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Organ donation in England has moved to an opt-out system
- throwawaysea 6y agoOpt-outs are the new insidious way to impose the state/collectivist views on the individual without permission. Opt outs are a problem because not everyone may be aware of the need to opt out, and it requires additional attention and effort. The default state, without requiring any additional action from an individual, must respect individual consent and bodily autonomy - which means that no one has a right to your body or your property unless you've granted it explicitly. An opt-out situation is not that, and it doesn't matter even if a majority of constituents would prefer an opt-out model. Moreover, the linked website's claim of universal religious support for organ donation is very suspicious. It relies on opinionated interpretation of religious texts and cherry picked quotes of support from random individuals that they've propped up as authoritative representatives of religions, when that is not really the case in reality. Religious ritualistic practices and interpretations of texts vary and there will be many for whom this permissive assumption of the state's right to an individual's organs will be a violation of their beliefs.
- ManoSinkosika 6y agothat is a good step
- amekp 6y agoMore totalitarianism. People are treated like a mixture between children and cattle. https://www.cbsnews.com/news/hospital-errors-lead-to-dead-patient-opening-eyes-during-organ-harvesting/ https://www.cbsnews.com/news/hospital-errors-lead-to-dead-pa...
- KeepFlying 6y agoThe article you linked is a truly horrifying thought. I wonder though if a change like this would reduce those cases in the long term though. If there are more organs available, wouldn't there be less pressure to harvest from any particular person?
- carlinmack 6y agohow is totalitarianism giving the option to opt-out?
- al_chemist 6y ago"If you don't like government ideas, why don't you move somewhere else?" Moving out is the best opt-out ever. (until pandemic hits and you can't move out)
- deleted 6y ago[deleted]
- tobib 6y agoWhile this is a horrifying story, I'm having a hard time seeing the relevance here. There is nothing in the article indicating that the errors were caused by the family agreeing to organ donation.
- ummonk 6y agoHad the family not agreed to organ donation, they wouldn’t have planned to harvest the organs in the first place.
- ncallaway 6y ago"More totalitarianism" Nonsense. Absolute and utter nonsense. There's an opt-out.
- anslq 6y ago> There's an opt-out. That was the spammer's excuse 10 years ago.
- mojzu 6y agoWhat relevance does a 10 year old article from a US hospital have on this UK news? As long as the opt-out is respected I also don't see what's totalitarian about it.
- VikingCoder 6y ago"Medical errors kill almost 100000 Americans a year" [1] You're picking one horror story because it fits your parameters, and pretending it's something to worry about. It's not. Cheers. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117251/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117251/
- anslq 6y agoI'm not aware that a medical procedure is opt-out, I always assumed it was voluntary. Unlike this state mandated organ seizure, if you haven't heard the news and opt-out of yet another thing.
- crooked-v 6y agoThere are about a million other things done to dead bodies that will kill a mistakenly-identified-as-dead person as stone dead as removing an organ, so organ donation specifically doesn't really have a special status here outside of it being potentially the first item on the long checklist.
- VikingCoder 6y agoEmergency procedures are often done without consent. Because patients are often unconscious and cannot give consent. Just like in your story.
- mathieuh 6y agoEngland is not the UK.
- techsupporter 6y agoAnd it's for long-term (more than one year) residents of England, not just citizens. The headline should read something like "As of today, all residents of England are organ donors unless they opt out" or "Organ donation law in England has changed to opt-out model."
- mathieuh 6y agoYeah, @dang what do you think, I live in NI and when I saw this I was surprised, but nope, it’s just someone conflating England and the UK. Health is devolved to the contituent countries here.
- rwbhn 6y agoCurrent title of the linked article: "Organ donation law in England has changed".
- onei 6y agoIt looks like Wales and Scotland already have this policy in place. Northern Ireland does not, but I'm not too surprised given that health is devolved to the government of the country and NI didn't have a government for 3 years. I can't tell if that's still the case.
