim" just wakes up suddenly, with no brain/body defects. What if one day, your wife is so called declared brain-dead and they wanna remove her organs, then maybe only until then you'll get what im saying. Im entitled to my opinion as well.
Ever heard of Lazarus phenomenon? I suggest if you want to answer gLc's post above - go read up on Lazarus phenomenon. That is what he is referring to. Some doctors claim that it does not exist but just because you don't see it does not mean it does not exist . Some hospitals have official code blue document that actually contains the a special comment box for the Lazarus phenomenon and even has a special space for time of phenomenon happening from "death" to "autoresuscitation" aka life without any intervention.
Lazarus don't happen everyday for every patient and not everyone will have seen it but once you see it you would think twice about the definitions of death.
Does the means really justify the ends if a person declared brain dead but able to feel pain gets cut up ? Not very much is known about consciousness or whether it still exists - especially when the body is still actually living even when declared legally dead. -
First of all , have you read the rest of the arguments? You opened the door to my reasons - I told you. I am now expanding on reason no. 1 and 2 since the door has been opened. Don't start running a vatican on a galileo because later down the road, Vatican found that the earth wasn't so flat. If you can't accept the reasons, don't ask for them.Originally posted by SingaporeTyrannosaur:Dismissing? That is a rather weak attempt at trying to define your opponent's positionÂ… and as anyone who has read my posts will see, a failed attempt to do so as well.
For the record, I for myself do not dismiss the issue of people being accidentally harvested for their organs. In fact by my reckoning these deaths are every bit as tragic as those who die because organs are needlessly wasted. The DIFFERENCE between you and me is that I do not rely overtly, irrationally, and in an unbalanced way on either side of the argument to make my caseÂ… which is really more then I can say for you.
The truth is most reasonable people in here know we should be striving towards a system that is as zero-error and works for as many different beliefs as possible, where no organs are wasted and nobody accidentally (or maliciously) harvested. What we are however making clear is that the mistakes we are making not should not discourage us from working towards correcting and rectifying the entire thing. [/quote]
If it cannot be zero error - it should not be done on an automatic basis. If it is done - informed consent will have to be taken - risks explained.
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It’s like one person saying “you like having your vegetables moderately fresh… why not have them totally fresh instead.” And another who goes “let’s throw out the loaf and eat bricks and centipedes instead.”. I think it’s quite clear who’s who.
And the point remainsÂ… at least most of your opponents have proper, solid ideas on how to improve the system while reducing the number of lives lost to organs wastedÂ… what has yours possibly been except stating out some rather commonsensical improvements but declaring quite proudly that you are happy to take a course of action counterproductive, or even outright contradictory to the very thing you suggest?
At the risk of using weasel words, I have plenty of friends who work in healthcare, seen plenty of death, the screw ups and what have you not. They however, seem to have a far more balanced view of organ donation then you do.
LOL I worked in the system as well. I have known medical and nursing colleagues in healthcare who are registered organ keepers - no organs to be donated as well as you know those who will .
There is always someone out there with differing opinions. So what? Either try and convince or try to find out why in order to boost the volunteer system or people's understanding. It has already been established that people want to donate to help a life. Now let's establish why others might be objecting to it. And I am not the only one in the world that objects to it because of the current system.
I suggest that you start answering questions on the application of the legal definition of death and the implications, general mistrust of the system , and about lazarus phenomenon which one forumner brought up. If not , sit back and let other answer the questions.
Want to improve organ donation? Let people put down their clauses and set the conditions for their bodies to be used . That way you have a variety of happy donors with a working opt in system. Nothing wrong with that even if they want to be declared as cardiovascularly and neurologically dead before having organs removed. Nothing wrong with them wanting organs to go to family members first . -
Now u r attempting another battle of yours by challenging the medical opinion of the whole world of doctors and researchers. R u sure u have wat it takes to challenge their medical opinion ?
First thing I have to say is, singapore is not the only country tat practise auto opt in for organ donations.
In some nations (for instance, Belgium, Brazil, Poland, Portugal and France) everyone is automatically an organ donor, although some jurisdictions allow opting out from the system
http://en.wikipedia.org/wiki/Brain_dead
If u really felt tat singapore is a babaric nation, take note tat the more developed nations are practising auto opt in for organ donation. In fact some country don't even give u the option of opting out of the system.Unacceptable but oh wait . There are sedatives which can overcome a criteria like that . There are freak cases which do not comply with the criteria. More to come about supplementary tests.
