France Begins Opt-Out Organ Donation (theoutline.com)

Laura June, reporting for The Outline: France began to use a new opt-out system of organ donation on Jan. 1, making it one of a large number of European nations that now use a "presumed consent" system. This means that any adult who dies will now donate their organs by default, regardless of their survivors' wishes, unless they have signed a refusal registry in advance. The new law gets around what has historically been a stumbling block for organ donation: the surviving families of the deceased. A survey in France previously showed that while up to 80 percent of the population was in favor of donating their own organs, about 40 percent of families refuse when pressed to make the choice.

Comments

AC begins opt out first post donation

[Anonymous Coward]

Click here to opt out.

NIMBY in full effect

[Opportunist]

Sure I'm for donations, they might save my life!

But I'd want to receive, not give!

Re:NIMBY in full effect

[jedidiah]

...assuming you don't get organs from a guy like me. You don't always want to receive. Sometimes you have no idea where it's been.

Re:NIMBY in full effect

[WarJolt]

I've heard a testimony a docs that was a little bit shocked at how they treat potential organ donors. The fact is in an ER you don't necessarily get the opportunity to have a 2nd opinion about you being pronounced legally dead.

Re:NIMBY in full effect

[ChromeAeonium]

I think they should be tied together. Unless you have some sort actual medical reason as to why you should not be an organ donor (HIV infection, ect.) opting out should put you on the bottom of the donation list should you need it. If you contribute to the system, you get priority if you need the system. Otherwise, you go to the back of the line. Don't expect to receive if you're not willing to give.

I just don't get the mentality of people who refuse organ donation. If you're dead, you're dead, why take other people with you? It's one last act of good that could save lives and, seeing as how you're never going to use them again, costs you absolutely nothing. How big of a prick do you have to be to look at that proposition and reject it?

Re:NIMBY in full effect

[mysidia]

I just don't get the mentality of people who refuse organ donation. If you're dead, you're dead, why take other people with you?

The concern is not "If you're dead". The concern is, If i'm in critical condition, the hospital that knows I'm a potential organ donor
may treat me differently in a manner that makes me less likely to survive, Or they may prematurely declare me dead out of concern for
the organs they could get from me to save someone else..... perhaps someone they deem "More worthy" of being saved.

Re:NIMBY in full effect

[AutodidactLabrat]

The rules for Dead are pretty solid.
and face it, if they part you out while you're unconscious, not breathing, not metabolizing, are you REALLY going to miss the remaining 5 or 8 minutes you might have had?

Re:NIMBY in full effect

[ooloorie]

I think they should be tied together.

That's a useless suggestion: people who need organ donations are generally not suitable to donate, and they know it long ahead of time.

I just don't get the mentality of people who refuse organ donation. If you're dead, you're dead, why take other people with you?

Well, one reason is a concern that doctors and hospitals might be less interested in saving you if that means potentially damaging donatable organs. There are many other reasons as well.

How big of a prick do you have to be to look at that proposition and reject it?

I should say not as big of a prick as you, who is ready to attribute base motives to everybody at the drop of a pin.

Re:NIMBY in full effect

[Anonymous Coward]

Which is an issue that an opt out system mitigates nicely. The more donors there are, the less likelihood of unethical behavior.

Re:NIMBY in full effect

[Khashishi]

The problem with selling your organs when you die is that you will now have strong incentives to kill yourself if your family needs the money.

Re:NIMBY in full effect

[Pentium100]

How can I be sure that the doctor would do everything that he can in order to save my life (including using drugs etc that might damage my organs in the long term or make them unsuitable for donation but would help me right now) when there is a child etc waiting for a transplant and my organs are compatible? I do not say that doctors would do this intentionally, but there may be some slight nudge in the "right" direction.

As far as I understand, once you are completely dead (heart stopped, body at room temperature etc), most organs are dead too and cannot be used. So, a decision has to be made before that and it may not be 100.00% accurate. Now, if the patient is not a donor, then the doctor can wait longer before pronouncing him dead, but not if the patient is a donor, since if the doctor waits too long, the organs will be useless.

Re:NIMBY in full effect

[Anonymous Coward]

What I want to ensure is that doctors are fully incentivized to keep me alive, and never incentivized not to for the sake of organ donations. The only safe way to do that is to opt out.

Re:NIMBY in full effect

[Khashishi]

Ok, that's very scary, but is there any evidence that that really happens? Are there any medical professionals here?

Re:NIMBY in full effect

[AmiMoJo]

I can see the logic in preferring people who donate, but if you go down that route you have to start thinking about people who smoke and destroy their lungs, or drink and wreck their liver, or get a sports injury that writes off a kidney...

Re:NIMBY in full effect

[ilctoh]

Well, one reason is a concern that doctors and hospitals might be less interested in saving you if that means potentially damaging donatable organs

While I'm sure this is a concern for some people, I'm questioning whether its a realistic concern. I have some experience in the health care field (as a paramedic), and infrequently but regularly find myself working on people close-to-death, where organ procurement is a concern. I can't say that I've ever witnessed, or even heard, of any inkling of an idea that we wouldn't put forth our full efforts to save the patient in front of us in favor of potentially harvesting organs. I'm also not sure that there's any difference in care that would be rendered even if, hypothetically, we were trying to preserve donatable organs without trying to resuscitate the actual patient. Furthermore, my understanding is that there's a great deal of opaque bureaucracy between an organ donor, and the eventual recipient. It's not like an ER doc can just think, "gee, there's a guy in the bed upstairs who can really use a new kidney, might as well swap out this one while I'm here." Rather, there's a rather involved (though efficient) process by which an independent organization is notified of available organs, and matches them to a recipient, who will likely be in a different hospital quite a distance away. I don't think there's usually much contact between personnel at the "donor site" and the "recipient site."

Re:NIMBY in full effect

[AmiMoJo]

If you are that paranoid why not just opt out?

Re: NIMBY in full effect

[sonamchauhan]

Few would object if that were the case. The issue is the "not breathing, not metabolizing" claim is not always true

Re:NIMBY in full effect

[ChromeAeonium]

Good point, I forgot to apply Hanlon's razor to the situation. I should have said prick or conspiracist with unreasonable fears. If there were any evidence whatsoever that organ donors die at a higher rate in emergency situation (are emergency medical staff even aware of your status in those situations?), it would be huge medical ethics news. Somehow I doubt that is the case.

Re:NIMBY in full effect

[ShanghaiBill]

The fact is in an ER you don't necessarily get the opportunity to have a 2nd opinion about you being pronounced legally dead.

If you are that far gone, you are likely better off dead anyway. It is a common scene in movies for the hero to flat-line, be revived with CPR and/or defib, and then be running, jumping and doing gymnastics a few minutes later. That is BS. Most people given CPR/defib don't survive or only survive for a few miserable hours or days, and even those that last longer usually have a very poor quality of life. They often are confined to bed or a wheelchair and often suffer brain damage.

People that work in ERs, or once worked there, are the most likely to ask for "Do Not Resuscitate" or DNR orders when they are hospitalized.

Re:NIMBY in full effect

[Shane_Optima]

That's a useless suggestion: people who need organ donations are generally not suitable to donate...

Err, if you have a bad heart, why must it follow that you have bad kidneys, corneas, skin, liver, etc?

...and they know it long ahead of time.

Even if true (do most of them know prior to the age of 18?), this seems irrelevant. The idea that you are pushed below organ donors on the recipient list if you've opted out of organ donation in the past X months (to prevent people from simply switching the moment they learn they need a transplant) is entirely sensible and entirely fair. Whether or not your condition is detectable far in advance and how long you've been on the waiting list is really beside the point.

Well, one reason is a concern that doctors and hospitals might be less interested in saving you if that means potentially damaging donatable organs. There are many other reasons as well.

But that's the only reasonable reason, and it's questionable how big of a concern it will be in an opt-out situation wherein the large majority of the population are organ donors. It's also questionable how big of a concern it is in any country with strong anti-malpractice liability law.

All other reasons are just sentimental and religious. People should still have a right to opt out for those reasons, but that doesn't mean exercising that right comes without consequences.

ready to attribute base motives to everybody at the drop of a pin.

Motivation is irrelevant. Regardless of the reasonableness of opting out of organ donation, it does not make it any less reasonable to insist that those who opt-in (or in the case of France, do not opt out) receive preferential treatment, except in the cases of minors whose parents have opted them out.

Arguing otherwise is akin to arguing that fire insurance companies should pay when anyone's house burns down, without regard to whether or not they've actually paid their premiums. You're arguing for something that will make the world a worse place.

Re:NIMBY in full effect

[hey!]

Technically you don't give anything when organs are harvested from your corpse. Even calling it "your" corpse is begging the question.

Re: NIMBY in full effect

[jabuzz]

Which provides the perfect solution, not registered for at least 12 months as an organ donor at the point you need an organ, then no organ for you. Heavy advertising as you bring in the scheme and a 12 month grace for those reaching 18 to register. Also change law so revlatives can't over ride your wishes.

Re:NIMBY in full effect

[LeftCoastThinker]

This exactly. I am all for organ donation, but the problem is that it is a statistically proven fact that organ donors don't get worked on as long as non-donors with the exact same injury, especially those involved in violence, such as car accidents, gun shots and other traumatic injury. I used to be an organ donor on my drivers license, now I am not on my license. I have told my family that if I am really dead and the opportunity to donate is there, I would like them to do it, but I want the doctors focused on saving my life, not thinking about the potential of my harvest-able organs.

I think that a lot of people are like me especially after doing a bit of research, and the best way to get around this issue is to have medical/religious only opt out (i.e. AIDS etc), where doctors, nurses, EMTs etc can't pronounce without a second opinion. To pronounce you it takes one MD who has not worked on you to come in with fresh eyes and make sure you are actually dead with no chance of coming back, if there is any question his job is to tell them to keep working on you. Part of the organ donor system should also keep track of the number of donors vs patients vs time they try to save you vs criticality of injury on a per doctor and per hospital basis. Doctors that are shortcuting to get more donors instead of saving their patients can be screened for and dealt with. The benefits are two fold. First, with opt out, it reduces the strain by making a lot more donors available, and second, it reduces the strain on families having to try and guess if the doctor has actually done everything possible before coming out and asking for donation.

Re:NIMBY in full effect

[ShanghaiBill]

The problem with selling your organs when you die is that you will now have strong incentives to kill yourself if your family needs the money.

You are assuming that organ prices would be high. But it is more likely that with incentives, the market will be flooded with donors. Once I am dead, I would be happy if my family can get a few thousand for my heart, kidneys, or whatever. That is certainly not enough to be worthing killing myself for.

Another option would be a much smaller payment at the time you donate. So when you get your driver's license, you get a $20 discount on the fee if you tick the donate box.

Disclaimer: I am a donor.

Re:NIMBY in full effect

[Ol Olsoc]

I'd rather them not turn me off prematurely just so they can steal my organs, thanks.

Cases in point: http://legalpublication.blogsp...

http://www.cbsnews.com/news/or...

And here's the icing on the cake: http://www.melissacaulk.com/th...

I'll just leave this here form the article:

"In a shocking statement, Dr. Neil Lazar, Director of the Medical-Surgical Intensive Care unit at Toronto General Hospital, says the focus should be on the well-being of donors rather than whether they are legally dead. That could mean giving anesthetics during organ harvesting.

He and his co-authors, Dr. Maxwell J. Smith of the University of Toronto, and David Rodriguez-Arias of Universidad del Pais Vasco in Spain, advocate replacing the current “dead-donor rule” with a policy that educates the public about the true nature of patients used in transplants, obtain informed consent from everyone — and ensure the donor does not suffer during the organ harvesting. The study was published in the American Journal of Bioethics.

The authors state frankly that under current practices donors may be technically still alive when organs are harvested – a necessary condition to produce healthy, living organs. Because of this, they say that protocol requiring a donor’s death is “dangerously misleading,” and could overlook the well-being of the donor who may still be able to suffer during the harvesting procedure.

All I know is that if I need anesthetics while they are ripping me apart, I might have a few concerns about whether I am dead or not.

Re:NIMBY in full effect

[ChromeAeonium]

That's a useless suggestion: people who need organ donations are generally not suitable to donate, and they know it long ahead of time.

Except in cases of injury, or where only one organ is the problem.

Well, one reason is a concern that doctors and hospitals might be less interested in saving you if that means potentially damaging donatable organs. There are many other reasons as well.

Considering that, far as I can tell anyway, virtually every medical organization on earth denies that happens, that seems an extremely unlikely and unreasonable concern. I would not be surprised if there were isolated incidents, but by that logic you should wear body armor in case someone stabs or shoots you. I think its much more reasonable to trust the opinions of major medical organizations than put stock in baseless fears pulled out the usual place.

Re:NIMBY in full effect

[RackinFrackin]

Exactly, the donation is a ripoff! The hospital using the organs makes a treasure chest full of money....My point is, the donor should receive a fair amount of money, say, $100k per organ harvested. It's a capitalist world, and you have pay the supplier of your goods.

If the hospital had to pay for the organ, they'd turn around and charge the recipient, making an already horrible financial situation even worse.

Re:NIMBY in full effect

[Cinnamon Beige]

The rules for Dead are pretty solid.

When there's reports of people waking up in the morgue or, even worse, having the medical examiner realizing they're not quite dead yet when starting the autopsy, I think it's safe to say we're not terribly good at telling if somebody's dead even off the old rules--and the organs are mostly useless for donation once the person's reached the no-heartbeat flavor of dead. (I think there's a few things you can still use, and in fact harvest for a bit after that, but...)

