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Devec
September 30 2012, 01:02:28 AM
A thing that keeps popping up from time to time is the shortage of organs and how society should battle this. A common sound is the opt out organ donor system that would have every single person signed as a donor, unless they specifically indicate that they don't want their organs removed after death. Personally I am in favour for such a system, because from my point of view I find that if I am dead I won't be needing my organs any way.

Other than say religious and or cultural reasons, what reasons are there against an opt-out organ donation? Would any of you be willing to donate your organs after death? If not, what are your reasons against donation?

Xiang Jiao
September 30 2012, 01:53:25 AM
The reason it shouldn't be opt out is precisely because there is a shortage, and a great demand. What if you fell off your motorbike and critically injured yourself and were unable to communicate your wishes to your family, and were too lazy, or didn't know you had to opt out? Doctors and hospitals start seeing you as a big skin sack full of money instead of a real person who probably wants to pull through. Hospitals would become organ harvesting facilities instead of critical care centers. What happens if you show up in an ER with no insurance? Will they make an honest effort to save your life? Read Larry Niven's short story, A Jigsaw Man - http://en.wikipedia.org/wiki/The_Jigsaw_Man. Criminals repay their debt to society by sacrificing their organs. I just don't see the Hippocratic Oath standing up in the face of a high demand for second hand organs. We are better off as a society looking at other avenues for better health care - regenerating organ tissues, genetic research, and disease prevention.

Secondly, why would you want to add an extra layer of bureaucratic paper work? Currently, you opt in for organ donation on your driver's license (in the States). If there really are a lot of people like you who don't care about giving up their organs, let them check the little box and sign the license and feel good about it. What happens in the case of people who don't carry a driver's license? Do they need to carry around a legal form at all times saying "Do not harvest" like the opposite of a DNR form?

Varcaus
September 30 2012, 02:27:43 AM
My organs are mine get your dirty hands off. No hospital is going to sell them off to anyone.

spasm
September 30 2012, 02:50:44 AM
My organs are mine get your dirty hands off. No hospital is going to sell them off to anyone.

Keep it serious.

Xiang Jiao
September 30 2012, 03:52:26 AM
My organs are mine get your dirty hands off. No hospital is going to sell them off to anyone.

Keep it serious.

To be fair, that is somewhat of a TL;DR on my post.

Cue1*
September 30 2012, 04:13:12 AM
Secondly, why would you want to add an extra layer of bureaucratic paper work? Currently, you opt in for organ donation on your driver's license (in the States). If there really are a lot of people like you who don't care about giving up their organs, let them check the little box and sign the license and feel good about it. What happens in the case of people who don't carry a driver's license? Do they need to carry around a legal form at all times saying "Do not harvest" like the opposite of a DNR form?

I doubt it would create more paperwork, actually I suspect it'd be less. As it is, that little checkbox on your license doesn't actually make you an organ donor. Anyone who can claim an interest in your affairs after your death can override that unless you specifically state it on your will.

As someone who in the future might need a donation organ(although I don't need one from a dead man, livers regenerate so I can just take half of someones), I am fine with someone not wanting to give up their organs. But the decision should not be left to grieving next of kin. Either make it opt out, or make the license checkmark an authority on the matter and require everyone to answer yes or no to the question.

Aea
September 30 2012, 04:43:02 AM
The reason it shouldn't be opt out is precisely because there is a shortage, and a great demand. What if you fell off your motorbike and critically injured yourself and were unable to communicate your wishes to your family, and were too lazy, or didn't know you had to opt out? Doctors and hospitals start seeing you as a big skin sack full of money instead of a real person who probably wants to pull through. Hospitals would become organ harvesting facilities instead of critical care centers. What happens if you show up in an ER with no insurance? Will they make an honest effort to save your life? Read Larry Niven's short story, A Jigsaw Man - http://en.wikipedia.org/wiki/The_Jigsaw_Man. Criminals repay their debt to society by sacrificing their organs. I just don't see the Hippocratic Oath standing up in the face of a high demand for second hand organs. We are better off as a society looking at other avenues for better health care - regenerating organ tissues, genetic research, and disease prevention.

Secondly, why would you want to add an extra layer of bureaucratic paper work? Currently, you opt in for organ donation on your driver's license (in the States). If there really are a lot of people like you who don't care about giving up their organs, let them check the little box and sign the license and feel good about it. What happens in the case of people who don't carry a driver's license? Do they need to carry around a legal form at all times saying "Do not harvest" like the opposite of a DNR form?

There's a few interesting points to address here.

1) Doctors within Hospitals typically have less financial incentive here then you would expect, in fact the incentive is just about opposite. Letting somebody die pays significantly less well then keeping them alive for as long as humanly possible.

2) Within the US it is illegal for ERs to ask / prompt / mention anything about payment and / or insurance before emergency care needs are met. Granted it is sometimes possible to assume whether a certain individual would be able to cover their care.

3) I believe all "opt-out" states mention this very clearly when applying for identification. The rest of your points seem really quite tangental and deflective. If such a system was implemented within the USA I would imagine the "organ donor" checkout would automatically be checked for you when you apply for driver's license until you opt out. Nobody will harvest your organs without consent, no license, no donor check, no harvesting.

Sacul
September 30 2012, 10:32:34 AM
I cant find the numbers but i heard a few dutch doctors say multiple times that it isnt so much a lack of organs as a good amount of carriers. One of the things most needed is a brain dead patient or at leat long enough 3/4 dead till they can harvest. One of the problems with that is the safety specs of cars and bikes which resulted in a huge decrease of fatality's with traffic accidents.

Aurora148
September 30 2012, 10:47:34 AM
I cant find the numbers but i heard a few dutch doctors say multiple times that it isnt so much a lack of organs as a good amount of carriers. One of the things most needed is a brain dead patient or at leat long enough 3/4 dead till they can harvest. One of the problems with that is the safety specs of cars and bikes which resulted in a huge decrease of fatality's with traffic accidents.

In the UK one of the biggest problems is that even if someone has signed up to donate their organs the family still gets a veto over it. Essentially doctors have to ask people going through the strongest stages of grief whether or not to take the person's organs, it isn't surprising that many have the irrational response to keep their loved one "whole" even against their wishes.

Sometimes the family comes around eventually and sees that its what the person wanted, but many organs have an expiry time even on a ventilator, and so its too late to take them, so they are wasted.

KathDougans
September 30 2012, 11:06:10 AM
I cant find the numbers but i heard a few dutch doctors say multiple times that it isnt so much a lack of organs as a good amount of carriers. One of the things most needed is a brain dead patient or at leat long enough 3/4 dead till they can harvest. One of the problems with that is the safety specs of cars and bikes which resulted in a huge decrease of fatality's with traffic accidents.

http://www.thedetroitbureau.com/2012/06/helmet-law-repeals-raising-motorcycle-deaths/

http://wheels.blogs.nytimes.com/2008/07/07/brain-dead-why-are-there-no-mandatory-helmet-laws/

http://www.sach.org.uk/journal/0401p07_thomson.pdf

http://articles.baltimoresun.com/1991-12-30/news/1991364025_1_organ-donation-organ-donors-transplants

There are many, many ways in which the supply of donors can be manipulated.

Helmet laws for motorcycles, seat belt laws, traffic calming measures, drink/drug driving laws, hospital facilities, and so forth.

Accident and emergency facilities in hospitals, and the ambulances that take people to hospital can be manipulated, by the provision or otherwise of equipment and training. This wouldn't necessarily involve the doctors, nurses or ambulance paramedics being co-erced into not caring for critically injured people, such that they cannot be saved except as a brain-dead donor. Just by not providing the best equipment and training, the care that a person receives can be manipulated so that that person can be a donor rather than a survivor.

Laws about helmets and seatbelts can be repealed, claiming "freedom for the individual".
Traffic management, speed limits, these can also be manipulated to increase donor supply. Claim no budget for road improvement at a crash blackspot, increase speed limits, remove speed cameras, say there's no budget for pedestrianising an area, these can all be done.