Tis is on the test for brain dead. First, there is a need to explain tat brain dead is
Brain death is defined as a complete and irreversible cessation of brain activity. Absence of apparent brain function is not enough. Evidence of irreversibility is also required.
Now u say tat there r drugs tat overcome the criteria. Now which drug can overcome all the criteria of brain dead ? U r not dismissing the singapore gov in here, u r challenging the medical opinion of the medical field. R u trying to say tat the doctors r stupid and u r better than them to know who is dead or not. The doctors proclaim a man dead but u can proclaim them to be alive ?All in all unacceptable when it is a life involved. And like I said - no one has ever returned from the afterlife to tell us whether that method of declaring death is correct. There are however some who returned from the afterlife who saw the great white light when they were actually pronounced as dead. So I think I rather trust the latter than the former.
I think tat is stupid. Wat do u mean by afterlife and asking someone to come back from afterlife ? U mean we have to wait till then before we start organ donation ? R u being unreasonable or childish here ? And the people who u claim tat had returned from the dead r either in time later than 1980 or in ulu hospital at ulu country or have never go through the brain dead test.I am sure that there are a lot of individuals who would be interested in details of how organs are harvested from a presumably dead person. Body kept alive on ventilator or not? Heartbeat and blood pressure measured after death prior to organ removal or not? Anaesthetics used in procurement or paralysing agents ( yes those are used in harvesting) ? If there is a need for paralysing agents - why? If anaesthetics - why?
It is interesting to know, if I have the time, but I can say most don't really care because they knew it will be a very complicated surgery and require a lot of cuts etc. I went to remove appenditic (don't know spelling) before and I don't even know wat r the steps they have taken. U mean u go and study how the medicine is derived, how the operation is done, how u get anesthetic etc before u went for a surgery ? U have taken panadol before, wat is derived from it ? Wat r the dangers of it ? U got find out before now ? I believe 99% of the population knew they r going for an operation but do not know every single detail of the operation. The rest of the 1 percent r freaks and actual doctor themselves.
Furthermore if they put in all the details, it is going to be as thick as a medical textbook. U want the gov to send a medical textbook to every home ? U expect the FAQs for organ transplant to include the whole 900 pages on how to transplant organ ? Is it even necessary ? U think the people who know their organ r being harvested do not know it is going to be a complicated surgery ?What's wrong with having a brain and cardiac death to declare a person dead? Some religions do believe that as long as the heart is still beating and the blood still flows - the person is alive regardless of a brain function. It has a spiritual meaning to them.
I think almost all religion now believe in the authority of medical doctors now. Tat is why pope, head abbot, and possibly almost all head of religious organisation accept brain dead as dead (and not beating heart and flowing blood) and accept organ donations. Even cults r not stupid enough to challenge the viewpoint of the whole world of doctors and medical researchers. But surprisingly u seems to think u know better medical knwoledge than doctors and more about spirituality than priest and popesLOL as for the last statement , I worked in hospitals . I seen major fuckups so don't ever try and even question me on this one again. Doctors are only humans who can make mistakes . Medical science is only at the tip of the iceberg . Science does not equate other spiritual beliefs and science does not have answers for everything.
Major fuckup ? u r already dead for goodness sake. Even if u aren't dead because a super incredible wrong dianosis was given, a major fuckup is still gonna kill u as the doctor will arrange for u to be burnt instead. Science does not answer for everything but tat is the best we got. U prefer to find a bomoh/priest/witch doctor for a stomachache than a doctor ? -
You know there is something seriously wrong with you if you got me and SIS on the same side. I won't repeat his arguments for your sake, but instead focus on the more "meta-issues" that are every bit as important.
If it cannot be zero error - it should not be done on an automatic basis. If it is done - informed consent will have to be taken - risks explained.
Excuse me, but do you intend on opening up every one of your posts with a self-contradictory statement? How the blatant paradox of your statement above seems to indicate the exact one-track thinking that you posses.
It does not take any effort of logic to realize that your rather weak attempt to pulling the onus of “zero error” on your side by making stating “If it cannot be zero error - it should not be done on an automatic basis.”.