The problem is that we've got unfortunately good evidence that we are not as good as we need to be about telling if somebody's brain dead--which is what you want for organ donation--and there's been questions raised, including simply on the ethics side, of if a doctor who knows the patient is a donor will be as careful about making sure the person is brain dead as we need them to be. I know that in the US, currently the doctor is supposed to have no clue--until brain death is declared, nobody's supposed to even check--but how true that is...

It doesn't help that, to put it bluntly, the hospital gets money even if you(r estate) doesn't.

Anyway. Basically, the problem is that the ethics involved look pretty good, right up until you actually start looking, and people freak out about what may actually be the most ethical possible situation of having somebody asking for their ventilator to be switched off before they hit shut-in syndrome, and for it to be done at a hospital so their organs can be donate. Yes, you're turning off somebody's life support so you can harvest their organs--but you're not ever going to get any better consent, and as long as they've the right to ask for their life support to be turned off the choice ought to be theirs.

Re: NIMBY in full effect

[Anonymous Coward]

Except they'll just declare you dead because another guy got wheeled and his organs look ripe for harvest. Can't be wasting time on you and your no harvest body.

Re: NIMBY in full effect

[Anonymous Coward]

Hospitals don't have profit motives in Europe where healthcare is socialized so your argument isn't valid. Not to mention that a donated organ is unlikely to be given to a patient in the same hospital. That said, if you think it's a valid concern that doctors might factor in saving your organs vs. saving you a proper procedure would be to not check whether a patient is a donor until after they've been pronounced dead.

Re: NIMBY in full effect

[Alain Williams]

I know, I don't want to donate my organs

Why not, what else will you be doing with them once you are dead ?

I sure don't want someone elses grubby organs.

So: faced between death or taking some "grubby" organs - what will you do ?

Re:NIMBY in full effect

[AthanasiusKircher]

I think its much more reasonable to trust the opinions of major medical organizations than put stock in baseless fears pulled out the usual place.

You mean the same "major medical organizations" whose errors may be the 3rd leading cause of death in the U.S., amounting to roughly 250,000 deaths per year?

Don't get me wrong: I agree with you to the extent that I think it's probably MUCH more likely that doctors are making errors rather than deliberately killing people or letting people die. But given how few actual errors are admitted by doctors, it's hard to put the word "trust" and "major medical organizations" in the same sentence. (And yeah, I get that the reason doctors aren't more forthcoming about errors has to do with a whole bunch of legal crap and a litigation-happy culture, but the fact is that there's a lot of times when the "opinions" of "major medical organizations" screw up.)

Regardless, given the stats (which even more conservative estimates put at at least 100k deaths/year due to medical errors), I don't think it's a "baseless fear" to say that sometimes doctors may not necessarily make the best decisions for you.

Re:NIMBY in full effect

[fahrbot-bot]

People that work in ERs, or once worked there, are the most likely to ask for "Do Not Resuscitate" or DNR orders when they are hospitalized.

When my wife Sue was diagnosed with fatal brain tumor the day before Thanksgiving 2005, she completed a health-care proxy (living will) stating that no extraordinary measures should be used and a DNR. When her brain stem was damaged six weeks later, she fell into a coma and I had the fun task of re-asserting her DNR. She died a week later on Jan 13, 2006. Sue was a teacher so, instead of donating her organs, she donated her body to science. She was only 61 (I was then 42) and in excellent health (other than the brain tumor) and most donors are much older and in poorer health, so the Virginia Anatomical Program was very happy to have her (so to speak).

I have also completed a living will and healthcare proxy form and registered them with the U.S. Living Will Registry specifying no extraordinary measures and registered with the Virginia State Anatomical Program to have my body donated to science.

Re:NIMBY in full effect

[tinkerton]

That's a downside of declining traffic casualties. Traffic is one of the sources of healthy and young donors.

Re:NIMBY in full effect

[AmiMoJo]

Do you have a link to that data? A quick Google turned up nothing.

Personally I'm more concerned with being kept alive too long. The last thing I want is to live in pain or unable to move.

Re:NIMBY in full effect

[Anonymous Coward]

Except it's not anywhere near as safe as you imagine, thinking that way, is it? Because you're only attending to one of the two risks: the risk you might be maliciously deprived of your own organ when you still need it. Meanwhile, you're ignoring the other risk: that you might not have a donor organ available to you when you need it. The more people like you there are, and the more you talk, the higher that risk becomes, because you'll persuade others to follow in your footsteps. It's like the tragedy of the commons, except played out by stupid and mean-minded little pricks like yourselves who put more energy into doubting the motives of doctors than they do into doing anything worthwhile with their own time on this earth.

Re:NIMBY in full effect

[shilly]

I'm both sorry for your loss and in awe of what you and Sue did.

Re:NIMBY in full effect

[Opportunist]

What makes you think a morally corrupt doctor would have any more incentive to keep you alive as a non-donor? If anything, it could convince him that you're a waste of human life anyway, selfish bastard.

Re:NIMBY in full effect

[shilly]

Oh goody. Why don't you tell us what proportion of donated organs have been collected through such unethical means? 50%? 10%? 1%? 0.5%? 0.2%?

If you can show it's above 1%, let's talk again. Otherwise, it's essentially an irrelevant risk

Re:NIMBY in full effect

[AmiMoJo]

It will never fly, because some people will claim religious discrimination as their beliefs force them to opt out. Others will complain that some people who are on the list are destroying their organs with alcohol and lifestyle choices.

Re:NIMBY in full effect

[Opportunist]

I could see that problem in the US, in France, there isn't really a financial incentive to the hospital to harvest body parts.

Also, the stories about people waking in the morgue are lovely tales from the crypt, but have little to do with reality, and have not had for at least 100 years now.

Re: NIMBY in full effect

[PolygamousRanchKid]

I know, I don't want to donate my organs

Why not, what else will you be doing with them once you are dead ?

Play with it. I was born playing with my organ, I've lived my whole life playing with it, and if death is as boring as life, I'll want to be able to play with it when I'm dead.

Re: NIMBY in full effect

[Opportunist]

From a purely economic point of view it's more sensible to keep a trained individual alive than to try to produce a new individual and train it. Hence I would put more emphasis on using contraceptives and putting some research into abortion-on-the-go procedures to reduce the production of more individuals that need training and a lengthy, usually between 18 and 25 year long training period before they get productive, and instead focus on keeping the trained and productive individuals alive.

You are of course allowed to decide for yourself to end your productive live prematurely, as long as this does not entail wasting resources beyond yourself.

Re:NIMBY in full effect

[Opportunist]

Ponder whether you really want that. Considering that there is a strong incentive for wives and husbands to off the relevant other part of the relationship for insurance money, how much stronger would the incentive be to put the SO on the organ market?

Re:NIMBY in full effect

[SuricouRaven]

I will join the chorus too: Citation needed.

Re:NIMBY in full effect

[SuricouRaven]

And yet somewhere, there will be a crowd of well-intentioned protesters and a pressure group working to keep the meat-sack alive as long as possible, because doing otherwise is murder, even though this usually means withdrawing water and allowing dehydration and 'natural' death to ruin the organs.

Idiots.

Re:NIMBY in full effect

[Shane_Optima]

It will never fly, because some people will claim religious discrimination as their beliefs force them to opt out.

It's pretty doubtful a religious discrimination case would win out in a first amendment battle, given the red letter law there, nor is the case one that's sympathetic enough to garner much support from lawmakers or the public ("So you're saying it's ok for us to defile our bodies to save your life, but not the other way around?")

Others will complain that some people who are on the list are destroying their organs with alcohol and lifestyle choices.

It's not the economics of each individual transaction that matters; it's the big picture. People will most likely make the decision early in their lives and then forget about it. There aren't any realistic perverse incentives there that I can see.

I see the issue of a default opt-in / explicit opt-out being a bigger problem in America than opt-ins getting preferential treatment, because you will inevitably get a grieving family member who goes apeshit over religious objections or not being able to see the body before it's cut up or something, and that will carry powerful emotional weight even though the arguments in favor of this scheme are very compelling.

Re:NIMBY in full effect

[Cinnamon Beige]

I could see that problem in the US, in France, there isn't really a financial incentive to the hospital to harvest body parts.

Also, the stories about people waking in the morgue are lovely tales from the crypt, but have little to do with reality, and have not had for at least 100 years now.

Nope, actually, it's just a lot rarer now--in the first world, anyway, and the general expectation now is that it means somebody botched their job. I think the last case was ~25 years ago, was a little old lady, and she was kicking around long enough afterwards to get interviewed. (I didn't catch much about the case, except apparently the fact that they put her in the freezer saved her life.)

Incidentally, it's cases like that which get brought up when somebody suggests being less careful in checking.

As for the issue with brain death--I think the paper discussing the problems getting noticed in correctly determining the amount of brain activity was published in 2015. I would very much enjoy reading it, but it's very much a current and ongoing problem in neuro.

As for financial incentives in France--can't tell you, I don't read French and any reports that go into the inner workings of France's organ donation system are almost certainly going to be in French. I can, however, with great confidence state that both the US and France have them as being supposed to be donations--because both countries are in pretty explicit agreement on payments being unethical--meaning that no financial incentive should exist, period, in either country.

Re:NIMBY in full effect

[butchersong]

I am happy to surrender my organs after death provided the person is willing to accept my brain as well.

Re:NIMBY in full effect

[Dread_ed]

There is a man on the runoff railway track and a family of 5 on the main track. A speeding train is heading toward the family of 5, which could be diverted if you pull a lever, though you will kill the man by himself on the runoff track.
What do you do?

There is a man in ICU. If you "declare him dead" his liver, heart, lungs, kidney(s), and other internal organs will save the lives of at least 5 people.
What do you do?

Re:NIMBY in full effect

[butchersong]

I think I remember reading an article recently fretting about this. They were worried specificaly about the automated cars "driving" down organ availability by drastically cutting down on traffic fatalities.

Re:NIMBY in full effect

[Dorianny]

You assume that "getting worked on for longer" correlates with a higher probability of recovery. That's simply not the case. Health care workers are the ones most likely to have DNR's and living will's stating "no extraordinary measures" as they know that Standard procedure is to extend the life of the patient no matter how hopeless the chances of recovery or how painful those procedures and the extra time they are giving you is. Organ donor or not, I would rather go then live a few more hours in excruciating pain

Re:NIMBY in full effect

[Ol Olsoc]

I gav the citations, now you can prove them wrong, so the balls in your court, or I just call ya a denier. I'll wait.

Re:NIMBY in full effect

[Opportunist]

In the first world or the US? Because quite frankly, when it comes to general healthcare, the US isn't quite on par with the first world...

Re: NIMBY in full effect

[Miamicanes]

The problem is, your health insurance would just add a clause giving them priority for any revenue from your organs. So if your final bill came out to $120,000 (with $24,000 co-insurance, but limited to $5,000 out of pocket) & your kidneys earned $20,000, your family would be *lucky* if it saw a cent, or even got to at least apply the first $5,000 of it towards the deductible, instead of having the insurance company swallow the whole amount by claiming your final bill cost them $115,000 after applying your coinsurance payment.

Re: NIMBY in full effect

[Anonymous Coward]

Why not, what else will you be doing with them once you are dead ?

I will have them intact. I'm don't want some entitled little shit mutilating and desecrating my body. They are MY organs. I came into the world with them and I sure as hell am leaving the world with them.

Not to mention in the event of an accident, organ donors are much more likely to be allowed to die so that their organs can be harvested.

So: faced between death or taking some "grubby" organs - what will you do ?

Uh, die. Are you really so stupid that you couldn't figure that out?

Re:NIMBY in full effect

[Z80a]

Multitrack drifting obviously!

Re:NIMBY in full effect

[Shane_Optima]

Others will complain that some people who are on the list are destroying their organs with alcohol and lifestyle choices.

Ah wait, were you alluding to, for example, a 70 year old opt-in organ donor who is an alcoholic and has already been through three livers being prioritized over a 20 year old non-drinker opt-out? Well, I think the answer for that is the prioritization of opt-ins doesn't have to be the only or overriding rule. Very high risk recipients, particularly those whose conditions were caused through their own recklessness, can and should be moved down or off of the list regardless of their opt-in status.

Re: NIMBY in full effect

[Anonymous Coward]

As the offapring of 2 parents employed in the healthcare industry, allow me to say you are 100% correct. If you are like a teenager whose odds are looking grim, they look at your body parts like a castaway who hasn't seen fresh meat in weeks. It's a sad, unfortunate, reality.

Re:NIMBY in full effect

[quenda]

I can see the logic in preferring people who donate, but if you go down that route you have to start thinking about people who smoke and destroy their lungs, or drink and wreck their liver

We already do. Alcoholics don't get new livers. Smokers are pushed way down the list of transplant recipients for anything. You want a new kidney? Then stop smoking and lose weight if obese. We do not hold patients responsible for past sins, but we do for current ones.
    So by analogy, you would not consider how long someone had been on the organ donor list, just if they are on it at the time they find out they want to be a recipient.

Re:NIMBY in full effect

[mysidia]

If you can show it's above 1%, let's talk again. Otherwise, it's essentially an irrelevant risk

(1) Less than 1% is all it takes. The average person has about a 0.4% chance of getting into a car accident and dying as a result. So tell me.... do you avoid wearing seatbelts? Do you take no steps to reduce the chance farther? Would you refrain from using seatbelts, if you learned that by not wearing it, you could potentially save one other person's life?

After all, the number of incidents is vanishingly small considering the global stats....

