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New UK Law Mandates Organ Donation by Default Unless Explicit Opt-Out (2020)

107 points by _red 5y ago

Crosseye_Jack 5y ago
New? Law came into effect on 20 May 2020 and received royal on 15 March 2019. Title of the post doesn't even reflect that of the link. Want more info on the subject including a brief reason as to why visit (Spoiler: not enough donors) https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/faq/what-is-the-opt-out-system/ https://www.organdonation.nhs.uk/helping-you-to-decide/about... The UK has been trying to push people more into being donors for a while. Back in 2011 (iirc) they added questions about your status as an organ donor to the driving license application. As the UK has about 75% of the adult population holding full licenses its was a good way of getting the question atleast asked to new drivers. Also > Will you automatically take my organs if I don't opt out? > No. Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured. EDIT: Also this is law in England. Wales has had a similar opt-out system in place since 2015 (Not checked Scotland or Northern Ireland)
- ninjin 5y ago
  I have been a registered organ donor (full body, even for research purposes) ever since I could legally do so, which is for almost twenty years now and registering for donation in every single country I have lived. However, not seeking consent is inexcusable, regardless of how noble the cause. Reading “80% of people in England support organ donation but only 38% have opted in. This means families are often left with a difficult decision when a loved one dies.” [1], it is clear that despite a massive amount of popular support the UK government fails to communicate effectively with its populace and instead of reflecting on its failures it now opts for a nuclear option. What about those without family? What about cases where family can not be contacted in due time? What about cases where the UK bureaucracy “accidentally” approves it? I am not a fan of slippery slope arguments, but here is a case where a good cause is hijacked and corrupted by a political body, leaving someone like me that considered donation to be a no-brainer with a bitter taste in my mouth wondering how best to protest as opting out clearly will not cut it given my moral inclinations. [1]: https://www.gov.uk/government/news/opt-out-organ-donation-max-and-keira-s-bill-passed-into-law https://www.gov.uk/government/news/opt-out-organ-donation-ma...
  - Crosseye_Jack 5y ago
    Yup, completely agree.. > it is clear that despite a massive amount of popular support the UK government fails to communicate effectively with its populace. I have no idea where you get that opinion from... https://www.bbc.co.uk/news/uk-politics-56818750 https://www.bbc.co.uk/news/uk-politics-56818750 (sarcasm tag, just in case :-p)
  - arp242 5y ago
    The biggest problem is people who would consent, but just never bothered filling in the form. I think asking people this question when they apply for a passport would be a good middle ground, and/or maybe on the intake form for their GP, or other kinds of government interactions (voting registration might make sense in the UK specifically). People would still be able to opt-out of choosing at all, but this would catch the large group of people who just never bothered to register.
    - onetimemanytime 5y ago
      The government has many ways of getting consent, as you said: driver's licenses, passports, tax, any other interaction with the state...or even mailing a separate form to each and everyone complete with a media campaign. I am no fan of opt out since with the right opt-in they could get enough.
    - lawtalkinghuman 5y ago
      > I think asking people this question when they apply for a passport would be a good middle ground This already happens. When you apply for a driving licence, you are asked whether you would like to be put on the donor registry.
  - Lio 5y ago
    I completely agree. I live in the UK, I’ve been a registered organ donor for as long as I can remember. I’ve opted out. I’m not a bag of parts that belongs to an all powerful state.
    - 5y ago
cercatrova 5y ago
Implicit opt in is the way to structure decisions you want the user to take. This is of course not only used for good things like this but also "bad" things like checkboxes that say "share my data" and are already filled in.
- asimjalis 5y ago
  Your organs are also your data. This could lead to a process where every dead person’s DNA is checked against outstanding criminal cases.
  - exporectomy 5y ago
    Yes please. Why do you say that as if it's a bad thing?
    - ostenning 5y ago
      Because humanities neurotic need to dissect, judge, survey and quantify everything is what is edging us ever so slightly into a dystopian world?
      - exporectomy 5y ago
        A world where most crimes are solved sounds good to me. Do you think we've passed the optimum point where enough crime is solved and we don't want any more because that would make it dystopian?