How can that “it cannot be zero error” statement, by any measure… be used only to dissolve any “automatic” procedures on your side, but yet on the same hand you are justifying other equally final and uninformed “automatic” procedures that your very position raises?
I would like to see you answer this.
On an off note, are there any automatic procedures that we can think off that are applied to us without requiring our “informed” consent with supposedly disastrous consequences but yet we continue on. And not to mention that even if so informed, most can make the appropriate value judgements that you mysteriously are unable to?First of all , have you read the rest of the arguments? You opened the door to my reasons - I told you. I am now expanding on reason no. 1 and 2 since the door has been opened. Don't start running a vatican on a galileo because later down the road, Vatican found that the earth wasn't so flat. If you can't accept the reasons, don't ask for them.
First of all, yes I have read the rest of the arguments. The thing that I find most amusing, and somewhat incredulous as to how it can constantly escape your attention.
ItÂ’s not that we do not accept your reasonsÂ… is that they are quite indeedÂ… laughably shallow and that point had but been raised to you time and time again. You however, seem to be incapable of even seeing the rather clear errors (which have been likeÂ… highlighted to you in the past 20 or so replies from all quarters) and yet again constanly seem to think that this is from people going Vatican on a Galileo on you. Is it not more of a case of you going abyssus abyssum invocat,a capite ad calcem with your arguments in here?.LOL I worked in the system as well. I have known medical and nursing colleagues in healthcare who are registered organ keepers - no organs to be donated as well as you know those who will .
LOL, it seems to me you have utterly failed to comprehend the words “at the risk of using weasel words”. How could you have missed the rather obvious fact that I was but referring to the irrelevance of the apparent weight of your experience with @#%ups and your colleagues by virtue of the vote. What that cannot be denied (and very “non weasel”) is the invalidity of the position of you and your ike.There is always someone out there with differing opinions. So what? Either try and convince or try to find out why in order to boost the volunteer system or people's understanding. It has already been established that people want to donate to help a life. Now let's establish why others might be objecting to it. And I am not the only one in the world that objects to it because of the current system.
Moving on, please do not be silly and try to bring up valid points that everybody from all quarters agree on- adversus solem ne loquitor . If you havenÂ’t noted (which is quite hard to do unless you have poor reading skills or missing out on most posts), most in here agree that something needs to be done with the way things are run in the mean time. If things were all well, it is quite apparent we would not even be having this discussion to begin with.
I suggest that you start answering questions on the application of the legal definition of death and the implications, general mistrust of the system , and about lazarus phenomenon which one forumner brought up. If not , sit back and let other answer the questions.
Want to improve organ donation? Let people put down their clauses and set the conditions for their bodies to be used . That way you have a variety of happy donors with a working opt in system. Nothing wrong with that even if they want to be declared as cardiovascularly and neurologically dead before having organs removed. Nothing wrong with them wanting organs to go to family members first .
The main issue and difference here isÂ… apparently your own irrational response to your own surprisingly, rather rational proposed solutions. ItÂ’s like a person who knows that to get from Singapore to New York is to fly, but proceeds to climb a building and jump right off facing in the appropriate direction.
As such, is it any surprise you often start your posts with self-contradiction and amusingly set down that line with pompous (and somewhat bizarre considering what you often suggest) declarations of concern for humanity and its rights? -
Not only meOriginally posted by stupidissmart:Tis is on the test for brain dead. First, there is a need to explain tat brain dead is
Brain death is defined as a complete and irreversible cessation of brain activity. Absence of apparent brain function is not enough. Evidence of irreversibility is also required.
Now u say tat there r drugs tat overcome the criteria. Now which drug can overcome all the criteria of brain dead ? U r not dismissing the singapore gov in here, u r challenging the medical opinion of the medical field. R u trying to say tat the doctors r stupid and u r better than them to know who is dead or not. The doctors proclaim a man dead but u can proclaim them to be alive ?
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Heard of Guillain Barre'?
