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  #81  
Old 23.10.2017, 00:19
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Re: Initiative for organ donation

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As for those who do not wish do donate being not wanting to receive- you'd be VERY surprised. As for potential organ recipients not being able to donate- just depends on the condition- it is perfectly possible to donate corneas, for instance, even if you have other health problems, in many cases.
As Tom said earlier, it's highly likely that a person in need of a transplant would be suitable to be a donor. That may change years down the line, but at the point when the decision is made, that would not be a relevant factor. It also would not be a consideration in the case of child recipients.
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PS: An other question just crossed my mind: If everybody is a donor by law, is one then allowed to donate to a relative who is further down the list than an other one who would fit?
Obviously, you don't get to pick and choose, but if you were a good match for a family member, it's a possibility.

Just as an example, when the need for a possible future stem cell transplant became a reality in our family 2 months ago, only the recipient's brother was deemed to be a suitable person to be tested for compatibility. There was a 25% chance that he'd be a match, and he was, but if he hadn't been the search would have been for a donor within the general population who had the same ethnicity. My partner is 100% Greek and a cancer survivor, so he was straight out of the equation, then the cousins were removed because they're Belgian/Greek, and had no greater chance of being suitable than someone in the general populace. The doctors were specifically looking for British/Greek as their first potential candidates.

Thanks to scandals surrounding tainted blood supplies, the regulations around live donations have tightened incredibly in the UK. Just expand the 'Blood Safety' tabs in this link... https://www.blood.co.uk/who-can-give-blood/

It's not as stringent when it comes to organ donation, but there are still many factors to consider. My partner and my mum were both told they could never give blood or be an organ donor because of childhood diseases. My mum was particularly upset by this because she was AB- which was always in short supply. https://www.organdonation.nhs.uk/faq/eligibility/
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  #82  
Old 23.10.2017, 00:27
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Re: Initiative for organ donation

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Judging by some of the laws that get passed, it's pretty clear that a lot of people have absolutely no idea what they are 'voting about'. *

Remember, Switzerland works well in spite of direct democracy and not because of it.

* Just to be clear, this the same in a lot of countries - just look what happened in the U.K. with Brexit.
Yes, sadly, many people do, in fact, vote about a topic about which they have no clue. Interviewed after the fact, people sometimes go on to explain what they had thought their YES or NO had meant.... and at times it becomes quite shockinlgy clear that those very voters had been swayed by some or other advertising campaign and did not actually have much of an idea what the actual text had said.
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  #83  
Old 23.10.2017, 01:10
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Re: Initiative for organ donation

First: I have signed my Swiss organ donation card, as I have in every country I have lived in for the last 30 some years.

So I am all for donation having made an informed choice. But there is a connected issue that concerns me. I am uneasy with an automatic presumption or opt out system because any loss of personal autonomy leaves me uneasy.

Recent experience has made me wary of giving control over when to 'pull the plug' to hospital personnel whose interests or ideas clearly do not align with mine, and I will admit that presumptions arising around the value of my life vs the value of my organs adds to that uneasiness.

If I could be assured that my wishes wrt pulling the plug, or in my incapacity my husband's as my proxy, would be followed I would no longer feel uneasy. But having had to argue with hospital personnel to convince them that yes, I really did fill the form out as I intended, and yes, despite having grey hair I believe my life is worth living and fighting for, I have lost a measure of trust in the system. It was an eye opening experience.

It's that lost trust in 'the system' that makes me uneasy about relinquishing more of my personal autonomy to that same system.

But once I really truly am dead - and my husband agrees that I really truly am dead - you can have any organs still fit for purpose. My choice, though.
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  #84  
Old 23.10.2017, 01:21
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Re: Initiative for organ donation

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... having had to argue with hospital personnel to convince them that yes, I really did fill the form out as I intended, and yes, despite having grey hair I believe my life is worth living and fighting for, I have lost a measure of trust in the system. It was an eye opening experience.
.
Oh, no! That sounds harrowing! Wow, I'm sorry you had to go through that.
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  #85  
Old 23.10.2017, 07:50
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Re: Initiative for organ donation

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And yes, there will be many interesting questions to answer:
Someone said, in GB and Spain everybody is a donor, unless he/she opted out.
So if such a person lives then dies in Switzerland, we can take their organs even if our laws are different. Can we not?
I hope you read your voting papers more carefully than you read this thread.

Nobody said that about the UK because it is not the case. Austria, Spain and Belgium have the opt out system and probably other countries too but the UK is not one of them.

Of course not. When resident in Switzerland the Swiss laws apply. By that logic if somebody from Saudi Arabia committed a theft in Switzerland they would have their hand cut off because that's how it is where they come from.

