7 ms·

Not one mention in the article about changing the organ donation system to be opt-out. That is such a wasted opportunity given the huge reach of NPR.

psychometry 6y ago
It absolutely should be opt-out. I also think that if you choose to opt out, you should not be eligible to receive donated organs.
- deleted 6y ago
  [deleted]
- ghastmaster 6y ago
  Do you feel the same way about blood donation/transfusion?
  - cjbprime 6y ago
    That's a trickier case in that giving blood is at least an inconvenience while you're still alive to experience it..
    - ghastmaster 6y ago
      The argument is fundamentally the same. The benefit outweighs the cost by a large margin. There are social and psychological reasons for not donating organs after death that apply to blood donation as well.
      - ceejayoz 6y ago
        Giving blood is low risk, but not risk free. Organ donation at death is entirely risk free to the donor. They have literally nothing to lose from it.
        ghastmaster 6y ago
        Setting aside the few religious exceptions, that is correct. This gets to the root of the issue. Whether the body is property of the family or of the state. I argue for the former. In the USA there has to be compensation for property taken by the state. There also has to be a public good argument in most jurisdictions as far as I know. Because the beneficiary of the organ is not the general public, but an individual, I do not see how this could work without massive revisions to state and federal law.
        ceejayoz 6y ago
        As far as I can tell, dead bodies aren't property in the US. They can't be stolen (although other laws would likely apply), they aren't part of the deceased's estate, etc. http://thelegalgeeks.com/2014/11/13/stealing-corpses-and-obstruction-of-justice/ http://thelegalgeeks.com/2014/11/13/stealing-corpses-and-obs...
        bborud 6y ago
        Aaaand suddenly the discussion took the un-charming turn where suddenly deceased human beings are possibly property.
        aklapa 6y ago
        This is just propaganda, in the recent thread there have been numerous examples that this is not always the case. This is why it is unethical to make it opt-out, but in line with the current mixture of ultra-left materialism and ultra-capitalism.
  - tialaramex 6y ago
    One reason it could be different - your blood is yours now, but your body after death isn't yours any more, it's just a corpse, any residual rights over it should not supersede society's claim on it for the needs of the living. So this would suggest that by Kant's Categorical Imperative it's fine to only use organ donations from the dead as medical treatment on those who agree (or whom society has taken to agree) that their organs could be likewise used, because if you don't want your dead body used what right could you have to do otherwise?
    - caseysoftware 6y ago
      > should not supersede society's claim on it We are not property of the State therefore, society has no claim on it. If we are property of the State then all we're disagreeing on is the moment where their claims supersede our own. The moment of death is a convenient but negotiable/re-definable point: "Well, they're brain dead already.." or "Well, their quality of life.." or "Their chance of survival.." Or to put it another way: Do you want want [your least favorite politician] writing this policy?
      - ceejayoz 6y ago
        As far as I can determine from Googling, under US/UK common law, bodies aren't property at all.
        ghastmaster 6y ago
        I saw your other comment and was surprised to find the same. I had no clue it was like this. The laws are either vague or explicitly prohibit doing much of anything to a corpse outside the normal burial and cremation.
      - ken 6y ago
        > We are not property of the State therefore, society has no claim on it. If we are property of the State then... You're trying to force this into a "We {are|aren't} property of the state". Both sound completely wrong to me, on multiple levels. It's a TypeError. You're applying words in ways that don't match. (You might as well try to convince me that "Beethoven's 5th is either color, or black-and-white". No, those are both wrong. I'm not going to agree with any conclusions you reach starting from either condition.) Humans aren't "property" (of themselves, or anything else). And the state doesn't own something today just because it may own it after your death (e.g., when a person without a will dies, their house may go to the state, but that in no way means their house was "property of the state" while they were alive, and definitely not that all houses are property of the state). > Do you want want [your least favorite politician] writing this policy? Again, that sounds like a fallacy that's trying to goad people into a false choice. I don't want my least favorite politician writing any government policy. There is no framework yet conceived under which a malicious administrator would not be able to cause great harm by instituting a policy of their own design. That doesn't mean all such policies are inherently ill-conceived.