Or maybe if you want the wise medical research that says so
"
Neurologic States That Can Mimic Brain Death
Misdiagnosis of brain death is possible if a locked-in syndrome,26 hypothermia,27 or drug intoxication28,29,30 is not recognized. The locked-in syndrome is usually a consequence of the destruction of the base of the pons. The patient cannot move the limbs, grimace, or swallow, but the upper rostral mesencephalic structures involved in voluntary blinking and vertical eye movements remain intact. Consciousness persists because the tegmentum, with the reticular formation, is not affected. The condition is most often caused by an acute embolus to the basilar artery.26 More dramatic is the reversible Guillain–Barré syndrome involving all the peripheral and cranial nerves. The progression occurs over a period of days, and knowledge of the history should prevent the dangerous error of diagnosing brain death.31
Accidental hypothermia from prolonged environmental exposure may mimic loss of brain function, but alcohol intoxication and head injury are often major confounders.27 Hypothermia causes a downward spiral of loss of brain-stem reflexes and pupillary dilatation. The response to light is lost at core temperatures of 28°C to 32°C, and brain-stem reflexes disappear when the core temperature drops below 28°C.27 These deficits are all potentially reversible, even after extreme hypothermia.32
The effects of many sedative and anesthetic agents can closely mimic brain death, but aspects of brain-stem function, particularly the pupillary responses to light, remain intact. When ingested in large quantities, many drugs can cause a partial loss of brain-stem reflexes. Formal determinations of brain death documenting conditions that are entirely similar to those caused by structural lesions are exceptional but have been reported in cases of intoxication with tricyclic antidepressants and barbiturates.28,29 A more complex problem is the possible confounding of the clinical determination of brain death by metabolites or traces of circulating pharmaceutical agents. Screening tests for drugs may be helpful, but some toxins (e.g., cyanide, lithium, and fentanyl) may not be detected by routine screening tests.29 A clinical diagnosis of brain death should be allowed if drug levels (e.g., of barbiturates used to treat increased intracranial pressure) are below the therapeutic range. A reasonable approach is as follows: If it is known which drug or poison is present but the substance cannot be quantified, the patient should be observed for a period that is at least four times the elimination half-life of the substance, provided that the elimination of the drug is not interfered with by other drugs or organ dysfunction. If the particular drug is not known but high suspicion persists, the patient should be observed for 48 hours to determine whether a change in brain-stem reflexes occurs; if no change is observed, a confirmatory test should be performed. " - The New England Journal of Medicine.
[quote]
Now u r attempting another battle of yours by challenging the medical opinion of the whole world of doctors and researchers. R u sure u have wat it takes to challenge their medical opinion ?
Some doctors challenge it as well like Dr David Evans . I can cut and paste his letter if you like.
Want more references questioning the validity of the tests? -
Amusingly I find it interesting that people class non-donors as selfish . I said I know as many people who object just like you know as many who will donate. Does that sound weaselly ? There is always someone with an opinion - that's a fact. Does it sound weaselly again?Originally posted by SingaporeTyrannosaur:As such, is it any surprise you often start your posts with self-contradiction and amusingly set down that line with pompous (and somewhat bizarre considering what you often suggest) declarations of concern for humanity and its rights?
We all established that donating organs is altruistic . Altruism may come as a detriment to the donor - am I not wrong?
I am no saint . Yes bring up all the nature arguments which I retorted to someone who was going around accusing those who oppose organ donation as selfish or inhumane. Contradictory I think not.
The fact remains that nature kills waiting recipients via the disease process if there is no match. The killer is nature , not a non-donor as some would love to blame non-donors for the so called lack of compassion. If you cannot accept that , then it is too bad. Buddhist saying the cause of death is life and this rings true now that presumed corpses are ventilated prior to organ removal - they don't look dead to family members and we are not talking denial - the bodies are warm and perfused.
The removal of organs will cease all living functions in the body. If you cannot accept that , too bad. OM already stated the heart and lung will be functioning and that is the window for transplantation.
Yes I stand by the fact I will not tolerate the killing of a living functioning human body to even satisfy my own. Is that bizarre for you? And fact remains that I do not accept brain death as utter death . It is a legal term which takes the right of a human being away once the brain-stem is dead, not a thoroughly proven one especially when it pertains to consciousness.
If you want to continue on your tirade , go ahead. You have not moved on as you would like to think you did. I am now discussing on the definitions of brain death legally and the implications and Lazarus phenomenon. Go find out what a brain stem does - it does not regulate the whole brain function. Neither do any of us even all those medical scientists out there have unlocked the absolute truth of neurophysiology . I remember a lecturer of mine stating that what we know about the brain now is only but the start. Advanced it may look , it isn't so.