Last edited by Belgianmum; 23.10.2017 at 10:31. Reason: Spelling
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  #86  
Old 23.10.2017, 08:13
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Re: Initiative for organ donation

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I'd wager this is pretty illogical and not at all the same. Things and money inherited are used by others after death - organs just die with you and are wasted if not donated.
Same with people's goods, you can decide to not tend to your stuff and let it rot. Requires a different timescale, I'd agree on that, but still essentially the same. Even credit (your account balance) will lose value over time.

Plus, your organs "grow" without society needing to do anything. Your wealth however would not be possible without society providing a favorable environment (try to achieve what you did in Somalia, Sudan or Yemen).
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Old 23.10.2017, 10:13
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Re: Initiative for organ donation

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If I could be assured that my wishes wrt pulling the plug, or in my incapacity my husband's as my proxy, would be followed I would no longer feel uneasy. But having had to argue with hospital personnel to convince them that yes, I really did fill the form out as I intended, and yes, despite having grey hair I believe my life is worth living and fighting for, I have lost a measure of trust in the system. It was an eye opening experience.

It's that lost trust in 'the system' that makes me uneasy about relinquishing more of my personal autonomy to that same system.
You probably want to look into setting up a Patientenverfügung (patient decree) or even a Vorsorgeauftrag (advance care directive).

According to civil law §378 the sequence of priority in deciding in your stead, if your unable and haven't provided either of the above documents, is as follows:
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1. a person appointed in a patient decree or in an advance care directive;
2. a deputy with a right to act as representative in relation to medical procedures;
3. any person who as a spouse or registered partner cohabits with the person lacking capacity of judgement or who regularly and personally provides him or her with support;
4. any person who cohabits with the person lacking capacity of judgement or who regularly and personally provides him or her with support;
[goes on with more bullet points, a list of other less and less close persons]
The deputy is a person tasked by the KESB (Kinder- und Erwachsenenschutzbehörde, agency on the protection of children and adults). As you can see s/he ranks higher than any person not explicitly assigned by you. A deputy probably won't be assigned unless your case takes an extended time, but still, he's a stranger to you.

The patient decree (Patientenverfügung) covers medical stuff like when the plug should be pulled, extent of medical procedures you consent to, probably also what to do with your organs, and last but far from least who will decide if you haven't done so already. Any such naming by you is final and keeps out everybody else, so if you name your husband only but he is also unable, I guess the default still applies and a deputy assigned to decide. I would expect though that family opinions will have a strong influence in the absence of a written directive.

It is important to note that the medical personnel will follow the patient decree unless it infringes on law or regulations, or in case of doubts that are considered valid that it still represents the patient's current will. Because of this it is advised to renew the decision every few years or so and to keep the history (perhaps unless you changed your mind on an important point). The longer a given decision has been standing and the more often it has been confirmed the clearer your will and the easier for the medical personnel to even act against the wishes and opinions of your dear ones, if necessary.

The Patientenverfügung can go so far as forbidding any kind of invasive treatment or using blood infusions (Jehova's Witnesses anybody?). That's why this will be searched for immediately upon admission to the hospital if your case is severe, including searching your purse/wallet and other stuff if potentially useful.

So you want to have the decree or a reference thereto in your wallet/purse at all times. Same in case of a Vorsorgeverfügung (advance care directive).

A Vorsorgeverfügung has much broader reach than a patient decree, it can cover literally everything legally possible, including but not limited to wealth management, power of attorney, issues otherwise covered by a Patientenverfügung, etc. Because of its broader reach it must satisfy heightened requirements to be valid. IIRC there's more than one way but the one I've memorised is to have it notarised.

However, to avoid liability issues banks are still likely to freeze your own and shared assets in case of death (probably also in case of coma and similar, should they become aware) in order to not discriminate against other potential heirs or current creditors. In order for the partner to stay liquid it is advised to preemptively open one emergency account with sufficient funds for each of the couple, in his or her name(!), respectively.

A template for a patient decree can be downloaded from fmh.ch (not available in English). This PDF in plain German, also by fmh.ch, gives an overview of the legal situation from a doctor's perspective.
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Old 23.10.2017, 10:30
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Re: Initiative for organ donation

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Now that was totally contradictory.
not at all in the context of an expat Forum in Switzerland, with many Brits as participants. I was of course talking about residents in Switzerland who happen to be British. We are currently not allowed to give blood if we lived in the UK at the time of the CJD crisis (I lived just a few miles from where it all started) - it seems that organ donation might be possible in some cases, as they wash the organs thoroughly of all donor blood.

As for picking and choosing the recipient - well no. We have to trust medical teams to pick the more suitable recipients, using 100s of determining factors. My comment about a case where a choice has to be made, for potential recipients where all other factors match and a choice can only be made by a roll of a dice- then the choice should be made for the donor or one among the donors. As said, you can choose for live donations if a relative, child, sibbling, friend - is a suitable donor. My niece in SA is a GP and in her early 50s- she recenty donated one of her kidneys to one of her best friends/patients- who was not a suitable match. New technology is now making this possible - both are in full health 1 year later. What amazing women.

