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How To Increase Organ Donation RatesPay It ForwardIsrael is pioneering a new approach over the past 3 yrs that prioritizes organ allocation based upon willingness to be a donor. If two people on the organ transplant waiting list are medically equally well matched as potential recipients, the organ will go to the person who previously agreed to be an organ donor.The results were dramatic with a 10X increase in donor registrations during the 10 week period promoting the new law. [1] Self-preservation is a powerful motivator.Chain of Living DonorsLet's say you have a loved one in need of a kidney transplant but no suitable match is found among their own relatives. You can become a donor for someone else on the waiting list while, in return, your loved one receives a well matched kidney. Both of the donors are called "non-directed" meaning that they do not choose who receives their kidneys. This dramatically expands the pool of eligible donors.This system arose in South Korea in the early '90s by initially pairing two sets of donors & recipients. Its expanded since then with one 60 person chain profiled by the New York Times. [2]Opt-Out"Opt-out" is when every citizen is assumed to be an organ donor unless they otherwise indicate their refusal. This is in comparison to "opt-in" where citizens must sign an organ donation card to be considered donors.It's well known that the majority of people will follow what is defaulted in any given situation.Let's take countries with similar cultures and see the differences in the % of the population willing to be available as donors.Germany (Opt-In) = 12% of its population assumed willing to be donorsAustria (Opt-Out) = 99% of its population assumed willing to be donors [3]The countries in gold are Opt-In and those in blue are Opt-Out.This seems like a clear winner in increasing donation rates, right? Well, here is where it gets interesting.Opt-out has the potential to dramatically increase the availability of organs. I write "potential" because the system only works well when its adhered to by doctors. In reality, when the time comes to actually donate, doctors still typically defer to the wishes of the deceased’s family. In some countries, this practice is even mandated by law, called "soft opt-out."Therefore, a country can have a high rate of presumed consent but still not see high rates of actual donations.Sweden is one such example. It has opt-out & 86% of the population presumably available. However, it has one of the lowest actual rate of organ donation in the EU, below that of opt-in countries such as Germany & Netherlands. [4]The trend is positive however with countries with opt-out systems having a 25-30% higher actual donation rates than countries with opt-in systems. [5]This graph shows actual rate of organ donation with Opt-Out (ie presumed consent) presented by the dark bars and those with Opt-In (ie informed consent) are white bars.[6]Conspicuous ConservationismHuman bodies are naturally created with recycling in mind.If you donate as a living donor, your community can celebrate your amazing sacrifice. This recognition is not available to the dead organ donor. So we need to move up the recognition of this good deed to the point when people become organ donors on paper.Toyota built the Prius hybrid to look noticeably different from any other car. Hybrid cars bestow social status on the drivers but only if its obvious their car is environmentally friendly. [7]By the same token, since organ donors are making a positive impact on society, they should be conferred higher status than non-organ donors. Instead of a tiny dot on my driver's license, I want a new design easily viewed and identified from far away that I am an organ donor.Every time I go to a club, buy alcohol or show identification I want to signal to those around me that I am an organ donor. Ideally we will get to the point that people will be embarrassed to take out their driver's license if they are not organ donors.Example of New Backside for Organ Donor Driver's LicenseCurrent Donor Driver's License (I'm seeking someone to redesign this image so that the donor designation is more visible)UbiquityLet's dramatically increase the opportunity to become an organ donor by making it available everywhere.Organ donation preference should be a standard section in government, employer, educational and professional forms. This includes estate planning, wills, life insurance, health insurance, social security card applications, medicare and medicaid, voter registration, passport registration, child custody directives, living wills & advance treatment directives, birth certificates, doctor office visits, tax returns, green cards, registering for the military, your student file at college, social service visits, etc...Organ donation cards should be available in cafes, voting booths, post offices, libraries, courts, parking lots, etc... The government should provide a QR code on the card for immediate registration. There should be standardized links on all government websites to state organ registries. [8]QR Code in New York City's Times SquareBecoming an organ donor will be easy, it will be integrated into life experiences we all share, and repeated exposure will habituate us to the discomfort that comes with thinking about our own death."An organ donor card to go with your latte?"God Knows We Need Your Organs Here on EarthThe views of the clergy hold tremendous weight for billions of people in matters of life and dead. Most of the world's religions accept organ donation. [9] Some leave it up to the individual while some proscribe conditions such as prior written consent (Islam), criteria for death (Judaism) or draining of the organ's blood prior to transplantation (Jehovah's Witness).I'm not in a position to discuss or challenge these belief systems to be stronger advocates for organ donation. What I am asking is that religious organizations and leaders vocalize more to their congregations the teachings of their faith. We are regularly told by faith leaders to be better people along with the specifics of what that entails.If organ donation is accepted, then let's make it part of the standard list of actions expected by the faithful along with honoring