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Self-Driving Cars Will Make Organ Shortages Even Worse (slate.com)

One of the many ways self-driving cars will impact the world is with organ shortages. It's a morbid thought, but the most reliable sources for healthy organs and tissues are the more than 35,000 people killed each year on American roads. According to the book "Driverless: Intelligent Cars and the Road Ahead," 1 in 5 organ donations comes from the victim of a vehicular accident. Since an estimated 94 percent of motor-vehicle accidents involve some kind of a driver error, it's easy to see how autonomous vehicles could make the streets and highways safer, while simultaneously making organ shortages even worse. Slate reports: As the number of vehicles with human operators falls, so too will the preventable fatalities. In June, Christopher A. Hart, the chairman of the National Transportation Safety Board, said, "Driverless cars could save many if not most of the 32,000 lives that are lost every year on our streets and highways." Even if self-driving cars only realize a fraction of their projected safety benefits, a decline in the number of available organs could begin as soon as the first wave of autonomous and semiautonomous vehicles hits the road -- threatening to compound our nation's already serious shortages. We're all for saving lives -- we aren't saying that we should stop self-driving cars so we can preserve a source of organ donation. But we also need to start thinking now about how to address this coming problem. The most straightforward fix would be to amend a federal law that prohibits the sale of most organs, which could allow for development of a limited organ market. Organ sales have been banned in the United States since 1984, when Congress passed the National Organ Transplant Act after a spike in demand (thanks to the introduction of the immunosuppressant cyclosporine, which improved transplant survival rates from 20-30 percent to 60-70 percent) raised concerns that people's vital appendages might be "treated like fenders in an auto junkyard." Others feared an organ market would exploit minorities and those living in poverty. But the ban hasn't completely protected those populations, either. The current system hasn't stopped organ harvesting -- the illegal removal of organs from the recently deceased without the consent of the person or family -- either in the United States or abroad. It is estimated that, worldwide, as many as 10,000 black market medical operations are performed each year that involve illegally purchased organs. So what would an ethical fix to our organ transplant shortage look like? To start, while there's certainly a place for organ donation markets in the United States, implementation will be understandably slow. There are, however, small steps that can get us closer to a just system. For one, the country could consider introducing a "presumed consent" rule. This would change state organ donation registries from affirmative opt-in systems (checking that box at the DMV that yes, you do want to be an organ donor) to an affirmative opt-out system where, unless you state otherwise, you're presumed to consent to be on the list.

39 of 295 comments (clear)

  1. Free Motorcycles by Anonymous Coward · · Score: 5, Funny

    They can compensate by giving out free motorcycles. And keeping helmets expensive, of course.

    1. Re:Free Motorcycles by MDMurphy · · Score: 3, Interesting

      I've said for years that helmet laws probably costs lives. One healthy young male with a head injury is a source of several potentially life-saving organs. I don't think that it's of such value that helmets should be banned, but just that it shouldn't be mandatory. That plus the "presumed consent" mentioned above would help the organ shortage a bit.

    2. Re:Free Motorcycles by ArmoredDragon · · Score: 5, Interesting

      As being on the organ transplant list myself, I'm all too familiar with the reality of receiving an organ, and it's not exactly what pop culture makes it out to be. Transplanted organs typically don't last as long as the rest of your body and are actually a somewhat crappy form of treatment to an even crappier disease. It varies by organ, but you can expect around a 10 year half life for most transplants (meaning if you took 100 patients that received an organ, after 10 years check back with them, only 50 of them will still have that organ.)

      And then of course, being on anti-rejection drugs is high maintenance and it just plain sucks.

      But this isn't the worst part of it: If you live in the US, often times your wait can exceed 7 years due to the way individual transplant networks are segmented. If you happen to live near two hospitals that cover two different transplant networks (and thus can list twice) your odds are better. If you're like Steve Jobs and you have your own private jet and can fly anywhere in the country within an hour, then you can list everywhere and have an organ in no time.

      Still though, it's better than nothing. I personally do like the idea of people being able to sell their organs, which would definitely level the playing field, just so long as it's done as a single buyer system with a fixed price. Countries that do it this way have practically zero organ shortage, and even if you were to pay $100,000 per patient, you'd still save a crapload money over what medicare pays for treatments like dialysis (the average dialysis patient costs medicare roughly $100,000 per year, whereas with a transplant it's a low, low price of $5,000 a year for the maintenance medication.)

    3. Re:Free Motorcycles by Hasaf · · Score: 4, Insightful

      However, even if people were permitted to sell organs, as part of their estate, then the money would be part of the estate. It would then be attached by the hospital that created the availability in the first place, as compensation for the medical expenses.

      The result would be a morbid incentive to the hospitals while providing, essentially, no remuneration to the family of the deceased.