With consciousness and neurological science barely in depth in studies - you cannot prove something which has not been studied much - Lazarus phenomenon is known to happen as well .If it cannot be concluded , it should not be done , even if a bunch of scholars in Harvard gave a definition. Bizarre you call it ...I don't think so. -
As for the vatican on galileo - let me refresh you on that historical fact - Vatican's opinions were carried by a majority - Galileo's opinion was carried by a silent minority . It was considered a heresy to go against Vatican ...somewhat like the sacred cow of organ donations.
I see no absolute truth or proof especially when it comes to a human life where no errors should be made if it is preventable - with the definitions of death , it is not preventable anymore- so I don't trust the system .
I am your minority - show me the absolute proof that the consciousness of a human will cease once brain stem death happens. I doubt you can because no scientific study has ever refuted that issue of consciousness yet.
Oh by the way , there is a case where a brain dead mother could still carry a child to full term. A life carried in a corpse? or A life carried by another life? Ask yourself this. -
Originally posted by stupidissmart:
You neglected to even fully read the brain dead side of it.
Now u r attempting another battle of yours by challenging the medical opinion of the whole world of doctors and researchers. R u sure u have wat it takes to challenge their medical opinion ?
First thing I have to say is, singapore is not the only country tat practise auto opt in for organ donations.
[b]In some nations (for instance, Belgium, Brazil, Poland, Portugal and France) everyone is automatically an organ donor, although some jurisdictions allow opting out from the system
http://en.wikipedia.org/wiki/Brain_dead
Major fuckup ? u r already dead for goodness sake. Even if u aren't dead because a super incredible wrong dianosis was given, a major fuckup is still gonna kill u as the doctor will arrange for u to be burnt instead. Science does not answer for everything but tat is the best we got. U prefer to find a bomoh/priest/witch doctor for a stomachache than a doctor ? [/b]
Note the bold
Legally dead does not equate to really dead . EEGs in Singapore's definition is only complementary- not compulsory.
" Traditionally, death has been defined as the cessation of all body functions, including respiration and heartbeat. Since it became possible to revive some people after a period without respiration, heartbeat, or other visible signs of life, as well as to maintain respiration and blood flow artificially using life support treatments, an alternative definition for death was needed. In recent decades, the concept of "brain death" has emerged. By brain-death criteria, a person can be pronounced legally dead even if the heart continues to beat due to life support measures. The first nation in the world to adopt the brain death as the definition of legal death was Finland in 1971. In the United States, Kansas had made a similar law at an even earlier date[1].
A brain-dead individual has no electrical activity and no clinical evidence of brain function on physical examination (no response to pain, absent cranial nerve reflexes (pupillary response (fixed pupils), oculocephalic reflex, corneal reflexes), absent response to the caloric reflex test and no spontaneous respirations). It is important to distinguish between brain death and states that mimic brain death (eg. barbiturate intoxication, alcohol intoxication, sedative overdose, hypothermia, hypoglycemia, coma or chronic vegetative states). Some comatose patients can recover, and some patients with severe irreversible neurologic dysfunction will nonetheless retain some lower brain functions such as spontaneous respiration, loss of both cortex and brainstem function. ......
Note that brain electrical activity can stop completely, or apparently completely (a "flat EEG") for some time in deep anaesthesia or during cardiac arrest before being restored. Brain death refers only to the permanent cessation of electrical activity. Numerous people who have experienced such "flat line" experiences have reported near-death experiences, the nature of which is controversial ." -
yap rite, the pot calling the kettle black. check for the last few posts on yr comments on me, b4 sprouting such words, u only see what u want to see.Originally posted by fymk:Selective looker is more applied to you. I suggest that you read up on the definition of brain death before calling me a selective looker.
I am stating that no one ever know what the proper declaration of death is especially pertaining to consciousness in a brain dead ...wait brainstem dead patient. Never mind that the higher functions could be possibly existing in a brain stem dead patient or that a person with a form of neurological disease may not be responding to the clinical assessment criteria and therefore declared as dead wrongly. Note that they said the advanced tests like EEG are just "complementary"
I am not stating that people don't deserve a second chance. I am very paranoid of the current definition of death in favor of organ harvesting. Once brain death occur , I believe that the body should be allowed to shut down. Cardiac death always follow brain death.