  - ken 6y ago
    I would not withhold blood from anyone who needs it, no matter how much of a jerk they are, but I am leaning towards the (admittedly unpopular) belief that members of society should have an obligation to donate at least a minimal amount on occasion. Blood is a funny case because we have a huge never-ending need for fresh blood, and a great number of people (est. 1/3 to 1/2 the population) are eligible to donate, yet very few do. Globally we're so desperate for supply that, even though the WHO has set a goal of 100% non-paid volunteer donors due to safety concerns, we do still have to pay people, and America sells a lot of blood overseas to all those other countries who are too cautious to pay their donors cash outright. Tons of people are perfectly willing to donate blood. That's not even the problem. In the aftermath of a disaster, blood centers near the disaster area often have so many donors they have to throw some of it away. People are not that afraid of needles, or unwilling to help their fellow humans. They just don't, usually. Living in my developed country with all of its benefits has costs. I pay taxes to help fund the general welfare, and may be called to serve on a jury, or even go fight in a war. Calling on a few people to give blood doesn't sound too onerous to me. I don't claim to have the answer, but I think everyone agrees we can do a lot better than what we've got now.
- liamkinne 6y ago
  Just because you opt out of organ donation doesn’t mean you can’t or haven’t donated an organ while you’re alive.
  - mattigames 6y ago
    Israel did it best, if you opt-out you are still a organ receiver but anyone registered as organ donor on queue has higher priority than you.
    - echelon 6y ago
      That's clever so long as it doesn't impact those who can't donate due to medical issues, eg. auto-immune disorders, cancer, etc.
      - mattigames 6y ago
        Organ donor is an umbrella term, is not determined your organs are actually gonna be used until you die and a doctor assess the quality of your organs -including damage pre-existing conditions-, so you can be legally a "organ donor" even if they none are actually good enough.
      - ceejayoz 6y ago
        Those folks can still donate. Their donations might just not be accepted. The willingness is what's important.
  - bborud 6y ago
    Note that there are more organs than kidneys. The hardest organ to find a donor/recipient pairing for are lungs.
- at_a_remove 6y ago
  You should think more about the edge cases on this one.
MattGaiser 6y ago
> That is such a wasted opportunity given the huge reach of NPR. NPR is a news organization, not a lobby group.
- monadic2 6y ago
  One would think educating their audience would be in their wheelhouse. This isn’t even political.
- trixie_ 6y ago
  They can at least enumerate potential solutions instead of describing a problem and nothing else.
superhuzza 6y ago
Agreed, it's a missed opportunity - Especially considering that organ donation just became opt-in for all of England as of the 20th of may. Seems like a relevant story to tie-in. https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-in-england/ https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-...
SkyBelow 6y ago
Opt out assume consent is the default position which is in general opposed the nature of consent being something given, not something that has to be withheld. I get it is for the greater good, but the mentality and treatment of consent in such a schema means the means aren't as clean. Do the ends justify the means in this case? One option I've heard that sounds better is just force people to make a selection when they apply for a drivers license. Current you can opt in, but if you don't do anything you automatically opt out. Instead, just don't accept the form unless they opt in or out. This means the people who would donate but either miss the form or think they'll eventually sign up later (and never get around to it) are signed up. And, if the ends do justify the means, what about requiring people to be organ donors except for the same exclusions allowed with vaccines? We effectively force vaccines for the greater good and this would be another similar case. Not like the people will miss their organs and as for the family, they won't even know unless you told them as the funeral industry routinely repairing bodies that have gone through far more than an organ donation.
- cjbprime 6y ago
  You're saying "maybe we should avoid saving millions of lives a year because someone might feel really strongly that they don't want to save lives after they die, but not strongly enough to go to the effort of ticking a box on a form". Yes, the ends justify the means. It's, like, one of the foremost global examples of an ends-justify-means cost-benefit change we could make to improve lives.
  - Vinnl 6y ago
    So how do you feel about GP's final paragraph: making donation obligatory?
    - cjbprime 6y ago