your parents, not stealing and treating others as we wish to be treated.11th CommandmentThe Personal is Political & PowerfulFacebook added an Organ Donor milestone to its Timeline feature in May 2012, creating an explosive, however brief, surge in organ donor registrations (over 100K). Why did Facebook add this cause, among the many to choose from, to add to the Timeline? Because Mark Zuckerberg's wife Priscilla Chan is a physician and has seen first hand children waiting for organ transplants. [10]Assemblyman Richard Brodsky of New York advocated for a switch from opt-in to opt-out to increase the availability of organs. Why did he pick this area to concentrate his precious political capital? Because his daughter was the recipient of 2 kidney transplants. [11]California passed a law in 2010 that created a live donor registry for kidney transplants and requires drivers to actively choose whether they want to be organ donors when they renew their drivers' licenses. Why would Steve Jobs, workaholic & international superstar, play such a major role in advocating for this minor state legislation that he was credited with being *the* reason it became law? Because he had a liver transplant. [12]The lesson here mirrors that of the movement to grant homosexuals full & equal citizenship. The more GLBT people we know, the more likely we are to be supportive of their rights. Similarly, those touched by organ donation have the most motivation to sign donor cards. Our success will grow to the extent that we come out as organ donors & recipients.Can We Talk?When British citizens are approached in British hospitals to donate their family member's organs 57% agree. However, when British people living in Spain are approached in Spanish hospitals, 91% agree!Spain has succeeded in designing an approach to grieving families that works, even cross culturally. It now has the highest rate of actual organ donation in the world. Some of its hospitals have a near 100% acceptance rate.Transplant coordinators may spend hours listening to the relatives and asking them to consider organ donation in a private room away from the hospital wards. A standard practice is to ask families what they think their relative would have wanted to happen. [13]Finally, I have a suggestion for a PSA, public service announcement, based on the well known anti-drug campaignThis is your heart when you take it with you to the grave.This is your heart transferred to its new owner after you no longer need it.A thumbs up from Erika, a 28 yr old from Mexico City [14]Kyle races in the Kona Ironman [15]Stefania gave birth to twins 16 months after her heart transplant [16]Peter walks his daughter down the aisle 6 days after receiving a new heart. [17]Goffrey is studying cardiovascular technology [18]8 year old Shanah can now do one-handed cartwheels. [19]Any questions?[1] In Israel, a New Approach to Organ Donation[2] Lives Forever Linked Through Kidney Transplant Chain [3] Organ donation[4] Page on Nvl002.nivel.nl[5] Organ Donation: To Opt In Or Opt Out[6] The impact of presumed consent legislation on cadaveric organ donation: A cross-country study[7] Hey Baby, Is That a Prius You’re Driving?[8] State Organ and Tissue Donor Registries[9] Religious Views on Donation[10] Why Priscilla Chan may become the country's most influential doctor[11] NY lawmaker wants presumed organ donation consent[12] http://www.businessinsider.com/steve-jobs-does-it-after-almost-dying-california-passes-his-organ-donor-law-2010-10[13] Spain leads world in organ donations[14] Dropped heart patient leaves hospital after transplant[15] Ironman Kona: Cancer Survivor, Heart Transplant Recipient Kyle Garlett[16] Page on Barnabashealth.org[17] Page on Barnabashealth.org[18] Patient Success Story - Goffrey, heart transplant recipient[19] Shanah Bridgett: Berlin Heart

Here’s your answer in a simple image:He doesn’t seem to have much in the way of strong personal convictions about policy issues, which makes him This doesn’t answer the question of what winds are aiming him, however.These seem to be the main ones:Where money, personal profit and power are not involved, look to what his base believes. Abortion, gun rights, political Christianity, for example.Where Vladimir Putin’s interests are involved, that seems to override anything else. This is clear from his words and deeds. Why probably won’t become clear until the New York State Attorney General can get access to his byzantine financial records, though there also seems to an element of hero worship in it, perverse as that seems, and the hope for a profitable real estate development in Moscow. But I’m just guessing about the “why,” while the “what” is obvious to any but the most besotted Trump cult member.3. Where money, personal profit and power are involved and not overidden by Putin’s wishes, he simply wants more of all three things, and to protect his money and power from attack or even the possibility of attack. Meaning he needs to have everyone in the federal government personally loyal to him—not to the country, its people, or its Constitution, or any larger concerns like the future of the human race and life on Earth.Because he’s free of scruples, shame, or commitment to anyone but himself (and Putin and maybe his immediate family), he isn’t hard to understand. In that sense he may be our simplest President in at least a century.With one exception. Unlike sociopaths, who treat people as things but doesn’t get pleasure from harming others, Trump has demonstrated repeatedly that he’s cruel and sadistic. He doesn’t want to defeat those he sees as his enemies. He wants to crush them, humiliate them, make them tiny and then step on them over and over. This is the nature of malignant narcissism, a mental disorder he almost certain has, amplified by four years of having acquired immense power, vastly beyond what he had before, and surrounded by bootlickers, having gotten rid of anyone who might say “no” to him.Trump's mental state — not Biden's — is the real concern, mental health professionals sayBecoming President doesn’t change people. It lets them become who they already were—only moreso. If someone is at heart a scared yet also spoiled little boy, you get a boy-king finally able to give in to his most destructive impulses.