In my opinion, that is the only way to declare a person fully and properly dead but it will never be done because they want better quality organs . That in my opinion , is viewing a person as a potential source of spare parts even before they are fully dead.
Ever heard of Lazarus phenomenon? I suggest if you want to answer gLc's post above - go read up on Lazarus phenomenon. That is what he is referring to. Some doctors claim that it does not exist but just because you don't see it does not mean it does not exist . Some hospitals have official code blue document that actually contains the a special comment box for the Lazarus phenomenon and even has a special space for time of phenomenon happening from "death" to "autoresuscitation" aka life without any intervention.
Lazarus don't happen everyday for every patient and not everyone will have seen it but once you see it you would think twice about the definitions of death.
Does the means really justify the ends if a person declared brain dead but able to feel pain gets cut up ? Not very much is known about consciousness or whether it still exists - especially when the body is still actually living even when declared legally dead.
if u can't accept that, i got nothing further to say since u won't admit even such facts, there's no point in debating with u since u will only regard yrself as the only one who is right. -
Informed consent should let people know about what they expect about how they might look after death and what happens when they donate their organs if they wish to know. All I ever get is " you will be treated with respect and dignity" PERIOD.
During the period before the HOTA was enacted, this was discussed extensively in the press. After the transplant, the donor's appearance is as if he had a major surgery: a laparotomy incision if the liver and kidneys were removed, a thoractomy if the heart and lungs were removed. You are free to ask the organ transplant coordinator in any hospital if you have questions about transplant. In the opt out system, there is no need to request consent prior to organ transplant under HPTA.Do they use anaesthetics or paralytic agents in removal then?
Once brain death has set in, what is the point of anaesthesia? Some patients may have been anaesthesized before brain death but to anaesthetic agents have to be withdrawn before the transplant for at least 2 good reasons.
First, anaesthetic agents may damage the transplant organs, especially the liver and kidneys which are needed to excrete them; and we need these organs to be in the best possible condition.
Second, you cannot certify brain death with anaesthesia, which brings me to your other question.Heard of Guillain Barre'?
The doctors cannot certify brain death if the underlying cause of brain death eg. a stroke, head injury is unknown or if the possibility of neurological conditions such as Gullian Barre or locked in syndrome cannot be excluded. The certification is doen by at least two independent senior doctors not connected to the transplant, one of whom has to be an expert in anaesthesiology or a related field.
Or maybe if you want the wise medical research that says so
The other important exclusion is anaesthesia. Many drugs eg. barbiturates can mimic signs of brain death and so even if the patient had been anaesthesized previously, this has to be stopped and the body cleared of such drugs before testing for brain death. -
EEGs in Singapore's definition is only complementary- not compulsory
EEG measures cortical activity, not brainstem activity. Brain stem death is irreversible but it cannot be detected by EEG, the clinical tests for brain death are used instead and have been widely recognized as indicative. Some brainstem dead individuals have residual EEG signals but the patients are clearly brain dead. -
Brain death is a concept which major religions might accept but not everyone. I am also the minority who refuses to believe in death or that the soul has fully left the body (I do believe in afterlife) until all vital functions has finally ceased.
Legislation in a society considers the welfare and opinion of the majority. Our law in this regard protects the minority view in that they can opt out if they so wish. As you said, your understanding of death is rooted in a personal belief which the majority of people do not share. You are entitled to your belief and you can opt out. Although for the sake of consistency, you will be placed at the back of the transplant queue if you should need one. -
I think there is a need to give us your link on where u get the information. However from your article
The patient cannot move the limbs, grimace, or swallow, but the upper rostral mesencephalic structures involved in voluntary blinking and vertical eye movements remain intact.
There r 3 of the tests of brain dead tat specifically check the eyes. Even if u have hypothermia and drug intoxification, it can still be check if the test r conducted properly since they don't affect the eyes.Some doctors challenge it as well like Dr David Evans . I can cut and paste his letter if you like.
