We were watching SVU last night and in short the episode was about a couple whose daughter was being 'red parrot' pranked by her friends (which is where they dared her to do stuff all day that she couldn't say no too).

Grossly insensitive. It's typical to ask shortly after the patient isn't expected to pull through, but to cut open a minor and remove organs without parental consent, and then tell the grieving family who the heart is going to, fake asking for permission after not getting it to begin with? Sick. 100% disagree with the doctor. Unfortunate that little boy died, but ethics exist for a reason

She was in highschool. No license so her parents actually needed to give consent prior to her organs being harvested.

That's what I thought too. But even in the moment, disagreeing with the doctors methods and agreeing with her parents decision to not consent to their daughters heart being given to the little boy seemed selfish especially thinking about what I would do if it was my own son needing a heart desperately.

I understand that pov too. I think there may be some guilt on my end if I were to say no, but I also believe I may stand firm on it because it wasn't right. I don't even think I would entertain the conversation honestly

Personally I think that organ donation should be an opt out situation instead of opt in. Like it should be the default unless specifically stated otherwise for religious beliefs and such. You're not using them, why not allow them to save another life?

my issue with that is how many providers can and will control the narrative. So many patients may not be saved because their organs can go to someone else

I hear you. And that's what the surgeon said too saying its legal in most European countries because thats the default and how it would be harsh to ask parents at such a tragic time of their lives without prior consent to consent to their childs organs being donated.

The ADA said as much too. Said how are we to know for sure that you did everything in your power to save this child amd weren't just thinking that several of her organs could go to someone else who had a better chance of surviving surgery and having a better off life.

and both points are so valid. It's a tough situation for sure

What a terrible and impossible situation for everyone. I understand the parents being upset. But I think the doctor did the right thing.

Definitely terrible and impossible Its hard to really think of what was truly right and wrong in the situation. especially also thinking about how if I was in the parents whose child was desperate for an organ, wouldn't necessarily mind how it came to be. Just that my child was being saved.

I remember this episode. I’ve watched it quite a few times and honestly still don’t know what I would do in that situation especially now being a parent and being a friend to someone who actually needed a kidney transplant and someone else who needed a heart transplant

It’s a tough decision to make hypothetically and in real life

Agreed. Hope your friends were able to get their transplants in time.

they did thankfully and are thriving! The one was an infant and the other was a 10 yr old

I’m familiar with the episode. While I want to believe I would have chosen B, because my child would obviously not be needing the organs anymore, that’s still my baby. You absolutely need my permission before I DISCOVER they’ve been butchered.

The doctor was 100% wrong for not checking with the parents. But if I were those parents, I would have let the heart go at that point.

The way the transplant world works makes that narrative pretty unlikely (like never would happen unlikely). The doctors saving one patient have absolutely no idea who those organs would go to (if there is even anyone close enough to receive the organs on time for them to still be viable.). ICU physicians and the organ transplant procurement and dispersement agency are completely separate entities. I'm an ICU nurse. I promise, we never give worse care to someone just because they are a donor, if anything we want those organs to be in tiptop shape in the event donation is requested by family! Not to mention that the doctors are not actually the ones providing the direct care, nurses are and we have even less to do with organ procurement than the physicians. We are the ones actively doing the CPR, giving medications, managing the ventilator etc, the doctors are usually just writing orders. Not to mention that there are very specific parameters that determine if organ donation is even possible.

exactly. It actually is the default in most of Europe. Not to mention that a vast majority of donors will not actually die in a way that makes organ donation viable for them anyway. The narrative that doctors will not try as hard to save you is completely fabricated.

exactly! I know it’s a fictional episode but people should be clear, at least in the US, this simply does not happen. The steps aren’t there.

That said, I firmly believe that once you aren’t using your organs, it’s only sensible to let someone else use them. Why let them rot into a juice soup in a casket instead of saving someone’s life?? Like what an amazing thing to be able to do with the last pieces of yourself.

absolutely! You would be shocked how many people truly believe that we just won't try. It's flabbergasting. We honestly never even know if someone is a donor until we've already started talking about brain death. It's just not information we have access to 🤷🏼‍♀️ but really the general public truly has so little knowledge about the healthcare system. Like the fact that 99% of the things any doctor/surgeon is doing on literally any medical drama at any given time is actually a nurses job 😂😂

I've never worked in a hospital and we don't get the big stuff in urgent care, so inform me a little lol. If there were 2 patients in need at the same hospital, is there communication or interference between providers?