- elgenie 6y agoThough it has nearly 85% of the UK's population (and organs).
- afarrell 6y agoYay! One less piece of life-administrivia to procrastinate on.
- _threads 6y agoIs this RGPD compliant ?
- arthurcolle 6y agoHow many people will die because their organs get preserved before they actually die?
- jjoonathan 6y agoOoh, I know the answer to this one: zero.
- ummonk 6y agoMeanwhile downthread we have this link where had the patient been slower to recover she would have been killed by organ harvesting. https://www.cbsnews.com/news/hospital-errors-lead-to-dead-patient-opening-eyes-during-organ-harvesting/ https://www.cbsnews.com/news/hospital-errors-lead-to-dead-pa...
- crooked-v 6y agoThat has nothing to do with opt-in or opt-out, just the incompetence of a specific hospital. It's also an article from 2013.
- deleted 6y ago[deleted]
- read_if_gay_ 6y agoIt is related to opt out because now you have to opt out to avoid this. Also not sure why you make it seem like 2013 is the middle ages or something.
- crooked-v 6y ago> now you have to opt out to avoid this There are many more things than organ removal done to dead bodies that would still kill a mistaken-as-dead person extremely dead, just slightly later in the process.
- 6y ago
- mberning 6y agoThe state will harvest your organs upon your death without the consent of you or your family. But scrolling down a webpage is not considered enough “consent” for accepting cookies. What a joke.
- onei 6y agoI have zero problem with whatever usable organs I have remaining going to someone who can make better use of them than my cold, limp corpse. It's not like I have a need for them anymore and it could save at least one person's life. Seems like a no brainer to me. I do have a problem with being tracked wherever I go and my data being sold on to people that have less than pure uses for it. The two things are not the same.
- CSSer 6y ago> Seems like a no brainer to me. I see what you did there.
- mberning 6y agoThat’s great for you. I’m sure you can agree that there are many that do not share your view. Just wait until they harvest organs from somebody and their family throws a fit on religious or other grounds.
- jlebar 6y agoCan we agree that people will be harmed on both sides of this? Like, if organ donation is the default, at the very best, it's extra work for people who want not to donate their organs after death. OTOH if organ donation is not the default, dramatically fewer organs are available to people in need, and many of them will die. How are we supposed to weigh these competing harms?
- tom_ 6y agoA tricky moral conundrum indeed - but I suspect we'll muddle through somehow.
- chanmad29 6y ago"Your family will still be approached and your faith, beliefs and culture will continue to be respected." This seems to be a good move that could help a ton of people in need, while also giving enough wiggle room to families to deny the donation.
- Barrin92 6y agoThis is a great decision. There's been a lot more interest in behavioural economics over the recent years and I remember reading one of Dan Ariety's books about this. The key thing that increases the rate of organ donations dramatically (from 30% to almost unviversal between opt-in and opt-out) is that there's a very significant cost to choice. The more choices people have to make, even if they arrive at desired outcomes, hugely diminishes the chance that they do.
- agilebyte 6y agoDan Ariely
- mft_ 6y agoWhile I totally support the opt-out approach (or indeed, no option to opt out) I wonder if we need a new term - as it doesn’t seem like a ‘donation’. ‘Donation’ implies gift, and also an element of conscious choice, both of which mightn’t apply any more.
- casefields 6y agoI refuse to be a donor. If they want me then make a real donation, say some money towards funeral expenses. I would sign up in a heartbeat. And I've been plenty more altruistic when it comes to tissue donations. About 10 years ago I came up as a match to a stranger through the Be The Match Foundation. I went through the whole process and gave that lady bone marrow. So I'm not just a grubby meanie out for a buck. Everyone else in the chain is getting paid, there's no reason the donor should be left empty handed.
