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I respect your feelings, I want to share mine. I feel mostly the same way, but kinda think that the doctors who decide if I live or die will do so whether or n

I respect your feelings, I want to share mine. I feel mostly the same way, but kinda think that the doctors who decide if I live or die will do so whether or not I’m an organ donor. It’s statistically more likely to die before the change of a shift, or before the weekend, or (more cynically, and less scientifically backed) before tee-time. People are people, and they make mistakes and have biases and get tired even if they went to med school for X years. So, If I’m close enough to be an in someone else’s book for some silly reason, at least it means somebody gets to live if I’m an organ donor.

smeej 2y ago
I think I'm more concerned about the cases when it's their actions that would cause my death. Like, when people are declared brain dead, it's common that the heart and other organs are still operating fine. As far as I understand, there isn't some hard and fast line where anything changes between "no detectable brain activity" and "let's take out the organs." Those events can be separated by minutes, hours, or days with minimal difference. What if they're wrong and I'm not actually dead? I certainly would be after my usable vital organs are removed, but what if I wasn't before? I can see the argument, what kind of life is it really if all you're doing is lying on a table, nit conscious and not moving for the rest of your life? Maybe you'd rather not live at that point anyway. But on the other hand, what kind of death is it to be cut open and have all your organs removed?
- schneems 2y ago
  One of my biggest fears is a “Johnny get your gun” (or Metallica’s ‘One’) scenario where I’m actually aware but cannot communicate it. That seems worse than death. For organ donation the organ removal doesn’t kill you. They take you off of life support equipment keeping you alive first. Basically it’s the same way you would have died if it weren’t for extreme modern medical intervention. Either way, you should communicate with your loved ones about what you want to happen if you’re diagnosed as brain dead. Ideally memorializing it in writing. It’s hell to have to make that decision without knowing what the patient would have wanted. It’s not the largest of the concerns involved but (if you haven’t) you might also want to consider the financial and mental/emotional cost to the people having to take care of you. This sounds biased (because I hold biases) but it’s not intended to convince. We had a family member on a ventilator recently and it sucked. But at least there were plans put in place before it happened.
  - smeej 2y ago
    The article made it sound like they actually don't turn the other devices off in case of brain death, because it's so much better for the organs that they be kept in as close to a living state as possible. If your lungs can keep moving air (even assisted by a ventilator) and your heart can keep pumping blood, it's better that they do so, right up until they're extracted. Is that not the case?
  - wing-_-nuts 2y ago
    >They take you off of life support equipment keeping you alive first. They absolutely do not do this. You're kept on life support until the very end because it's important to keep the organs oxygenated. You're also not given any anesthetic because it's presumed you're completely brain dead and unable to feel anything. Given our primitive understanding and testing for brain death, I'm not comfortable with that. Edit: Accounts like this one do not comfort me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880062/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880062/
    - wl 2y ago
      > You're also not given any anesthetic because it's presumed you're completely brain dead and unable to feel anything. The linked article is about doing just that. Anesthesia for brain dead organ donors is the standard of care.
      - wing-_-nuts 2y ago
        So they receive the same sort of anesthesia as a surgery patient? When I asked other doctors about this I was told the patient was given some things to control blood pressure, etc, but not anesthesia, as it would be 'wasted'. edit: I admit I didn't read the article, I get queasy reading about that sort of stuff.
        wl 2y ago
        Yes, the same sort of anesthesia. You mention blood pressure in particular. Controlling pain, usually with opioids, is a huge part of controlling blood pressure.

smeej 2y ago

I think I'm more concerned about the cases when it's their actions that would cause my death. Like, when people are declared brain dead, it's common that the heart and other organs are still operating fine. As far as I understand, there isn't some hard and fast line where anything changes between "no detectable brain activity" and "let's take out the organs." Those events can be separated by minutes, hours, or days with minimal difference. What if they're wrong and I'm not actually dead? I certainly would be after my usable vital organs are removed, but what if I wasn't before? I can see the argument, what kind of life is it really if all you're doing is lying on a table, nit conscious and not moving for the rest of your life? Maybe you'd rather not live at that point anyway. But on the other hand, what kind of death is it to be cut open and have all your organs removed?

schneems 2y ago
One of my biggest fears is a “Johnny get your gun” (or Metallica’s ‘One’) scenario where I’m actually aware but cannot communicate it. That seems worse than death. For organ donation the organ removal doesn’t kill you. They take you off of life support equipment keeping you alive first. Basically it’s the same way you would have died if it weren’t for extreme modern medical intervention. Either way, you should communicate with your loved ones about what you want to happen if you’re diagnosed as brain dead. Ideally memorializing it in writing. It’s hell to have to make that decision without knowing what the patient would have wanted. It’s not the largest of the concerns involved but (if you haven’t) you might also want to consider the financial and mental/emotional cost to the people having to take care of you. This sounds biased (because I hold biases) but it’s not intended to convince. We had a family member on a ventilator recently and it sucked. But at least there were plans put in place before it happened.
- smeej 2y ago
  The article made it sound like they actually don't turn the other devices off in case of brain death, because it's so much better for the organs that they be kept in as close to a living state as possible. If your lungs can keep moving air (even assisted by a ventilator) and your heart can keep pumping blood, it's better that they do so, right up until they're extracted. Is that not the case?
- wing-_-nuts 2y ago
  >They take you off of life support equipment keeping you alive first. They absolutely do not do this. You're kept on life support until the very end because it's important to keep the organs oxygenated. You're also not given any anesthetic because it's presumed you're completely brain dead and unable to feel anything. Given our primitive understanding and testing for brain death, I'm not comfortable with that. Edit: Accounts like this one do not comfort me: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880062/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880062/
  - wl 2y ago
    > You're also not given any anesthetic because it's presumed you're completely brain dead and unable to feel anything. The linked article is about doing just that. Anesthesia for brain dead organ donors is the standard of care.
    - wing-_-nuts 2y ago
      So they receive the same sort of anesthesia as a surgery patient? When I asked other doctors about this I was told the patient was given some things to control blood pressure, etc, but not anesthesia, as it would be 'wasted'. edit: I admit I didn't read the article, I get queasy reading about that sort of stuff.
      - wl 2y ago
        Yes, the same sort of anesthesia. You mention blood pressure in particular. Controlling pain, usually with opioids, is a huge part of controlling blood pressure.