Lets put it tis way. There r many doctors in the world and it is not surprising if u find a few doctors tat do not support the test of brain dead. I think it wil be more substantial if u can back up your claim with reputable scientific organisations. There r many scientific organisations but they consists of a panel and discussion among the members thus r more credible compared with single individuals. I mean if all the scientific organisations support the test of brain dead, then I don't see why it loses to a mere individualYou neglected to even fully read the brain dead side of it.
I have read the whole article before and I find nothing is wrong
Note the bold" Traditionally, death has been defined as the cessation of all body functions, including respiration and heartbeat. Since it became possible to revive some people after a period without respiration, heartbeat, or other visible signs of life, as well as to maintain respiration and blood flow artificially using life support treatments, an alternative definition for death was needed.
Tat is true. Traditionally there is no cure for headache, or stomachache and operation has a high mortality rate. Traditionally there is no such thing as a life suppor machine. Note the word "traditionally". In the past people do state tat death is when the heart stop beating. But now with more medical knowledge brain dead is the real deadA brain-dead individual has no electrical activity and no clinical evidence of brain function on physical examination (no response to pain, absent cranial nerve reflexes (pupillary response (fixed pupils), oculocephalic reflex, corneal reflexes), absent response to the caloric reflex test and no spontaneous respirations). It is important to distinguish between brain death and states that mimic brain death (eg. barbiturate intoxication, alcohol intoxication, sedative overdose, hypothermia, hypoglycemia, coma or chronic vegetative states).
U need to re read the article. It say brain dead individual and list etc as brain dead. Then u read there r possible sickness tat mimic brain dead (meaning coma, hurting it have no effect), but the brain dead test still can check for sure if it is brain dead or not.Note that brain electrical activity can stop completely, or apparently completely (a "flat EEG" for some time in deep anaesthesia or during cardiac arrest before being restored. Brain death refers only to the permanent cessation of electrical activity. Numerous people who have experienced such "flat line" experiences have reported near-death experiences, the nature of which is controversial ."
Note tat EEG is not part of the major test but supplementary one
-
Really fmyk... what do you intend to acomplish here except to abuse your right to free speech by getting your position demolished by an uneasy collation of traditionally antagonistic parties in here?
Do you being in the minority simply means that you hold a piece of enlightened wisdom that the majority are simply unaware of? Or does it mean instead that you are one of the few still hiding in the crevices of dark and fear?
Galileo sought to expand our horizons... it seems that your case in here resembles that of the Vacatian in that issue instead of Galileo . As much as you try to hijack him as an analogy of your stance... it has been like the rest of your adventures abyssus abyssum invocat,a capite ad calcem.
Here's a suggestion: Try logic- it works. -
The pupillary light reflex, oculocephalic and vestibulo-ocular relexes can be diminished or abolished in hypothermia and drug intoxication eg. barbiturates.Originally posted by stupidissmart:There r 3 of the tests of brain dead tat specifically check the eyes. Even if u have hypothermia and drug intoxification, it can still be check if the test r conducted properly since they don't affect the eyes.
That is why for certification of brain death, the doctor has to ensure that the body temperature is normal and there are no evidence of drug intoxication. If the patent had been anaesthesized, the drugs have to be withdrawn and certified to have been washed out of the body before the clinical tests for brain death can be conducted.
All these possible confounding factors that might affect brain death certification are well recognized by doctors when they certify brain death. It's part of the protocol, so such concerns are superfluous.
However, fymk is fully entitled to her beliefs and she can opt out of the system if she so desires. I have no issue with that, as long as she understands that she will be put at the back of the transplant queue if she needs an organ, just like Muslims who do not opt in. -
In case you didn't see The New England Journal of Medicine reference at the end - link for you. So please read these articles carefully before attempting to take another potshot.Originally posted by stupidissmart:I think there is a need to give us your link on where u get the information. However from your article
quote:
------------------------------------------------------------------------
The patient cannot move the limbs, grimace, or swallow, but the upper rostral mesencephalic structures involved in voluntary blinking and vertical eye movements remain intact.
------------------------------------------------------------------------
The New England Journal of Medicine is a peer reviewed medical journal .
I got access to it through organisational membership. You probably need to buy the whole article or join the trial period. Alternatively you can go to the medical library and look for it.