I carry both a Swiss donor card (made my own) and a UK one- and have notes signed regularly in my purse (wallet), my bag and my passport- but mainly, all my relatives know and appprove, and know to volunteer and not wait. Of course it should be a choice - it is very easy to opt out in those countries- just as it would be in the UK or CH. The notes I carry state I lived in UK during CJD crisis and my blood group, which is very rare.

Last edited by Odile; 23.10.2017 at 12:26.
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  #89  
Old 23.10.2017, 17:50
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Re: Initiative for organ donation

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This is nonsense.

Swiss society is cohesive because new laws have a high degree of acceptability. The acceptability of Swiss laws is guaranteed by the combination of exhaustive consultations before legislation is presented to the Federal Assembly, and then due to the existence of a popular veto being possible where a new normative rule is too far from the current social reality.
I never mentioned whether laws helped with social cohesion or not. That's a different argument.

One could have the most ridiculous laws in the world that might make everyone happy but it doesn't make them better laws than those passed through a parliamentary democracy.

But as you have brought it up, it's true that Swiss laws may make people happy but it doesn't make them always sensible laws.

I'm not a medic and I don't have the knowledge or expertise to know whether a healthcare initiative is good for the population's health or not.

And I'd wager that most Swiss don't either (or at least the ones that bother to vote) otherwise at least a couple of recent healthcare initiatives that resulted in referendums with results that may have made people happy but were not beneficial to the health of the nation compared with other results.
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Old 23.10.2017, 19:48
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Re: Initiative for organ donation

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I am uneasy with an automatic presumption or opt out system because any loss of personal autonomy leaves me uneasy.
This!

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We are currently not allowed to give blood if we lived in the UK at the time of the CJD crisis (I lived just a few miles from where it all started) - it seems that organ donation might be possible in some cases, as they wash the organs thoroughly of all donor blood.
ROFL! I don't know if it's necessary to worry about the CJD crisis re transplants. But if it is, it sure is funny that "washing the organs thoroughly" is good enough then. As my organs for example are full of blood and don't work at all without blood pumped through them.

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I hope you read your voting papers more carefully than you read this thread.

Nobody said that about the UK because it is not the case. Austria, Spain and Belgium have the opt out system and probably other countries too but the UK is not one of them.

Of course not. When resident in Switzerland the Swiss laws apply. By that logic if somebody from Saudi Arabia committed a theft in Switzerland they would have their hand cut off because that's how it is where they come from.
No need for you to worry about my voting. So NotAllThere wrote, UK is considering it. Fine. But anyway, THAT was not the message of my post

Amazing how you folks already know exactly how the opt-out law will be construed. Or maybe not? As there is absolutely no logic in your example: Why would we apply Saudi Arabian law which we don't practice here on Saudi Arabians?!
We do transplants here though. And it very well would be applicable to just take the organs of a Spanish (to be on the safe side this time on unimportant details) who died here. The explanation would be "of course the person doesn't carry an agreement-card, any Spanish person not disagreeing is a donor".
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Old 23.10.2017, 20:10
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Re: Initiative for organ donation

Please let me (modestly) show-off our national pride...

"It's not about donor cards, registers or "presumed consent" but about the teams of transplant co-ordinators in every hospital. "The key is organisation. European people are not that different from one country to another. What really changes is how you approach the moment of death," he says"

"The importance of the family in Spanish healthcare, who help feed and care for their relatives in hospital day by day, cannot be over-estimated".

"The first and most important thing is the reaction to the announcement of the death," he says. "That is a hard moment for the family and also for the doctor. It is a painful situation but my job is to explain to the family that in their pain, they could find happiness in helping others."

https://www.theguardian.com/world/20...ily-transplant
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Old 23.10.2017, 20:41
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Re: Initiative for organ donation

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Amazing how you folks already know exactly how the opt-out law will be construed. Or maybe not? As there is absolutely no logic in your example: Why would we apply Saudi Arabian law which we don't practice here on Saudi Arabians?!
We do transplants here though. And it very well would be applicable to just take the organs of a Spanish (to be on the safe side this time on unimportant details) who died here. The explanation would be "of course the person doesn't carry an agreement-card, any Spanish person not disagreeing is a donor".
How is applying Spanish law regarding organ donation to spaniards who die here any different from applying Saudi law to Saudis who commit crimes here?

Read your post again, your argument is quite frankly ridiculous.

