Why doctors WILL NOT let you die if you’re a registered organ donor01/29/2019
What’s in it for a doctor to deny a patient proper care if they knew she or he signed up as an organ, tissue and cornea donor? It’s a deeply rooted concern that anyone personally or professionally connected to donation hears on a regular basis—from a broad range of ages and cultures. Some skeptics cite this as the reason they choose not to join the more than 3.5 million people in the DonateLifeAZ Registry.
With countless myths, fears and personal reasons, people unnecessarily rule themselves out all the time. But no other factor hints so directly at a disturbing version of donation—the trading of one life for another, which is not anyone’s MO. Picture it: It’s the Hollywoodized interpretation of an emotionally conflicted medical professional letting a patient’s life slip away to make sure a [insert family member here] receives the heart transplant they so desperately need.
We get it—it’s suspenseful and compelling. That’s the point. Movies and television shows get more viewers with some drama and a tug at your heartstrings—accuracy tossed out. In this context, entertainment supports an urban legend, and the fear it perpetuates actively prevents the lifesaving gift of life.
Here are FIVE REASONS WHY THEY WON’T LET YOU DIE simply because you have the DONOR ❤️ printed on your state ID or driver’s license. Take a look below, and visit DonateLifeAZ.org to register as an organ, tissue and cornea donor today.
1. The Hippocratic oath:
This is one of the oldest binding documents in history. Hippocrates of Kos, also known as Hippocrates II, wrote this oath, and it is still held sacred by physicians. The U.S. National Library of Medicine provides an in-depth look at the history of this oath. Originally written in Greek, the widely accepted modern, English version says in part:
“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm … May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.”
And, while it doesn’t appear directly in any version of this text, a common abbreviated interpretation of the Hippocratic Oath is “First, do no harm.” In other words, the patient in front of a physician is their top priority. A patient’s death in the ER happens because all ethically possible lifesaving efforts have been made, but the trauma was too severe.
“Being a physician is not just a profession or career choice. It’s a commitment to our patients above all. We put a patient’s wellbeing above our own,” says Dr. Natasha Bhuyan, who practices family medicine with One Medical Group in Phoenix. “By becoming an organ donor, [our patients] are making a very selfless choice, but it won’t impact the quality care they receive.”
The Hippocratic Oath is specific to physicians, but every medical professional title has its own version of an oath to do right by the patient.
2. The emergency room process:
In an emergency, physicians, nurses and other EMS workers don’t have time to even check a patient’s name—let alone their donation registration status, assuming it’s even shown on their ID. They work hard and swiftly to stabilize a patient. That’s it.
Cesar Alvarez worked for the Los Angeles Fire Department as a firefighter and paramedic. He and his team rushed to emergencies without thinking twice countless times over the more than two decades of his career, but never once stopped to wonder if a sick or injured person was registered.
“That just doesn’t happen. We’re trying to save your life,” Alvarez says. “That’s a big myth out there.”
Alvarez’s career of battling blazes ended after a structure collapsed on him and some of his teammates. He broke both of his knees, and he says the high dose of anti-inflammatory medication he was prescribed for the pain damaged his liver.
He eventually received his own gift of life and has since worked to educate the public about donation as a Donate Life Arizona volunteer.
In the event a medical professional was to see a registered donor’s ID with the DONOR ❤️, it is not confirmation of that person’s status. Anyone can call Donor Network of Arizona (DNA) to remove themselves from the registry at any time and still have the heart on their ID unless they get a new one through Arizona Department of Transportation Motor Vehicle Division (ADOT MVD). Some people who register online or at an event will not have the heart printed on their ID. Also, all hospitals in the state are federally required to call DNA in the event of the patient’s death, regardless of what they think that patient’s donor registration status is.
Plus, registered or not, becoming a donor is rare. Less than 1 percent of people who die in a hospital setting are even eligible organ donors since a donor needs to be on a ventilator and die from brain death or circulatory death.
- Brain death must be declared by a physician. According to the American Academy of Neurology (AAN), brain death is defined as the irreversible loss of function of the brain, including the brainstem. Specific and multiple tests to determine brain death that fall under the guidelines of the AAN are used in the declaration of brain death.
- A patient may have a nonsurvivable injury or a severe injury that would affect the patient’s quality of life. At this point, a family can elect to withdraw the ventilator. (This determination is not the same as irreversible brain death.) Then, only after the ventilator is withdrawn, the patient must die within a certain time frame, per hospital policy, and is declared dead by a physician via circulatory death.
3. Donor registry confidentiality and the accreditation agencies:
DNA is a highly regulated organization subject to oversight and audits by various organizations, including:
- Centers for Medicare and Medicaid Services (CMS)
- The Office of Inspector General (OIG)
- Association of Organ Procurement Organizations (AOPO)
- American Association of Tissue Banks (AATB)
- Eye Bank Association of America (EBAA)
- United Network for Organ Sharing (UNOS)
- Food and Drug Administration (FDA)
The entire donation process is subject to auditing, on both the clinical and administrative sides. An important factor is the handling of personal information.
The DonateLifeAZ Registry is strictly confidential. DNA does not disclose a person’s donor status or details of a case to the public without specific written permission from legal next of kin. Many DNA employees don’t even have access this information. Therefore, it’s not possible for medical professionals to know with certainty a donor’s registration status until donation is even in the realm of possibility and DNA gets involved.
4. Compatibility complexity:
Once organ donation is deemed possible, there are countless variables that add to the complexity of realizing that donation for transplantation—from donor to recipient. These variables include clinical and physiologic variables, such as: overall donor health and organ function; social and medical history; size the of patient; size of the organs; and blood type. They also include logistical variables, such as: allocation policies; geography; hospital services; and transportation.
A doctor would not know the specific details mentioned above without first performing human leukocyte antigen (HLA) testing to show histocompatibility between the donor and potential recipients on the national waiting list—a process not done in hospitals or even the transplant centers in Arizona. DNA has an accredited immunogenetics laboratory to conduct this type of testing.
5. Trauma doctors’ separation from transplantation and the allocation process:
Assuming somehow, someway a doctor knew your registration status—what good does that do? This doctor has no control in the donation process once you’re declared dead.
As stated above, a trauma surgeon is separated from the process of transplantation. They are not involved in organ or tissue recovery, they don’t contribute in any way to histocompatibility testing, and the organ placement is handled by United Network of Organ Sharing (UNOS), a national nonprofit.
UNOS is the link between donors and recipients. Following national laws and policies, the allocation of organs is done with the help of a computerized network that identifies transplant candidates in ways that save as many lives as possible.
“Only medical and logistical factors are used in organ matching,” UNOS’ website states. “Personal or social characteristics such as celebrity status, income or insurance coverage play no role in transplant priority.”
Therefore, a doctor in the ER—who presumably let you die—has literally no idea where any donated organs would go.
So, let’s ask ourselves again: What’s in it for a doctor to let you die just because you have a DONOR ❤️? Absolutely nothing.
In an emergency, they’re not checking your ID. They don’t have immediate access to this confidential information. And they have no say over who gets which organ donations if you actually become a donor at all.
DNA wants everyone to live long, healthy lives, and when that is no longer possible, we want everyone to consider sharing their gifts with others whose days are otherwise numbered.
Sign up now. Save lives later. Change the world! DonateLifeAZ.org