Next example; less than 1% of violent crimes actually happen in dark alleyways on the bad side of this particular city.
Most people would still not be OK with the 15-year-old daughter taking nightly walks in that area.

We don't use globally summarized statistics to gauge personal levels of risk for different activities!

There are other values in play.... Also, when you think about it, 1% is not that small of a number.

If there are 325 million people in the US, then 1% is 3.25 million people

Different people may have cause to suspect treatment with their local facilities are more likely to be part of that 1%.

(2) Counterpoint: If ANY organs can show to ever have been harvested through unethical means, then it's a reasonable assumption that there have been many more similar events, And they've been successfully covered up. The nature of the whole thing is that cover-up would be trivial. The uncounted incidents are impossible to measure.

Knowing the medical industry..... Consumers are highly litigious. Hospitals and professionals alike have been known to deliberately cover up minor mistakes out of the concern of getting sued later and losing their entire business over 1 small goof. It's unlikely you could Ever produce any statistics on anything approaching deliberate malfeasance, As the cover-ups would be part of the equation.

Re:NIMBY in full effect

[Cinnamon Beige]

In the first world or the US? Because quite frankly, when it comes to general healthcare, the US isn't quite on par with the first world...

On this, it's an issue of technology and staff training. Third World countries typically fail to have the tech needed but have some pretty skilled health care workers once you adjust for the simple fact that they're working around not having access to high tech; First World countries tend to have what fails be staff training, and sometimes overly-dependent on tech so they may not always think to do such common-sense things as confirm that the heart monitor is not just singing the Broken Machine Blues.

Some of these horror stories don't necessarily get talked about outside of the medical community, since the overall feeling is that the general population is going to distinctly overestimate the chances of it happening to them--but the stories get passed around precisely to remind everybody inside that certain steps might seem pointless but aren't. They're cautionary tales, much the local tale(s) of the fate of whomever thought trying to repair a computer while it was on was a Good Idea.

Re:NIMBY in full effect

[arglebargle_xiv]

It's not necessarily NIMBY, it's just going with the default. When this was introduced in other countries, organ-donorship went from large-majority-don't to large-majority-do, with no change in people's attitudes. People just went with whatever was the default, so you may as well make the default option the better one.

Re:NIMBY in full effect

[ooloorie]

I think its much more reasonable to trust the opinions of major medical organizations than put stock in baseless fears pulled out the usual place.

If organ donations are your concern, then it is those "major medical organizations" that are principally responsible for the shortage and unwillingness to donate in the first place, because they have put a system into place in which they get control of a very valuable resource (organs) without compensating the donor or his estate.

Re: NIMBY in full effect

[ChoGGi]

There aren't your organs anymore, it's just a lump of deteriorating flesh soon to be a rotten sack of maggots.

Not to mention in the event of an accident, organ donors are much more likely to be allowed to die so that their organs can be harvested.

Oh, you're one of those, I suppose I shouldn't even bother posting this.

Cut me open and take whatever you need, though I'd stay away from the heart and lungs...

Re:NIMBY in full effect

[ooloorie]

You're arguing for something that will make the world a worse place.

No, you are arguing for a feel-good policy that would do nothing to increase the number of organs available for transplants: the small number of people needing a transplant would become donors (many of them unsuitable anyway), and nobody else would care one way or another.

What's "making the world a worse place" is that some special interests managed to push through legislation decades ago that allowed hospitals to take people's private property (i.e. their organs) without compensation; it's no wonder that that creates scarcity and hoarding.

You want more organs for transplantation? Create a free market in them and have recipients (or their insurance companies) pay the estate of organ donors what those organs are actually worth, as determined by auctions.

Re:NIMBY in full effect

[ChoGGi]

Pretty much the same situation as my mom; mid-sixties, fatal brain tumor, and a DNR (as well as no treatments/experiments, only quality of life).
She was a nurse for a few decades, so she had plenty of first hand experience of what the butchers (well-meaning, but still butchers) will do to keep a body "alive".

I'm not trying to say anything bad about E.R. doctors (that's a hard and usually shitty job), but they will try anything and try again.

Re:NIMBY in full effect

[gijoel]

Actually the ball is still in your court. You are trying to claim that there is a systematic effort to kill patients on organ donor lists and all you have produced is a two half baked sites that appear to run by pro-life sites that would make Terry Schiavo's relatives wince with their conspiracy mongering. The news article is from 14 years ago, couldn't find anything more relevant?

There is nothing in the site you have given that doesn't appear to be cherry-picked justifications for people's selfish, paranoia. I won't call you a denier, but I will call you a conspiracy crank. Because you'd rather believe dedicated, trained health professionals would make less of an effort to save your life due to a tick on a card.

Re:NIMBY in full effect

[Shane_Optima]

and nobody else would care one way or another.

Only if there are no PSAs or news stories on it. Show a guy who's been waiting for years next to a guy who got one immediately, and then when people see the checkbox when they renew their driver's license, many will change their minds.

the small number of people needing a transplant would become donors

As I said, there would be a waiting period after switching from non-donor to donor before one gets moved onto the short list with the rest of the donors. Ideally this waiting period would vary by transplant type such that the waiting period for non-donors who immediately switch to donor status is just somewhat shorter than (not vastly shorter than) just waiting it out as a non-donor.

many of them unsuitable anyway

You keep saying this. I'm not at all convinced that people who are eligible for organ transplantation are likely to have multiple organ failure and/or be suffering from an incurable disease that has contaminated all major organs. I suspect these people are, under the current scheme, at the bottom of the list or completely ineligible for organ transplantation due to the low likelihood of it making a significant difference.

If someone needs a new kidney and they're also in congestive heart failure and have liver disease... guess what, they're not getting any of that. If someone just needs one of those things, and switches over to donor status to get a slight speed benefit, if they die before they get their organ then those other organs become available. There could be some corner cases here with people who are very healthy but HIV positive... meh.

What's "making the world a worse place" is that some special interests managed to push through legislation decades ago that allowed hospitals to take people's private property (i.e. their organs) without compensation

The dead don't have rights. The grieving family does to an extent, but if the living don't want to bother making their wishes clear while they are still living (no one here is arguing that opt-out should be impossible), I see no need to literally let people die to try to try to rectify the presumed sloth of the dead.

Create a free market in them

I'm for this as well. I'm for all of these things: default opt-in / explicit opt-out, opt-ins getting preference over opt-outs, and legalization of organ sale (particularly kidneys, livers, and other organs that can be removed from a live donor) with safeguards in place to minimize the chance of nastiness.

Re:NIMBY in full effect

[OhPlz]

We have a lot of people in prison.

Re:NIMBY in full effect

[RandomFactor]

Naturally given the needs of society, the death penalty will be applied for only the most major crimes, like excessive traffic tickets.

Re:NIMBY in full effect

[LeftCoastThinker]

I couldn't find the original journal article, but this WSJ article lays it out pretty clearly. The tests they use are from the 1960s and among other things, not checking for higher brain function with an EEG is a real problem for me.

http://www.wsj.com/articles/SB...

An excerpt: " In a 1999 article in the peer-reviewed journal Anesthesiology, Gail A. Van Norman, a professor of anesthesiology at the University of Washington, reported a case in which a 30-year-old patient with severe head trauma began breathing spontaneously after being declared brain dead. The physicians said that, because there was no chance of recovery, he could still be considered dead. The harvest proceeded over the objections of the anesthesiologist, who saw the donor move, and then react to the scalpel with hypertension."

Those of you looking to avoid pain may not like it if you can feel yourself being slowly dissected...

Re:NIMBY in full effect

[FatdogHaiku]

The thing is, by saving a life the hospital makes x dollars. If a person dies, the hospital is going to do multiple organ recovery procedures, and possibly some of the transplants as well. So, if when you roll in the door, they KNOW you have not opted out of donation, you become a bifurcated revenue stream which could effect your caregivers either consciously or unconsciously. That would be troubling, but not as troubling as a stacked revenue stream where you seem to be holding your own until your insurance maxes out and THEN you take a turn for the worse...
Of course, there is another path that will come along as we stroll towards the "Everything which is not forbidden is compulsory" Highway...
A long ago vision from Larry Niven.

Re:NIMBY in full effect

[khallow]

You assume that "getting worked on for longer" correlates with a higher probability of recovery.

We already know the patient has harvestable organs. Right there is a considerable threshold for good health prior to whatever event made them a potential organ donor. So yes, I don't consider it a stretch that being worked on longer would correspond to a higher probability of recovery.

Re: NIMBY in full effect

[ArylAkamov]

DEJA VU!

Re:NIMBY in full effect

[Bugdanoff]

Just wanted to say A Big Thank You to you and your wife Sue. It's thanks to people like you that students like my daughter get to be trained in Medical School and get a chance to continue the chain of "Heal the Living".

Re:NIMBY in full effect

[Dog-Cow]

The guy doing the autopsy aught to notice organs missing, no matter how much after death the autopsy is done.

Re:NIMBY in full effect

[moronoxyd]

Isn't it the other way round? When donors are rare, every chance to get a donor organ 'must' be taken.
If everybody is a donor by default there is less incentive to to play loose with the life of a donor as the next donor is right around the corner.

Re:NIMBY in full effect

[tinkerton]

Yes I recall reading that, but it sounded too much like an self driving car triumph story. Of course traffic fatalities have been going down dramatically over the last 40 years without automated cars.

Re:NIMBY in full effect

[moronoxyd]

These factors are just the same in an opt-in system. There are not specific to opt-out.

So GPs argument stays: In an opt-out system, there are potentialy more donors so less incentive to behave unethically.

Re: NIMBY in full effect

[Opportunist]

Mine isn't. But hating kids might play a role there, too.

Re:NIMBY in full effect

[Opportunist]

Yes, in the US, but can something like that happen in a country with better healthcare standards?

Re:NIMBY in full effect

[Opportunist]

Is it? Who does your body belong to when you no longer exist? Or rather, why do you cease to exist? As much a philosophical question as it is a legal one.

Re:NIMBY in full effect

[EvilAlphonso]

That is BS. Most people given CPR/defib don't survive or only survive for a few miserable hours or days, and even those that last longer usually have a very poor quality of life. They often are confined to bed or a wheelchair and often suffer brain damage.

I was given the defib in 1981 following a severe reaction to intravenous corticosteroids (lungs and heart stopped) and CPR in 1984 following a fall where I landed flat on my back with a stone between my shoulder blades (lungs and heart stopped again). While I agree with you that I wasn't running and jumping a few minutes later in either case, here I am 35 years later leading an active life like nothing happened.

Re: NIMBY in full effect

[Alain Williams]

Wrong, they are my organs until they are naturally absorbed by the Earth. Until then, only I get to say what happens to them, even after I'm dead.

I would check that in your jurisdiction, but. here in England, it is your relatives who decide. They might take note of your wishes, but they don't have to.

Re:NIMBY in full effect

[Jahta]

I just don't get the mentality of people who refuse organ donation. If you're dead, you're dead, why take other people with you?

The concern is not "If you're dead". The concern is, If i'm in critical condition, the hospital that knows I'm a potential organ donor may treat me differently in a manner that makes me less likely to survive, Or they may prematurely declare me dead out of concern for the organs they could get from me to save someone else..... perhaps someone they deem "More worthy" of being saved.

I think the real reason, for many, is not fear of not being revived in ER if they are a card carrying donor. It is the fact that many people, deep down, have an emotional attachment to the idea of being buried "intact". I've even seen cases where families have tried to override (sometimes successfully) the wishes of a deceased donor because "we want him to be buried whole".

Re: NIMBY in full effect

[SnowZero]

...reasonable organs come down the pipe.

I will never think of the word "organ pipe" quite the same way anymore.

Re:NIMBY in full effect

[shilly]

Instead of shouting "pig" and "murder" like a dimwit who's never heard of the trolley car problem, you could on occasion try engaging what passes for your tiny mind in some actual hard thinking.

Amazingly enough, the risk that patients might possibly be murdered is not in fact the only relevant consideration for the ethics of organ transplantation, a subject about which, I am fairly confident, I know a shit load more than you. For example, there is some moral weight to attach to all the people who will die if everyone is imbecilic enough not to allow their organs to be donated on account of the kind of hysteria you have so amply displayed.

Re:NIMBY in full effect

[shilly]

The chance of any one of us being in a position where we might donate organs is low in the first place. The UK had 1,364 deceased donors in 2015, out of 529,655 deaths. That's 0.26% of all deaths, and 0.0023% of the population. Let's say 1% of deceased donors involved some sort of unethical collection: that would be 14 out of 529,665 deaths (0.0026%), or more practically out of 60m people (0.000023%). I say "more practically" because if we're assessing personal risk, we start with the assumption that we're among the living population, not the subset of those who will die this year. In the UK that's c60m.

That's what I meant by irrelevant. Each one of us is quite unlikely to die; of those of us who do, only a small fraction will donate organs; and a low risk of malfeasance means that each of us can be pretty damn sure that however we go, it won't be due to an evil doctor hastening our deaths in order to harvest our organs. Sheesh, people.

You want to worry about something: worry about pointless interventions being done to keep you alive when all it does is cause you suffering. That's a real risk, and that's driven by real incentives in the system: doctors' and families' wishes to do "everything possible" (partly driven by cultural conditioning that this is the right thing to ask for) plus fear of getting sued if you can't show you did everything possible. Atul Gawande has much to say about this.

Re:NIMBY in full effect

[bluefoxlucid]

In general, doctors interfacing with a living patient don't know the patient is an organ donor. There's a large amount of protocol to prevent this.

