4 ms·

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 bu

by 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.
- eganist 6y ago
  > To suggest they might not work hard to save someone right in front of them is insulting and horrible. Counter-argument in the form of a question: does one life matter as much as (or more than) three or four that might be saved from that one life's organs? Especially if the one that's clinging to life might've ended up in that position as a consequence of their own actions, such as by way of an at-fault car crash? I'd argue that the doctor's responsibility is to save any life presented to them regardless of how, but I won't put it past anyone to do the calculus above. (this may appear to meet the textbook definition of a strawman argument, but I'd venture that this is--by virtue of how many organs can come from one person--a real enough possibility to warrant consideration)
  - grecy 6y ago
    Of course, organ donation is far from a guarantee. There are a lot of complications and challenges, and it's major surgery.
    - eganist 6y ago
      No disagreement at all. Coming back to the calculus performed: if the odds of survival are much less than certain, what's the point at which a doctor, thinking algorithmically rather than with a mission, decides that there's more value in lives saved from a patient's organs than in trying to save the primary patient and potentially losing organ viability (or just time) if the mission fails? I'm pretty certain the vast majority of doctors will obey the Hippocratic Oath as intended. I'm also somewhat certain that a minority subset of doctors will interpret the Oath differently than others, and this is the most impossible assertion to falsify because very few surgeons/teams will admit this short of a certifiably anonymous survey... if that.
mattigames 6y ago
...they work as hard to save convicted pedophiles don't think their incentives will change for donors.
tobylane 6y ago
As well as the great reasons already given, they don’t know what your donor status is or the quality of your organs. Your family still has the right to deny harvesting. Wales switched to opt out a few years ago and the rest of the UK is changing now.
shkkmo 6y ago
The organ donation does lead to perverse incentives, though cases of ER malpractice of the sort you describe are so exceedingly rare that any steps you take to solve this will save more live by being primarily focused on alleviating people's fear rather than reducing the minuscule number of actual cases. The real issues of perverse incentives having a significant impact has to do more with for-profit companies that participate in the market for body parts and the state of interdependence that now exists with our understaffed medical examiners. There are far more cases of aggressive organ harvesting interfering with criminal investigations than ER doctors letting people die to collect the organs.

by ls612 6y ago

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.
eganist 6y ago
> To suggest they might not work hard to save someone right in front of them is insulting and horrible. Counter-argument in the form of a question: does one life matter as much as (or more than) three or four that might be saved from that one life's organs? Especially if the one that's clinging to life might've ended up in that position as a consequence of their own actions, such as by way of an at-fault car crash? I'd argue that the doctor's responsibility is to save any life presented to them regardless of how, but I won't put it past anyone to do the calculus above. (this may appear to meet the textbook definition of a strawman argument, but I'd venture that this is--by virtue of how many organs can come from one person--a real enough possibility to warrant consideration)
- grecy 6y ago
  Of course, organ donation is far from a guarantee. There are a lot of complications and challenges, and it's major surgery.
  - eganist 6y ago
    No disagreement at all. Coming back to the calculus performed: if the odds of survival are much less than certain, what's the point at which a doctor, thinking algorithmically rather than with a mission, decides that there's more value in lives saved from a patient's organs than in trying to save the primary patient and potentially losing organ viability (or just time) if the mission fails? I'm pretty certain the vast majority of doctors will obey the Hippocratic Oath as intended. I'm also somewhat certain that a minority subset of doctors will interpret the Oath differently than others, and this is the most impossible assertion to falsify because very few surgeons/teams will admit this short of a certifiably anonymous survey... if that.

mattigames 6y ago

...they work as hard to save convicted pedophiles don't think their incentives will change for donors.

tobylane 6y ago

As well as the great reasons already given, they don’t know what your donor status is or the quality of your organs. Your family still has the right to deny harvesting. Wales switched to opt out a few years ago and the rest of the UK is changing now.

shkkmo 6y ago

The organ donation does lead to perverse incentives, though cases of ER malpractice of the sort you describe are so exceedingly rare that any steps you take to solve this will save more live by being primarily focused on alleviating people's fear rather than reducing the minuscule number of actual cases. The real issues of perverse incentives having a significant impact has to do more with for-profit companies that participate in the market for body parts and the state of interdependence that now exists with our understaffed medical examiners. There are far more cases of aggressive organ harvesting interfering with criminal investigations than ER doctors letting people die to collect the organs.