With assumed consent for donation, there are types of person who are "more valuable to society", as potential organ donors than if they're alive. E.g. young, healthy but poorly educated people. They're not going to contribute all that much in tax revenue over their lifetime, but their organs could make an older high rate taxpayer generate a few more years of tax revenue.


Elsewhere in the world:

http://www.nytimes.com/2001/10/18/world/on-death-row-china-s-source-of-transplants.html

http://www.guardian.co.uk/world/2009/dec/21/israeli-pathologists-harvested-organs

Xiang Jiao
September 30 2012, 03:32:13 PM
There are many, many ways in which the supply of donors can be manipulated.

I know this is a matter of perspective, but a find these statements a little disgusting:


Better care for accidents victims, increased seat belt use and tougher drunken driving laws have saved more lives, but not without a cost -- fewer organ donors for patients needing transplants.

Oh noes! Less people are ending up in the ER brain dead, what will happen to the second hand organ market?


Doctors within Hospitals typically have less financial incentive here then you would expect, in fact the incentive is just about opposite. Letting somebody die pays significantly less well then keeping them alive for as long as humanly possible.

I don't buy that at all. In an industry where hospital administrators can make more than specialty surgeons, I don't care to think how many people would be reduced to the price of their component parts, particularly in the absence of family members to block the organ harvesting. The homeless, destitute, and uninsured would become assets for the auction block.

Amantus
September 30 2012, 03:55:19 PM
Honestly the way things are going right now, this discussion will be irrelevant in a few years time. We'll be able to make perfectly serviceable organs.

KathDougans
September 30 2012, 07:12:03 PM
There are many, many ways in which the supply of donors can be manipulated.
I know this is a matter of perspective, but a find these statements a little disgusting:


Exactly. It's disgusting to read some of those articles, and see how there are doctors complaining about lack of donors because of road safety improvements. And how some politicians are involved in repealing road safety laws. And how some researchers say the "positive outcomes" of road traffic accident victims being brain dead should be a factor considered when making road safety policy decisions.

It shows that some politicians and some lobby groups already consider many people as being worth less alive than as donors.

And it's not even dependent on needing doctors to be complicit, even though some think that way already.

Tellenta
October 1 2012, 03:30:58 AM
If your shit is broke others who have perished before you should be forced to fix you. That is the only statement that backs up forced organ donations. Beyond that maybe fund science instead of farming possible rejections of organs from dead people. I heard stem cell research might be good for that.... oh wait I'm an American how could I say such things.

Ophichius
October 1 2012, 04:51:40 AM
Honestly the way things are going right now, this discussion will be irrelevant in a few years time. We'll be able to make perfectly serviceable organs.

At what price? If growing an organ on scaffolding is more expensive than harvested organs, you still have room for a market in secondhand parts. And given that the tech to do so will likely be patented, I can't see it being cheap at all until the patents expire, two decades later.

Until in vitro organs are cheaper than transplant costs, there will always be some market for transplants.

-O

Vortex
October 1 2012, 06:26:48 AM
I'd be all for mandatory opt-in, with no opt-out clause available. The Western world, and the United States in particular, gives far too much slack to religious differences on these sorts of things. Just as we don't accept some batshit crazy excuse to not get blood transfusions or refuse lifesaving medication, so too should we not accept those arguments as an excuse not to administer vaccines or harvest valid organs. I'm not saying every fatty in the US is going to make for the best donor ever, but on the occasions where good organs wind up on the table, its a complete waste for them to go to, well, waste.

Hell, I'd be up for limited sale of organs as well, except it would wind up as all the rich people buying fifth kidneys from poor brown people.

Xiang Jiao
October 1 2012, 06:55:33 AM
I'd be all for mandatory opt-in, with no opt-out clause available. The Western world, and the United States in particular, gives far too much slack to religious differences on these sorts of things. Just as we don't accept some batshit crazy excuse to not get blood transfusions or refuse lifesaving medication, so too should we not accept those arguments as an excuse not to administer vaccines or harvest valid organs. I'm not saying every fatty in the US is going to make for the best donor ever, but on the occasions where good organs wind up on the table, its a complete waste for them to go to, well, waste.

Hell, I'd be up for limited sale of organs as well, except it would wind up as all the rich people buying fifth kidneys from poor brown people.

Good troll is excellent. Think of how much money we can save the insurers if we just let the fatties croak and eat their organs.

Smuggo
October 1 2012, 07:23:33 AM
I'd be all for mandatory opt-in, with no opt-out clause available. The Western world, and the United States in particular, gives far too much slack to religious differences on these sorts of things. Just as we don't accept some batshit crazy excuse to not get blood transfusions or refuse lifesaving medication, so too should we not accept those arguments as an excuse not to administer vaccines or harvest valid organs. I'm not saying every fatty in the US is going to make for the best donor ever, but on the occasions where good organs wind up on the table, its a complete waste for them to go to, well, waste.

Hell, I'd be up for limited sale of organs as well, except it would wind up as all the rich people buying fifth kidneys from poor brown people.

Good troll is excellent. Think of how much money we can save the insurers if we just let the fatties croak and eat their organs.

Why would this be a troll? I agree. The dead don't need organs so they should be used to help the living. If its against people religious beliefs then maybe they should fuck off to some primitive shithole where sky faeries are still deemed to be in charge.

And yeah, I'm a registered donor but the fact my family could override it is a joke. Fortunately my wife is also a donor though so I would hope she will respect my wishes.

Vortex
October 1 2012, 09:34:36 AM
I'd be all for mandatory opt-in, with no opt-out clause available. The Western world, and the United States in particular, gives far too much slack to religious differences on these sorts of things. Just as we don't accept some batshit crazy excuse to not get blood transfusions or refuse lifesaving medication, so too should we not accept those arguments as an excuse not to administer vaccines or harvest valid organs. I'm not saying every fatty in the US is going to make for the best donor ever, but on the occasions where good organs wind up on the table, its a complete waste for them to go to, well, waste.

Hell, I'd be up for limited sale of organs as well, except it would wind up as all the rich people buying fifth kidneys from poor brown people.

Good troll is excellent. Think of how much money we can save the insurers if we just let the fatties croak and eat their organs.

I imagine most obese people's organs aren't often all that high of quality, but I'm not a doctor so I can't speak much on that issue past speculation. Also not a troll. The deceased have zero use of the organs. They will never ever need them again. Assuming their organs are of the right quality, and they died in the right way, maybe their organs can go on to make the life of a living, breathing person better. Maybe that person will even still, you know, keep breathing! Organ donation turns a negative event - death - into a positive event by aiding those still alive.

Religious objections to it are just so irrelevant. Oh yes, I believe in XYZ, so therefore that person over there needs to suffer and/or die to because I want his organs to rot in the ground instead! Fuck that shit. Human life and human organs are expensive and valuable, and until we have readily accessible, grown-to-order replacements, this is the only* way to increase supply of a highly finite supply. Society put a lot of money into raising you, least you can do is give back the organs you no longer need to help somebody else (assuming they are in the correct quality and retrievable at the right time).

Aurora148
October 1 2012, 10:30:55 AM
Honestly the way things are going right now, this discussion will be irrelevant in a few years time. We'll be able to make perfectly serviceable organs.

While true, the upcoming tech for "growing" organs requires the scaffold of an existing organ. So it still requires an organ to be sourced from somewhere.

Lallante
October 1 2012, 10:34:44 AM
A lot of the problems with Opt-out organ donation described in this thread don't apply if hospitals are state-owned and not-for-profit.

Rans
October 1 2012, 06:06:21 PM
I'm against this idea, some politician tried to do it in my country as well, but he failed(Thank god), it goes against basic human rights, human decency and respect for the dead and is deeply unsettling and even immoral. It reminds me of Frankenstein-type books where humans sacrifice their humanity in the name of science, for the greater good and so on. People should be allowed to chose if they want it or not. You might not be spiritual, religious or even care about your body or those of your family, but most of us do and I had an argument with my family just because I'm a registered donor and they didn't like the idea.

The state forcing people to become spare parts once they die is a bad idea.