Theoretically, if most all patients are donors, the doctor can simply assume any patient is a donor; and, also theoretically, if most all patients are donors, there should be a huge supply of organs available anyway.

Re:NIMBY in full effect

[bluefoxlucid]

Why? It's always going to be non-zero. How many people were murdered by policymakers who didn't allow ethical practices?

When you choose between 10,000 dead and 10,000,000 dead, you still have blood on your hands if you do nothing and allow 10,000,000 to die. It is, in fact, a lot more blood than if you took the knife to the 10,000 throats yourself.

Re:NIMBY in full effect

[bluefoxlucid]

Seat belts and airbags cause deaths. They also prevent deaths.

Re: NIMBY in full effect

[BarbaraHudson]

Wrong, they are my organs until they are naturally absorbed by the Earth. Until then, only I get to say what happens to them, even after I'm dead.

You're so full of shit from a legal point of view. You don't have any rights after you're dead - that's up to your estate. You know, your next of kin, etc. Unless you have an advanced directive that the medical team is aware of, your wishes are non-existent.

Re:NIMBY in full effect

[BarbaraHudson]

Flying cars will fix that.

Re:NIMBY in full effect

[headlessbrick]

Also, the stories about people waking in the morgue are lovely tales from the crypt, but have little to do with reality, and have not had for at least 100 years now.

Meanwhile in Poland http://metro.co.uk/2016/11/30/... . Not sure I'd be interested in his organs though.

Re:NIMBY in full effect

[AndyG314]

This is absolute bullshit, everything you just said, is totally false.

Organ donation isn't even considered until after a patient has been pronounced brain dead. It actually requires more neuro tests before organ donation than would be required to pronounce someone dead. Patients who are to donate are often cared for for over a day before donation, during which time all of their organs are tested and they are under the care of the organ donation doctors.

Literally everything you just said couldn't be more false.

Re:NIMBY in full effect

[BarbaraHudson]

Don't give a shit. What is mine is mine and what is yours is yours. Now kindly keep your nose out of other people's business.

Well, maybe if there were fewer selfish people like you, there'd be a spare colon available so you could give a shit.

Bunch of cowards afraid to donate an organ. You've got a spare kidney, you can donate 70% of your liver and it will grow back, what is your problem?

Re:NIMBY in full effect

[BarbaraHudson]

When it comes to non-donors you just need a small team to grab the organs and pay off the dude doing the autopsy.

Do you really think autopsies are done that soon after brain death? The organs have to be alive when you put them in someone else you know.

Psst - the person you're replying to is probably brain-dead already. :-)

Re:NIMBY in full effect

[Ol Olsoc]

Actually the ball is still in your court. You are trying to claim that there is a systematic effort to kill patients on organ donor lists and all you have produced is a two half baked sites that appear to run by pro-life sites that would make Terry Schiavo's relatives wince with their conspiracy mongering. The news article is from 14 years ago, couldn't find anything more relevant? Your conceding the point is noted. If you can't do anything but deride the source, you have failed. Thanks for playing though - Vanna has your copy of the home Slashdot game for you on your way out.

Re:NIMBY in full effect

[BarbaraHudson]

How the fuck is it selfish to want to keep all of the parts of your own body? You're just an entitled little whiner who wants what other people have without having to do anything for it.

And if you need a kidney or liver, you'd better hope that someone who's alive is willing to part with their spare kidney or a chunk of liver that they're still using, because fresh is best. Maybe we should make it mandatory that only people who are willing to donate can also be allowed to receive. Cut all the selfish people out of the loop, because after all you're just a waste of oxygen anyway.

Re:NIMBY in full effect

[ooloorie]

I'm for all of these things: default opt-in / explicit opt-out, opt-ins getting preference over opt-outs, and legalization of organ sale (particularly kidneys, livers, and other organs that can be removed from a live donor) with safeguards in place to minimize the chance of nastiness.

Once you treat organs like any other personal property, you don't need anything else: the last will becomes the organ donation opt-in/out. And if there is no specific provision in the last will, the heirs have a $100000+ incentive to opt in.

Re: NIMBY in full effect

[BarbaraHudson]

Few would object if that were the case. The issue is the "not breathing, not metabolizing" claim is not always true

Would you rather be a dead organ donor or a mostly mindless vegetable in some long term care death ward who can't remember the names of the people around them, can't tell when they've shit themselves? Not all lives are worth preserving. That's why I've signed my advanced medical directives - pull the plug and harvest away in such cases.

Re:NIMBY in full effect

[BarbaraHudson]

Do you really want to be one of those patients that makes a "partial recovery?" Go watch a few of them - sure, they're mostly aware, but their whole day is watching tv, having someone change their diapers, getting bathed once a month, maybe being fed through a tube, and having paranoid delusions because a mind that's not stimulated makes up shit.

Given a 50% chance of ending like that, kill me, or I'll do it myself if I'm able.

Re:NIMBY in full effect

[Cro Magnon]

My GFs mother had defib. She decided not to go through that again and did a DNR.

Re:NIMBY in full effect

[BarbaraHudson]

You're living in the dark ages. Assisted death has been around on the down-low for decades. Now that it's legal here, it's just bringing the practice into the light. There are doctors who have launched lawsuits against it, but they are, without exception, connected with religious organizations, and mostly seen as the attention-seeking assholes they are.

Strange how people who believe death is the gateway to eternal peace and happiness are so damn afraid of it. Just goes to show that, deep down. they know it's all bullshit.

Re:NIMBY in full effect

[BarbaraHudson]

I have no problem discriminating against religious people who discriminate against others. As they sow, so shall they reap. Besides, shouldn't they be eager to get into heaven so they can worship all day? Keeping them alive is discriminating against their beliefs that heaven awaits them.

Of course, these are the same people who don't want to donate their organs because they don't want to be missing something when they get there, even though the bible says they get a whole new perfect body, and they don't want to be cremated because that's what the "heathens" did way back when.

I've offered to do both a live directed kidney donation (risk of death 2.6% after having a kidney removed - not the 0.03% bs stat based on a fraudulent study that is frequently cited to back up the lie that "donors live longer than non-donors") and a live directed liver lobe donation (risk of death, short or long term, to right lobe liver donors ~1%). Turns out that the intended recipient wasn't healthy enough. And was also one of those religious types deathly afraid of dying.

Seems that god must like cowards - he made so many of them in his own image.

Re:NIMBY in full effect

[BarbaraHudson]

Bull. Shit. The national post article cites an opinion, not a proven medical fact. Fake news (then again, the national post is also canada's leading conservative oil-friendly climate change denier rag).

As for the other ones, "technically still alive" means nothing. There are plenty of people who are brain-dead who are "technically still alive." Same as the chicken whose head you chop off but runs around. And they all cite the same unproven opinion.

Should we do anesthesia during organ harvesting? Makes no difference either way, really. Once you're unconscious, you aren't aware of pain, even if your brain isn't dead. That's what being unconscious means. If you feel it, by definition you're not unconscious. But if you're brain dead, there's nothing to experience pain, joy, fear, whatever.

Probably the first organ that should be harvested is the brain, and not just for the protective membrane around it.

Re:NIMBY in full effect

[BarbaraHudson]

So a couple of misguided lawsuits in the US, the home of ill-conceived lawsuits, and a grieving mother who has taken exception to the fact that doctors endeavour to keep blood pumping around a body in order to preserve the organs for transplant. Thankfully the majority of the population are smart enough to consent to organ donation.

Given the trends in fake news, scams on social media that keep finding suckers, etc., don't be so sure. 95% support organ donations, but only 45% when it's their organ that's up for grabs, and 40% of those are blocked by next of kin. They figure it's better to receive than to give.

Re:NIMBY in full effect

[AmiMoJo]

I don't want to see religious views protected either, all I mean is that in practical terms it would be politically unpalatable.

Re: NIMBY in full effect

[stdarg]

Nice try. There's much more money in treatment than in letting someone die. However, if they're an organ donor then there's even more money to be made taking their organs.

Re:NIMBY in full effect

[stdarg]

My problem is not being paid for it. I'm all for organ transplants, but if someone wants to take whatever parts of me are still functional after I die, they're going to have to compensate my estate. That's all I'm waiting for.

Re:NIMBY in full effect

[stdarg]

If we remove the restrictions on organ sales then it would be pretty clear: your body is a valuable asset and that should belong to your estate, and any organs not immediately needed by an heir would be sold at fair market value.

Re:NIMBY in full effect

[stdarg]

If an increase in supply leads to a decrease in price, unethical behavior could potentially be encouraged because people will need to cut corners or increase volume to stay competitive. I'm not saying that's a definite, but neither is "there are potentially more donors so less incentive to behave unethically."

Re:NIMBY in full effect

[BarbaraHudson]

I don't want to see religious views protected either, all I mean is that in practical terms it would be politically unpalatable.

Only in the more backwards countries. Much of the modern world has gone secular. For example, here the catholic church knows to keep it's mouth shut about abortion, same sex marriage, etc. if they want to stay even a bit relevant. And any politician trying to introduce their personal religious beliefs into policy gets smacked down for being a whacko religious nutcase. A lot has changed in the last couple of generations, when you couldn't throw a rock without breaking a church window.

Re:NIMBY in full effect

[BarbaraHudson]

My problem is not being paid for it. I'm all for organ transplants, but if someone wants to take whatever parts of me are still functional after I die, they're going to have to compensate my estate. That's all I'm waiting for.

So you want to add another layer of lawyers to suck off you even after you're dead? Bad enough they f*ck you over when you're alive ...

Re:NIMBY in full effect

[stdarg]

There's quite a difference between dying because of "fate" versus dying because someone made a choice in advance to kill you under certain circumstances. I'm sure you know the fat man version of the trolley car problem, and how differently the results turn out.

Re:NIMBY in full effect

[stdarg]

So would you be okay with an opt-out DNR system?

Re:NIMBY in full effect

[shilly]

Why would you think I would be?

Re:NIMBY in full effect

[shilly]

The whole point of the fat man problem is to raise the question of whether there is, in fact, a moral difference. There is no definitive resolution.

In any event, you're rather missing the point of what I'm arguing: I didn't raise the trolley car to *defend* the doctor actively taking someone's life early in order to harvest organs to save another -- that doctor has behaved unethically. I raised the trolley car to point out that if everyone refrains from donating organs for fear of being killed by an evil doctor of this sort, then that ultimately causes more harm and costs many more lives. So we should:
- create systems that guard against doctors acting on the incentives to take lives too early (such incentives are small in my view, but still this should be policed)
- create systems that minimise the incentives (opt-out DNR does this by increasing the supply of organs, reducing the intensity of demand for any single organ. Increasing the supply of organs has other benefits too, of course)
- not act like dicks and thus not shout about minuscule risks while ignoring much bigger harms
- prevent more suffering and harm by being cautious about the use of close to end-of-life interventions, per Atul Gawande

Re: NIMBY in full effect

[stdarg]

From a purely economic point of view it's more sensible to keep a trained individual alive than to try to produce a new individual and train it.

Looking at the totality of a person's economic output, a young person on average will produce more economic output than an old person. That's true whether you look at the remainder of their lives which is quite obvious, or the entirely of both their lives (productivity per person has been increasing for a long time).

Re: NIMBY in full effect

[stdarg]

It doesn't work like that though. They can't just add clauses to say whatever they want, just like they can't say "your final bill came out to $120,000, so we added a clause that lets us confiscate your house and car even though your out of pocket is supposed to be limited to $5,000."

I think it's pretty reasonable to expect your estate to receive your body and any proceeds that come from it, just like all your other stuff.

Re:NIMBY in full effect

[suss]

Your organs are useless once you're dead. They're harvested when you're "technically dead" (aka still alive).

Depending on how much they want your organs, they will adjust the "technical" limit to their needs.

Re: NIMBY in full effect

[GateGuy]

I would mind being a "mindless vegetable", but if I were a "mindless vegetable" would I mind?

Re:NIMBY in full effect

[stdarg]

It's already bad. The first year cost for a kidney transplant is $262k (http://www.cpmc.org/advanced/kidney/patients/topics/financing_kidney_transplant.html)

Why not round that up to $300k? It would raise kidney transplant costs by 15% but it would make a substantial difference for the families of many organ donors.

Re:NIMBY in full effect

[FatdogHaiku]

Naturally given the needs of society, the death penalty will be applied for only the most major crimes, like excessive traffic tickets.

I actually posted a link to a Larry Niven short about that very topic, here it is again... a nice short read from the 60's:
http://will.tip.dhappy.org/blog/Compression%20Trees/.../book/by/Larry%20Niven/The%20Jigsaw%20Man/Larry%20Niven%20-%20The%20Jigsaw%20Man.html
Also, NoScript pops no alerts on the page, what a shock!

Re:NIMBY in full effect

[Cederic]

Take my lens cap off.

Photojournalist ethics are a fucking minefield, I tell you.

Re:NIMBY in full effect

[stdarg]

It's pretty definitive from what I've read. In surveys, about 90% of people will pull a lever to sacrifice one person already tied up to save other people who are already tied up. But 90% of people will NOT kill someone who was not in harm's way already in order to save a greater number of people.

In any event, you're rather missing the point of what I'm arguing: I didn't raise the trolley car to *defend* the doctor actively taking someone's life early in order to harvest organs to save another

But that's the entire point of the trolley car problem. It's a fundamental argument about utilitarianism, which is exactly what you're talking. You're literally saying "sure there will be problems but the good outweighs the harm." That's utilitarianism in a nutshell.