Nope! We don't get any information about donors or recipients at all. Even when we have a donation case, the only info we get about where the organs were sent is a general region i.e. "the liver saved the life of a person in the Pacific Northwest region", "the heart saved the life of a person in the Appalachian region". We never get any info on age, gender, or location of the recipient. And all transplanted organs are coordinated by an agency that is contracted to the hospital but not employed at or by the hospital such as UNOS or Donor Alliance. Once brain death is determined and the decision to donate is made, the organ donation agency takes over all management of care so our nurses still give bedside care but it is under the order/direction of the donor agency and not our own physicians.

good to know! I think there are other valid reasons to not be listed as an organ donor and leave your family responsible for deciding, but it's good to know we have it wrong when it comes to surgeons choosing to grab a lung from someone they could've saved lol

we can agree to disagree on that!

agree to disagree on not listing yourself as an organ donor? I think different groups of people have different concerns when it comes to this, and it's completely valid. Maybe you just aren't in that group.

A crucial missing part of this episode is that she took the organs just BEFORE she was classed as legally dead. She was only brain dead and the doctor made both decision for the parents. (End her life & donate her organs)

This is such an iffy one for me as not only am I in immediate shock and that dismay that my baby is dead.. my baby has been cut open and parts of her have been removed without my permission.
Organ donation is such a sensitive issue and I’m not sure I could let her heart go 🫣

I think I would have let it go to the child because they've already taken it out, it can't be undone and if it saved another child and part of my child loved on then I'd take comfort, I'd feel spiteful and like my daughter had been violated for nothing but then I'd also sue the Dr

So they have to ask as soon as possible as there’s a time limit to harvest. But the family wishes should be respected. I’m an organic donor so it baffles me why someone would say no to that but you have to honour it

you said "leave your family responsible for deciding", I disagree that the burden should be put on someone who is already grieving. Big decisions like that should absolutely be prepared for ahead of time. I see families experience life altering grief everyday, and asking them to make choices like that in the moment always seems cruel, just more burden to the weight they are already feeling in the moment.

the alternative would be to not list yourself at all, which leads to the same outcome. And I think you can communicate with those who would be responsible. It's not a decision they're making on behalf of you, it's just one they're making after you can't say it on your own.

Actually, brain death is considered legal death. When someone donates organs their date and time of death is actually the minute they are declared brain dead. They may be still kept artificially "alive" for hours or even days after their legal time of death in order to plan for organ procurement. Just wanted to clarify that point!

The doctor is wrong 100%. If in fact they knew the child had passed. The doctor should have consulted the parents. Its their right and their child (baby).

I understand the need to help others but there is a process and the death of a child should be honored by the family's wishes.

you'd be surprised how little actual decision making a person can make in the midst of grief. It's 10000% better to have a written healthcare directive. Even if you don't have "donor" on your license, your wishes should be legally documented either way. Because without legal documentation family can make whatever decision is "easiest" when they are already dealing with their grief. Not to mention it often causes tension when family members disagree amongst themselves on a course of action. Obviously each person can do whatever they want, but as someone who actively works in that world and watches families struggle to make those decisions each and every day I would never put my own family in that position. If I had a dollar for every time I had a family lament and agonize over the fact that their family member didn't have a legal POA or advanced directive so that they didn't have to be the one to make the decision, I could retire tomorrow.

I wasn't implying otherwise. You just assumed so

actually I didn't assume anything, I took what you said at face value. If you didn't mean that the burden would fall on family, you should word it differently. Because " leave your family responsible for deciding" is exactly what that means. If that was not what you meant then that's fine, but I'm not a mind reader and was just reply to what you explicitly stated.

my second response said they wouldn't be making the decision for you because this is something that was communicated prior. Obviously it can be in writing, like a living will. Actually I already clarified that for you and you repeated yourself. It's condescending at this point lmao

Also I get the confidence because you're in this specialty, but you're just making assumptions based on your experience lol.

I'm not trying to be condescending. You never said anything about it being in writing. I stated that a lot of families still have trouble making that final call and
having it in a legal document deters those issues, because even if wishes were verbally communicated prior the living family member still has to be the one to state that decision and people do struggle with that. You asked for education and I thought we were having a nice discussion, but I see that's not the case so I will end my input here. I hope you have a lovely day.

the education went out the window after you informed me of what I was asking about, and then we had this small exchange of you agreeing to disagree and claim you're not a mind reader. Maybe I misinterpreted the tone. Nonetheless thanks for the info and back at ya