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When getting a driver license, one of the very first questions that they ask is, would you like to be an organ donor? In this case, that is exactly what Elijah Smith did. One September day, when getting his driver’s license, he checked yes, he would like to be an organ donor.
His decision to check yes, would have a drastic impact on many lives quicker than he would have imagined. The following July 3rd, at 4 am, in Columbus’ north end, Elijah was struck as he was biking home from work.
Doctors declared him brain dead the following day. His parents wanted to stop the donation of his organs. They felt that Elijah did not fully understand what he was agreeing to and they wanted more time to see if he would recover. Is it right to try and overturn someone’s decision to be an organ donor, if they are unable to speak for themselves?
Elijah Smith’s organs were harvested under court order over his family’s objections, when he was pronounced dead.
This case is the first time that Lifeline of Ohio has gone to court over a donation. Had Elijah not been an organ donor, he would not have been kept on life support. The doctors kept Elijah on life support to preserve his organs for proper removal and donation. The machines were there only for the purpose of keeping his organs healthy, not for keeping him alive. Elijah’s family did not consent to have his organs removed and transplanted, they said that Elijah did understand the choice he had made when signing up to be an organ donor. Instead, they wished for “him to be unplugged, to see him die completely, to know that we did everything we could,” according to his mother, Pam Smith. (McCleskey,2013). It’s hard for families of victim’s to understand that their family member is already dead. They see that they are breathing and do not except that, it is the machine breathing for them and there is no chance for recovery. Elijah’s mother saw signs of improvement in Elijah. She did not want to accept that Elijah was not breathing on his own. She wanted her son to be taken off the machine and die after the respirator came off not after his organs were donated. On July 7th, the Smiths wrote a letter explaining their wishes to Grant Medical Center and Lifeline, an Ohio charity that “promotes and coordinates the donation of human organs and tissues for transplantation.” Ms. Smith says that the family isn’t against organ donation, they just object to the process. She wants people “to better understand what organ donation entails and to discuss it with family members.” Ohio law says that only the person donating the organs can overturn their own decision .
The judge that oversaw the case, Judge Guy Reece, was only doing his job and following the law, when he granted Lifeline permission to harvest Elijah’s organs. Elijah’s mother was enraged and felt that Lifeline had gone behind their backs to get Elijah’s organs. This case has shown just how difficult end-of-life decisions can be, particularly when weighed against the dire need for organs for transplantation. Less than 1% of deaths are classified as brain deaths, but these cases make up the majority of donations, as doctors prefer organs that are still connected to a functioning heart and body. Ohio currently has 5.3 million registered organ donors, but the need still far outstrips supply. 18 people die every day in the US waiting for a transplant.( McCleskey 2013) Lifeline says that they encourage everyone that decides to become an organ donor, to have conversation with their family before doing so. This may deter something like this from happening again.
When the death of a patient is expected or has already occurred, hospitals that receive Medicare and Medicaid are required to have steps in place for notifying the local federally designated organ procurement organization (OPO). This notification is mandatory whether the patient has a signed organ donor card or not. The OPO determines is the donor is medically suitable and usually sends a trained organ donation coordinator to the hospital to review the patient’s records, speak to the family, clarify health-related information, and request permission for organ donation. Some OPOs have specially trained family counselors who request permission for donation from the family. The refusal of families to grant permission is a factor in organ donation. Several things have been shown to improve the chances that a family agrees . First, the request for organ donation should not be discussed when discussing the situation of being brain dead. This allows the family time to understand and accept the concept of brain death. Then the request for organs should be made by an OPO representative along with the hospital staff. It is best that the doctor or nurse caring for the patient not discuss organ donation with the family before the OPO arrives. The hospital staff and OPO can work together to determine the best time to talk to the family. Finally the request should be made in a private.
Even when a patient has a signed organ donation card, the OPO often seeks family permission to proceed with donation. The Uniform Anatomical Gift Act (1968, revised 1987) established that a signed organ donation card is sufficient to proceed with donation, and it has been confirmed recently that such documents function legally as advance directives. In the United States, however, it is customary for the OPO to request permission from the next-of-kin due to fear of litigation.(Hanto MD PHD 2005). There are several states that have passed legislation establishing first person consent. This means that the family cannot override an individual’s want to be an organ donor. Some states have established first-person consent registries for people interested in being deceased organ donors. It is not different from a last will and testament. Each year more states are passing first-person consent laws that are strongly supported by the OPOs.
Less than 1% of deaths are classified as brain deaths, but these cases make up the majority of donations, as doctors prefer organs that are still connected to a functioning heart and body. It is imperative that health care professionals make sure that family members are educated about organ donation and what exactly the term bran dead means. It is also of the utmost importance that people whom desire to become organ donors are educated about their decision and share their information. This is so important because at the end, it is the decision of the organ donor, to have their organs donated. People can only hope that their family members are left with the knowledge that their family member passed away being a hero. They were able to give someone else the gift of life.
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