Monday, March 7, 2011
Organ donation. Not just the donor's decision...
There is a lot of mis-information outside the hospital about the organ donation stuff that people really care about beyond the medical jargon.
"Will the doctors be gentle?"
"Can we still have them for a funeral"
"Will they get less care if they can be used after death?"
"what about MY choice?"
I hope this is of help to someone, and if just one person takes steps to ensure that their organs will be available for donation, I am happy. A lot of the information on this page can be found at Organ donation NZ as well as being based on my own experience as an OR nurse (but not part of the transplant team).
There is plenty of heart wrenching information about those of our community who need a second chance by way of an organ donation. Enough information that I didn’t think twice about putting that I am an organ donor on my driver’s license.
It was an easy enough decision for an atheist like me, no rules from god, distaste from my family or concerns that the soul might in fact be stored in the heart. Just the idea that if I die young, the waste would not be so great if I could benefit someone else.
For the average Jo, there is not as much good strong information about what happens to the donor and equally importantly, the family of the donor.
An amazingly helpful link is this one here taking you through the donation process. Please read this before continuing on through my blog post.
In New Zealand if you wish to become an organ donor there are a lot of barriers between you saying yes, and the right thing happening when you die.
• Even if I say yes; if I die suddenly and my heart no longer pumps, there is a very high chance or organ death, and I can no longer be a donor.
• Even if I say yes, and I die of brain stem death whilst my heart continues pumping; my partner can say no.
• Even if I am a valid donor, and my partner and I say yes; any other family member can say no.
• Even if I am a valid donor, and everyone involved says yes; if they sign me off as brain dead, turn off the ventilator and I do not stop breathing within a certain amount of time, I will be put back on the ventilators to continue being cared for.
It is no wonder that the annual rate of deceased organ donors in NZ has always sat under 47 pa.
Not only do you need to be ok with it, but your family needs to be ok with it too.
Talk through the positives and the negatives.
Your family will be asked about this by an intensive care doctor, once the diagnosis of brain death is clear. They will be heartbroken and stressed and do not need to be making hard decisions at this time
Although the donor is brain dead, and would never survive without the machines helping them breathe, they appear very much alive, just asleep. – This can be hard to cope with.
The donor does not visibly ‘die’ (their cardiac and respiration stopping) in ICU. They are taken to theatre still breathing, with a heartbeat. - This can be hard to reconcile with the diagnosis of death.
There is more done for a donor patient to ensure a correct diagnosis of death, than is done on a non-donor patient.
If you have discussed donation with your family in advance and they understand what is involved and are happy for donation to take place, the idea that a positive is coming from it, can be a small ray of light in a horrible situation.
Once the patient is assessed to be a donor, and the family has been asked, donation is still very personal and the family can select what they are happy donating, e.g. My partner might be happy with donating my heart, but does not want my corneas taken – that is totally ok.
There is a donor coordinator whose only job is to help facilitate the smooth running of donations, and ensure the wellbeing of the donor and donor family.
The donor’s body is returned to the family for them to say their goodbyes in the same way as any patient who passes away in the OR.
The donor is treated just like any other patient in the OR. It is a surgical team working respectfully on them. Their wounds are sutured and dressed, just like they would normally be.
“Although confidentiality is maintained, recipients are able to write an anonymous letter of thanks to the donor family. These letters are forwarded through Organ Donation New Zealand to the family of the donor, if they wish to receive them. Donor families are also able to write to recipients and these letters are handled in the same way.” *“Each year in April or May, a service is held in Auckland in recognition of those who have donated organs and given the gift of life to others. A second service is also held on alternate years in Wellington and Christchurch.
Donor families, recipients and their families, and health professionals are invited to these services."
So PLEASE, if you do want to be an organ donor in NZ, don’t just ensure that it is written down. Talk to your loved ones about it and make sure everyone understands and agrees.
I have personally discussed this with my close family, to the point where my parent’s understand that I would still be breathing when I left them. They know as much as they can know so that if, FSM forbid something should happen, the decision has already been made and they can just go through the motions.
For more information on the limitations of NZ's current Organ Donor system please visit http://www.givelife.org.nz/ and take a look.