CastleBravo
October 1 2012, 06:22:25 PM
If an opt-out system resulted in there being no shortage of organs then we wouldn't have to worry about the healthcare system letting people die to harvest them.

I think that the people who have been registered as a potential organ donor for the past year should receive priority if they end up needing a donated organ themselves. I don't think you should be able to claim that you think its wrong for someone to cut your corpse up to save someone else's life and then turn around and ask for someone else's body to be desecrated when its your life on the line.

Aurora148
October 1 2012, 07:14:35 PM
I'm against this idea, some politician tried to do it in my country as well, but he failed(Thank god), it goes against basic human rights, human decency and respect for the dead and is deeply unsettling and even immoral. It reminds me of Frankenstein-type books where humans sacrifice their humanity in the name of science, for the greater good and so on. People should be allowed to chose if they want it or not. You might not be spiritual, religious or even care about your body or those of your family, but most of us do and I had an argument with my family just because I'm a registered donor and they didn't like the idea.

The state forcing people to become spare parts once they die is a bad idea.

Wouldn't people who definitely didn't want it be sure to opt out though? That is the entire point, to pick up the large percentage of people who say they are in support of organ donation but are either to lazy to sign up or don't because it would make them confront their morality. Its not a measure to force anyone who doesn't want to.

Straight Hustlin
October 1 2012, 07:29:08 PM
Reposting my post that went in the Paternalism thread, because it still an angle that alot of people are not considering


A perfect example of a liberal paternalist policy to correct irrational behaviour is an "opt-out" organ donation scheme. The irrational behaviour is that many people who don't mind having their organs donated to save lives, never actually sign up as an organ doner to ensure this happens. The policy leaves people with the same freedom they had before but ensures that the irrational behaviour is corrected.


Registered specifically to address this point as it was something I had a discussion about with my sister when she had started med school. I will try to find out what the name of the article was that served as the basis for this, but it was basically outlining the pro's & con's of opt out & opt-in organ donation scheme. The conclusion of the doctors that wrote the article was that an opt-in is the preferable method, and heres why. Your argument is that in an opt out scheme would prevent people from irrationally wasting their organs. However this ignores that people are going to treat an opt-out scheme with the same apathy & lack of rationallity that they would an Opt-in Scheme. Your concern of people not opt-ing in when they should is now going to be replaced with people who are not opting out when they should. With an opt in scheme, while there are fewer organs to go around, there is a far less chance of the organ being tainted by the donors life style, as this is something that one considers when they opt in; which is why I am a donor for eyes, liver, & kidneys, but not for lungs & heart as I am a smoker.

With an opt out scheme & people being a donor by default, you will have many more organs available but the likely hood of them being tainted by the donors lifestyle is much higher as well. This means that you now have to have more stringent testing of the organs before transplant & with the time sensitive nature of certain transplants like a heart, this can rob you of the window of opportunity for a successful surgery.

So yes there are pro's & con's to each side of it, but as far as the medical practioner's side they would rather ensure the organs are as healthy as possible, rather then as plentiful as possible.

Xiang Jiao
October 1 2012, 07:31:09 PM
If an opt-out system resulted in there being no shortage of organs then we wouldn't have to worry about the healthcare system letting people die to harvest them.

That makes no sense. It's not as if you can keep a stock of frozen organs on hand indefinitely. They have to be recently harvested from a brain dead patient, which is why motor vehicle accidents supply the bulk of the demand. Unless you are China, of course, then you can just take organs from political and religious prisoners while they are still alive.

http://www.theepochtimes.com/n2/china-news/chinese-doctor-admits-to-falun-gong-organ-harvest-279113.html

KathDougans
October 1 2012, 08:00:29 PM
Found a better link to an article that I had read, regarding motorcycles

http://www.econ.yale.edu/seminars/labor/lap09/elder-091009.pdf

"in 2003, California Assembly Bill 1200 and New Mexico Senate Bill 239 would have made consent for organ donation presumed for all helmetless motorcyclists involved in fatal accidents"

It seems the federal laws regarding motorcycle helmet use were repealed, and it's up to individual states to legislate about helmets.

Make laws that allow people to ride motorcycles without a helmet, and laws that make organ donation consent presumed, when there's a pile of statistics to show the number of motorcyclists killed increases a lot when they're allowed to ride without helmets.

I find that disturbing.

Frug
October 1 2012, 08:31:46 PM
Found a better link to an article that I had read, regarding motorcycles

http://www.econ.yale.edu/seminars/labor/lap09/elder-091009.pdf

"in 2003, California Assembly Bill 1200 and New Mexico Senate Bill 239 would have made consent for organ donation presumed for all helmetless motorcyclists involved in fatal accidents"

It seems the federal laws regarding motorcycle helmet use were repealed, and it's up to individual states to legislate about helmets.

Make laws that allow people to ride motorcycles without a helmet, and laws that make organ donation consent presumed, when there's a pile of statistics to show the number of motorcyclists killed increases a lot when they're allowed to ride without helmets.

I find that disturbing.

I am really struggling to agree with you on it being disturbing, but the right wing streak in me is telling me that people who choose not to wear helmets and end up splattered are responsible for their own mess, and a great source of organs.

Pacefalm
October 1 2012, 11:01:30 PM
Currently in holland there is a several YEARS waiting time on some donor organs such as lungs. And those on the organ transplantation list are not there 'by default'. In order to become eligible for an organ transplant you have to basically already be terminally ill before you are even considered. So get this, you have to be terminally ill to be put on the donor transplant list, and THEN is takes an additional SEVERAL YEARS before you are next in line. It is absolutely absurd.

Speaking from experience, a lot of donor organs are wasted now even if the patient in question was a donor. That is because the doctors/nurses don't like to ask the close relatives of the patient if the patient was an organ donor. They feel it is unethical to ask it if that person just passed away. An opt out organ donation system prevents this issue and thus would mean even more organs are free for donation, -Even if everyone who is currently not a donor opts out-.

And the "oh noes i am a donor now hospitals will not treat me because they need organs omg" stories are retarded bullshit so stop spreading these lies. There are many idiots in this world and some may actually believe what you say. If anything it is clear that doctors are actually hesitant to use donor organs, rather than overeager.

Not many people on this forum knew that my sister is actually currently dying slowly from a genetic disease that manifests mostly in the lungs. Transplantation is a common topic for me and I feel strongly about this issue. Opt out donation has my full support. There are literally no downsides.
The only people who would be against opt out donation are those that don't want to donate organs but are too damn lazy to fill out a form. Yeah fuck them tbh.

I myself am an organ donor and I would like to think that my organs won't be wasted after I pass away. My last act in this world at least will be a good deed, maybe even save someone's life. That's something to be proud of tbh.

Xiang Jiao
October 1 2012, 11:32:03 PM
Opt out donation has my full support. There are literally no downsides. The only people who would be against opt out donation are those that don't want to donate organs but are too damn lazy to fill out a form. Yeah fuck them tbh.

There are no downsides to opt-in either. If doctors are too timid to harvest organs from registered donors, even with legal consent, then that's an issue all its own and doesn't need to be addressed here. Changing it to opt out won't fix that. Similarly, if the family fights it on legal, emotional or spiritual grounds, it's another impasse so it doesn't matter anyway.

I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

DevilDude
October 1 2012, 11:36:27 PM
the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


The organ bank problem

In Niven's universe, it was possible to transplant nearly any organ in the body (and prevent rejection) by the mid 21st century. Since any organ could now be replaced, in theory one could use the organ banks to extend life indefinitely. To maintain communal organ banks, one needs donors (i.e. dead people). When the death rate is reduced (via the organ banks), the number of donors decreases. Thus, the supply of organs would continually reduce.

Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.

An example in the Known Space universe was that anyone who wore eyeglasses was considered a reasonable candidate for an eye transplant (one or both); whereas in the real world, today's nearsighted population can solve the problem (temporarily) by wearing corrective lenses or (more permanently) by undergoing laser surgery.

