therenalunit.com

It would seem that Scottish doctors are placing their own personal morals ahead of legislation, and patients waiting for organ transplants are suffering as a result.

New laws passed the Scottish Parliament in September 2006, allowing doctors to “take organs from donor card-carrying patients even if relatives object”, have seen medics “proved reluctant on ethical grounds to override the wishes of next-of-kin.”

The Australian Parliament has been considering this option as a way to reduce organ waiting lists, but the Scottish example should prove food for thought for legislators anywhere in the world considering this approach.

The article, in the ScotsmanonSunday, says that “since the new rules aimed at strengthening donation were introduced 10 months ago the waiting list has grown by about 20% and the number of transplants has dropped slightly.”

The question which needs to be answered here, is whether a doctor’s philosophical, religious, or moral objections should be a factor in them acting within the current legislatory framework?

Surely if a doctor objected on moral or religious grounds to administering the most basic of medical technologies, such as influenza immunisations, they would either be sacked, or moved to a department where their (misguided?) views would not impact negatively on outcomes for healthcare consumers?

It is offensive that, given a deceased person has consented to donate their organs, a relative (even an estranged one) can over-ride this consent.

What do you think? Would you be happy for your family to over-ride your consent to be an organ donor? Do you think it’s fair, as someone waiting for an organ, that the family of a deceased person can object, even though the deceased person has consented?

There’s an interesting articlce at wlky.com about patients in Louisville, Kentucky complaining that they are being picked up late and forced to endure long post-dialysis waits for transportation to take them home again.

The article quotes both patients and carers, with the most ire being directed at the late pickups, which are forcing patients to cut short their treatment time.

Anyone on dialysis will understand that acheiving the best possible outcome for those with ESRD depends on strict adherence to the dialysis regime outlined by the treating physician. To have a dialysis treatment cut short by factors outside the control of the patient is completely unacceptable.

But where does the blame actually lie?

It’s rather simplistic to lay the blame at the feet of TARC 3, the city transportation system for the elderly and disabled in Lousville, but is there more to it than that?

One of the complainants, Sandra White, daugher of elderly dialysis patient Link Moore (who has unfortunately since passed away, apparently due to having nine out of eleven dialysis tratments cut short due to arriving late for his tratment), told WLKY.com that:

From the article:

But on May 18, they arrived at 2:56 p.m., loaded him up at 3:08 p.m. and wheeled him into the downtown dialysis facility at 3:33 p.m. After 30 minutes of pre-dialysis treatment, Moore lost 30 minutes of his scheduled 3.5 hour treatment because the center closed at 7 p.m.

I’m sorry, what was that?

Moore lost 30 minutes of his scheduled 3.5 hour treatment because the center closed at 7 p.m.

It seems to me that there are at least two parties at who’s feet the blame needs to be laid here. Why is a dialysis unit closing at 7pm, cutting its patient’s treatment time short, and thus placing their lives at risk?

Are we so bottom-line driven in this day that we’re prepared to put a patient’s life at risk so we can close the dialysis unit on time.

Nice try wlky.com, but a little further thought and investigation would have shown that there are at least two parties responsible for this tragedy. You should have done better.

I’ve been having some interesting results with my tacrolimus (prograf) blood levels in the last couple of weeks.

Tacrolimus is the frontline anti-rejection immunosuppressant being used to stop my shiny new (nearly six months old) kidney from rejecting.

Apparently, the level should be 10, whereas the last couple of readings have been 4.8, and then 6.

The interesting thing is that all the other blood test results have been fine, with creatnine floating between 130 and 140.

Speacking of tacrolimus, I’d be interested in hearing from anybody else who’s on this drug, as to whether you experience a strange mild tingling and weakness in the muscles about four to five hours after you take your dose.

I assume that this is because the level of the drug is highest in your blood at this time, just feels a little too wierd, and a little too like the symptoms of freaky high potassium to me.

If you’re experienceing anything like this, I’d love for you to leave a comment here.

Cheers

Stu

According to a BBC article, the fake Dutch reality show “The Big Donor”, in which three “contestants” competed to receive the organ of a “terminally ill” patient, has seen 12,000 new registered organ donors in the Netherlands since the show went to air.

Whilst I’m still not convinced as to whether the show was the right way to go about getting more people to register as organ donors, you can’t argue with the success it’s had.

What do you think? Is there some imaginary line in the sand which should not be crossed in promoting the idea of organ donation?

It seems that the UK Government is considering implementing on opt-out organ donor registry.

The principle behind this idea is that everybody is considered a potential organ donor, unless they specifically register their non-consent for their organs to be used.

This model us already being used with great success in Belgium and Spain, where according to the news report from Sky News, has tripled the organ donation rate.

I’d love to see something like this happen here in Australia, where I live, although there are a couple of things which would need to be taken into consideration before such a system would work:

• What about people who have English as a second language? Would they be considered to have consented as donors because they didn’t understand their rights and obligations under an opt-out system
• People under the age of 18 would need to be considered to have specifically given non-consent

All in all though, I think that this is a positive move, which should be considered by more countries.

What do you think?

It’s now over three months since I received the wonderful gift of a new kidney. Things have been quiet around here as I recovered and concentrated on other projects.

I plan on spending a litle more time around here now, and will be bringing some new features such as book reviews and the opportunity for readers to tell their story.

Check back soon to see the new stuff, or subscribe in the feed reader of your choice