      Then the ends are no longer awesome, because people would likely be sad about not having their decisions respected by the rest of society.
ls612 6y ago
I get that argument but I fear that the organ donation system in general can lead to really perverse incentives in some cases. If you show up to the ER alive but on deaths door and the doc knows you will be a good donor will they work as hard to save you?
- ceejayoz 6y ago
  > will they work as hard to save you? Yes.
- grecy 6y ago
  This comes up from time to time as a counter argument to opt-out, and it makes me sick. That ER doc you're talking about has spent their entire life working their fingers to the bone to help others. They are beyond committed and passionate about saving every possible life, even when it's detrimental to their own health. To suggest they might not work hard to save someone right in front of them is insulting and horrible.
  - catalogia 6y ago
    While I'm an organ donor and don't take the supposed risks of that seriously, I don't think your argument is a good one. Not all surgeons are wonderful people. They're only human after all. A simple web search for "surgeon charged with" will reveal that sometimes surgeons do things they shouldn't, just like members of any other profession. How do you square "They are beyond committed and passionate" with surgeons who rape their patients, or knowingly perform unnecessary surgeries out of greed? You can't.
  - csharptwdec19 6y ago
    Orrrrrr maybe just like every other industry we should acknowledge that there are bad actors and/or people who make questionable judgments about the best way to 'help others'? Look at even the mental health profession, where in all cases Doctors are supposed to be 'helping others'. And yet I know that I could never see my housemate's doctor and get the same set of meds that I get seeing mine. We both have very similar conditions, and yet the life outcomes are vastly different in that change in meds. Yet housemate's doc insists they are doing the 'morally right' thing. Edit: FWIW, my interactions with Doctors and Pre-med students outside of the actual medical profesison and the stories I've heard do nothing to help my assessment.
mdavis6890 6y ago
This is far too much power for the govt or healthcare industry to have over people. A lot of people won't know they need to opt-out, and the opt-out can be, or become, very burdensome. I know you want to stop wasting valuable organs from dead people that could go to help living people - and I do too! I just don't want people to lose agency over their own lives and body parts. Then there are the wicked, amoral, heartless people - like me - who think people should be free to sell their organs if they want to. I would personally sell any of my organs (after I'm dead) for $1 each. But as a form of protest against the current system, I won't ever willingly donate them. I hope you'll reconsider.
- mattigames 6y ago
  People lose their agency when they die, after that there is no agency to lose.
- xtreme 6y ago
  While I don't think being able to sell your organs is immoral or unethical, there are practical ramifications that makes it difficult to agree with your position. If organ selling is legalized, poor people will be coerced by force or by money. And they may not realize the full health implications of that until much later, where they have no recourse. As a society, we generally try to prevent people from entering such unfair contracts, e.g, you can't agree to become a slave, or establishing ceiling on interest rates to limit predatory lending. People willing to sell their organs are probably desperate enough to agree to anything, and saving them is worthwhile.
- eeZah7Ux 6y ago
  > Then there are the wicked, amoral, heartless people - like me - who think people should be free to sell their organs if they want to. The act of creating a market for organs is intrinsically morally repugnant. Money are just an tool used by humanity, not the other way around.
- bborud 6y ago
  And I'm sure your little rebellion against The System may feel good, but here's what I think you should do. Go to your nearest dialysis clinic and offer to keep people strapped to a dialysis machine for 5 hours, 3 days per week company. It might occur to you that your childish ideas about "sticking it to the man" is ignorant horseshit.
ghaff 6y ago
Even people like Richard Thaler who favor "nudges" to drive behaviors, have been somewhat skeptical of opt-out [1] in this case. One of the problems is that defaults are so powerful. Therefore, in the case of an emotional decision like organ donation, it's easy for a distraught family to argue that the deceased never made an informed decision. (In the referenced column, Thaler argues for mandated choice, e.g. you have to make a choice when you renew your drivers license.) [1] https://www.nytimes.com/2009/09/27/business/economy/27view.html https://www.nytimes.com/2009/09/27/business/economy/27view.h...
- trixie_ 6y ago
  The choice is there - check this box to opt out of organ donation on your drivers license renewal form.

