4 ms·

It's been like that in Poland for many years now, but in reality this doesn't really work since families are always asked before the donation and they usually r

by sdfhbdf 10y ago

It's been like that in Poland for many years now, but in reality this doesn't really work since families are always asked before the donation and they usually refuse and the law doesn't really expect the doctors to ask the families but they still do it anyway, just to be on the safe side and not have to deal with repercussions like the family suing the doctor.

x1798DE 10y ago
This seems like a perfectly sensible thing to do, honestly. If I were designing the system, I'd say that the default option is opt-out and that if you make an affirmative choice (yes or no) during your lifetime, that choice overrides your family's wishes, but otherwise your family gets a "veto" over your organ donation. The whole problem that "opt-in" organ donation is that most people just do whatever the default is and no actual human decisionmaking takes place, so it's preferable to have sensible defaults. If a human is overriding the default, that's the desired behavior.
- jhasse 10y ago
  Why wouldn't you want to donate your organs though? And especially: Why wouldn't the family want to donate the organs of their relative?
  - jobigoud 10y ago
    That's a different issue. Some people are religious or superstitious, and I guess there are religions against organ donation.
    - ryanlol 10y ago
      Why can't we expect people to have reasonable reasons for their refusal?
      - BugsJustFindMe 10y ago
        Reasonable reasons unrelated to superstition? Name one?
        ryanlol 10y ago
        I can't think of any, but I do strongly believe that anyone who can come up with one should be allowed to keep their organs :)
  - nhaehnle 10y ago
    Some people are afraid that doctors will make less of an effort to keep you alive if you're an organ donor. Knowing doctors I find that fear extremely implausible, but it exists.
  - slv77 10y ago
    Families are typically out of their depth in these situations and completely dependent on medical staff to guide them in decisions regarding their loved one. Medical staff may confront the family with the question of organ donation before they have been able to internalize the decision to withdrawl life support. Without time to internalize the decision to withdraw life support families may feel that allowing organ donation may be bias medical staff and, even subconsciously, tip the scales. Families may be uncomfortable with yielding control of their loved ones body to the medical establishment. The question of organ donation is presented as a binary choice to families (all or nothing) and requires a significant degree of trust in the medical community. They may worry that they are unwittingly consenting to donations of germ cells; that part of their loved one may end up in a student lab or that organ donation may delay a funeral. Families may worry that donation will incur additional costs or that someone will profit from the deceased organs (see Henrietta Lacks and HeLa). Also making an opt-in decision in any complex situation that requires unanimous consent of what is essentially a committee is typically going to result in no-action.
- jobigoud 10y ago
  This would render the whole point moot. Why have a default in the first place if you always require an affirmative choice, either from the person or from the family?
  - ghaff 10y ago
    That is basically the practical problem with an opt out system. Defaults are sufficiently powerful that lack of an opt out can't really (and really shouldn't) be taken as an affirmative choice.
  - x1798DE 10y ago
    Well, ideally yes you'd just enforce an affirmative choice here, but I think the whole point of having an organ donor registry is for time-critical situations like when you can't find someone to ask or when there is not clear person to ask.
marcosdumay 10y ago
This. Is there any place where the de-facto policy isn't to ignore anything on paper and ask the family? I am not sure this change makes any difference.

by sdfhbdf 10y ago

x1798DE 10y ago

This seems like a perfectly sensible thing to do, honestly. If I were designing the system, I'd say that the default option is opt-out and that if you make an affirmative choice (yes or no) during your lifetime, that choice overrides your family's wishes, but otherwise your family gets a "veto" over your organ donation. The whole problem that "opt-in" organ donation is that most people just do whatever the default is and no actual human decisionmaking takes place, so it's preferable to have sensible defaults. If a human is overriding the default, that's the desired behavior.

jhasse 10y ago
Why wouldn't you want to donate your organs though? And especially: Why wouldn't the family want to donate the organs of their relative?
- jobigoud 10y ago
  That's a different issue. Some people are religious or superstitious, and I guess there are religions against organ donation.
  - ryanlol 10y ago
    Why can't we expect people to have reasonable reasons for their refusal?
    - BugsJustFindMe 10y ago
      Reasonable reasons unrelated to superstition? Name one?
      - ryanlol 10y ago
        I can't think of any, but I do strongly believe that anyone who can come up with one should be allowed to keep their organs :)
- nhaehnle 10y ago
  Some people are afraid that doctors will make less of an effort to keep you alive if you're an organ donor. Knowing doctors I find that fear extremely implausible, but it exists.
- slv77 10y ago
  Families are typically out of their depth in these situations and completely dependent on medical staff to guide them in decisions regarding their loved one. Medical staff may confront the family with the question of organ donation before they have been able to internalize the decision to withdrawl life support. Without time to internalize the decision to withdraw life support families may feel that allowing organ donation may be bias medical staff and, even subconsciously, tip the scales. Families may be uncomfortable with yielding control of their loved ones body to the medical establishment. The question of organ donation is presented as a binary choice to families (all or nothing) and requires a significant degree of trust in the medical community. They may worry that they are unwittingly consenting to donations of germ cells; that part of their loved one may end up in a student lab or that organ donation may delay a funeral. Families may worry that donation will incur additional costs or that someone will profit from the deceased organs (see Henrietta Lacks and HeLa). Also making an opt-in decision in any complex situation that requires unanimous consent of what is essentially a committee is typically going to result in no-action.
jobigoud 10y ago
This would render the whole point moot. Why have a default in the first place if you always require an affirmative choice, either from the person or from the family?
- ghaff 10y ago
  That is basically the practical problem with an opt out system. Defaults are sufficiently powerful that lack of an opt out can't really (and really shouldn't) be taken as an affirmative choice.
- x1798DE 10y ago
  Well, ideally yes you'd just enforce an affirmative choice here, but I think the whole point of having an organ donor registry is for time-critical situations like when you can't find someone to ask or when there is not clear person to ask.

marcosdumay 10y ago

This. Is there any place where the de-facto policy isn't to ignore anything on paper and ask the family? I am not sure this change makes any difference.