      . . . it is a good idea, but the presence of people in the system will screw it up.

    4. Re:Free Motorcycles by ShanghaiBill · · Score: 2, Insightful

      One healthy young male with a head injury is a source of several potentially life-saving organs.

      Indeed. We not only get the organs, but the mean intelligence of humanity goes up every time an idiot is removed from the gene pool. We need to repeal helmet laws.

    5. Re:Free Motorcycles by ShanghaiBill · · Score: 2

      Countries that do it this way have practically zero organ shortage

      Can you provide a citation for this? I am unaware of any countries that allow donors to be compensated. Most, including America, allow the buying and selling of organs, and hospitals make a lot of money doing that, but it is currently illegal for any of that money to go to a donor or a deceased donor's family.

    6. Re: Free Motorcycles by MBGMorden · · Score: 2

      That SCOTUS case is nearly 100 years old at this point. Actual honest to goodness slavery was only gone for ~60 years prior to that ruling. There's no guarantee (and I'd think it possibly even likely) that a modern court wouldn't differ in their ruling.

      --
      "People who think they know everything are very annoying to those of us who do."-Mark Twain
    7. Re:Free Motorcycles by ArmoredDragon · · Score: 2

      Here's an NIH paper on how Iran does it, and their model seems to work particularly well:

      https://www.ncbi.nlm.nih.gov/p...

      This will probably never happen in the US though. Too many people have this idea that it will lead to widespread organ theft, thanks to an old urban legend promoted by an episode of Law and Order where a dude woke up with a missing kidney. So far, there haven't been any actual confirmed cases of organ theft anywhere in the world, only unproven rumors.

      The truth is, harvesting organs is not at all simple and it takes a lot of effort (and knowledge) to keep them alive outside of a body. Contrary to popular belief, you can't freeze organs, they can't come from a person who is dead on arrival, (only about 3% of all deaths are viable for organ harvesting) and you actually need a whole team of doctors just to harvest them, never mind implanting them.

      And by the way, if you search Google for 'organ theft', the first two links are crap.

      The first is a wikipedia page that mentions people selling their own organs on the black market, which does happen but it's by definition not theft, and the rest of the sources talk about a Kosovo incident that hasn't been confirmed; even Wikipedia's own dedicated page about the topic says so.

      The second Google link is this:

      https://www.psychologytoday.co...

      Note that ALL THREE of the examples cited are either false or didn't result in actual organ theft.

      - The Chinese kid's eyes were gouged out by his aunt.
      - The African girl had nothing happen to her, and they wouldn't have done anything without her positive consent at any rate (it was a UK hospital, after all, and the donor has to agree multiple times over the span of a few weeks.)
      - As for Kendrick Johnson, the fact that the brain was missing should immediately raise a red flag, and indeed it turns out that the doctor who performed the autopsy removed them, and the funeral home inserted newspaper to fill in the body cavity (which is legal; same with other common materials like cotton and sawdust.) After Kendrick Johnson's family lost the lawsuit, they're now being sued for defamation by multiple parties, and will probably lose.

  2. Then it's a good thing by taustin · · Score: 3, Insightful

    we're closer and closer to organ cloning.

    1. Re:Then it's a good thing by JustNiz · · Score: 4, Funny

      So your'e saying the real question is organs or synthesizers?

    2. Re:Then it's a good thing by KiloByte · · Score: 4, Insightful

      Well, it's China who's at the forefront of innovation here: there's more Falun Gong people than road fatalities, and they can be kept alive in prisons until their organs are actually needed.

      --
      The creatures outside looked from Alt-Right to Antifa; but already it was impossible to say which was which.
    3. Re:Then it's a good thing by murdocj · · Score: 3, Insightful

      Larry Niven (sci-fi writer) had a series of stories about a near future society that did just that. Starts off with just harvesting based on existing capital punishment, but of course the demand exceeds the supply, so capital punishment gradually gets expanded. After all, everyone wants an organ when they need it.

  3. oh no by Anonymous Coward · · Score: 5, Insightful

    Think of all those people who are going to die because of all those other people who aren't going to die!

  4. Oh noes! by Anonymous Coward · · Score: 3, Insightful

    You mean healthy people will keep their healthy organs, instead of dying and giving them to unhealthy people?

    1. Re: Oh noes! by Anonymous Coward · · Score: 4, Insightful

      It doesn't matter if it's outside of their control. If you need an organ, you are unhealthy.

    2. Re: Oh noes! by ranton · · Score: 2

      What about somebody that gets shot? Perhaps in the liver? You don't think that person might be healthy? Hell, they could be an olympic gold medalist. Prime condition.