As I have mentioned in another post, my precious mother died of a very painful disease when she was seventy-two years old.She was ill for over a year, so we got to spend a lot of quiet time together.During this time, she shared memories of her childhood and her life experiences.My father was killed when I was a little girl, and I was eager to discover what he was like.My mother painted an honest portrait of him. According to her, I AM my late father.They met at his family's saw mill in Eastern Canada. He worked in the woods as a lumberjack, and my mother was one of the cooks at the mill.Once a month, the village had a ‘pie social’. The single women would bring something they baked, and the bachelors would bid on it. The man with the highest bid got the pie or cake AND the privilege of walking the baker home.My mother was a beautiful woman. When she auctioned her chocolate cake with boiled icing (delicious!), the young men started a bidding war.My father spent a week's pay for the honor of walking my mother home (and the chocolate cake)!Mom was furious with him for embarrassing her and spending so much money on something so trivial.My dad was in love! Soon they were courting. After a few months, my father got down on one knee and asked my mom to marry him.He promised to take her to New York city on their honeymoon. She thought he was joking. No one she knew had ever left the province, let alone Canada!He was the man of her dreams, and after a short engagement, they married.True to his word, my dad left the safety of rural life in Eastern Canada, and took my mother on an unforgettable trip, beginning on a dirt road deep in the countryside, and ending at Times Square in the Big Apple!No one believed that my dad would actually do this. He became a legend.My mother smiled as she said they had the time of their lives. My father seemed to be fearless! He drove the old pick up truck in downtown traffic!They saw and did everything, including going to the top of the Empire State Building, Radio City Music Hall (where they saw the can can dance troupe the ‘Rockettes’ perform), the Brooklyn Zoo, the Statue of Liberty, Coney Island and Chinatown.My mother seemed to be back in time as she told me my dad was one of a kind. He was hilarious, full of fun, and a man's man.This was one of the most special and sacred times in my life, as I was getting to know who my father was, while at the same time watching my mother slowly die.My mother said I had my father's outgoing nature and sensitivity, as well as his lack of intimidation by wealthy or famous people.After his father died, and the saw mill was sold, my father worked for the billionaire oil tycoon J.K. Irving in New Brunswick, Canada.He would sit with Mr. Irving and talk about everyday things while having a cup of tea in the kitchen at the sprawling mansion.My father had a grade eight education, but his life experience more than compensated for his lack of formal schooling.The Irvings entrusted him to keep an eye on their estate while they were away, and Mrs. Irving insisted that my father would be their chauffeur to the airport.Interestingly, I sat in the same kitchen, many years later, talking with the second generation of Irvings, when I taught piano lessons at the mansion.I would never have known this about my father if my mother and I didn't have this intimate time together.In my father's day, African Americans and caucasians generally stayed apart, except for work situations.My dad told my mom he was bringing home a dinner guest after work. When she opened the door she greeted a black man.My father didn't see colour. He saw his friend. When mom asked him why he didn't mention that his guest was a different colour, he said it didn't even cross his mind.This was seventy years ago. 1948.My mother shared many other wonderful stories about my father. What an UNUSUAL person he was. He lived life on his own terms with great integrity.I have a great sense of respect for the father I didn't get a chance to know. Apparently his funeral was full of people who shared stories of the kind things that he had done for them.My grieving mother had not been aware of these good deeds.One of the last things my mother said to me as she was dying was, “Gail, isn't it wonderful that you and I got to be together at the same time on this planet!”Oh yes indeed mother it was wonderful, and I will always love you.