New organ donation passes without commitment

New regulation on organ donation: Health insurance companies must be willing to donate organs

02/11/2012

Due to the new regulation of organ donation, the statutory health insurance funds are obliged to inquire about the organ donation readiness of their insured every two years. Therefore, the health insurance funds have been sending organ donor passes with the electronic health card or the contribution notification since yesterday. After the organ donation scandal the donation readiness of the Germans had fallen in October by nearly 50 per cent. Whether the new regulation will turn out in favor of the approximately 12,000 patients who are currently waiting for a donor organ will be shown.

Organ donor card will be sent with health card or contribution notification
After the Bundestag has spoken out in favor of the amendment of the Transplantation Act, the so-called decision-making solution has been in effect since November 2012. Thereafter, the health insurance companies are obliged to ask every two years, the willingness of their members to donate. For this, the health insurance funds send organ donation cards together with the electronic health card or the contribution notification to all insured persons 16 years and over. For the initial information, the health insurance companies have one year time.

In this way, the population should be sensitized to the subject of organ donation and the general willingness to donate should be increased. Surveys had previously shown that many people are indeed willing to donate their organs, but do not have organ donor card and therefore not officially considered as organ donors. The so-called decision-making solution makes it possible for the insured to react to the letter of the cash registers. Nobody is obliged to make a decision or even to donate organs.

People who decide not to donate organs after death or who do not give a statement, but who are eligible as donors, will be interviewed as they were before the reform.

Living will should not conflict with information in the organ donor card
As informed by the German Foundation for Organ Transplantation (DSO), those who decide to donate organs after death should keep in mind that "the information in the organ donor card does not conflict with those in the living will, such as the reference to not taking life-support measures". For an organ donation it is absolutely necessary to maintain the blood supply after the brain death. Otherwise, the organs could no longer be transplanted. The DSO therefore advises "to supplement clear information on short-term intensive care measures in the living will".

Organ removal takes place only after determination of the brain death
As the DOS informs, many people's fear of organ harvesting before the onset of death is unfounded. A corresponding intervention is only carried out if the brain death of the patient, for example, after a serious traffic accident, determined by a doctor. This is the case when the affected person's brain functions are irretrievably damaged and completely destroyed. The DOS defines this state as „irretrievable loss of all perception, thinking, control of breathing, and centralized control of all bodily functions“.

Once a person's brain death has been diagnosed, further medical efforts are meaningless. In the event that one or more of the affected person's organs are suitable for transplantation, doctors or a transplant coordinator will have a conversation with relatives. During this time, the brain dead will continue to be artificially ventilated.

If the members of the organ donation agree or if the person concerned has an organ donor card, the Organizational Center of the German Foundation for Organ Transplantation (DSO) will be informed, which will coordinate the organ donation in Germany and cooperate with Eurotransplant, a non-profit organization that coordinates the international exchange of donor organs.

A laboratory examination of donated blood provides information about possible diseases. In addition, blood type and tissue characteristics of the donor are determined. A final decision on whether an organ is suitable for transplantation, however, takes place only at the organ removal in the operating room. If the verdict of the doctors is positive, the organ is taken to the transplantation center by the fastest route, where the organ recipient is already prepared for the transplantation.

Due to organ donation scandal, willingness to donate in Germany has dropped
After an organ donation scandal was discovered last summer, in which doctors should have manipulated the urgency for a donor organ in some patients in part, the willingness to donate of the citizens in October fell by almost 50 percent. For the approximately 12,000 patients who are currently waiting for a donor organ, the situation is precarious. Because every day three people die while waiting for a donor organ. Whether the reorganization of organ donation in favor of those affected fails, will show in the future. (Ag)

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Cash registers should query organ donation readiness

Picture: Günther Richter