- majormajor 6y agoIf you want change, take action in a way that will matter. Withholding an organ donation in a way that will never be visible to the people at the relevant time isn't it. So some poor sap who needs an organ is gonna get fucked because your "principled" stance against "the system" will keep you from donating? You think they'd have a problem with your estate getting money? You think that marginal additional expense would cause them to be like "welp, better just die then." I wouldn't oppose this "compensate the estate of the donor" idea at all, but to refuse to save lives as a result is insanity, especially because your refusal, and some posts about it on the internet, will amount to 0.
- prennert 6y agoEngland != UK (I don't know what the law in Scotland, Wales and Northern Ireland is, might be that England is just the last of UKs nations to make opt-out standard)
- Silhouette 6y agoOpt-out is the position in Wales already. Scotland is working on it but as far as I'm aware it hasn't completed the required legislative process yet. NI is still opt-in.
- edh649 6y agoApparently it became law in Scotland in July 2019, and will become opt-out in Scotland in March 2021 https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-in-scotland/ https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-...
- Silhouette 6y agoThanks. That does say it received Royal Assent, so the legislative process has indeed finished now, the relevant preovisions just haven't come into effect yet.
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- exabrial 6y agoThis is kinda jacked up
- airstrike 6y agoAs interesting as this is, this seems very political and therefore not really HN material, as you can tell by how quickly the comments have turned to shit
- walshemj 6y agoI don't see many "shit" comments and the whole organ transplant is interesting fore hackers. I did consider using a raspberry pi plus camera cliped to the waste line and a trained ML model to detect problems with peritoneal dialysis
- scollet 6y agoThis is a government source, right? I think if it was from an inflammatory source this comment would be a little appropriate. Regardless, everything is political, if even by its context alone, tech especially.
- airstrike 6y agoSource doesn't matter. It's not HN material
- coronadisaster 6y agoDo you have a better chance of surviving a big accident if you opt out?
- booleandilemma 6y agoNot sure if you're being serious or not - but it is an interesting question. Have there been any studies on survival ratings of donors vs non-donors?
- crooked-v 6y agoThat seems like the kind of thing that would immediately run into confounding factors, such as the potential that people who have dangerous hobbies may be more likely to opt into organ donation because they're more aware of the possibility of death.
- crooked-v 6y agoBroadly speaking, the first responders and emergency room workers providing emergency care neither know nor care about your organ donation preferences. Transplant work is done by separate specialists who only come into the picture after legal death.
- coronadisaster 6y agoThat would be an ideal situation but someone with large amounts of money might be able to change the course of actions and big data probably could make this easier. Let say they scan their blood type, etc, then type in the condition and wait for an answer from the computer for further actions...
- triceratops 6y agoSomeone with an unlimited amount of money wouldn't be keeping an eye on emergency rooms if they desperately needed an organ. There are other places/organizations that will play ball.
- 6y ago
- BlackVanilla 6y agoRegardless of what you think about the decision, the communication here has been poor. As of posting, there is no information on BBC News's front page, the UK's main source of news, as to this rule change or how to opt-out. [1] Likewise, on the UK Government's website's homepage, there is no information on this or information on how to opt-out. [2] I haven't come across a friend or family member who knows this is happening today. Regardless of your view on this, the communication has been poor. It was publicised when Wales moved to opt-out organ donation. [1] https://www.bbc.co.uk/news https://www.bbc.co.uk/news [2] https://www.gov.uk/ https://www.gov.uk/
- ryanmarsh 6y agoUncomfortable news has a way of doing that.
- jonny_eh 6y agoIn this case, the poor communication should result in more lives being saved.
- cameronbrown 6y agoAre you kidding me? People should have the right to make an informed choice, however they feel about it.
- jonny_eh 6y agoDid it ever make the front-page of a paper that you could opt-in? Why was that not a scandal?
- cameronbrown 6y agoIt's widely known that the NHS needs organ doners. That itself is not the issue for me, the new status quo of the state having the right to harvest my organs is. How are targeted ads and Facebook notifications _opt in_, but this isn't??
