Should the UK switch to an opt out organ transplant system?

In the UK there is currently an Opt in organ donation system. This is where people have to actively sign up to a register to donate their organs after death. In opt-out systems, organ donation will occur automatically unless a specific request is made before death for organs not to be taken. However, there is much deliberation over whether the current policy should remain in place or be changed.

For living people, the ability to control what happens to their bodies is acknowledged to be a fundamental right of all competent adults. Patient autonomy is a key legal and ethical concept that is so highly regarded that it even allows competent adults to refuse life prolonging treatment. (Somerville 2012) So why should we threaten this autonomy with something morally unjustifiable even if a policy sounds medically desirable? Patient autonomy may not be respected because they may be unaware of the changes put in place. If this is the case, then the consent by which the government are taking the organs is not informed and therefore is it justifiable to remove a person’s organs when they have not expressly said they want this to be done. This would go against the human tissue act 2004 because there is not the appropriate level of consent. A human’s relationship with their body can be hugely important to the value of their lives which places deontological constraints onto what others should be able to do with our bodies after we die. Furthermore, a lot of people have interests that survive their deaths including their faiths so ignoring these interests could be a showcase of disrespect and potentially cause posthumous harm. (Glannon W 2003)

On the other hand, the most attractive and persuasive facet of an opt out system is the potential increase in donation rates; it is assumed that there is a positive correlation between opt out systems and a rise in donation. More than 6,500 people in the UK need a transplant, but a shortage of donors means that around 3,500 transplants are carried out annually.  The British Medical Association recently recommended an opt out scheme with safeguards as the best method of improving organ donation rate. (BMA 2012) As we have found through medical experience, a transplanted organ has the ability to save someone’s life, and can also improve the quality for life for many. Despite the success of these surgeries, there is still not enough organs to meet the demands of the National Health Service. So why wouldn’t we operate an opt out scheme if it meant a better quality of life for many people?

If most people are donors, supply may exceed the demand for the organs. If this does occur, how do we distinguish between the organs which are donated? This would mean valuing one person’s body higher than someone else’s. In addition to this what would happen to the organs which are not used. Organ removal without the expressed wish from a deceased patient who hadn’t considered that they would need to ‘opt-out’ could be very distressing and upsetting for family members too.

Subsequently, it’s said that most recipients would prefer their donated organs to come from someone who had made a deliberate decision to donate. However, all statistics indicate that many more people are prepared to donate their organs after death than are registered as potential donors. With this new system, it saves people from the inconvenience of having to register, as they are automatically put forward for organ donation. Those who have strong opinions still do have the option to opt out, and will be made easy to do so, however it is slightly inconvenient, which may sway people to not do it, meaning more organs for the NHS, meaning more lives can be saved. Therefore an opt out policy should be enforced.

Another argument against Opt out schemes is that the pressure from society/positive stigma associated with organ donation may deter people from choosing to opt out even if this was their wish. If they were made to feel selfish this may put people off expressing their right to choose what happens to their body. It creates social tensions example, if a terminally ill person opts-out they may be made to feel selfish; highlighting a sudden inadequacy of right to refuse. This is unfair. A person should have the right to decide what happens to their body, whether it be for the greater good or not. Therefore an Opt out system is highly unethical.

An argument for opt out organ donation, is that a dead body is an inanimate object and has no use. Although it may hold sentimental value, once somebody has died, they do not longer require their working organs. If a person has viable and working organs when they decease, why would these be wasted? The dead body is incapable of feeling, thus there is no pain involved. Doctors are also competent to respect the cadaver’s body, meaning that the person would still be looked after, and receive good medical treatments, even when they’re deceased.

Another argument against the opt out system is that it could threaten individual rights in a number of ways, particularly with the conflict of interests between care of the dying and those waiting for organs in a way that the state could gain unwarranted control and ‘exploit’ donors. Moreover, there is fear that the new system could be misused, such that donation procedures could be implemented before patients are confirmed dead or that less effort will be made to keep patients alive if their organs could help younger patients awaiting transplantation and medical professionals may consequently hasten death. Along with fears that their bodies will be mutilated. This goes against the ethical law of non-maleficence. If an organ is removed before a person is pronounced dead, it harms the patient. (Automatic organ donation: The pros and Cons, 2016)

To counteract this, Doctors go through 5 years of intense medical training, before they start working as a Junior Doctor. This is an adequate amount of time for the people to learn and appreciate ethical laws, and become competent Doctors. It is extremely unlikely that a Doctor would ‘hasten death’. Therefore we should not worry about the ability of our Doctors, as they are fully aware of medical laws and know the consequences of not acting in the best interests of the patient.

To conclude, I believe that the UK should not change to an opt out system. In an ideal situation individuals should make a positive choice to donate tissues or organs after their death for the benefit of others without coercion or manipulation. I also feel that donating your organs after death is a valiant thing to do; if everyone were to donate their organs it wouldn’t be as much of a good deed, therefore possibly increasing the number of people who would opt out, as it would be seen as devalued, and pointless. Therefore I think we should keep the current system, however we should raise the awareness of organ donation, as the benefits from it are really important within the health service.

 

 

Automatic organ donation: The pros and cons (2016, 12 ,8) Retrieved from the Week: http://www.theweek.co.uk/35635/automatic-organ-donation-the-pros-and-cons

English, V Sommerville A Presumed consent for transplantation: a dead issue after Alder Hey? A journal of Medical Ethics 2003;29:147-152

BMA, Building on Progress: Where next for organ donation policy in the UK?‟ (February 2012, BMA Medical Ethics Committee) 69.