psychometry 6y ago

It absolutely should be opt-out. I also think that if you choose to opt out, you should not be eligible to receive donated organs.

deleted 6y ago
[deleted]
ghastmaster 6y ago
Do you feel the same way about blood donation/transfusion?
- cjbprime 6y ago
  That's a trickier case in that giving blood is at least an inconvenience while you're still alive to experience it..
  - ghastmaster 6y ago
    The argument is fundamentally the same. The benefit outweighs the cost by a large margin. There are social and psychological reasons for not donating organs after death that apply to blood donation as well.
    - ceejayoz 6y ago
      Giving blood is low risk, but not risk free. Organ donation at death is entirely risk free to the donor. They have literally nothing to lose from it.
      - ghastmaster 6y ago
        Setting aside the few religious exceptions, that is correct. This gets to the root of the issue. Whether the body is property of the family or of the state. I argue for the former. In the USA there has to be compensation for property taken by the state. There also has to be a public good argument in most jurisdictions as far as I know. Because the beneficiary of the organ is not the general public, but an individual, I do not see how this could work without massive revisions to state and federal law.
        ceejayoz 6y ago
        As far as I can tell, dead bodies aren't property in the US. They can't be stolen (although other laws would likely apply), they aren't part of the deceased's estate, etc. http://thelegalgeeks.com/2014/11/13/stealing-corpses-and-obstruction-of-justice/ http://thelegalgeeks.com/2014/11/13/stealing-corpses-and-obs...
        bborud 6y ago
        Aaaand suddenly the discussion took the un-charming turn where suddenly deceased human beings are possibly property.
      - aklapa 6y ago
        This is just propaganda, in the recent thread there have been numerous examples that this is not always the case. This is why it is unethical to make it opt-out, but in line with the current mixture of ultra-left materialism and ultra-capitalism.
- tialaramex 6y ago
  One reason it could be different - your blood is yours now, but your body after death isn't yours any more, it's just a corpse, any residual rights over it should not supersede society's claim on it for the needs of the living. So this would suggest that by Kant's Categorical Imperative it's fine to only use organ donations from the dead as medical treatment on those who agree (or whom society has taken to agree) that their organs could be likewise used, because if you don't want your dead body used what right could you have to do otherwise?
  - caseysoftware 6y ago
    > should not supersede society's claim on it We are not property of the State therefore, society has no claim on it. If we are property of the State then all we're disagreeing on is the moment where their claims supersede our own. The moment of death is a convenient but negotiable/re-definable point: "Well, they're brain dead already.." or "Well, their quality of life.." or "Their chance of survival.." Or to put it another way: Do you want want [your least favorite politician] writing this policy?
    - ceejayoz 6y ago
      As far as I can determine from Googling, under US/UK common law, bodies aren't property at all.
      - ghastmaster 6y ago
        I saw your other comment and was surprised to find the same. I had no clue it was like this. The laws are either vague or explicitly prohibit doing much of anything to a corpse outside the normal burial and cremation.
    - ken 6y ago
      > We are not property of the State therefore, society has no claim on it. If we are property of the State then... You're trying to force this into a "We {are|aren't} property of the state". Both sound completely wrong to me, on multiple levels. It's a TypeError. You're applying words in ways that don't match. (You might as well try to convince me that "Beethoven's 5th is either color, or black-and-white". No, those are both wrong. I'm not going to agree with any conclusions you reach starting from either condition.) Humans aren't "property" (of themselves, or anything else). And the state doesn't own something today just because it may own it after your death (e.g., when a person without a will dies, their house may go to the state, but that in no way means their house was "property of the state" while they were alive, and definitely not that all houses are property of the state). > Do you want want [your least favorite politician] writing this policy? Again, that sounds like a fallacy that's trying to goad people into a false choice. I don't want my least favorite politician writing any government policy. There is no framework yet conceived under which a malicious administrator would not be able to cause great harm by instituting a policy of their own design. That doesn't mean all such policies are inherently ill-conceived.
- ken 6y ago
  I would not withhold blood from anyone who needs it, no matter how much of a jerk they are, but I am leaning towards the (admittedly unpopular) belief that members of society should have an obligation to donate at least a minimal amount on occasion. Blood is a funny case because we have a huge never-ending need for fresh blood, and a great number of people (est. 1/3 to 1/2 the population) are eligible to donate, yet very few do. Globally we're so desperate for supply that, even though the WHO has set a goal of 100% non-paid volunteer donors due to safety concerns, we do still have to pay people, and America sells a lot of blood overseas to all those other countries who are too cautious to pay their donors cash outright. Tons of people are perfectly willing to donate blood. That's not even the problem. In the aftermath of a disaster, blood centers near the disaster area often have so many donors they have to throw some of it away. People are not that afraid of needles, or unwilling to help their fellow humans. They just don't, usually. Living in my developed country with all of its benefits has costs. I pay taxes to help fund the general welfare, and may be called to serve on a jury, or even go fight in a war. Calling on a few people to give blood doesn't sound too onerous to me. I don't claim to have the answer, but I think everyone agrees we can do a lot better than what we've got now.
liamkinne 6y ago
Just because you opt out of organ donation doesn’t mean you can’t or haven’t donated an organ while you’re alive.
- mattigames 6y ago
  Israel did it best, if you opt-out you are still a organ receiver but anyone registered as organ donor on queue has higher priority than you.
  - echelon 6y ago
    That's clever so long as it doesn't impact those who can't donate due to medical issues, eg. auto-immune disorders, cancer, etc.
    - mattigames 6y ago
      Organ donor is an umbrella term, is not determined your organs are actually gonna be used until you die and a doctor assess the quality of your organs -including damage pre-existing conditions-, so you can be legally a "organ donor" even if they none are actually good enough.
    - ceejayoz 6y ago
      Those folks can still donate. Their donations might just not be accepted. The willingness is what's important.
- bborud 6y ago
  Note that there are more organs than kidneys. The hardest organ to find a donor/recipient pairing for are lungs.
at_a_remove 6y ago
You should think more about the edge cases on this one.