NEJM .Volume 344:1215-1221 April 19, 2001 Number 16 :The Diagnosis of Brain Death by Eelco F.M. Wijdicks, M.D.
http://content.nejm.org/cgi/content/short/344/16/1215?query=prevarrow&ck=nck
Another article worth reading about is locked in syndrome
Is the patient brain-dead? R Agarwal, N Singh and D Gupta
http://emj.bmj.com/cgi/content/full/23/1/e05
This is by Emergency Medicine Journal which is another reputable journal -
Originally posted by SingaporeTyrannosaur:
Bioethics is controversial . In case you have not noticed - organ donations belong to that realm . It's not a clear black and white - it's a gray. You do not have the rights answers and neither do I . Nobody has. Want to argue ethics? You have to know the philosophical , theological , legal, moral and biological stance . So far you are arguing just plainly on a one sided moral stance which may even be in the gray as well and if the old definitions of death was used, it would be in the black . How's that for logic.
Really fmyk... what do you intend to acomplish here except to abuse your right to free speech by getting your position demolished by an uneasy collation of traditionally antagonistic parties in here?
Do you being in the minority simply means that you hold a piece of enlightened wisdom that the majority are simply unaware of? Or does it mean instead that you are one of the few still hiding in the crevices of dark and fear?
[b]Galileo sought to expand our horizons... it seems that your case in here resembles that of the Vacatian in that issue instead of Galileo . As much as you try to hijack him as an analogy of your stance... it has been like the rest of your adventures abyssus abyssum invocat,a capite ad calcem.
Here's a suggestion: Try logic- it works.[/b]
Why call it an abuse of free speech? That is unless you yourself are starting to feel uncomfortable with the indepth discussion of the concept of death and organ removal. That's too bad for you because others might want to discuss theirs or voice their opinions. It's a public forum and I am doing nothing wrong or illegal.
I won't call OM antagonistic - at least he answering my questions as well as stating his opinions very neutrally, not you. For that I do actually thank him for his efforts at explanation - unlike others who took personal potshots, he just said that I am fully entitled to my views , defended the diagnosis of brain death protocols, and gave me the warning that I will be at the bottom of the list . I do not see it anyway as antagonistic , he is just voicing his opinions as well and I can respect that.
Yes I am expressing a reason which is based on my moral and religious beliefs, fear of being conscious while in the name of death and organ transplant, they cut me up. That also brings about the question of religious and moral obligation when the definition of brain death can neither be proven or debunked as true death. Fear does not need to be rationalised neither does it deserve condemnation . However this fear this time is rational in part and in tune with my religious and moral beliefs when one questions the real definition of death , not the legal one. Like I said Legally dead does not mean REALLY dead. -
My sons n our family members supported yr views!!!Originally posted by fymk:Bioethics is controversial . In case you have not noticed - organ donations belong to that realm . It's not a clear black and white - it's a gray. You do not have the rights answers and neither do I . Nobody has. Want to argue ethics? You have to know the philosophical , theological , legal, moral and biological stance . So far you are arguing just plainly on a one sided moral stance which may even be in the gray as well and if the old definitions of death was used, it would be in the black . How's that for logic.
Why call it an abuse of free speech? That is unless you yourself are starting to feel uncomfortable with the indepth discussion of the concept of death and organ removal. That's too bad for you because others might want to discuss theirs or voice their opinions. It's a public forum and I am doing nothing wrong or illegal.
I won't call OM antagonistic - at least he answering my questions as well as stating his opinions very neutrally, not you. For that I do actually thank him for his efforts at explanation - unlike others who took personal potshots, he just said that I am fully entitled to my views , defended the diagnosis of brain death protocols, and gave me the warning that I will be at the bottom of the list . I do not see it anyway as antagonistic , he is just voicing his opinions as well and I can respect that.
Yes I am expressing a reason which is based on my moral and religious beliefs, fear of being conscious while in the name of death and organ transplant, they cut me up. That also brings about the question of religious and moral obligation when the definition of brain death can neither be proven or debunked as true death. Fear does not need to be rationalised neither does it deserve condemnation . However this fear this time is rational in part and in tune with my religious and moral beliefs when one questions the real definition of death , not the legal one. Like I said Legally dead does not mean REALLY dead.
Pls save yr breath to talk 2 those who r not in the industry,wasting yr time!!!