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- _jal 6y agoI support "motivated opt-in": your choice, but if you don't opt-in, you're at the end of the line for any organ needs you may find yourself with. It tends to align nicely with ethical and religious objections as well as moral intuitions, and should expand supply while signaling proper expectations to the demand side, without simply allowing the rich to buy their way to the front of the line.
- jonny_eh 6y agoIn that case, I support "unmotivated opt-out". If you opt-out, you don't get an organ if you need one.
- triceratops 6y agoThat's not right. If there's an organ available and a recipient in need, it should be used rather than wasted. Regardless of the recipient's donor status. But donor status can be used as a tie-breaker.
- jonny_eh 6y agoMy comment was meant to be absurd, as a counter-argument. Nearly every argument against opt-out can be turned back against itself in this way.
- _jal 6y agoTo be clear, I wasn't arguing against the British out-out approach; it seems mostly OK, too, and it is silly to make the perfect the enemy of the good. There are different colors to different approaches, and they're going to have varying degrees of success in different cultures.
- balfirevic 6y agoKeep in mind that for many kinds of organ transplants, you will know in advance that you have a good chance of needing one, without actually needing it yet.
- A4ET8a8uTh0 6y agoEh, I guess here comes an unpopular opinion. While the pragmatist in me is well aware of how opt-in increases donations ( although at certain point the question has to be asked whether if they coerced through law, is donation the right term for that ), I instinctively dislike government imposition here. I do not believe ends justifies the means. And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
- bassman9000 6y agoAlready happening in this thread https://news.ycombinator.com/item?id=23252408 https://news.ycombinator.com/item?id=23252408 The next step is shaming those who opt-out. Which will then cement the ownership of the state over your organs. Edit: and more: https://news.ycombinator.com/item?id=23252636 https://news.ycombinator.com/item?id=23252636
- ch4s3 6y agoWould you prefer your next of kin be allowed to sell them instead?
- bassman9000 6y agoStrawman. I would prefer opt-in.
- vkou 6y agoI would happily support the privilege of people to opt out of organ donations, as long as they are willing to irrevocably forego being the beneficiaries of an organ transplant. Or hell, at that point, I'd happily make it opt-in.
- yongjik 6y agoI'm not so sure about that. I can easily imagine misguided parents angrily opting their children out - it would be cruel to deny transplant to these kids just because their parents are, well, not so bright.
- bassman9000 6y agoI'm an organ donor. Opted in. If living in England, would now opt out. The de-facto approach can't be your organs belong to the NHS.
- saberdancer 6y agoIt's not uncommon in other countries. In reality, no one takes your organs without strict approval from your family, but this kind of policy makes it easier for them to get the approval as you did not need to opt in before your death.
- rootusrootus 6y agoIf they have to get permission from your family anyway, then why bother with asking the donor at all? Just always ask the family and be done with it.
- crooked-v 6y agoThe difference here is that they're now asking the family if they have objections to the organs being donated, rather than asking the family if they want to donate the organs. The latter results in fewer organs available even though in logical terms it's the same question.
- saberdancer 6y agoI'm not expert of the legalities, but is it legal to take your organs if you did not opt in? Can your family opt in after your death? I'd say it's a difficult question and obviously made easier by making it opt out system. Anyone objecting has to opt out so majority of people will stay default which improves organ donation rates.
- teruakohatu 6y agoIf living in England would you also refuse an organ if you had just hours to live? Be honest.
- stuartd 6y agoI’m an opt-in donor, always have been. And I think this change is good, albeit poorly communicated. Some ammunition for those who disagree - organlegging! http://www.technovelgy.com/ct/content.asp?Bnum=337 http://www.technovelgy.com/ct/content.asp?Bnum=337
- Traster 6y agoI'm also an opt-in donor. I would've been in favour of postponing this change by a year. It was impossible to communicate this to the public effectively in the middle of a crisis, and whilst I think people should be donors and agree with it being opt-in, I think it's pretty shifty to do it at a time where it's very likely people aren't going to be able to make an informed decision.