MattGaiser 6y ago

> That is such a wasted opportunity given the huge reach of NPR. NPR is a news organization, not a lobby group.

monadic2 6y ago
One would think educating their audience would be in their wheelhouse. This isn’t even political.
trixie_ 6y ago
They can at least enumerate potential solutions instead of describing a problem and nothing else.

superhuzza 6y ago

Agreed, it's a missed opportunity - Especially considering that organ donation just became opt-in for all of England as of the 20th of may. Seems like a relevant story to tie-in. https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-in-england/ https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-...

SkyBelow 6y ago

Opt out assume consent is the default position which is in general opposed the nature of consent being something given, not something that has to be withheld. I get it is for the greater good, but the mentality and treatment of consent in such a schema means the means aren't as clean. Do the ends justify the means in this case? One option I've heard that sounds better is just force people to make a selection when they apply for a drivers license. Current you can opt in, but if you don't do anything you automatically opt out. Instead, just don't accept the form unless they opt in or out. This means the people who would donate but either miss the form or think they'll eventually sign up later (and never get around to it) are signed up. And, if the ends do justify the means, what about requiring people to be organ donors except for the same exclusions allowed with vaccines? We effectively force vaccines for the greater good and this would be another similar case. Not like the people will miss their organs and as for the family, they won't even know unless you told them as the funeral industry routinely repairing bodies that have gone through far more than an organ donation.

cjbprime 6y ago
You're saying "maybe we should avoid saving millions of lives a year because someone might feel really strongly that they don't want to save lives after they die, but not strongly enough to go to the effort of ticking a box on a form". Yes, the ends justify the means. It's, like, one of the foremost global examples of an ends-justify-means cost-benefit change we could make to improve lives.
- Vinnl 6y ago
  So how do you feel about GP's final paragraph: making donation obligatory?
  - cjbprime 6y ago
    Then the ends are no longer awesome, because people would likely be sad about not having their decisions respected by the rest of society.

