And more questions about the new Donor Act
The Donor Act will come into effect in 2020. If you haven’t arranged anything yet, it’s better to do so before then. Otherwise you will automatically give permission for the donation of organs and tissues, even if you do not want that.
Will the new law add thousands of donor organs?
New. The chance that organs and tissues will be removed if someone dies is and remains very small. In 2016, 148,000 people died in our country, according to figures from the Central Bureau of Statistics. Only 235 of them have become donors of one or more organs, according to the Dutch Transplantation Foundation. There are so few donors because organs can only be transplanted if they are still functioning properly. After death, the organs deteriorate rapidly. You can only be an organ donor if you are on a ventilator in a hospital when you die. In this way, the organs still receive enough oxygen and nutrition after death. This is the case, for example, with a serious stroke or brain haemorrhage, and sometimes also after a traffic accident. In any case, it doesn’t happen often.
What will change with the new Donor Act?
At the moment, 6.3 million Dutch people have registered in the Donor Register whether they want to be donors of tissues and organs after their death. Roughly 9 million people have left this behind. If they die, it is difficult for a doctor or the family to determine whether they would have wanted to be an organ donor. The family says ‘no’ in two out of three cases. That is sour for the 1,071 people on the organ waiting list, 130 to 150 of whom die each year. In order to do something about this, politicians have adopted the new Donor Act. Everyone will automatically enter the Donor Register from 2020 onwards. The only conditions are that you are 12 years or older, are mentally competent and are registered with a Dutch municipality. Don’t you pass on anything? Then you say ‘yes’ to (the small chance of) organ donation after your death.
What happens if I don’t make a choice?
With the law, politics actually forces the 9 million people who have not made a choice to do so. Everyone will receive a letter in 2020 asking them to record their choice in the Donor Register. Do you not respond to the letter and to the repeat letter? Then after a few weeks you are automatically registered as ‘Yes, I give permission’ (or ‘no objection’). You make all organs and tissues available for transplantation after death. Don’t you want this? Or do you want to leave the choice to your partner, family or a self-chosen person? Then go to the website of the Donor Registry. There you can also tick which organs and tissues may and may not be used. You do not have to wait for the new law to come into effect.
Where can I find the Donor Register?
The Donor Register is a website. You log in with DigiD and fill in the form online. No computer? A paper form is available at the town hall and via the Donor info line: T 0900-821 21 66 (usual call charges).
I still have an old donor card in my wallet. What do I have to do with that?
You can throw that away. The doctor no longer searches for these kinds of codes or passes because it takes too much time if someone has died and can possibly become a donor. The doctor only checks the Donor Register.
Can you also arrange the donorship at the notary?
New. The doctor needs to know quickly whether a potential donor has consented to donation. This can be quickly looked up in the Donor Register. The process to the notary takes too long. Nevertheless, many notaries have included a donor clause in the living will. You can use this to make it extra clear to your partner and family what your wishes are.
Suppose a loved one has a brain haemorrhage, the condition is critical. The person does not want to be an organ donor, but has not completed the Donor Register. What then?
If someone has not registered anything in the Donor Register, then after 2020 it will automatically read ‘yes, I have no objection to organ donation’. Even if the person didn’t want this. But the new law does have a safety net for this. Family members can stop organ donation if they have serious objections. They must then demonstrate that organ donation does not correspond to the wishes of the person concerned.
Can someone be a donor after euthanasia?
Yes, that’s possible. The GP must then make certain preparations and must therefore be informed well in advance. Euthanasia is usually done at home. If someone wants to be an organ donor, the euthanasia has to take place in the hospital, so that the doctor can remove the organs in the operating room within a short time after death. Euthanasia at home is possible for tissue donation. In the case of organ donation in the hospital, the family must say goodbye quickly after the death, so that the removal can take place quickly. After the removal there is time for an extensive farewell and the loved one can be buried or cremated. Organ donation after euthanasia is often possible up to and including about age 75, tissue donation up to 86 years.
Will my demented mother also be an automatic donor?
It depends on. If she has had her wish recorded in the Donor Register and subsequently became demented (and therefore incapacitated), then her wish applies. It is different when someone has not recorded a wish and becomes incapacitated. Anyone who does not respond to the call to indicate their choice in the Donor Register after the new law has been introduced will be registered as ‘No objection’. In the event of the death of this person, the next of kin will be consulted about the choice of organ and tissue donation. Did this person really want to be a donor? That question can be answered by the legal representative of the deceased. If there is no such representative, the next of kin decide. If they are also missing, no organ donation may take place.
Can you be too old to become an organ donor?
Whether someone becomes a donor depends on the time, cause and place of death. The body condition of the deceased donor and the quality of the organs and tissues are also important. 40 percent of donors are over 56 years of age. There is a different maximum age for each organ. For example, the heart of a 67-year-old is no longer suitable for donation, but that person can still be a fine kidney donor. Eye tissues can be donated up to age 85.
What if you have been seriously ill, are on medication or have smoked all your life?
In principle, anyone can register as a donor. If you have cancer, organ donation is usually not possible. But it is possible with certain types of cancer, just like with a well-treated cancer in the past. Active infections with tuberculosis, HIV or herpes zoster can make you unfit for donation. Due to the scarcity of organs and the death risk of people on the waiting list, the criteria for organ donation are lower than for tissues.
Can organs and tissues also be used for scientific research?
Yes. Organs and tissues are intended for transplantation. If they are not suitable, they will not be taken out. However, it is possible that an organ or tissue that has been removed cannot be used for a transplant. Doctors then want to use such an organ or tissue for scientific research aimed at improving transplantation techniques. If you do not want this, you can indicate this in the Donor Register.
More questions?
- Do you have questions about what happens to your organs or to your body during a transplant? View on www.transplantationstichting.nl
- A lot of extra information about donating can be found at www.donorregister.nl
Organ transplants from deceased donors in 2016
Kidney: 426 transplants
Lung: 73 transplants
Liver: 151 transplants
Heart: 35 transplants
Pancreas: 29 transplants
Cornea: 1523 transplants
Heart valve: 86 transplants
Bone tissue: 2129 transplants
Source: Transplant Register.
This article originally appeared in Plus Magazine in May 2018. Not yet a Plus Magazine subscriber? Becoming a subscriber is done in no time!
Sources):
- Plus Magazine