Attempts by governments to solve the problem

On Earth, the problem led to a repressive society almost unrecognizable by today's standards. Since the average citizens wished to extend their lives, the world government sought to increase the supply by using condemned criminals to supply the organ banks. When this failed to meet the demand, citizens would vote for the death penalty for more and more trivial crimes. First violent crimes, then theft, tax evasion, false advertising, and even traffic violations became punishable by the organ banks. This failed to solve the problem, as once the death penalty was passed for a crime, people stopped committing it. This resulted in nearly every crime meriting the death penalty. Further attempts to alleviate the problem by declaring certain groups of cryogenically frozen people to be dead in law (the so-called "Freezer Bills") and harvesting their organs also proved to be unsuccessful. The freezer vaults represented a finite supply and therefore were eventually exhausted.

http://en.wikipedia.org/wiki/Organlegging

Pacefalm
October 2 2012, 12:01:55 AM
Opt out donation has my full support. There are literally no downsides. The only people who would be against opt out donation are those that don't want to donate organs but are too damn lazy to fill out a form. Yeah fuck them tbh.

There are no downsides to opt-in either. If doctors are too timid to harvest organs from registered donors, even with legal consent, then that's an issue all its own and doesn't need to be addressed here. Changing it to opt out won't fix that. Similarly, if the family fights it on legal, emotional or spiritual grounds, it's another impasse so it doesn't matter anyway.

I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.
One of the downsides to opt-in is that people are too lazy/don't have time/forget to fill in the donor form even if they would actually be willing to donate organs. Organs are in very short supply, making it easier for people to become organ donors is in everyones best interest.

I think the hesitation to make use of donor organs would indeed be alleviated by the opt-out system. With the opt-out system the question will become a routine question rather than a special case. It might sound like a small effect, and I doubt that it makes a huge difference, but even small things help in this situation.

Also currently close relatives have a say in wether the organs can be used even if the person him/herself explicitly made his/her choice clear. This imho is a bad thing but subject for another discussion.

And let me be clear on one thing, there is no "pilfering of organs from the unwilling"! It simply does not happen. No legit doctor will ever use organs against the patient's wishes. The reverse is much more often the case. The opt-out system does not change this at all. In fact it makes it even LESS likely to happen because of a higher abundance of organs.

In Holland, opt-in system, several years on the transplant list. A few km away, across the border to Belgium, the transplant list is many, many times shorter because they have the opt-out system. People are literally crossing the border just to be put on the waiting list there. The results speak for themselves. The opt-out system saves lives.

Vortex
October 2 2012, 12:15:27 AM
Opt out donation has my full support. There are literally no downsides. The only people who would be against opt out donation are those that don't want to donate organs but are too damn lazy to fill out a form. Yeah fuck them tbh.

There are no downsides to opt-in either. If doctors are too timid to harvest organs from registered donors, even with legal consent, then that's an issue all its own and doesn't need to be addressed here. Changing it to opt out won't fix that. Similarly, if the family fights it on legal, emotional or spiritual grounds, it's another impasse so it doesn't matter anyway.


Except opt-in does have downsides, namely that most people are too lazy and/or stupid to do so. Compare the rates of organ donation in states with opt-out and opt-in, they are in completely different leagues and yet nobody gives a fuck. If the family fights it on emotional or spiritual grounds they can suck it as far as I'm concerned. We don't let those arguments hold sway in all sorts of other situations, why the fuck would we let those pathetic excuses for arguments literally kill a living person?



I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

The dead don't have wills, there is nothing unethical about using the bits they don't need to help somebody else who is still alive. Make a logical, ethical, philosophically sound argument that precludes the ability to have mandatory opt-in. Just try. Tacking on the word "ethical" to your argument doesn't just make it so.




the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


Ok lets see how well this stacks up:



Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.


So in a world with immense, skyrocketing demand for a dwindling resource (organs), professional doctors and politicians decided that wasting organs (via transplant) was the better course of action than repairing damaged tissue (via drugs/surgery/etc) . All medical research stopped because, hey, this one method works, even though there is immense profit to be made in solving the problem through some other solution (artificial growth of organs, repair of organs, etc), and even though the present solution was clearly untennable. In this universe, what would happen when a organ bank would run out? "Oh tough luck joe, we don't have any more livers. I could give you some drugs that would cure that infection that's eating your present liver, but that doesn't strike me as terribly effective. Best of luck!"

Riiiiiight.

Varcaus
October 2 2012, 12:19:59 AM
Opt out donation has my full support. There are literally no downsides. The only people who would be against opt out donation are those that don't want to donate organs but are too damn lazy to fill out a form. Yeah fuck them tbh.

There are no downsides to opt-in either. If doctors are too timid to harvest organs from registered donors, even with legal consent, then that's an issue all its own and doesn't need to be addressed here. Changing it to opt out won't fix that. Similarly, if the family fights it on legal, emotional or spiritual grounds, it's another impasse so it doesn't matter anyway.


Except opt-in does have downsides, namely that most people are too lazy and/or stupid to do so. Compare the rates of organ donation in states with opt-out and opt-in, they are in completely different leagues and yet nobody gives a fuck. If the family fights it on emotional or spiritual grounds they can suck it as far as I'm concerned. We don't let those arguments hold sway in all sorts of other situations, why the fuck would we let those pathetic excuses for arguments literally kill a living person?



I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

The dead don't have wills, there is nothing unethical about using the bits they don't need to help somebody else who is still alive. Make a logical, ethical, philosophically sound argument that precludes the ability to have mandatory opt-in. Just try. Tacking on the word "ethical" to your argument doesn't just make it so.




the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


Ok lets see how well this stacks up:



Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.


So in a world with immense, skyrocketing demand for a dwindling resource (organs), professional doctors and politicians decided that wasting organs (via transplant) was the better course of action than repairing damaged tissue (via drugs/surgery/etc) . All medical research stopped because, hey, this one method works, even though there is immense profit to be made in solving the problem through some other solution (artificial growth of organs, repair of organs, etc), and even though the present solution was clearly untennable. In this universe, what would happen when a organ bank would run out? "Oh tough luck joe, we don't have any more livers. I could give you some drugs that would cure that infection that's eating your present liver, but that doesn't strike me as terribly effective. Best of luck!"

Riiiiiight.

Sounds kinda like oil look how that's turning out.

Pacefalm
October 2 2012, 12:52:42 AM
I would like it if reality and fiction were kept seperate in this thread at least.

Vortex
October 2 2012, 12:59:59 AM
Sounds kinda like oil look how that's turning out.

Yea I was tempted to make an oil comparison, but to be honest oil isn't anywhere near as valuable as described in that post, and the United States is essentially immune to changes in oil prices (at the state level) due to the oil markets being exclusively listed in US Dollars.

Smuggo
October 2 2012, 09:15:57 AM
I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

Why is it unethical? A corpse has absolutely no need of an organ. If anything it's unethical to deny a living person in need so that you can instead bury it in the ground and let it rot.

DevilDude
October 2 2012, 05:22:31 PM
I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

Why is it unethical? A corpse has absolutely no need of an organ. If anything it's unethical to deny a living person in need so that you can instead bury it in the ground and let it rot.

Well, just to play devil's advocate, it'd be unethical if you harvested the organs of someone who held objections, but did not know that it was opt out. Sure you could say it's on them to read up and make sure they opted out, but on the other hand many people consider the same ethics questionable when applying to bundled software downloads, much less something as important as the treatment of one's remains. Funerary practices are important to the living, just as much as the dead, the vast majority of humans would consider your attitude to be extremely disrespectful of the living and the dead.

note: I personally am an organ donor, and care little what happens to my carcass after I'm done with it, but that doesn't mean I'd ever so blithely disrespect the beliefs of those who don't share my opinions, if only to be polite.

DevilDude
October 2 2012, 05:48:40 PM
the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


Ok lets see how well this stacks up:



Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.