ls612 6y ago

I get that argument but I fear that the organ donation system in general can lead to really perverse incentives in some cases. If you show up to the ER alive but on deaths door and the doc knows you will be a good donor will they work as hard to save you?

ceejayoz 6y ago
> will they work as hard to save you? Yes.
grecy 6y ago
This comes up from time to time as a counter argument to opt-out, and it makes me sick. That ER doc you're talking about has spent their entire life working their fingers to the bone to help others. They are beyond committed and passionate about saving every possible life, even when it's detrimental to their own health. To suggest they might not work hard to save someone right in front of them is insulting and horrible.
- catalogia 6y ago
  While I'm an organ donor and don't take the supposed risks of that seriously, I don't think your argument is a good one. Not all surgeons are wonderful people. They're only human after all. A simple web search for "surgeon charged with" will reveal that sometimes surgeons do things they shouldn't, just like members of any other profession. How do you square "They are beyond committed and passionate" with surgeons who rape their patients, or knowingly perform unnecessary surgeries out of greed? You can't.
- csharptwdec19 6y ago
  Orrrrrr maybe just like every other industry we should acknowledge that there are bad actors and/or people who make questionable judgments about the best way to 'help others'? Look at even the mental health profession, where in all cases Doctors are supposed to be 'helping others'. And yet I know that I could never see my housemate's doctor and get the same set of meds that I get seeing mine. We both have very similar conditions, and yet the life outcomes are vastly different in that change in meds. Yet housemate's doc insists they are doing the 'morally right' thing. Edit: FWIW, my interactions with Doctors and Pre-med students outside of the actual medical profesison and the stories I've heard do nothing to help my assessment.

mdavis6890 6y ago

This is far too much power for the govt or healthcare industry to have over people. A lot of people won't know they need to opt-out, and the opt-out can be, or become, very burdensome. I know you want to stop wasting valuable organs from dead people that could go to help living people - and I do too! I just don't want people to lose agency over their own lives and body parts. Then there are the wicked, amoral, heartless people - like me - who think people should be free to sell their organs if they want to. I would personally sell any of my organs (after I'm dead) for $1 each. But as a form of protest against the current system, I won't ever willingly donate them. I hope you'll reconsider.

mattigames 6y ago
People lose their agency when they die, after that there is no agency to lose.
xtreme 6y ago
While I don't think being able to sell your organs is immoral or unethical, there are practical ramifications that makes it difficult to agree with your position. If organ selling is legalized, poor people will be coerced by force or by money. And they may not realize the full health implications of that until much later, where they have no recourse. As a society, we generally try to prevent people from entering such unfair contracts, e.g, you can't agree to become a slave, or establishing ceiling on interest rates to limit predatory lending. People willing to sell their organs are probably desperate enough to agree to anything, and saving them is worthwhile.
eeZah7Ux 6y ago
> Then there are the wicked, amoral, heartless people - like me - who think people should be free to sell their organs if they want to. The act of creating a market for organs is intrinsically morally repugnant. Money are just an tool used by humanity, not the other way around.
bborud 6y ago
And I'm sure your little rebellion against The System may feel good, but here's what I think you should do. Go to your nearest dialysis clinic and offer to keep people strapped to a dialysis machine for 5 hours, 3 days per week company. It might occur to you that your childish ideas about "sticking it to the man" is ignorant horseshit.

ghaff 6y ago

Even people like Richard Thaler who favor "nudges" to drive behaviors, have been somewhat skeptical of opt-out [1] in this case. One of the problems is that defaults are so powerful. Therefore, in the case of an emotional decision like organ donation, it's easy for a distraught family to argue that the deceased never made an informed decision. (In the referenced column, Thaler argues for mandated choice, e.g. you have to make a choice when you renew your drivers license.) [1] https://www.nytimes.com/2009/09/27/business/economy/27view.html https://www.nytimes.com/2009/09/27/business/economy/27view.h...

trixie_ 6y ago
The choice is there - check this box to opt out of organ donation on your drivers license renewal form.