Glannon W Do the sick have a right to cadaveric organs? Journal of Medical Ethics 2003;29:153-156.

Research Shows ‘One Too Many’ Can Cause Fatal Heart Risk

Alcoholism. How common is it? It is extremely hard to answer that question. As many alcoholics live through their drinking abuse in silence. However just take this statistic: on average, it is estimated that the lives of five other people will be harmed when one individual becomes addicted to alcohol.

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According to Government statistics, more than 1.4 million people are dependent on alcohol in the UK. 33,000 people die each year due to alcohol-related incidents or associated health problems. Alcohol is involved in 15% of road accidents, 26% of drownings, and 36% of deaths in fires. A quarter of accidents at work are drink-related.

Realistically, every body loves and enjoys a drink from time to time, however when this becomes excessive, it can cause problems.

By definition cardiovascular disease  generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Thus possibly leading to death. In the UK it is estimated that 2.3 million people suffer from heart disease. New research examines the link between arterial stiffness – a significant indicator of cardiovascular health – and alcohol consumption over time.

The research was conducted by Darragh O’Neill, Ph.D., who is an epidemiological researcher at University College London in the United Kingdom. He found a link between heart disease and alchol. He found that overconsumption of alcohol can lead to stiffness of the arteries occurs when the walls of the blood vessels lack elasticity, which can negatively impact the artery’s response to variation in blood pressure.

Consistent moderate drinkers at risk were defined as those who consumed between 1-112 grams of ethanol per week, so less than the 14 units. One U.K. alcohol unit is roughly the equivalent to a shot of whiskey or half a pint of beer. So when thinking about it in terms of a night out, that is 7 pints of beer or about 11-14 shots.

Interestingly, after the longditudinal study it was found that after adjusting for several factors including BMI, heart rate, and arterial pressure, the associations were not significant for women, even though 73 percent of the study participants were men. By no means does this mean women are free to drink as much as they like, as there are many other health risks alcohol can lead to.

After vigorous research, they also found that alcoholism could lead to aging of the arteries.

The researchers finally concluded that excessive drinking can increase risk of cardiovascular disease, especially in men. They also found that constant heavy drinking can affect the arteries, thus interfering with blood flow. So I can conclude from this, that maybe its about time people really started looking into how MUCH they are actually drinking.

Thankyou.

 

Antimicrobials: why is everyone so worried?

‘Overuse and misuse of antibiotics is increasing the problem of antibiotic resistance. We are all part of the problem and the solution.’

Antimicrobials are a category of drugs that include antibiotics, antivirals, antifungals, and antiparasitics. When we regularly, and overly expose the body to antimicrobials, the harmful bacteria in our bodies can build a resistance, so they can survive an attack from these drugs. When this happens the antimicrobials will no longer be effective and will not kill the organisms/bacteria that they used to.

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In the present day, less and less new antimicrobials are being produced. Also the time it is taking for bacteria to become resistant to new antibiotics is getting shorter. This means we are forced to use stronger drugs in order to combat bacteria, which means when a more serious illness comes along, we will have no antibiotics to treat it with, as the bacteria have already become resistant to that particular antimicrobial.

Over prescription of these drugs has meant that the bacteria have had more and more chance to become resistance to the antibiotic. This involves giving out antibiotics when they are not needed. Also not taking the drug at the correct times and dosages that were recommended by your Doctor can also cause resistance. This gives the bacteria time in your system to become resistant.

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Without antibiotics, simple medical procedures such as delivering a baby or appendectomy, would prove much harder without antimicrobials. The procedures would include a much higher risk of infection, and we obviously would have nothing to treat it with.

In order to combat antimicrobial resistance, it is important to remember that you should not ask for antibiotics for viral infections, like a common cold or flu. You should only take antibiotics when your doctor recommends, and you should not pass left overs of antibiotics on to friends or family, throw any left over drugs away. It is possible to transfer antimicrobial resistant bacteria to others, therefore you must  practice good hygiene.

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If not dealt with this could become an international problem. Reduce, replace, rethink.

Thanks, Sophie.

Zika Virus Is Now Linked To Guillain-Barré syndrome?

 Guillain-Barré syndrome, by definition is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. Guillain-Barre is an autoimmune disorder in which the body’s immune system attacks the nervous system. The disease typically affects axons, the parts of peripheral nerves that transmit nerve signals, or the myelin sheath covering the axons. After several weeks of having the disorder sufferers may experience tingling in their legs, then weakness in their legs and arms, and in some cases even lose the ability to use muscles. It may take weeks, to years to recover from it.

zika-virus

Guillain-Barré syndrome has been linked to many mosquito causing infections in the past, it is said to be linked to Zika as during a period between 2012-2014 there was a sudden up rise in contraction of the virus, at this same time, there was an increase in reported cases of Guillain-Barré syndrome.

Guillain-Barré-syndrome

The logic behind the Zika virus causing Guillain-Barré syndrome is that as the body produces antibodies in order to provide the immune response, these same antibodies also recognize parts of the nervous system.

Although there are no current treatments for the Zika virus, like other mosquito-borne diseases, many scientists for example Jae Jung, director of the Institute of Emerging Pathogens and Immune Diseases at the Keck School of Medicine at the University of Southern California, hope they will become available in coming years and help control spread of the Zika.

Thank you.