So in a world with immense, skyrocketing demand for a dwindling resource (organs), professional doctors and politicians decided that wasting organs (via transplant) was the better course of action than repairing damaged tissue (via drugs/surgery/etc) . All medical research stopped because, hey, this one method works, even though there is immense profit to be made in solving the problem through some other solution (artificial growth of organs, repair of organs, etc), and even though the present solution was clearly untennable. In this universe, what would happen when a organ bank would run out? "Oh tough luck joe, we don't have any more livers. I could give you some drugs that would cure that infection that's eating your present liver, but that doesn't strike me as terribly effective. Best of luck!"

Riiiiiight.

actually if you think about it, it stacks up quite well, even if you don't take it to the extreme niven did. Given the basic reality of population dynamics you'll literally never have enough organs to fulfill the possible demand. All you'll do by increasing the supply is make a few of the more marginal transplant cases viable, and upset a lot of people.

Cue1*
October 2 2012, 06:43:31 PM
If you register as an organ donor and your immediate family is supportive, that should be enough.

THIS IS THE PROBLEM. I don't understand why people can't see this. It's my goddamned body, and I have made the decision that I want someone else to live from my organs if I die. Why the fuck do my family get a say? I made a decision, while I was conscious, of sound mind, and in reasonably good health that I want to donate every organ that could be helpful. My family, be it my parents, children, wife, or whoever should not have a say in the matter. It works to everyone's advantage, since I get what I wanted and my family don't have to make a hard decision during grief. Why is it that I can decide to give away everything I own and no one can question it, but my body? No no no, that, my family gets the real final say.

Xiang Jiao
October 2 2012, 06:56:39 PM
I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

Why is it unethical? A corpse has absolutely no need of an organ. If anything it's unethical to deny a living person in need so that you can instead bury it in the ground and let it rot.

What people are failing to understand in this thread is organs are usually harvested from brain dead patients, not corpses. If you are brain dead, you are still using your organs. If you think not giving up an organ to a stranger in unethical, you've got a perverted sense of altruism.

Vortex
October 2 2012, 07:39:42 PM
I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

Why is it unethical? A corpse has absolutely no need of an organ. If anything it's unethical to deny a living person in need so that you can instead bury it in the ground and let it rot.

What people are failing to understand in this thread is organs are usually harvested from brain dead patients, not corpses. If you are brain dead, you are still using your organs. If you think not giving up an organ to a stranger in unethical, you've got a perverted sense of altruism.

If you are brain dead, you are dead. All the various organs in the body are nothing more than one giant, elaborate, mobile life-support system for the brain. Once brain death has occurred, those organs purpose has come to an end. Rather than let them go to waste, they can be re-purposed (in limited, highly specific situations) to replace the organs of those who need them, to keep their brains still alive.

Seriously this is not complicated.

Xiang Jiao
October 2 2012, 07:41:28 PM
I'm sorry your sister is sick and it makes for an effective appeal to emotion, but any sort of legislature mandating organ harvesting is unethical no matter how well intentioned. If you register as an organ donor and your immediate family is supportive, that should be enough. The fact that it could save the lives of others does not make it right and decent to pilfer organs from the unwilling.

Why is it unethical? A corpse has absolutely no need of an organ. If anything it's unethical to deny a living person in need so that you can instead bury it in the ground and let it rot.

What people are failing to understand in this thread is organs are usually harvested from brain dead patients, not corpses. If you are brain dead, you are still using your organs. If you think not giving up an organ to a stranger in unethical, you've got a perverted sense of altruism.

If you are brain dead, you are dead. All the various organs in the body are nothing more than one giant, elaborate, mobile life-support system for the brain.

Thank you, Dr. House! Legally, you are still alive.

Vortex
October 2 2012, 07:46:00 PM
the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


Ok lets see how well this stacks up:



Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.


So in a world with immense, skyrocketing demand for a dwindling resource (organs), professional doctors and politicians decided that wasting organs (via transplant) was the better course of action than repairing damaged tissue (via drugs/surgery/etc) . All medical research stopped because, hey, this one method works, even though there is immense profit to be made in solving the problem through some other solution (artificial growth of organs, repair of organs, etc), and even though the present solution was clearly untennable. In this universe, what would happen when a organ bank would run out? "Oh tough luck joe, we don't have any more livers. I could give you some drugs that would cure that infection that's eating your present liver, but that doesn't strike me as terribly effective. Best of luck!"

Riiiiiight.

actually if you think about it, it stacks up quite well, even if you don't take it to the extreme niven did. Given the basic reality of population dynamics you'll literally never have enough organs to fulfill the possible demand. All you'll do by increasing the supply is make a few of the more marginal transplant cases viable, and upset a lot of people.


It doesn't stack up at all, and Niven's example is highly fallacious. Opt-out (or mandatory if I had my way) organ donation would signfiicantly increase the number of organs available. This, in turn, would significantly increase the number of viable transplant procedres, and increase the odds of somebody living through organ failure of one variety of another. THIS SAVES LIVES.

Your argument amounts to "if it doesn't save every last person's life on every organ donor waiting list, then we shouldn't have any organ donation lists at all!". That is not only unethical, but just silly. Hiding behind "oh but people will be mad~" is just silly. The average person doesn't have a clue, nor really cares. Tie it into DMV registration, don't make a fuss about it, and there won't be a fuss about it. Those who do make fusses about organ donation are the same morons that don't like vaccines, or any other medical procedure past blood letting. They are irrelevant - ignore them.

Frug
October 2 2012, 07:50:39 PM
Thank you, Dr. House! Legally, you are still alive.

You begin by talking about ethics and then, when cornered, you resort to citing law.

I think you failed your argument right here. Would have been better to keep grasping at other straws than this kind of shooting yourself in the foot.

Xiang Jiao
October 2 2012, 07:54:58 PM
Thank you, Dr. House! Legally, you are still alive.

You begin by talking about ethics and then, when cornered, you resort to citing law.

I think you failed your argument right here. Would have been better to keep grasping at other straws than this kind of shooting yourself in the foot.

I disagree. Law and ethics are pretty closely intertwined. This quasi-mandatory donation concept is just sad. Better to let the sick die with dignity than steal the organs from others.

Xiang Jiao
October 2 2012, 07:58:25 PM
Thank you, Dr. House! Legally, you are still alive.

You begin by talking about ethics and then, when cornered, you resort to citing law.

I think you failed your argument right here. Would have been better to keep grasping at other straws than this kind of shooting yourself in the foot.

I disagree. Law and ethics are pretty closely intertwined. This quasi-mandatory donation concept is just sad. Better to let the sick die with dignity than steal the organs from others.

I know this is the :srs: discussion area, but I honestly have to ask. This is a troll, right?

Negative, I am being completely serious. Deal with it. Just because you are convinced mandatory donations would save so many lives doesn't mean it's the right system to have in place. I almost feel like you are saying the sick are entitled to the organs of others. Why?

Aramendel
October 2 2012, 08:01:09 PM
If you are brain dead, you are dead. All the various organs in the body are nothing more than one giant, elaborate, mobile life-support system for the brain.

Thank you, Dr. House! Legally, you are still alive.

Actually, in most locations you aren't. (http://en.wikipedia.org/wiki/Legal_death#Brain_death) Legally.


In the United States, brain death is legal in every state with exceptions for New York and New Jersey, which require that that a person’s lungs and heart must also have stopped before it can be declared they are really dead.

Also, opt-out donations != mandatory donations. If you are afraid that the big bad doctors will harvest you when you go into the hospital with a bad case of the sniffles you can opt out. So where is the problem?

It certainly isn't people who are too lazy to inform themselves and/or to go through the process to opt out. I value their "loss of freedom" due to stupidity and/or laziness far less than the loss of freedom of people who die because they got no organ donor with the old system.

KathDougans
October 2 2012, 08:10:06 PM
Honestly the way things are going right now, this discussion will be irrelevant in a few years time. We'll be able to make perfectly serviceable organs.

While true, the upcoming tech for "growing" organs requires the scaffold of an existing organ. So it still requires an organ to be sourced from somewhere.

What sort of scaffold ? is this the thing where you take an organ, remove the cells, leaving a collagen scaffold, then put the patients cells into the scaffold and it grows into a new organ ?

What about those modified pigs that there is/was a plan for, to make heart valves ? Could they work here ?