And of course naive utilitarianism leads to nightmare scenarios where the state tramples over everything. So the classic rebuttal is that "good" and "bad" are subjective so you can just add in emotional consequences, like "if the state could come kill anybody and take their organs and give them to others to save more lives, it would not outweigh the harm in everybody being scared all the time that they're about to be killed and harvested."

I'm curious what your resolution is since you are actually rejecting that approach. Is it just "Don't worry about it, it won't happen?"

Re:NIMBY in full effect

[stdarg]

Are you dodging the question, or are you genuinely curious? I assumed you supported the opt-out organ donation system, because in this thread you are pooh-poohing criticism of it along the lines of "don't worry about unethical organ collection, who cares, it does more good than harm unless it rises above a certain arbitrary threshold." That means you probably don't have an issue with presumed consent, and you're probably okay with other utilitarian stuff.

So... are you? Or not?

Re:NIMBY in full effect

[stdarg]

I'm not sure I follow.. I'm not talking about suing the hospital. It would be more like a life insurance plan, except you don't pay premiums because the payout is funded by your organ sales. You'd have an advocate in getting the highest prices possible since the hospital would screw you completely if it were all in their power.

Re:NIMBY in full effect

[Wulf2k]

I'd assume because it's unlikely to affect you, and the gist of your argument seems to be that you don't care about unlikely things.

Re:NIMBY in full effect

[Wulf2k]

Unless you're tattooing a DNR on your forehead, you're really rolling the dice for a "partial recovery" anyway.

May as well have the doctors trying their best, and deal with what happens when it happens.

Re:NIMBY in full effect

[darnkitten]

...or the lawyers have a $100000+ incentive to tie things up in court...

Re:NIMBY in full effect

[david_thornley]

Thing is, if you give up on consequentialist ethics, where do you get your ethics from, and why should I give a rat's ass what your ethics are? People who base their ethics on firm principles that don't account for consequences scare the heck out of me.

My thinking on the slight danger of doctors screwing up my care for my organs is that it isn't worth worrying about. I drive to work every day, and I don't worry about threats that are a lot less significant than that.

Re:NIMBY in full effect

[BarbaraHudson]

Any time there's money involved in an estate, lawyers are going to be there. That includes payouts to your estate after death. Even if it's not really required, they'll make damn sure it is.

Re:NIMBY in full effect

[david_thornley]

All health care providers have limits at which they will just give up on a patient. A system to specifically ask for a greater attempt to save one's life sounds reasonable to me.

Re:NIMBY in full effect

[david_thornley]

The doctors doing their best to give me a slight chance at a life I don't want to live could be treating someone else. The ER bed I'm occupying could go to someone who's actually got a decent chance of recovery. "Their best" is always relative.

Re:NIMBY in full effect

[BarbaraHudson]

Here we have universal health care, and your advance medical directives are visible to anyone looking at your file. They simply cannot be ignored. You can refuse all care including food and hydration, and all they'll give is pain medication. You'll die, and you won't even be aware of it. This avoid the whole "I'm not able to consent to euthanasia any more" problem. Plus, it's really easy to commit suicide nowadays with all the information on the internet. Just search for scholarly articles on massive insulin overdoses. You won't know what hit you.

Re: NIMBY in full effect

[BarbaraHudson]

These are two separate issues. People who are no longer able to breed aren't exactly capable of continuing to contribute to the overpopulation problem, and who knows, it may be one of them who realizes that we are not going to willingly solve the problems of global warming and overpopulation and hack into the missile systems to trigger WW3 and nuclear winter.

Re:NIMBY in full effect

[wallsg]

Remember Niven's warnings.

When organ donations didn't keep the organ banks stocked, people started to vote for harvesting the organs of the condemned, and then for the Death Penalty for lesser crimes. Then they went for the Corpsicles.

Re:NIMBY in full effect

[AutodidactLabrat]

Aside from Anecdotes, show me the person who was pronounced, in a clinical setting, who sat up in the morgue.
I'll accept chastisement if you find ONE verified by uninterested medical documentation.

Re: NIMBY in full effect

[AutodidactLabrat]

Not metabolizing has always been true. MOST corpses are not tested for O2 consumption, but those who fail that test are ALWAYS dead

Re:NIMBY in full effect

[Cinnamon Beige]

Review that happens to not only mention the outcomes of 38 medically-documented cases published in journals of a particular type of it, but also the possible causes and measures to take. Will that do?

Re:NIMBY in full effect

[jeremyp]

I promise you that no heart and lung donor has ever woken up in the morgue.

Re:NIMBY in full effect

[AutodidactLabrat]

Your citation doesn't even mention O2 consumption measurement.
Nice try though.
Localized circulartory collapse has caused false positives for death, but is NOT a definitive test, whereas force-sense O2 concentration is an absolute.
I repeat, we have well defined differentiators for DEATH
Case closed.

Re:NIMBY in full effect

[Cinnamon Beige]

Is moving the goalposts your hobby or just a bad habit of yours? These people were pronounced, in a clinical setting, dead as per your request. These people didn't have 'localized circulatory collapse,' they had their heart and breathing stop, and as the paper notes, this is probably an under-reported problem. Moreover, I donno how to break it to you, but O2 consumption monitors work on the assumption that you are experiencing respiration, something that if you are doing when somebody starts CPR on you? They're doing it very wrong.

It seems unlikely for two reasons that O2 consumption monitoring would have not identified these people as dead, anyway. For one, if you'd read the paper, you'd know it explicitly discusses means for detecting Lazarus syndrome without relying on chance. If it'd work, they would suggest it. Perhaps more to the point, several of the cases in the lit suffered the kinds of damage that strongly indicate oxygen deprivation--no respiration was taking place, meaning you'd be unlikely to notice much difference between it and a fresh corpse since the microbes involved in decomposition also consume oxygen. (How do you think vacuum-preservation of meat works, magic?)

Oh, and the paper covers what medical science defines death as though I suppose it might be hard to understand if you don't have a biomedical background. (Here's a bit of help: in asystole the heart isn't even twitching, the heart monitor flatlines, and it is very, very memorable once you've seen it happen. So of course the physio lab on how heart monitors work required we wrap up with flatlining our pithed frog...)

Re:NIMBY in full effect

[BarbaraHudson]

Go back a few years later and ask some of those patients with partial recovery if they're still happy they survived. Many are NOT. And you're a fool if you would take "any form of partial recovery over death." Permanent vegetative state? Dementia that prevents you from recognizing anyone? Pain 24/7? We have euthanasia because we recognize that some things are worse than death. If you can't think of some situations where you'd rather be dead, you are just showing your lack of imagination.

Also, medicine is NOT "advancing at such a rapid rate that I expect partial recoveries will be only a temporary state of being." Even if we could replace your damaged brain with a new one, YOU would still have ceased to exist. 64% of all medical studies cannot be replicated, and most of the rest, the effect is far less than the original study. Thank the whole "publish or perish" cycle, where new results get all the funding, attention, and tenure tracks, and trying to repeat old studies to see if the results hold is for suckers. A great example of bad medical a bad medical study was the Women's Health Initiative, which suffered from a combination of bad design, non-representative population, commercial interference, bad stats, and sensationalism, resulting in the erroneous conclusion that HRT is risky to women.

The immediate result was driving millions of women off hormone replacement therapy and onto antidepressants (which we now have to worry about the link between SSRIs and dementia). Long term, there's also the increased death rates of those who don't use estrogen-only hormone replacement therapy, increased risk of cardiovascular disease, quicker bone density loss, earlier onset dementia and Alzheimer's, and we're not even counting economic and individual losses due to the disease of menopause being mis-treated as "normal" (it's only normal because for most of the lifespan of Neanderthals and Homo Sapiens we - and I say we because the two species interbred quite a lot - didn't live long enough for menopause to rear its' ugly head). This affects everyone - after all, pretty much everyone has a mother at some point, and many have sisters, daughters, female life partners, or (gasp) are themselves women.

Your faith is not based on facts. Just look at how many doctors have DNRs, because they know how useless extreme measures are.

Re:NIMBY in full effect

[AutodidactLabrat]

Nice try. I specified O2 Consumption and NOT ALL ARE SO TESTED and THOSE WHO FAIL ARE ALL DEAD.
Now what part of that changed from statement to rebuttal?
Nothing
Nice try though!

Re:NIMBY in full effect

[stdarg]

and why should I give a rat's ass what your ethics are?

That's true no matter what the basis for your ethics.

I drive to work every day, and I don't worry about threats that are a lot less significant than that.

Hmm I don't know about that. Are you sure? There are so many factors that go into risk, but one of the biggest must be mitigation steps. Dying in a car is more likely than dying in a fire, but I bet you have smoke alarms in your house.

How would you even measure the risk of dying from organ harvesting? It's not like they're going to put cause of death: needed his lungs for someone else. It'll say cause of death: car accident.

I think when thinking about probabilities you have to keep in mind Bayes' Theorem, which is about probabilities given prior knowledge of conditions. Yes, the overall absolute chance that I die because someone wants to harvest my organs is teeny tiny. But that's because to be in that situation I first have to have a life threatening injury, which is very unlikely day to day. The question is really what is the probability GIVEN that I'm already in that situation? If it's 1%, that's pretty high. I don't do things that have a 1% risk of death very often.

Re:NIMBY in full effect

[Shane_Optima]

Just because I usually favor a reduction of government interference in the marketplace doesn't mean I've overdosed on libertarian flavored acid.

And if there is no specific provision in the last will, the heirs have a $100000+ incentive to opt in.

Except prices obviously won't stay that high for long. Equilibrium will most likely be at a price point that still guarantees a shortage. There's no reason to dismantle a nationalized (dare I say socialized) waiting list system as well. Keep that checkbox there when you get your driver's license, but add a little bit in bold about how if you're not an organ donor, you're at the back of the line. That simple change might obliterate most of the shortages right there.

And then we still have the perverse incentives to think about. This is why I'm pretty solidly in favor of selling kidneys and livers but not entirely convinced about hearts.

Re:NIMBY in full effect

[ooloorie]

Except prices obviously won't stay that high for long. Equilibrium will most likely be at a price point that still guarantees a shortage.

That statement makes no sense.

There's no reason to dismantle a nationalized (dare I say socialized) waiting list system as well.

There is every reason to; it's not a fair or transparent system.

Keep that checkbox there when you get your driver's license, but add a little bit in bold about how if you're not an organ donor, you're at the back of the line. That simple change might obliterate most of the shortages right there.

Ah, the usual progressive approach: simply deny reality and facts and double down on stupid policies.

Re:NIMBY in full effect

[peawormsworth]

Fentanyl overdoses being an upside?

http://www.nytimes.com/2016/10/06/us/as-drug-deaths-soar-a-silver-lining-for-organ-transplant-patients.html?_r=0

Re:NIMBY in full effect

[Shane_Optima]

Except prices obviously won't stay that high for long. Equilibrium will most likely be at a price point that still guarantees a shortage.

That statement makes no sense.

I phrase that badly and it's dependent on a number of assumptions about the assumed social and emotional "costs" borne by the family members. But let's put that aside and focus on your $100,000 claim here:

Please draw me a supply&demand graph illustrating how everyone gets their organ in a timely manner AND people still get $100,000 per dead family member, keeping in mind that there are millions of poor people who would be very happy with a mere $1000 and also plenty of poor people who need a heart and can't afford $100k. I'm assuming you're arguing for a REAL free market here, with no price discrimination and thus one spot price (or a bid/ask, perhaps.) If you mean something else, say so.

Now, just go look at the figures of the number of poor people that die every month in the country vs. the number of people who have been added on organ waiting lists during that month (NOT the total number of people currently on the list; that isn't a relevant comparison). Yes yes, there are some caveats here re: tissue type matching, but they're getting better and better at working around that. So with your system, either you:

1. ...can coax enough people into the system to make the price for most organs quickly crash, turning the system into an effective charity, possibly with some nominal for-your-trouble amount. People's propensity for charity has almost nothing to do with the magical free market or any of your other arguments, except to the extent that *any* change in the way things are done would get people talking about it and thinking about it (and this could lead to a cultural change.)

2. ...can coax a smaller number of people (not enough to meet the demand), so small in fact that the price can be bid up to $100,000ish, blocking out the poor. This would be a failure of your system, not a success.

The situation is a bit different with kidneys and livers, since there is a real cost in inconvenience and health risks. The free market will have a stronger positive impact here, and the price won't drop quite as low unless enough cadaver organs become available (in which case live donations will pretty much cease.)

I'm broadly in favor of the free market (with reservations about cadaver donations due to perverse incentives), but in practical terms this is mainly just a means to increase supply and raise awareness. The idea is to get us to a tipping point outlined in #1, not to settle into some hellhole status quo you alluded to where only the rich can afford hearts.

There is every reason to; it's not a fair or transparent system.

Well make it fair and transparent then. This isn't the IRS or EPA or DEA we're talking about here. It's fucking optional, it's not something that requires money beyond a little administrative overhead and it leverages the fact that you can ask people and make them think about it in common governmental settings like the DMV. The point is to get enough organs available (from private donors and from the public system) that the waiting time for everything drops to a matter of days or weeks. I'm in favor of anything that does that without containing significant downsides.

Ah, the usual progressive approach: simply deny reality and facts and double down on stupid policies.

That statement makes no sense.

It's not progressivism to argue for the continued existence of a centralized institution, particularly one that isn't sucking up a significant amount of money and has voluntary participation. If that's progressivism, then anything other than rabid anarcho-libertarianism must be "progressive".

I want public roads to remain public, too. Guess that makes me a bleeding heart, eh? But this isn't even 1/10,000th as intrusive as public roads are... the costs are minimal, and there's no trampling on people's rights through eminent domain.