      I think the term you are looking for is "otherwise healthy". The healthiest person in the world who then gets shot and is dying is no longer healthy, he is otherwise healthy. Being healthy is being generally free of disease, weakness or malfunction. No one with a failing organ which is killing them can claim to be healthy.

      --
      -- All that is necessary for the triumph of evil is that good men do nothing. -- Edmund Burke
  5. Comment removed by account_deleted · · Score: 5, Insightful

    Comment removed based on user account deletion

  6. Comment removed by account_deleted · · Score: 2

    Comment removed based on user account deletion

  7. Re:That's great news by Ritz_Just_Ritz · · Score: 2

    Or perhaps it will just create more incentive for the Chinese to more aggressively harvest organs from their prison populace.

  8. Problem solved! by LordHighExecutioner · · Score: 4, Funny

    Just implement a car self-driving mode that, following an organ shortage, starts driving the car very fast, so that plenty of organs for transplant are promptly collected. The only question remaining to solve is to decide if it is better to collect the organs needed from the passengers or from nearby pedestrians.

  9. Organ donor shortage by JohnTaylor3905 · · Score: 2

    "Think of all the people who will now die because of all the people who won't die". Classic!! LOLz

  10. Self Driving Cars Don't Solve Transportation by SumDog · · Score: 2

    There is so much coming out about self driving cars, even through the tech is years away from mass use. We may never seen consumer owned self driving vehicles either, just due to security and safety issues. I wrote a post on this recently:

    http://penguindreams.org/blog/self-driving-cars-will-not-solve-the-transportation-problem/

    It goes into many of the hardware, software and general transportation issues with self driving cars. I don't think they'll be a reality in the near future. They're a good 6 ~ 8 years off at a minimum.

  11. Re:A problem that is worth having by DreadCthulhu · · Score: 5, Interesting

    It will probably be a long time before truck drivers are completely replaced - take a look at railroads, for example. It would be technically possible to automate railroads right now, but the rail companies haven't done so; having a person onboard is very useful for legal liability, security, and fixing all the minor, odd issues that come up, and so on. I guess that we will probably end up with "freight stewards" in trucks, where the computer does most of the driving, but the steward takes over for odd cases, and gets out and fixes minor issues to keep the truck on the road, provide physical security to the freight, and help with loading/unloading at the end points.

  12. An unasked question by 93+Escort+Wagon · · Score: 3, Interesting

    What percentage of the people who need organ transplants are in that condition because their organs were damaged in an automobile crash? Is it significant, or is it tiny?

    --
    #DeleteChrome
  13. All at once! by phantomfive · · Score: 3

    Until the leap-year bug hits, and we have a bunch of organ donors all at once, right?

    Seriously though, we're closer to lab-grown organs than we are to self-driving cars. This is a problem that is (fortunately) well on the way to being solved.

    --
    "First they came for the slanderers and i said nothing."
  14. Pigs to the rescue by Tony+Isaac · · Score: 2

    It seems that science is close to being able to grow human organs in pigs. So maybe we don't have to worry so much about losing transplant organs because fewer people are dying in car crashes.

  15. Re:That's great news by mysidia · · Score: 2

    This isn't a bad idea....... Let's compel all prisoners to submit their organs in the event they should be executed Or die.

    Step up the number of offenses that will be given the death penalty in order to help with the shortages, And make sure the manner of death preserves the organs.

    More than one count of 1st degree murder = Automatic death penalty for 90% of cases.

    Being convicted a second time dealing hard drugs or narcotics after serving Jailtime, or a 3rd time for any illegal substance = Automatic death penalty for 90% of cases.

    Being convicted of aggravated rape on more than 1 victim Or sexual assault or statutory rape on more than one minor victim = Automatic death penalty for 90% of cases.

    There are more than enough people being caught doing these crimes to be taken out of society make up for the shortfall that safer cars' bettering society will cause.

    This should also help with prison population issues and associated costs and reduce recidivism.

  16. Cue fallacies by Just+Some+Guy · · Score: 4, Insightful

    That is the worst example of the broken window fallacy that I've ever heard.

    --
    Dewey, what part of this looks like authorities should be involved?
  17. Re:That's great news by Ol+Olsoc · · Score: 3, Insightful

    If less people are dying on the road (resulting in organ shortage) those lives are already saved. Can't say I support people dying for the sake of their organs. Hopefully through, it will accelerate artificial organ (biological or chemicoelectrical) development.

    This! REading some of these posts, it would seem that some folks here want to go out and kill others to harvest their internal organs.

    --
    The shepherds did so well protecting the flock that the sheep no longer believed that wolves existed.
  18. Re:A problem that is worth having by drew_kime · · Score: 2

    First step will be modifying the current hours of service regulations. I envision the driver doing the pickup, getting the rig onto the highway, then sleeping in back while the truck self-drives overnight. Wake up the next day to fuel up, then bring it in to the next warehouse.