Vortex
October 2 2012, 08:43:34 PM
Thank you, Dr. House! Legally, you are still alive.

You begin by talking about ethics and then, when cornered, you resort to citing law.

I think you failed your argument right here. Would have been better to keep grasping at other straws than this kind of shooting yourself in the foot.

I disagree. Law and ethics are pretty closely intertwined. This quasi-mandatory donation concept is just sad. Better to let the sick die with dignity than steal the organs from others.

I know this is the :srs: discussion area, but I honestly have to ask. This is a troll, right?

Negative, I am being completely serious. Deal with it. Just because you are convinced mandatory donations would save so many lives doesn't mean it's the right system to have in place. I almost feel like you are saying the sick are entitled to the organs of others. Why?

Ok chill, just wanted to check.

Law and ethics have nothing to do with one another. Both are human constructs, and in an ideal world law would approximate morality, but in reality they only are vaguely similar at the best of times. Law deals with political realities, ethics is concerned with philosophy. For example, while I would like mandatory opt-in, and many others would like opt-out, as a practical matter this will likely never change in the united states in a significant way. Certainly not for a long time. As such, in this discussion, we are not dealing with with what can happen (the status quo), but instead what should happen.

Regarding the legal definition of brain dead, Aramendel already covered that point. To be blunt, you're wrong. Most states consider a brain-surgeon's signature stating that you are, in fact, brain dead, as proof that, you know, you're dead. I'm a bit surprised we need to have an epistemological discussion of "self" here, but you are not your liver, or your kidney. The very nature of self-identity is transient, and your body regularly replaces every last molecule in your body every couple years as it stands. The only construct we are concerend with is keeping the brain alive, and as technology progresses (particularly in the fields of cybernetics and organ cloning), this will happen in increasingly "bizarre" circumstances

The sick are not "entitled" to the organs of others. The sick are entitled to spare organs. There is nothing "dignified" about the slow death from liver failure, or a kid who dies young because he was born with a defective heart valve. We have the technology to keep those people alive, to make their lives better, and we have a corpse with organs that, if not harvested, will either be incinerated to ash or left in the ground to rot. It doesn't take a philosophical genius to put two and two together to take the healthy, perfectly functioning organs from a brain-dead patient, and put them into a brain-living patient who is otherwise fine besides that one missing piece.

Honestly Xiang, it sounds like you are afraid to confront your own mortality here.

Remember, It is every citizen's final duty to go into the tanks and become one with all the people.

Xiang Jiao
October 2 2012, 08:43:56 PM
Also, opt-out donations != mandatory donations. If you are afraid that the big bad doctors will harvest you when you go into the hospital with a bad case of the sniffles you can opt out. So where is the problem?

No shit? Thanks for the clarification. The only reason I addressed mandatory donations was this:


Opt-out (or mandatory if I had my way) organ donation would signfiicantly increase the number of organs available.

I don't buy this. The reason why organ transplants are so difficult is because suitable donors are so rare. This is a good thing. It means less people are showing up to the ER in irreversible comas. Changing the way the system works doesn't magically make more organ donors. Opt-in is indistinguishable from opt-out except the latter requires unnecessary bureaucratic red tape. Why must I have to opt out if I do not wish to donate my organs? Vortex's complaints about selfish people not wanting to give up their organs they no longer need so they can save lives is meaningless. They wouldn't be willing donors under either system so their opinion makes no difference. Perhaps donation proponents and medical professionals need to do a better job educating people about organ donation. This would be the proper way to go about raising awareness and increasing organ donations.

Aramendel
October 2 2012, 09:32:38 PM
Also, opt-out donations != mandatory donations. If you are afraid that the big bad doctors will harvest you when you go into the hospital with a bad case of the sniffles you can opt out. So where is the problem?

No shit? Thanks for the clarification. The only reason I addressed mandatory donations was this:


Opt-out (or mandatory if I had my way) organ donation would signfiicantly increase the number of organs available.

I don't buy this...

Yeah, right. Vortex addresses there primary Opt-out donations. What he said also applies to opt-out AND mandatory donations. You pick there only the parts which you like and ignore the other.

You are also avoiding the question. Where is the problem if it isn't mandatory?


Why must I have to opt out if I do not wish to donate my organs?

You are contradicting yourself here. You said that "Opt-in is indistinguishable from opt-out". Therefore, by your own logic it would make no difference whatsoever for you if you have to opt-out instead doing nothing. So, what is it?

Has opt-out the same results as opt-in - meaning the opt-out "effort" for you does not matter?
or
Does opt-out have other results than opt-in - precisely because the opt-out "effort" matters for people who are indifferent?

Xiang Jiao
October 2 2012, 09:51:44 PM
No, I'm not contradicting myself. I addressed both opt-out and mandatory, so try again.

DevilDude
October 2 2012, 11:25:18 PM
the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


Ok lets see how well this stacks up:



Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.


So in a world with immense, skyrocketing demand for a dwindling resource (organs), professional doctors and politicians decided that wasting organs (via transplant) was the better course of action than repairing damaged tissue (via drugs/surgery/etc) . All medical research stopped because, hey, this one method works, even though there is immense profit to be made in solving the problem through some other solution (artificial growth of organs, repair of organs, etc), and even though the present solution was clearly untennable. In this universe, what would happen when a organ bank would run out? "Oh tough luck joe, we don't have any more livers. I could give you some drugs that would cure that infection that's eating your present liver, but that doesn't strike me as terribly effective. Best of luck!"

Riiiiiight.

actually if you think about it, it stacks up quite well, even if you don't take it to the extreme niven did. Given the basic reality of population dynamics you'll literally never have enough organs to fulfill the possible demand. All you'll do by increasing the supply is make a few of the more marginal transplant cases viable, and upset a lot of people.


It doesn't stack up at all, and Niven's example is highly fallacious. Opt-out (or mandatory if I had my way) organ donation would signfiicantly increase the number of organs available. This, in turn, would significantly increase the number of viable transplant procedres, and increase the odds of somebody living through organ failure of one variety of another. THIS SAVES LIVES.

Your argument amounts to "if it doesn't save every last person's life on every organ donor waiting list, then we shouldn't have any organ donation lists at all!". That is not only unethical, but just silly. Hiding behind "oh but people will be mad~" is just silly. The average person doesn't have a clue, nor really cares. Tie it into DMV registration, don't make a fuss about it, and there won't be a fuss about it. Those who do make fusses about organ donation are the same morons that don't like vaccines, or any other medical procedure past blood letting. They are irrelevant - ignore them.
I bolded the part where your whole argument falls apart. You are working from your own personal ethical framework, and then demanding that it be applied to everyone else on the planet, whether they agree with you or not, even with the option to opt out you're still attempting to assert that your own morals are the default and thereby superior to those of others. People try this all the time, mostly it results in them getting killed, occasionally they manage to start a war about it and get a lot of people killed.

Vortex
October 3 2012, 12:02:34 AM
the problems inherent to organ transplantation in general were addressed pretty succinctly by Niven in some of his 'known space' stories:


Ok lets see how well this stacks up:



Compounding this problem, the high success rate of organ transplants tended to discourage research into other viable medical treatments. As a result, medical research was stagnated to a large extent, focusing primarily on improving transplants and little else. Repairing a failing organ (which could presumably fail again later) was considered secondary to the "complete" solution of replacing the failing organ.


So in a world with immense, skyrocketing demand for a dwindling resource (organs), professional doctors and politicians decided that wasting organs (via transplant) was the better course of action than repairing damaged tissue (via drugs/surgery/etc) . All medical research stopped because, hey, this one method works, even though there is immense profit to be made in solving the problem through some other solution (artificial growth of organs, repair of organs, etc), and even though the present solution was clearly untennable. In this universe, what would happen when a organ bank would run out? "Oh tough luck joe, we don't have any more livers. I could give you some drugs that would cure that infection that's eating your present liver, but that doesn't strike me as terribly effective. Best of luck!"