Re:NIMBY in full effect

[ooloorie]

Please draw me a supply&demand graph illustrating how everyone gets their organ in a timely manner AND people still get $100,000 per dead family member, keeping in mind that there are millions of poor people who would be very happy with a mere $1000 and also plenty of poor people who need a heart and can't afford $100k.

The $100k was a rough magnitude for what they are currently worth. If the price for the totality of organs of a dead donor settles at $1000, all the better. Whatever the supply and demand curve is, and wherever its optimum ends up being, it ends up in a better place than with the current set of price controls; that's the point of matching supply and demand in a free market. Or are you seriously suggesting that we get more organs through fixing their price at zero?

Re:NIMBY in full effect

[Shane_Optima]

Again, I say go both routes. Plenty of people will want to pay the money to skip the line. The prime obstacle here is a cultural impediment standing in the way of the huge supply reaching the moderate demand, and this obstacle should be attacked through both the charity and the capitalistic angles. In some areas these two things might work against each other (like, say, municipal wifi. Or schools and universities) and you would thus have an argument at least in principle, but not in the case of organ donation.

If I had to choose between the aforementioned reforms of the current system and legalizing organ sale, I'd probably choose the latter because it will make bigger waves[1], leading to both reforms and increased awareness. But we don't have to choose. Arguing for the abolition of the public charity option sabotages your own case, makes you sound like your real priority here is blindly promoting libertarian means with the ends (saving lives) as a mere afterthought. I still consider myself a libertarian of sorts, but this political orientation will remain doomed to irrelevance so long as this tedious, predictable zealotry is adhered to.


1. The default opt-in reform, depending on how it's set up, could give you a much bigger boost in the organ supply but in practice I suspect it's going to be hard to enforce over the objections of family members, particularly in America. Still, it would be worth doing as a firm yet resistible push in the right direction. Don't take away rights, but force people to actually expend a little effort if they really, really don't want to their (or their family member's) organs to save anyone's life. This is something most people simply don't think about. Force them to think about it a little bit if they do want to opt out, and I suspect that a lot of current non-donors won't.

Re:NIMBY in full effect

[ooloorie]

If I had to choose between the aforementioned reforms of the current system and legalizing organ sale, I'd probably choose the latter because it will make bigger waves[1], leading to both reforms and increased awareness. But we don't have to choose. Arguing for the abolition of the public charity option sabotages your own case,

How is arguing for property rights in organs arguing "for the abolition of the public charity option"? Obviously, if you have property rights in your organs, you have the right to leave them to any public organization you like. What you're saying is that there should be a default for intestate deaths, which is fine.

I still consider myself a libertarian of sorts, but this political orientation will remain doomed to irrelevance so long as this tedious, predictable zealotry is adhered to.

The cause of liberty seems to be doing well: governments all over the world are losing power over the people.

Re:NIMBY in full effect

[Dread_ed]

My insinuation is that it is easy for humans to think incorrectly about ethical problems. The "greater good" is not always the "right thing" and this is hard for people to not only recognize this but also to reconcile it with their code of ethics.

Good

[Anonymous Coward]

Screw the family's choice. If I decide I want to give my organs at death, it should be respected regardless or what my surviving family think.

Re: Good

[RLaager]

The problem is: how does the hospital know what you wanted? You're dead, so they have to ask your family.

I believe Minnesota (where I live) recently changed this to make the election on your driver's license (or ID) binding.

Re: Good

[jordanjay29]

If you have a Living Will (Health Care Directive) in your medical records, this is one way.

Re: Good

[SuiteSisterMary]

You know, the western world already has a whole body of law on 'how to know what you wanted' after you die. It's incredibly complex, but very simple: write a damn will. You should have one anyway, and update it every few years.

Check your state/provincial laws, but you can probably write one yourself, pretty easy. In Ontario, a 'holographic,' or completely hand-written, will is perfectly legal and valid. You can also find 'write a will' kits and templates easily enough, and they'll include health care directives, living wills, and all that stuff. If your estate is too complex for a mad-lib style will, you should already have a lawyer on retainer to do that sort of thing.

Donate how much and for what purpose?

[tgibson]

The assumption is that only vital organs needed to help a living, sick person survive are harvested. But is that the case? Does the system define which organs may be harvested and for what purpose? Can one's entire body be donated for the purpose of research or training? Is the system truly altruistic or are there people profiting from the practice? Who decided what the rules are?

Re:Donate how much and for what purpose?

[Anonymous Coward]

It's ruled by law as is all society, no different. Besides, when you're dead you can't give a fuck so who cares. If someone wants to sell me a perf-enhancing whale blubber when I'm dead, fine.

Re:Donate how much and for what purpose?

[mysidia]

But is that the case?

No.... donated body parts, if they cannot be used to save somebody's life will likely be used for Scientific research, or educational purposes instead.

Can one's entire body be donated for the purpose of research or training?

Yes. Schools that graduate people as medical Doctors use Human kadavers for the purpose of teaching physiology and teaching surgeons.

Historically, these are expensive and hard for them to obtain. There may be research uses as well.

I don't know what the new French law is, but this would be clearly incomprehensible and a possible major infringement of the free exercise
of religion regarding robbing one's deceased loved ones from the grave......

Re:Donate how much and for what purpose?

[Khashishi]

Maybe you only want to donate to save a life, but donating one's body for research or training potentially helps more people people survive in the long run. Of course, the latter path means your organs will die, if that's something you actually care about. (But hey, maybe they'll find a way to make your cell line immortal.)

Of course people profit from the practice. Did you think the doctors were working for free? There's no problem with profit as long as the dividends are proportionate to the skills, risk, and labor. All you had to do was check some box, right?

Re:Donate how much and for what purpose?

[gurps_npc]

No one 'profits' from it, at least not direct monetary profit. Yes, some body make make money off of medical inventions developed using research done using these organs, but that is about it.

Organ donation is very difficult, very expensive, and heavily regulated in all western countries. Hence the medical tourism to non-western countries.

This will definitely save a lot of lives. In the US the wait for kidney donation (keep in mind that you can donate one of your two kidneys with minimal health issues) is often longer than the life expectancy of people that need a kidney.

Re:Donate how much and for what purpose?

[nnull]

Why is that? Somehow I can leave my money to someone else in a will, but I can't decide what to do with my organs after death?

Re:Donate how much and for what purpose?

[misexistentialist]

Most people invest quite a lot maintaining their cells, granted this does not result in much research value, but if scientists had to use farm-raised humans it would cost them at least a few bucks per pound.

Re:Donate how much and for what purpose?

[Cinnamon Beige]

Actually, it turns out that the difference between a cadaver's anatomy and a live person's anatomy is sufficient that most doctors actually get their anatomy training on the job--as in, when they get to see inside live people. The best anatomy texts we have are from imaging of live people, followed by a project that worked using donated bodies of people who died under circumstances that meant their body could be frozen at the point of death (or close enough) and then sliced (I think the images are online somewhere), followed by the result of Nazi crimes against humanity in the form of vivisecting some human victims for science.

This isn't to say that there's definitely other areas of training and research for which donated bodies are highly useful--but, well, some aren't as useful as you think, and providing a cell line is something you can do without dying. (Seriously, I could whip up a cell line from myself given a bit of prep and lab time. Immortal cell lines are easy, too. Hint: In the body they're called 'cancer.')

Re:Donate how much and for what purpose?

[thegarbz]

Is the system truly altruistic or are there people profiting from the practice?

Something tells me when I'm dead I won't care.

Re:Donate how much and for what purpose?

[Jack9]

https://en.wikipedia.org/wiki/...

Re:Donate how much and for what purpose?

[Anonymous Coward]

Yes you can. There's a reason this law is called an "opt-out" law. It's because you can, you know, "opt-out".

Re:Donate how much and for what purpose?

[Tokolosh]

Read this: http://www.inforum.com/news/41...

How about visitors?

[johannesg]

If you die while on a visit to France, will the family receive a stripped body?

Re:How about visitors?

[manu0601]

It's safe to assume this would only apply to French citizens...

Most of laws apply on a territory, regardless of people nationality. There are exceptions, but I do not see any reason for this one.

Re:How about visitors?

[fbobraga]

Please don't contribute to generate audio pollution here on /. :/

Default yes is a bad idea

[Anonymous Coward]

As much as I like the idea of more organ donation, default yes is a very dangerous precedent and should never be used of free individuals. Heck we don't like it on installers, why should be think differently about it for organs? If you want to improve organ donation participation there are better ways of doing so. For example, a lower fee for license renewal. IN my home state Licenses cost some pittance like 15 dollars every 5 years or some such, if you are an organ donor then it drops to 10. Or better yet, educate individuals on the benefits of organ donation. Instead a default yes position makes the program subject to potential severe abuse. Oh the computer is down, so we should harvest this persons organs because the default is yes and we cannot prove he did not want them harvested, or someone misplaces paperwork, etc. Whether you agree with a particular faith or not, there are some that strongly oppose organ donation and even autopsies. They should still be respected.

Re:Default yes is a bad idea

[Yosho]

Whether you agree with a particular faith or not, there are some that strongly oppose organ donation and even autopsies. They should still be respected.

I'm gonna have to disagree there. If you place more value on a sack of meat that's just going to rot in the ground than saving another person's life, your opinion should not be respected.

Giving people some kind of monetary compensation for rights to their corpse both sets a dangerous precedent and is stupid -- $5 every five years is a pittance. I'm willing to respect a person choosing what happens to their own body after they're dead, but if they haven't expressed any preference, letting living people die because of their families' religion is absurd.

Re:Default yes is a bad idea

[Cinnamon Beige]

I think it'd be safer to avoid making it something like a lower fee for a license renewal. Go for something more likely to encourage families to agree to the decision--maybe defray the final costs for donors, especially any costs associated with donating, since now it's quite common for dying to be rather expensive if you aren't DOA.

Re:Default yes is a bad idea

[thegarbz]

As much as I like the idea of more organ donation, default yes is a very dangerous precedent and should never be used of free individuals.

You're thinking like an alive person. A dead person doesn't give a shit.

For example, a lower fee for license renewal.

Err. Maybe come up with an example that is relevant for something other than one crappy little state in the USA.

Re:Default yes is a bad idea

[fbobraga]

I don't follow your logic... my country, Brazil, adopted organ donation policy like this, being adopted by France now, several years ago, with no issues (that I've known)

Re:Default yes is a bad idea

[fbobraga]

something like a lower fee for a license renewal

it's a good idea to work with the Default yes!

Re:Default yes is a bad idea

[stdarg]

"If you place more value on a sack of meat that's just going to rot in the ground than saving another person's life, your opinion should not be respected."

"I'm willing to respect a person choosing what happens to their own body after they're dead"

Pick one. You can't have both.

Presumed consent

[jdavidb]

This gets very, very tricky. I don't think presumed consent in this particular area bothers me per se, but I can imagine a lot of other issues where presumed consent would scare the living daylights out of me. Sounds like a very slippery slope.

Re:Presumed consent

[AthanasiusKircher]

I don't think presumed consent in this particular area bothers me per se, but I can imagine a lot of other issues where presumed consent would scare the living daylights out of me. Sounds like a very slippery slope.

I agree. While I too think it's somewhat silly to be concerned about ownership of body parts after death, this effectively causes ownership of the corpse (or at least parts of it) to pass to the state, unless you opt out. So while your property, finances, etc. pass to your family members by default, your own body comes under control of the state by default (who cedes it to medical professionals, it seems).

Death rituals are important to many people, especially loved ones who have to go through mourning. As the summary notes, many families DO object when it comes to this, even if they may be in favor of organ donations in the abstract. Does the state's interest in keeping other people alive outweigh the family's interest in their mourning ritual, particularly when it involves the actual physical parts of that loved one?

I'm all in favor of increasing organ donations -- making it trivial to sign up at any opportunity, etc. But what this law is effectively doing is removing ownership of the deceased person from the family and passing it to the state. I'm generally skeptical of any "opt-in" policies, and this one seems a bit worrying in terms of what it's saying legally about what the state can do.

Just to throw out some "slippery slope" possibilities -- could the government also decide that you are "opt-in" to a DNR order by default? If it would save on healthcare costs, perhaps speed up organ donation (and thus save lives), could that also be justified? If that seems extreme, how about if you're on life support in a coma? How about a persistent vegetative state? At what point can the state's interest in your organs outweigh the slim possibility you might ever wake up? Why let those organs deteriorate in that body for weeks, months, or years? What about those who don't have family members around to argue legally that organs should NOT be harvested yet?

Some of these scenarios may seem more extreme than others, but it seems like this seemingly minor "change in default" could have other legal consequences in the future in terms of how many decisions family members have control of in determining what happens to a loved one who is potentially near death. How far can the state's interest go here in superseding the wishes of the family?

Re:Presumed consent

[AthanasiusKircher]

By the way -- I am aware that some other countries have adopted this system already and haven't apparently seen such abuses or problems. I'm just posing some thoughts about where things COULD lead when we start changing basic assumptions like this.

Re:Presumed consent

[Shane_Optima]

This gets very, very tricky. I don't think presumed consent in this particular area bothers me per se, but I can imagine a lot of other issues where presumed consent would scare the living daylights out of me. Sounds like a very slippery slope.

I don't know...limiting implied consent to dead people feels like a pretty good firewall to me. Where do you imagine we could end up sliding to? (Talking about implied consent only, not other issues like doctors possibly being less than enthusiastic to save someone.)