For anyone resident in Switzerland Swiss laws apply whether that is for transplants, speed limits, theft or whatever.
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  #93  
Old 24.10.2017, 08:37
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Re: Initiative for organ donation

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For anyone resident in Switzerland Swiss laws apply whether that is for transplants, speed limits, theft or whatever.
What do you think would be done, about organ transplants, when someone ordinarily resident in Spain, and who has not opted out there, dies while on holiday in Switzerland?

To the Spaniards here: are the organs of non-residents who happen to be in Spain when they die, automatically made available for transplant?
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Old 24.10.2017, 08:49
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Re: Initiative for organ donation

I can't see why making it opt-out instead of opt-in is such a great deal.

If you believe your organs shouldn't safe the life of someone else, fine, say so.

Nothing that the new proposed suggestion wouldn't allow. So all those religious people can have their "will". And let everyone else life.

The only negative area I can see is that health insurances might go even up. But then usually patients having to wait ages for a new organ also cost a LOT to keep their (not yet fully) failing organs still working. So possibly not even increased costs.

Oh, and just that my words aren't hollow: I'm a registered organ donor, got my card on me 7/24
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Old 24.10.2017, 09:14
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Re: Initiative for organ donation

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What do you think would be done, about organ transplants, when someone ordinarily resident in Spain, and who has not opted out there, dies while on holiday in Switzerland?

To the Spaniards here: are the organs of non-residents who happen to be in Spain when they die, automatically made available for transplant?
I would expect the immediate family to be consulted. How would the Swiss authorities know whether a Spanish tourist had opted out or not? Unless the deceased was carrying documentation outlining their wishes the default option should always be no to organ donation.

Likewise for tourists who were to die in Spain. As non residents they should be exempt.


Tourists and visitors are obviously very different from permenent residents or nationals.
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Old 24.10.2017, 11:27
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Re: Initiative for organ donation

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So all those religious people can have their "will". And let everyone else life.
Very few faiths hold a negative view of organ donation.

https://www.organdonation.nhs.uk/sup.../myth-busting/

To nullify the debate about organ donors dying outside of their native country, this shows how long organs are viable for transplant outside of the body.

http://www.transweb.org/faq/q24.shtml

Very few people die in circumstances where they are viable donors, despite their wishes.
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Old 24.10.2017, 11:48
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Re: Initiative for organ donation

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What do you think would be done, about organ transplants, when someone ordinarily resident in Spain, and who has not opted out there, dies while on holiday in Switzerland?

To the Spaniards here: are the organs of non-residents who happen to be in Spain when they die, automatically made available for transplant?

This is a google translation of the relevant bit.

Official webpage here, in Spanish:

http://www.ont.es/informacion/Pagina...ci%c3%b3n.aspx


"Family Consent and Donation.
According to the Law of transplants, in Spain we are all considered donors if in life we have not expressed otherwise. However, this expression may have been formulated in different ways, which requires that relatives are asked about the will of the deceased regarding the donation. In practice, the family's decision is always respected, since it is assumed that they will not contradict the wishes of their loved one. The signature of the family to proceed with the donation, is what we call family consent."

As you can see, they don't go against the wishes of the family.


I think this is an important point too:

"Is there any advantage for donors?
Under the current legislation altruism is guaranteed in the donation: no one can donate, or receive a transplant, with other intentions or means other than altruistic solidarity.
All donations must be voluntary, free of charge, not for profit and anonymous, so that it is not possible to obtain financial compensation, or any other type. The greatest compensation is the satisfaction of knowing that you have the possibility to help other people.
At present, it is contemplated the obtaining of viable organs for transplantation either by death in situation of cerebral death, or in situation of death by cardiac arrest. Therefore, not all people who intend to be a donor can become and receive this service."
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Old 24.10.2017, 12:12
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Re: Initiative for organ donation

Can someone summarise please

Do I go to Spain to die to donate organs, or not?
Or take Spanish nationality and die here?

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Old 24.10.2017, 13:14
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Re: Initiative for organ donation

@gbn
From what I read, you can fill out a standard organ donation card, or make your own, or in a country where it is possible to do so register your wish that you do, or do not, wish to donate some or all of your organs.

Even so, seems to me that in many contexts there is an awful lot of talk about first consulting the family and in some cases even of obtaining their permission - irrespective of whatever one may have decreed while alive.
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Old 24.10.2017, 13:17
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Re: Initiative for organ donation

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Very few faiths hold a negative view of organ donation.

https://www.organdonation.nhs.uk/sup.../myth-busting/

To nullify the debate about organ donors dying outside of their native country, this shows how long organs are viable for transplant outside of the body.

http://www.transweb.org/faq/q24.shtml

Very few people die in circumstances where they are viable donors, despite their wishes.
Thanks for the interesting links. How does the last one, about how long an organ is viable, nullify the debate about organ donors dying outside of their native country? Within the number of hours specified, one could fly an organ across several European borders, to a suitable recipient, couldn't one?
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