Riiiiiight.

actually if you think about it, it stacks up quite well, even if you don't take it to the extreme niven did. Given the basic reality of population dynamics you'll literally never have enough organs to fulfill the possible demand. All you'll do by increasing the supply is make a few of the more marginal transplant cases viable, and upset a lot of people.


It doesn't stack up at all, and Niven's example is highly fallacious. Opt-out (or mandatory if I had my way) organ donation would signfiicantly increase the number of organs available. This, in turn, would significantly increase the number of viable transplant procedres, and increase the odds of somebody living through organ failure of one variety of another. THIS SAVES LIVES.

Your argument amounts to "if it doesn't save every last person's life on every organ donor waiting list, then we shouldn't have any organ donation lists at all!". That is not only unethical, but just silly. Hiding behind "oh but people will be mad~" is just silly. The average person doesn't have a clue, nor really cares. Tie it into DMV registration, don't make a fuss about it, and there won't be a fuss about it. Those who do make fusses about organ donation are the same morons that don't like vaccines, or any other medical procedure past blood letting. They are irrelevant - ignore them.
I bolded the part where your whole argument falls apart. You are working from your own personal ethical framework, and then demanding that it be applied to everyone else on the planet, whether they agree with you or not, even with the option to opt out you're still attempting to assert that your own morals are the default and thereby superior to those of others. People try this all the time, mostly it results in them getting killed, occasionally they manage to start a war about it and get a lot of people killed.


I freely admit my own personal opinion on the subject will never occur. Hell, I freely admit opt-out in the united states will probably never occur (50% due to ~death panels~, 50% due to it being a non-sexy political issue). Instead of addressing any of the statistical or ethical arguments made in this thread (by myself and others), you are basically saying "NO U". Are you not applying your own ethical framework? Or your author's? Try addressing the actual arguments instead of implying godwins law to everybody who takes a different stance and has actually bothered to post a coherent thought on the subject.

Pacefalm
October 3 2012, 12:33:59 AM
There are several misconceptions going on in this thread. One which I have seen several times now is that opt-out equals mandatory, which is false as has been explained.

Related to that misconception is the idea that doctors are less willing to save a persons life if that person is an organ donor. This is both false and additionally would be a weak argument even if it was true: opt-out would actually help against such practices.

One misconception is that "it is only bureaucratic hassle and nothing really changes/it makes no difference/the amount of donors is the same". I would like to present the number of transplantation procedures per population size between Holland (opt in) and Belgium (opt out). These numbers are relatively recent (2006):
Holland: 16.5 million people, 559 transplantation procedures.
Belgium/Lux.: 10.8 million people, 819 transplantation procedures. *

What you are seeing here is a significantly smaller population with significantly more operations. The amount of operations per citizen is more than a factor 2 apart. There are no two ways about it.

Lastly I would like to remind everyone that ths thread is NOT for discussing wether you should or should not be an organ donor. This is purely about if the opt ou system is prefferable over the opt in system.

I would like to keep things simple and prevent personal discussion from dominating this thread. Opt-out saves lives, this much is clear. That is all I need to know to be very much in favour of this system.

* Source: http://www.vhla.be/orgaan.html

spasm
October 3 2012, 01:04:13 AM
ITT: a lack of understanding about Godwin's Law (http://www.faqs.org/faqs/usenet/legends/godwin/).

Who is invoking it?

If you're just going to make blanket statements about everyone against you instead of a counter-argument than take it to general chat.

DevilDude
October 3 2012, 05:52:39 AM
ITT: a lack of understanding about Godwin's Law (http://www.faqs.org/faqs/usenet/legends/godwin/).

Who is invoking it?

Its implied, but its there.



You are working from your own personal ethical framework, and then demanding that it be applied to everyone else on the planet, whether they agree with you or not, even with the option to opt out you're still attempting to assert that your own morals are the default and thereby superior to those of others. People try this all the time, mostly it results in them getting killed, occasionally they manage to start a war about it and get a lot of people killed.



godwin's law is specifically about comparing people to nazis.

I didn't even imply that.

Oh I see. So you aren't comparing me or my opinion or my arguments to Nazis, just to guys who want to impose their own, superior morality on everyone at gunpoint and get lots of people killed in the process. Gotchya. PHEW, I thought we were going into ad hominem and faulty comparisons territory there for a second!

Call me when this discussion is elevated a few levels. I've addressed every actual argument against opt-out organ donation selection, and I get this in reply. Also I'm sad nobody picked up on the Alpha Centauri reference I made earlier :(

ok, so you didn't pay attention in history class then. Right.

Humans have been doing that shit to each other for all of recorded history, all the way back to the first dynasty of the upper kingdom in egypt, and it's probably been going on as long as we've had language, it's just nobody was writing it down till about 12,000 years ago. Just because you decided to latch onto the most recent major example to be noticed by westerners, rather than say, the communist revolution in china, or the centuries of warfare between muslims and non muslims across half the planet, or the conflicts of any of a hundred empires through the mists of time, doesn't mean I was comparing you to a nazi.

I was, have been, and am still trying to get the point across to you, is that the policy you're supporting would go over well with only a small minority of people. when you start messing with their dead friends bodies people are likely to react very violently, because respect for the dead is very VERY VERY important to many people and part of that is respecting the body of the deceased. Attempting to assert that you have the right to do what you will with the body of someones dead mother because she didn't fill out the proper paperwork isn't likely to go over very well. It is in fact the sort of thing that is likely get you lynched.

Pacefalm
October 3 2012, 06:28:44 AM
Shut the fuck up about nazis already you fucking faggots

Also, the opt out system is not there simply to create a legal way for doctors to take organs. There is more to it than that, specifically in the opt out system relatives still get a final say in wether the organs may be used or not. The actual amount of people that explicitly make their choice clear (one way or another) is still pretty low in countres with the opt out system. The relatives of the deceased in that case are thus often the ones that decide in the end.

So it is almost exactly like the opt in system. Except when the person died the doctors dont have to ask "do you think s/he would have -wanted- her/his organs donated?" but rather "do you think s/he would have -objected against- donating her/his organs?". It is a subtle difference but keep in mind that people, when confronted with a very emotionally painful situation, will choose passivity when a question is asked that they don't really know the answer to.

So the doom scenarios just dont occur. I linked some numbers earlier: even with the opt out system the amount of organ transplant operations is still lower than 0.001% of the population per year. There is still a waiting list in these countries. Doctors are not aggressively scooping each and every organ that happens to walk into the hospital. The demand for organs is still higher than the supply but at least the supply is larger than with the opt in system.

And try to keep the discussion on topic please.

Cue1*
October 3 2012, 06:41:03 AM
I was, have been, and am still trying to get the point across to you, is that the policy you're supporting would go over well with only a small minority of people. when you start messing with their dead friends bodies people are likely to react very violently, because respect for the dead is very VERY VERY important to many people and part of that is respecting the body of the deceased. Attempting to assert that you have the right to do what you will with the body of someones dead mother because she didn't fill out the proper paperwork isn't likely to go over very well. It is in fact the sort of thing that is likely get you lynched.

But it's ok for me to assert that I have the right to do what I will with someone's dying mother because she didn't fill out the proper paper work right? DNRs are nothing but opt out life saving. What really is the difference here?

Aramendel
October 3 2012, 07:11:54 AM
No, I'm not contradicting myself. I addressed both opt-out and mandatory, so try again.

Hint: When refuting something "No, its not" isn't enough. It is just hot air.


But it's ok for me to assert that I have the right to do what I will with someone's DEAD mother because she didn't fill out the proper paper work right? DNRs are nothing but opt out life saving. What really is the difference here?

Fixed.

DevilDude
October 3 2012, 07:47:05 AM
I was, have been, and am still trying to get the point across to you, is that the policy you're supporting would go over well with only a small minority of people. when you start messing with their dead friends bodies people are likely to react very violently, because respect for the dead is very VERY VERY important to many people and part of that is respecting the body of the deceased. Attempting to assert that you have the right to do what you will with the body of someones dead mother because she didn't fill out the proper paperwork isn't likely to go over very well. It is in fact the sort of thing that is likely get you lynched.