Re:Presumed consent

[by (1706743)]

Would the rich and powerful hire people to keep track of those who had compatible organs and arrange suitable 'accidents' in case that rich & powerful person needed one or more of their organs?

But what's to stop that from happening now? At least where I live in the USA, we have a little donor sticker on our license. It shouldn't be hard to get a list of donors (either legitimately or by paying someone at a liquor store an extra buck to log every ID checked) and arrange for 'accidents' for them.

But I think the real issue here is that your nightmarish scenario -- and I do agree it's nightmarish -- relies on organs being a scarce commodity, which ostensibly will not be the case going forward in France. So there's no need to kill someone when you're drowning in viable organs. As macabre as that phrasing is, I think it's a Good Thing. Personally, I make a huge distinction between dead people and living people, and I think that our default actions should favor the living. Should the deceased specifically not want that, they have -- er, had? -- a way to change that.

Re:Presumed consent

[Jack9]

Most importantly (IMO) is that, statistically, nobody thinks about organ donation too much in the US except when looking at their Driver's License every couple years. The public thinks long and hard about comas and other altered states and has plenty of time to do so. The slippery slope can't practically apply when comparing events that have orders of magnitude difference, in time between deliberation and consequence.

Re:Presumed consent

[jdavidb]

But what this law is effectively doing is removing ownership of the deceased person from the family and passing it to the state.

Exactly! And while I'm sure we all know some people who have terrible families, I think the state is all too happy to play on fears of individual families making the "wrong" decision and to present itself as the enlightened benevolent decision maker who should have the right to decide.

Just to throw out some "slippery slope" possibilities -- could the government also decide that you are "opt-in" to a DNR order by default?

That is the specific slippery slope scenario I have in mind. And I've actually worried about that since the late 1980s.

Re:Presumed consent

[fbobraga]

the uncivilized country strikes again!

Re:Presumed consent

[fbobraga]

From "Americans" ("United States people" - "American" stands for a living human for a whole continent...): you, socialist shit! Get out of my lawn!

Re:Presumed consent

[SuiteSisterMary]

I agree. While I too think it's somewhat silly to be concerned about ownership of body parts after death, this effectively causes ownership of the corpse (or at least parts of it) to pass to the state, unless you opt out. So while your property, finances, etc. pass to your family members by default, your own body comes under control of the state by default (who cedes it to medical professionals, it seems).

So?

Death rituals are important to many people, especially loved ones who have to go through mourning. As the summary notes, many families DO object when it comes to this, even if they may be in favor of organ donations in the abstract. Does the state's interest in keeping other people alive outweigh the family's interest in their mourning ritual, particularly when it involves the actual physical parts of that loved one?

No, the state's interest doesn't, which is why the person has the first, last, and final say. The family's wishes, of course, should have no bearing whatsoever; if Johnny's family is all against organ donation, but Johnny is for it, then Johnny's organ's get donated.

I'm all in favor of increasing organ donations -- making it trivial to sign up at any opportunity, etc. But what this law is effectively doing is removing ownership of the deceased person from the family and passing it to the state. I'm generally skeptical of any "opt-in" policies, and this one seems a bit worrying in terms of what it's saying legally about what the state can do.

No, what it's doing is setting up a default action when no other instructions are specified. Just like everything else that happens when you die; if you haven't specifically declared what happens to your property, chattels, dependents, and so on, there are default rules that kick in and attempt to dispose of everything. Just, up till relatively recently, those default rules were 'buried in accordance with local majority religious views.'

Just to throw out some "slippery slope" possibilities -- could the government also decide that you are "opt-in" to a DNR order by default? If it would save on healthcare costs, perhaps speed up organ donation (and thus save lives), could that also be justified? If that seems extreme, how about if you're on life support in a coma? How about a persistent vegetative state? At what point can the state's interest in your organs outweigh the slim possibility you might ever wake up? Why let those organs deteriorate in that body for weeks, months, or years? What about those who don't have family members around to argue legally that organs should NOT be harvested yet?

They could, sure. Hell, the government could, in theory, simply designate you for organ donation for the high Party officials, enslave your children, and induct your beloved cat Mittens into their harems.

Some of these scenarios may seem more extreme than others, but it seems like this seemingly minor "change in default" could have other legal consequences in the future in terms of how many decisions family members have control of in determining what happens to a loved one who is potentially near death. How far can the state's interest go here in superseding the wishes of the family?

Well, this is why we've seen developments in things like living wills and treatment directives. You assume that 'family members' should have a large amount of say in what happens to a loved one. I question that assertion; have ever since that episode of The Practice when Rebecca was badly injured, needed a blood transfusion, and her Jehovah's Witness parents refused it on religious grounds, on her behalf, while her friends and coworkers all swore up and down that Rebecca was not an adherent, and would want the transfusion.

We in the west also have a lot of State control based on old religious strictures; I, for one, do believe that a person (not their family, or the State) should be allo

Re:Can you imagine

[AutodidactLabrat]

Yep, that's a Holy Grail
but Americans won't be allowed to benefit
Because religitards have fits over the word "Clone" and that is what you are doing.
So, move to Korea now, live forever....though you might not want to

shades of Larry Niven's Known Space

[kallen3]

Wonder how long before some crimes will no longer carry the death penalty but organ donation penalty? No one was really executed just all of their organs donated, too bad they could not live without kidneys, liver, and both lungs. But hey they were not executed, meanwhile since they are suffering a major life ending trauma lets just grab that heart, too.

Dies? Guess again!

[Anonymous Coward]

You are harvested BEFORE you die! It's true! Not that there's anything wrong with that if you really are going to die in the next few... but you will be harvested if they THINK you are going to die in the next few... Many do/would not!

What about - ?

[Black Parrot]

How do the doctors know that the, uhm, donor, doesn't have a condition that will make the organ bad news for the recipient?

Re:What about - ?

[SuricouRaven]

A check of medical records, and standard blood tests for all the testable diseases that might be transmitted. You can't be absolutely sure - it's always possible the donor picked up HIV on a one-night-stand a month ago and didn't tell anyone, and isn't yet carrying enough virus to show on the test. But you can get the risk down to an acceptable level: That is, the risk of dying from disease via donation is less than the risk of dying through not having an organ.

Re:What about - ?

[fbobraga]

How do the doctors know that the, uhm, donor, doesn't have a condition that will make the organ bad news for the recipient?

medical examination (including test's results)?

Re:The reason opt-in does not work

[mysidia]

Opt-in does not work because it is opt-in for donating. It should be opt-in for both donating and receiving at the same time.

I think you're on the right track to suggest Provide an incentive for opting in.

However, I am in disagreement about excluding those who Opt-Out from receiving.
The purpose of organ donation is to save lives, and we should save as many lives as possible, PERIOD.

I would however suggest a few possible incentives:

    (1) A cash payment while you are alive for agreeing to be a donor:

              (a) A $20US non-refundable credit against your taxes for every year that you are signed up. This doesn't necessarily mean the government's giving up money..... they can levy an extra $20/Year tax on your health insurance before offering you this credit.

              (b) When you donate to a non-family member without other consideration: A $500US individual tax credit, for every year, for the rest of your life, if you make a donation such as an un-needed Kidney when you are alive.
                        Multiply by the number of categories donated from these 3 things: (Kidney, Liver nodes, Stem cells).

              (c) After making any actual donation, priority placement on donor lists, waiver of fees, if you ever have problems later.

    (2) If you require an organ; An 'Organ receipt' fee to be charged to you after you complete the operation used to fund the donor registry; A portion of the fee will be discounted if you signed up as an Organ Donor.

Re:life insurance

[fredgiblet]

Suicide is usually not covered.

Can I at least specify ...

[PPH]

... what kind of sauce I'd like my organs served with?

Re:Can I at least specify ...

[Zocalo]

Whoever gets my liver also gets some fava beans and a nice chianti.

Yes, it has happened

[Anonymous Coward]

In Germany https://www.google.com/amp/s/amp.theguardian.com/world/2013/jan/09/mass-donor-organ-fraud-germany and it wasn't a one-off either.

In California https://www.google.com/amp/people.com/archive/organ-donation-did-a-doctor-speed-a-patients-death-vol-69-no-17/amp/

In New York https://www.google.com/amp/nypost.com/2012/09/26/organs-taken-from-patients-that-doctors-were-pressured-to-declare-brain-dead-suit/amp/

Re:life insurance

[Motherfucking Shit]

It's often covered, beginning 2 years after you start the policy. The waiting period is an effective hedge against hasty decisions.

Re: The reason opt-in does not work

[jabuzz]

Sorry if you are not willing to donate then what moral right do you have to receive? Basically none.

Re:Dies? Guess again!

[DonaId Trump]

He's right, folks! The global elite doctors harvested my brain, believe me.

huge organ

[PopeRatzo]

You want my organ, come and get it.

https://lh3.googleusercontent....

More than you might imagine

[Okian Warrior]

While I'm sure this is a concern for some people, I'm questioning whether its a realistic concern.

The book "Death to Dust" (by an MD, and which is fascinating, BTW) examines this point in detail.

He comments that there is no certain method to certify being dead. Absent massive bodily damage we can't determine true death with any certainty.

There are many cases where the patient has no perceptible breathing or heart rhythm, but wakes up at a later time - in some cases living years longer.

The book refers to a study of Civil War coffins which were moved to a different cemetery, where they studied the buried corpses, and noted some 7% (IIRC) showed indications of having woken up after burial, such as scratches on the inside of the coffin.

Those corpses were buried in a time before embalming, and given the proportion of *those* burials who had severe traumatic damage due to the civil war, the proportion of dead with *no* traumatic damage who wake up inside a coffin would be proportionally higher.

Being pronounced dead when you're not actually dead appears to be more likely than one would imagine, at first glance.

Re: More than you might imagine

[ilctoh]

There's also a growing body of research, conducting much more recently than the Civil War, which does indicate clear signs that a patient is in fact dead and damn near 100% unlikely to "wake up."

Re:More than you might imagine

[ilctoh]

There are many cases where the patient has no perceptible breathing or heart rhythm, but wakes up at a later time - in some cases living years longer.

Many cases? There's a small handful of anomalies whose stories get retold because they are so bizarre... but that's just statistical noise compared to the billions of humans who have died, and stayed that way.

Death is something that happens with a great deal of regularity, there's actually quite a bit of research done to correlate various medical interventions with survival rates... Obviously assessment techniques and record keeping have both improved considerably since the Civil War days. I don't think what you're citing here is a substitute for actual evidence-based research.

Re:no penalty if they ignore your opt-out

[nospam007]

"and then claim they assumed you had not opted out because they "couldn't find" an opt-out record for you?"

For the paranoids, I offer a 'Not an organ donor!" tattoo for your sternum for only $99.99

This is normal in Europe

[Anonymous Coward]

I am actually amazed by the comments here.
I live in Austria and we have had opt out for a veeery long time and it is no issue at all.
We only use the nickname "organ donors" for motorbikers as a joke.

You can still choose not to donate and can communicate that intent in various ways(also informally).
Examples:
* register in a government database that is restricted to only this opt outs
* carry a signed piece of paper that says something like "i dont want to donate my organs"
* your family "testifies" that you wish your organs not to be donated

A few comments that i read here stated that people are concerned about doctors not helping a patient because his organs can be used as transplants.
There are two arguments that might help alleviate your concerns:
1: Because of the opt out system there are a lot of potential donors. This means there is no need to create artificial supply.
2: Patients are only considered for organ extraction if doctors determine through a fixed set of rules and procedures that they are brain dead.

Furthermore, the transplant receiver is determined by a waiting list created by fixed rules and managed by the independent non-profit Eurotransplant https://www.eurotransplant.org/.

Re:This is normal in Europe

[fbobraga]

here in Brazil too (I don't know the situation of the rest of Latin America, tough...): I think almost all of the "strange" comments comes from a single country (that thinks is going to be "great again"!)

Blatant violation of the individual's rights

[Damouze]

Especially the right to the integrity of one's body.

Death has now become a taxable event and one's organs are the fee.

Re:Blatant violation of the individual's rights

[SuricouRaven]

You can't call organs a fee when they have zero value to the donor, on account of the donor being dead. It's just taking from them something that they no longer have any use for, and giving it to someone who has a very dire need.

If you have the ability to save the life of one person, possibly more, and you refuse to do so for no other reason than sentimental attachment or superstition, then you bear responsibility for the consequences of this inaction. So I am entirely wiling to see any number of corpses mangled in order to benefit those still alive. At the end of the day, they are just bags of spare parts.

Re:Blatant violation of the individual's rights

[OrangeTide]

My heirs should be able to collect the proceeds of my body.

Re:Blatant violation of the individual's rights

[fbobraga]

"Socialist fucks! Commies! Red danger!" ("American", right?)

Re:Blatant violation of the individual's rights

[The-Ixian]

You can't call organs a fee when they have zero value to the donor, on account of the donor being dead. It's just taking from them something that they no longer have any use for, and giving it to someone who has a very dire need and has the money to pay for it.

I unticked the "donor" box on my DL renewal a long time ago after I realized that organs only go to wealthy people.

Re:Blatant violation of the individual's rights

[dywolf]

libertarians believe in screwing over all of society in the name of freedumb.
so naturally he would refuse.

Re:Blatant violation of the individual's rights

[The-Ixian]

I should rephrase, organs do not go to poor people. Wealthy is a relative term. I consider any "middle class" person to be wealthy in this context. For example, a homeless person would never be considered a viable organ recipient.

Re:Blatant violation of the individual's rights

[SuricouRaven]

And what is your alternative?