- TheRealPomax 6y agoWhy is this on the front page of a tech news aggregator? Sure, everyone has an opinion on this, but why _here_ instead of some subreddit? (and then making it to reddit front page, which is topic-agnostic)
- yndoendo 6y agoLibertarian paternalism. Where the default is set to be the most beneficial. Another example is you get a raise at work and instead of going into your pocket by default goes into your retirement. You still have the ability to change it. Nudge by Thaler and Sunstein talk about this and so does Daniel Kahneman in Thinking, Fast and Slow. This mentality has actually helped other countries save more lives by default. While each person still retains the power to opt-out. And yes other countries have done this before the UK. US should do this too!
- mathieuh 6y agoHow are those two things in any way the same?
- crooked-v 6y agoThey make the default behavior something that benefits most people (everyone's better off if old people have enough money to exit the job market gracefully, for example), while still making it easy to act otherwise if someone specifically wants to do so.
- throwawaysea 6y agoThe "libertarian" bit should be respected if we're talking about modifying choice architectures. When life is full of various burdens, when people are busy, when information may not readily reach everyone, things are different. People may simply need to know that they even need to be on the lookout for something like this, because assumed consent and assumed right to your body seems unconscionable to many.
- ray991 6y agoThe opt-out form [0] asks only for the name, phone number, DOB, address, email, etc. How do they ensure that someone else did not opt-out or opt-in on someone else’s behalf without their permission? And how are they deduplicating people with the same name and DOB? By a fuzzy match against their address? How do these things usually work in UK? [0]: https://www.organdonation.nhs.uk/register-your-decision/refuse-to-donate/refuse-donation-form/ https://www.organdonation.nhs.uk/register-your-decision/refu...?
- SXX 6y agoIt's just a guess for this exact case, but UK government do have some access to credit history and this usually mean name plus dob plus address. And it's can use electoral roll databases for actual citizens.
- davidw 6y agoNo one has posted this yet? Feels kind of necessary... https://www.youtube.com/watch?v=Sp-pU8TFsg0 https://www.youtube.com/watch?v=Sp-pU8TFsg0
- caseysoftware 6y agoThat means when you die, you drop loot. - not my joke, forgot where I saw it
- al_chemist 6y agoIncreased loot rate usually increases farming.
- zeristor 6y ago“Mr Cohen? We’ve come for your liver” - Monty Python: The Meaning of Life https://youtube.com/watch?v=Sp-pU8TFsg0 https://youtube.com/watch?v=Sp-pU8TFsg0
- ap77 6y agoFirst, the lack of a public vote on this issue is troubling. Second, it's inappropriate for a state agency to make such personal decisions on behalf of people without asking. Choice matters, and it's each individual's choice to make. Finally, was this even necessary? Why not simply ask the family at the time of death? If there's no surviving family, THEN the state decides. Last, not first.
- Fnoord 6y ago> First, the lack of a public vote on this issue is troubling. Not like every law in the UK gets some kind of referendum first. There are tons of laws which have been introduced which affect me, where I did not get a vote at. That's a problem with our democratic systems, and how the ruler's of one country affect the lives of others (e.g. via threat of war, diseases/epidemics, economy, and so on and so forth).
- 11thEarlOfMar 6y agoSince when is it Ok to exploit the uninformed?
- LargoLasskhyfv 6y agoIMO this is an institutionalised form of cannibalism, and while it may help some people in need of an organ donation, setting the wrong incentive. By that i mean relieving of the pressure to develop truly compatible artificial replacement parts, no matter if they are "grown" on some substrate, or completely mechanical, not having to take immunosupressors afterwards, and so on. Crude & Backwards.