    --
    Nope, no sig
  19. How many car accident people, ... by CaptainDork · · Score: 2

    ... who survive, are in that population of people who need organs?

    --
    It little behooves the best of us to comment on the rest of us.
  20. Re:The next step of anti-efficiency rhethoric by Pentium100 · · Score: 2

    Such people â" who are convinced, factories exist to provide employment â" are, to put it mildly, cretins.

    Of course factories exist to provide profit for the rich factory owners. What the people (who are not factory owners) should do is every so often stage a revolution, round up a lot of the factory owners and kill them, then redistribute their wealth. After that, go back home and wait for a new crop of rich factory owners to grow. This would be so much better than working in a factory. And this is what you would get if there were a lot of unemployed hungry people and some rich people in the same country.

  21. Re:A problem that is worth having by Kjella · · Score: 3, Interesting

    It will probably be a long time before truck drivers are completely replaced - take a look at railroads, for example. It would be technically possible to automate railroads right now, but the rail companies haven't done so; having a person onboard is very useful for legal liability, security, and fixing all the minor, odd issues that come up, and so on. I guess that we will probably end up with "freight stewards" in trucks, where the computer does most of the driving, but the steward takes over for odd cases, and gets out and fixes minor issues to keep the truck on the road, provide physical security to the freight, and help with loading/unloading at the end points.

    That sounds very inefficient. I'm thinking it will go in three directions:
    1) Remote operation, we do it with drones so why not trucks? If each truck needs help maybe 1% of the time one operator can support a whole fleet.
    2) Location-based staff that help trucks in their area, like a tow truck light that either work at a depot or loading/unloading area or are on call.
    3) Use armored cars, stronger locks, dye packs if forced entry and have the car report in as often as possible. Miss a checkpoint, alarm goes.

    Pretty sure the moment trucks drive themselves the whole "one truck, one man" concept will go out the window pretty quick. That said I think we're still some years away from commercially available self-driving cars.

    --
    Live today, because you never know what tomorrow brings
  22. Iran has a legal market for kidneys by TheSync · · Score: 2

    Iran has a legal (and regulated) market for kidneys. Donating a kidney is a mild risk, but frankly less of a risk than many professions.

  23. I need a kidney and still think this is good. by gurps_npc · · Score: 3, Interesting

    There are lots of things wrong with our organ policy, but the way to fix it is NOT to continue (or increase) dangerously stupid activities in the hopes of getting donors.

    Instead we can fix the "no compensantion laws" that are ridiculously tight, and do simple things like:

    1) Have tax credits that cover things like a) travel and housing costs for donors, b) unemployment payments if you have to take more than 2 weeks off to donate,

    2) Require all government ID's (except passports) to have a field for organ donation yes/no, on the front of the ID. You want to drink, drive, etc. you have to at least think about being a donor.

    3) Fix the opt - in system - either 1) Legally enforce opt in for donations so if you sign permission for organ donation, your heirs can not over-ride it) and/or 2) allow states to use an opt-out system, so people have to consciously say no thanks to avoid being listed as an organ donor, rather than go out of their way to sign up.

    --
    excitingthingstodo.blogspot.com
  24. Not for everyone by russotto · · Score: 4, Funny

    Fewer organs for most of us, maybe. But for Larry Page, Sergey Brin, Travis Kalanick, and the other self-driving car company executives... well, when they need an organ, a perfectly matching donor will have the perfect crash.

  25. lots of blame, no solutions by Dorianny · · Score: 2
    We need to provide incentives and remove barriers. I propose:

    Priority on the recipient list if the patient had been on the donor list for at least 2 years prior to getting sick

    Parents can add their children to the donor list to receive this priority as well

    The donor registration can no longer be overridden by the family

    A tax break for being a registered donor

  26. Re:A problem that is worth having by PrimaryConsult · · Score: 2

    Three of the five subway lines in Singapore are fully automated with no driver. From what I understand increasing/decreasing service is a matter of someone pushing some buttons in a control center, and more trains make their way to/from the yards. They're essentially horizontal elevators.
    Of course this is only possible due to strict control of the right of way - platform screen doors and having the entire route underground allow for this.

    If NYCT can do this with the L line (which would mean enclosing the outside portion) then they might be able to get rid of the entire crew. Not a union violation if there are no union employees taking on additional duties (which was how they 'won' the conductor ruling, 8 car trains with doors controlled by just the train operator).

  27. Re:That's great news by currently_awake · · Score: 2

    Countries have experimented with the death penalty for stealing, and discovered that robbers would kill their victims instead of letting them go. After all, if the punishment for robbery and murder are the same, you may as well commit the crime least likely to get you caught.