"I could save your life at no cost to myself, but I don't actually have to, so fuck you."

Re:no penalty if they ignore your opt-out

[fahrbot-bot]

"and then claim they assumed you had not opted out because they "couldn't find" an opt-out record for you?"

For the paranoids, I offer a 'Not an organ donor!" tattoo for your sternum for only $99.99

Just don't give those to people who ride motorcycles w/o a helmet 'cause it can cause a paradox in the space-time continuum.

Re:Can you imagine

[jordanjay29]

If you lower that age to 40, you'd be closer to the money.

Re:surrender your organs!

[Anonymous Coward]

At least France takes them after you're dead, not like China...

Re:no penalty if they ignore your opt-out

[Opportunist]

If you're that paranoid, at least also come to the conclusion that it would be easy for a hospital to forge an opt-in.

doctors can't take organs of minors

[v1nce29]

without the written authorization of the 2 parents.

Re: The reason opt-in does not work

[Etcetera]

Sorry if you are not willing to donate then what moral right do you have to receive? Basically none.

Not sure you really want to go there... unless you're willing to renounce ER regulations about serving the indigent who don't pay any taxes.

no this did not happen

[v1nce29]

not in France at least. Or link...

organs and operations are free

[v1nce29]

operation is paid by hospital that will transplant the organ

Re:organs and operations are free

[Jack9]

> operation is paid by hospital

Or insurance. In the US, it's always an insurance company. The idea that a hospital/caregiver cares more about an organ than a patient, is economic suicide for multiple parties, with even the appearance of impropriety. It's laughable to see this discussion blow up because of studies in other countries. Insurance company decisions, in regards to long-term care and super-expensive procedures, is closely scrutinized in the US.

Not harvesting

[netean]

Any discussion about this topic should NOT talk about organ "Harvesting". It is NOT harvesting, it's recycling and reusing something that you no longer have any need of.

Comment removed

[account_deleted]

Comment removed based on user account deletion

Don't do it

[WaffleMonster]

I'll happily become an organ donor as soon as there is process in place to deny hospitals any and all financial incentive arising from harvesting organs. Until then call me a conspiracy theorist until your blue in the face betting against human nature or thinking doctors are goddamn saints having your best interests at heart.

Look at all the people addicted to prescription drugs in recent history. What changed? Who the heck do you think keeps prescribing all of this shit? Receptionists? Why are all the pharma sales reps always young chicks that just happen to be as hot as hell? How is this even an industry let alone a multi-billion dollar one to begin with? How does this serve the best interests of the patient? Numerous studies indicating widespread instances hospitals pressuring doctors to be profitable by forcing them to cut corners to cover for unsafe staffing levels to ordering tests or procedures they believe to be unnecessary or redundant to profit based discharge and admitting criteria. You would be hard pressed to find a hospital anywhere in the US where those involved in providing care would not admit to being forced to act in ways that go against their training to accommodate pressures of their job. Ask anyone you know who works in the field. A doctor a nurse...anyone and see what the they tell you or just lookup the stats showing 100k hospital deaths/year due to preventable errors. Hospitals are not run as bastions of humanity helping others they are businesses looking for profit the same as any other commercial enterprise.

I deal with enough assholes in my own family who openly root for death of relatives so they can cash in on inheritance. People are inherently scum. The only way to keep them in line is not to incentivize them to do scummy things. Organ donation is too big a carrot... one that can easily be addressed by structures to prevent people from devolving into scum.

I don't know of anyone who refuses to donate because they care what happens to their organs or some religious/philosophical bullshit... everyone I've spoken to refuse because they are human and they know enough about human behavior to fear being looked at as a profit center rather than a patient... You can strongly disagree and say I'm and everyone who thinks like me is full of shit...but you'll never change my mind nor will you be able to explain why structurally such a conflict of interest even needs to exist in the first place. If it is really about helping people this should be a no-brainer and everyone should be on board with structurally doing what is necessary to make it a reality. The little that does exist such as NOTA has effectively been bypassed/ignored with impunity.

Re:Don't do it

[fbobraga]

hurry! get the tinfoil hats you two!

Re: Don't do it

[fbobraga]

That's their worry, Anonymous Coward :P

Soylent Green

[OrangeTide]

This is how we get to legalizing soylent green.

Re:Soylent Green

[fbobraga]

What a shitty movie!

Re:Soylent Green

[OrangeTide]

Sometimes terrible movies are the most quotable.

"It's because of men like you that all must be destroyed." -- Eros, Plan 9 from Outer Space

"Ill never let go Jack, I'll never let go." -- Titanic (Minutes later she lets him drop into the bottom of the ocean.)

"“No! Not the bees! Nooooo! Not the bees! My eyes! Arghhhhhhh! Arghhhhhh! Arghhhhhh!" - The Wicker Man

Re:so children are fucked, right?

[OrangeTide]

infant mortality is so low that I can't imagine it being a significant problem.

Re: Smart. Overriding the emotions of the bereave

[OrangeTide]

Why should those lives be saved? I'm serious.

Because we can.

Re: The reason opt-in does not work

[mysidia]

Sorry if you are not willing to donate then what moral right do you have to receive?

It's not a question of rights. Opting in to donate in the past doesn't give you any right either. Prioritizing people with less need than others based on administrative criteria over people with greater need would reduce the number of lives saved and reduce the value of organ donation.

There's a fundamental principle that Mercy is a virtue; medical centers care for the sick and try to save the dying, And past deeds are not a factor; there is always a chance for reform.

Assuming you're able to procure payment for the procedure; you can be a Lowly tradesman,
or a Twice-convicted Burglar, or Rapist in the past, and it doesn't even matter, doctors have sworn to try to save your life all the same, Because the life is still precious, And you should actually have an equal priority Versus Bill Gates, Donald Trump, Barrack Obama, etc,
receiving an organ donation, assuming the both of you developed the same extent of medical need.

Re:no penalty if they ignore your opt-out

[mysidia]

then over the next 10 years the death rate in France will not decrease as much as in otherwise comparable countries which still require opt-in.

Actually.... this signal is likely to become distorted. Doing Opt-Out Is likely to result in more donations and legitimate lives saved from bonafide deaths as well.

That is small comfort, however, for additional people that actually die as a result of malfeasance with organ harvesting.
This is a Risk to Individuals. Even in the malfeasance case or unethical donations case, the Total Number of Lives saved is likely higher by more organ donations, because when organs to transplant are scarce, each person dying and successfully donating organs saves multiple lives.

hasten your death and then claim they assumed you had not opted out because they "couldn't find" an opt-out record for you?

"Our computer system was down, or hacked by ransomware", Or "Due to a technical error, their Opt-Out was accidentally missed, And we had to harvest the organs immediately, or they would become non-viable".......
"We've already implanted the Heart and Lungs in other people, They'll die if we take them back, what are you going to do, try and get a court order to kill?"

Re:no penalty if they ignore your opt-out

[mysidia]

For the paranoids, I offer a 'Not an organ donor!" tattoo for your sternum for only $99.99

They screwed up and only saw the "Organ Donor" part, Or after 'accidentally' harvesting the organs, they painted over the "Not an" part of the Tattoo or took out that bit of skin to conceal what was there.

You say that as though it's ok with lefties

[NotSoHeavyD3]

Unfortunately SCNT, IE therapeutic cloning, requires quite a bit of genetic engineering to pull off and last I checked genetically modified anything gets heavy resistance from the left. (Funny how both sides have a streak of naturalism running through them.)

Re:You say that as though it's ok with lefties

[AutodidactLabrat]

No.
The left is resisting GMO FOOD, not medicine
Once again, the reality does not match the statement.

Makes sense

[manu0601]

It makes some sense: when I am alive, my family do not own my body. Why should it be different once I am dead?

Re:Makes sense

[stdarg]

So are you against inheritance in general? "When I am alive, my kids don't own my 401k, car, house, etc. Why should it be different once I am dead?"

Re:Makes sense

[manu0601]

Human dead bodies are not a common good you inherit. If we look it that way, we quickly see contradictions: you would own it but without the right to resell it?

Re:Makes sense

[stdarg]

I'd guess that one of the reasons we don't inherit bodies is that traditionally they have no economic value in our society. Because of modern medicine, now they do. If people ever widely accept the idea of compensating organ donors (which I think is growing.. look at egg donation, it's pretty well compensated in the US), I think it'll be a natural consequence that a person's organs go to his estate upon death.

Fuck donations, why am I not allowed to sell them?

[Anonymous Coward]

Fuck donations, why am I not allowed to sell my organs if I die? My family should be able to get the proceeds of any organs that can be harvested.

Part V

[ben_kelley]

Live Organ Transplants
No longer any need for "Can I have your liver then?"

Belgium has the same policy

[vdhaeyere]

Belgium has had the same policy since 1986... https://www.bruxelles.be/artde... Selon la loi belge du 13 juin 1986 régissant les dons d’organes, des organes et des tissus destinés à la transplantation peuvent être prélevés sur le corps de tout belge domicilié en Belgique ainsi que sur ceux des étrangers domiciliés en Belgique depuis plus de 6 mois, excepté s’il est établi qu’une opposition formelle a été exprimée contre un prélèvement.

"Churrasquinho da gente diferenciada"

[fbobraga]

HigienÃpolis is a funny neighborhood in São Paulo, Brazil: people there raise against a Subway Station there!

Re:Pay

[fbobraga]

"Pay" for what, friend AC?

Re: Smart. Overriding the emotions of the bereave

[fbobraga]

Why should those lives be saved?

You really ask this question? (it's obvious only to "socialist shits", right? I bet you are "American"...)

Re:Exceptions will be made, of course

[fbobraga]

religion is a PITA some times...

Re:Broker-friendly hospitals....

[Hognoxious]

I know of cases of organ theft including one in France where a man disappeared for several days and was eventually found on a park bench minus one kidney.

How do you think opt-in/opt-out would have made a difference, assuming it was done by criminals?

That's if it's not an urban myth anyway.

Re:Alistair Sim, the actor who played Scrooge

[fbobraga]

The hospitals would use the bodies for teaching purposes. They would remove the eyeballs remove the internal organs they would practice on the body. They would return the body to the family two years later sometimes even longer.

creepy!

Re:so children are fucked, right?

[fbobraga]

"American", right? (note the quotes: "American" stands for person for a whole fucking continent!) "French people are all socialist shits!", right?

to cut off reflex and other inconvenience

[aepervius]

You can be utterly brain dead, but still have some reflex going in the spinal cord (e.g. lazarus sign : https://en.wikipedia.org/wiki/...). Imagine the doctor cutting skin to harvest an organs, and the body trash. That is why IIRC a paralyticum is given to avoid such inconvenience. And yes if you are brain dead but spinal still working, you are not alive.

Re:Totally ghoulish

[fbobraga]

Doctors make mistakes all the time, or are pressured to declare people "brain dead" in order to meet harvesting quotas.

"US" != "the world", you know...

There are a lot more, but posting space is limited.

it's not that I've known, but if it is, hardly it's minor than 1.000x of the number of characters of your post...

Re:Fuck donations, why am I not allowed to sell th

[fbobraga]

I'm very curious: how you will collect and use the payments?

Re:Socialist Paradise

[fbobraga]

"American" (from US) AC, right? (people from United States: "Americans" are persons living on a whole fucking continent! It annoys me [a Brazilian])

Re: Exceptions will be made, of course

[fbobraga]

OK, and thanks for the answer Anonymous Coward

It's bullshit

[AndyKron]

Presumed consent is bullshit. If the US ever does this I'm going to stop being a donor, which I have been for many years now.

Re:no penalty if they ignore your opt-out

[BarbaraHudson]

"and then claim they assumed you had not opted out because they "couldn't find" an opt-out record for you?"

For the paranoids, I offer a 'Not an organ donor!" tattoo for your sternum for only $99.99

Just don't give those to people who ride motorcycles w/o a helmet 'cause it can cause a paradox in the space-time continuum.

I brought up that subject while in the ER after a motorcycle incident (the city had ripped up the pavement in a curve AND turned off the street lighting), and he agreed it's not the ones who die, but the ones with no helmet who "live", who are really screwed. Not competent enough to refuse treatment so they can die, but aware enough that death is preferable to living.

Re:no penalty if they ignore your opt-out

[BarbaraHudson]

I seriously doubt that if they accidentally harvest your organs that you'll be all that upset about it.

Re:life insurance

[BarbaraHudson]

Actually, in many policies the 2-year exclusion window is now void because it's considered discriminating against a pre-existing condition. Gives the insurers incentive to provide better mental health care coverage so they can avoid the big pay-out from people taking the really really big easy.

Unsurprising Discrepancy

[karlfike6498]

A survey in France previously showed that while up to 80 percent of the population was in favor of donating their own organs, about 40 percent of families refuse when pressed to make the choice.

This is a textbook example of social desirability bias, so it isn't really that surprising.

Re: The reason opt-in does not work

[darnkitten]

This happened in Israel fairly recently: Israel had one of the lowest rates of donation in the world, due to a general perception that Judaism forbade organ donation (it being equated to desecration). There was a long list, however, of people waiting for transplants (as receiving an organ was not forbidden), many deaths per year among those waiting for organs, and a thriving trade in "transplant tourism" among those wealthy enough to afford it.

The Israeli government passed a law that, in essence, said that a person who was a donor received priority over one who wasn't, and a long-time donor received priority over a recent one. Combined with incentives for live donors, including reimbursement for expenses/time off when donating, this "don't give, don't receive" policy has resulted in a steady increase in donor registration, though rates are still lower than in Europe.