But it's ok for me to assert that I have the right to do what I will with someone's dying mother because she didn't fill out the proper paper work right? DNRs are nothing but opt out life saving. What really is the difference here?

different issues, but tbh rationality doesn't enter into it, I'm pointing out the inevitable end result of trying to legislate a new moral standard and the massive amount of problems it would likely cause, not arguing that anyone's morals make any sense, all morality is relative in the end.

Smuggo
October 3 2012, 08:35:02 AM
So this thread took a turn for the stupid.

At the end of the day, opt-out will still respect all the retarded belief systems, assuming you care enough to go and fill out a form. If you don't care enough to do that then evidently your belief isn't all that strong or you would have done it.

I really don't see how you can argue against it.

Pacefalm
October 3 2012, 08:59:34 AM
different issues, but tbh rationality doesn't enter into it, I'm pointing out the inevitable end result of trying to legislate a new moral standard and the massive amount of problems it would likely cause, not arguing that anyone's morals make any sense, all morality is relative in the end.
I'd like to again point to Belgium where this exact same debate has occurred in the past. The opt-out donation laws were only established in early 1987. Before that, the opt-in system was in place. Now, more than 25 years later, there are no signs of this "inevitable end result" that you mention. Do you have other examples that show why this end result is inevitable?


So this thread took a turn for the stupid.

At the end of the day, opt-out will still respect all the retarded belief systems, assuming you care enough to go and fill out a form. If you don't care enough to do that then evidently your belief isn't all that strong or you would have done it.

I really don't see how you can argue against it.
While this is true, also keep in mind that opt-out still respects your believes/wishes -even if you didn't fill out a form-. There is no such thing as "oh no form? Tough luck" in the opt-out system. In essence the opt-out and opt-in are very similar on all levels except results, where opt-out is significantly better than opt in.

Cue1*
October 3 2012, 10:27:29 AM
But it's ok for me to assert that I have the right to do what I will with someone's DEAD mother because she didn't fill out the proper paper work right? DNRs are nothing but opt out life saving. What really is the difference here?

Fixed.

I was going for a bit broader scope with the word dying. DNR can extend to someone who's not dead yet, who's heart hasn't stopped yet, but the irony of using the word dead isn't lost on me either. 50/50 on that, splitting hairs either way.


different issues, but tbh rationality doesn't enter into it, I'm pointing out the inevitable end result of trying to legislate a new moral standard and the massive amount of problems it would likely cause, not arguing that anyone's morals make any sense, all morality is relative in the end.

Your argument against opt-out is that forcing a set of moral standards on someone is wrong, but it's OK to do it if we're already forcing moral standards on someone? :psyduck: Either it's wrong to force your moral standards on someone, and we should never give anyone CPR, or it's ok to allow them to have their own moral standards with paperwork, meaning opt-out and DNRs are OK. You can't have it both ways.


If you don't care enough to [fill out a form] then evidently your belief isn't all that strong or you would have done it.

TBH, I don't know that it can be said any more simply than this. As it stands, the opt-out system would make the most sense, and the opt-in system as it exists in the US makes the least amount of sense.

spasm
October 3 2012, 12:21:50 PM
Thread has been cleaned, infractions and removal from serious business will start if this happens again. If you want to discuss nazis than make another thread about it.

If you just want to ridicule someone without adding to the discussion than you can go back to general chat.

Aramendel
October 3 2012, 02:31:22 PM
I was going for a bit broader scope with the word dying. DNR can extend to someone who's not dead yet, who's heart hasn't stopped yet, but the irony of using the word dead isn't lost on me either. 50/50 on that, splitting hairs either way.

I have to admit I misunderstood you there. OK, lets try that again.

"DNRs are nothing but opt out life saving." isn't really correct. It assumes that the life in question can be saved and that said life is worth living.

I assume you are referring to the situation in the UK here since only there the Doctor can decide if to do a DNR or not if the patient hasn't specified his/her wishes. To be precise, the doctor has the duty to act in the 'best interest' of their patient. Basically, he has the same position as the relatives.

So I ask you, who is more likely to make the decision which is best for the patient - someone who isn't in emotional turmoil and knows how likely the patient is to survive and if, if he/she would even want to live because of constant pain, etc. -or- someone who very likely is unable to think rationally at the moment and who has no medical knowledge to speak of?

And in case you want to answer now "But..but with opt-out organ donation the doctors might let a person die to harvest their organs!" - Why would they do that? They do not get money from it. Sure, they might be corrupt and try to "arrange" things with someone on the waiting list, however the same argument can be used against the relatives as well who might happily let grandpa die to finally get that juicy inheritance. The decision to do DNR can be abused from both sides.

Cue1*
October 3 2012, 04:42:26 PM
I was going for a bit broader scope with the word dying. DNR can extend to someone who's not dead yet, who's heart hasn't stopped yet, but the irony of using the word dead isn't lost on me either. 50/50 on that, splitting hairs either way.

I have to admit I misunderstood you there. OK, lets try that again.

"DNRs are nothing but opt out life saving." isn't really correct. It assumes that the life in question can be saved and that said life is worth living.

I assume you are referring to the situation in the UK here since only there the Doctor can decide if to do a DNR or not if the patient hasn't specified his/her wishes. To be precise, the doctor has the duty to act in the 'best interest' of their patient. Basically, he has the same position as the relatives.

No, I'm referring to a "do not resuscitate" order in the US. Anyone over the age of 18 can get one, and it is a legally binding order to not use medical life saving at all. Basically, if you see granny having a heart attack in McDonalds and she's got a DNR, you just let her die. It really is opt-out life saving.


And in case you want to answer now "But..but with opt-out organ donation the doctors might let a person die to harvest their organs!" - Why would they do that? They do not get money from it. Sure, they might be corrupt and try to "arrange" things with someone on the waiting list, however the same argument can be used against the relatives as well who might happily let grandpa die to finally get that juicy inheritance. The decision to do DNR can be abused from both sides.

Huh? You've got me on the wrong side of this. I'm all for opt-out organ donation. In fact it's a totally selfish side of mine, chances are if the US was to move to an opt-out system it would mean I am more likely to live longer.

Frug
October 3 2012, 05:01:15 PM
I disagree. Law and ethics are pretty closely intertwined. This quasi-mandatory donation concept is just sad. Better to let the sick die with dignity than steal the organs from others.



Actually, in most locations you aren't. (http://en.wikipedia.org/wiki/Legal_death#Brain_death) Legally.


In the United States, brain death is legal in every state with exceptions for New York and New Jersey, which require that that a person’s lungs and heart must also have stopped before it can be declared they are really dead.


I noticed you didn't respond to that one Xiang.

This is what happens when you resort to flimsy arguments to support your position, and is a good example of why I said you'd shot yourself in the foot when you cited law.

The Law (is supposed to) reflect our ethics, but you're not supposed to base your ethics on law. That's an incredibly immature position to take on any matter. I shouldn't need to point out to you the plethora of laws that exist that run counter to your (or our) ethics. Only someone like Judge Dredd thinks the law = ethics and there's a reason it makes him a morally broken individual.

Whenever you say "but the law says..." in a discussion on morality, it shows that you haven't deeply considered the case for your moral position. It's no better than saying "but lots of people think it" or even "but judge judy thinks it".

The rest of your points are likewise riddled with holes. You resort to claiming that you can predict the statistics of available organs won't change if an opt-out system is imposed, which is nonsense.

If that's the strongest argument against an opt-out system, then I certainly hope we all switch to opt-out systems. I don't think it's the strongest argument though.

In theory opt-out would catch people who are lazy/don't care while not affecting anyone who actually cares. In practice there will be people who don't want their organs harvested but who lacked time or information to make the decision. They might be scared that paramedics will be more inclined to let them die in order to save their organs.

I think having your family doctor ask you explicitly when you reach a certain age (like 18) would fix the pragmatic problem. Prior to that, maybe let parents decide, though I'm not sure how children are dealt with.

Aramendel
October 3 2012, 07:18:50 PM
stuff

err.. yes, sorry, consider my answers retracted. It seems I got somewhat confused there.