- dennis_jeeves 6y agoFully agree. It's one of those things which will have terrible unintended consequences, even if the supposed intent is good. It sure will be a boost to the organ trade.
- tonycoco 6y agoThis might be the world's worst "unsubscribe" button ever.
- cmdshiftf4 6y agoThe mental gymnastics statists perform to justify the actions of their beloved state never fails to amaze.
- ayaa 6y agoIt is indeed sad that we live in an age with barely any humanistic ideals. Everything is utilitarian, people belong to the wealthy and the ruling classes, swallow the manufactured consent and believe the propaganda that they are free. Actual personhood is for the 1%, it would be instructive to know how many of them opt out in the UK. Then again, the geriatric ruling class who think that they possess other people's bodies can safely do nothing: Their organs are not fit to be harvested anyway.
- vinni2 6y agoWhat I don’t understand is while they can make everyone organ donors by default, blood donation is still restricted for men having sex with men (with temporary restrictions to blanket ban in many countries). I have heard of blood banks refusing to take blood from gay men (including doctors) who abstained for whatever restrictions they have. If they test the blood before transfusion I don’t understand the need to discriminate.
- jcrawfordor 6y agoBlood for transfusion is screened principally using antibody tests. These tests can be negative for up to two months for an HIV-infected person and even longer in the case of Hep-C (retest at six months recommended to rule in/out). So, while the antibody tests used today have a very low false-negative rate, there remains a concern around people who may have contracted a blood-borne disease in the the last few months. As a gay man, I was for some time frustrated with donor exclusion policies related to MSM. However, keep in mind - blood donation is not any benefit to the donor, but rather to the recipient. It is in the best interest of the recipient for blood banks to obtain blood with the lowest risk of infection. For this reason, blood banks exclude a wide variety of donors with elevated risks of various infectious disease (MSM, IV drug user, in the UK in a certain time period, deployed overseas by military, etc depending on the organization). The number of people not excluded by these policies is normally sufficient to meet need, so it makes perfect sense for the blood banks to stick to a policy designed "out of an excess of caution" to avoid blood with higher risk of infectious disease. Because of improved accuracy and affordability of antibody testing, the exclusion period for MSM was reduced to 12 months (from lifetime). Because of an abnormal blood shortage related to COVID-19, FDA has temporarily reduced the exclusion for MSM and individuals with tattoos/piercings to 3 months. 3 months is actually cutting it somewhat close as far as reliable detection of antibodies, so the period will likely be increased again post-crisis to maintain a wide margin of safety. Organs are evaluated for suitability based on guidelines that are similar to, and often stricter than, blood donation.
- vinni2 6y agoThe 3 months or 12 months deferral in reality is useless. As I said there are many documented instances where people abstained for 3 months and the blood banks still turned them down and Gay people with coronavirus antibodies are not eligible to donate too [0]. In [0] they also make good arguments on why the ban should be lifted. And people like me who are monogamous gay relationship feel discriminated and who expects not to have sex with their spouse for 3 months? [0] https://m.youtube.com/watch?v=DLtpWaIzQ8U https://m.youtube.com/watch?v=DLtpWaIzQ8U
- dntbnmpls 6y agoThink about what this means, your body by default belongs to the state. You are born as state property, not an individual with bodily autonomy and rights. You have to ask for that right. This kind of sick mentality has crossed the atlantic into america with more "liberals" demanding opt out. What's striking is that the "liberals" who scream about consent are the same ones who want to take it away from individuals. The same ones who scream "my body, my choice" are happy to take that choice from individuals and give it to the state. So this is no longer organ donation. It's organ confiscation/theft. Of course the state media which rants about china's "organ theft" are all supportive of this.
- Markoff 6y agoin those few countries with opt-out system I'm familiar with, they still ask for family's approval regardless opt-out system and can't imagine anyone would disrespect wish of family despite the law so in the end the difference is just in theory and law