  - bigmattystyles 5y ago
    I’ve actually never thought of that. In most countries, does your next of kin own your corpse?
  - onion2k 5y ago
    There's no DNA evidence found in the overwhelming majority of crimes. This would have almost no impact on unsolved cases. Life is not CSI.
lsiebert 5y ago
Good! organ donations save lives,restore vision to the blind, and help burn victims, and this lets people who don't have strong opinions on what happens to their body help other people, while still letting those who have strong opinions against organ donation opt out.
- cskinner 5y ago
  Just my personal (contraversial) opinion, but I believe that opting out of being a donor should also opt the person out of being a recipient. Include a 12 month waiting period for someone who has previously opted out, but now wants to opt back in to qualify as a recipient to reduce the ability to gain the system.
  - deleted 5y ago
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  - tasogare 5y ago
    Yes, let’s shame and punish people that think differently than "the good way", it will totally help the cause get more support.
    - arp242 5y ago
      There are long waiting lists for organ donors; why should I donate my organs to someone who won't return the favour? I'd rather donate them to someone who would.
    - kelnos 5y ago
      It's not just that; it's punishing people who want to benefit from a system they refuse to "pay" into.
      - dazc 5y ago
        What if I off-shore my earnings to avoid paying tax; what if I vote Republican. Does consenting to organ donation make me a worthy person despite anything else you may disagree with?
tareqak 5y ago
I like the idea of opt-in by default for organ donations. However, I am curious about the results of changing the opt-out option of “you can opt-out but you cannot receive an organ donation if you choose to opt-out”-choice would fare in the real world.
- viraptor 5y ago
  There would have to be a really large number of opt-outs for that to matter. Unless the opt-outs actually cause still cause a problem after this change, why do it? Trying to punish dead people doesn't sound effective.
  - kelnos 5y ago
    My hope is that it would instill a sense of responsibility in some people. If you want to benefit from an organ donation if you ever need a transplant, then the responsible and fair thing to do is to donate into that system yourself when you die.
  - tareqak 5y ago
    It’s not punishing dead people. It’s punishing people who benefit from organ donations but choose to not contribute their own organs i.e. those who receive organ donations from those who chose to donate their organs without themselves choosing to donate their own organs. The default-to-being—an-organ-donor/presumed consent approach has proven benefits when it comes to outcomes in medical situations that require organ donors [0][1][2]. The thing that I personally dislike about defaults like these is that it allows people to move through their life ignorant of the good that they are able to do for others and the good that others are able to do for them. In the case of an organ donation question on a driving license, I would personally like there to only be two options that are both not default: opt-in to being an organ donor and being able to receive organ donations, and opt-out to not being an organ donor and then be unable to receive donations. An answer to this question would be required (opt-in or opt-out), and not making a selection would the equivalent of submitting an incomplete driver’s license application such that the application would be rejected. [0] https://en.wikipedia.org/wiki/Default_effect#Default_setting_as_a_policy_instrument https://en.wikipedia.org/wiki/Default_effect#Default_setting... [1] https://sparq.stanford.edu/solutions/opt-out-policies-increase-organ-donation https://sparq.stanford.edu/solutions/opt-out-policies-increa... [2] https://www8.gsb.columbia.edu/sites/decisionsciences/files/files/Defaults_and_Donation_Decisions_-_Transplantation.pdf https://www8.gsb.columbia.edu/sites/decisionsciences/files/f...
ostenning 5y ago
A good cause aside, opting out of anything is a terrible practice that needs to be abolished. It’s shameful that we keep having to opt out of every facet of our lives. Life is hard enough as it is, but let’s make it harder by forcing people to have to opt out of choices they never made! Maybe it’s just the phrasing, but unless there is a proper shift away from a given default expectation, lots of people will be blind sided by this.
- mbg721 5y ago
  I think you've just described citizenship-by-birth anyway. Being born opts you into all sorts of crazy stuff.
  - kelnos 5y ago
    I'm surprised this isn't a "sovereign citizen" argument: "I never opted into citizenship and taxes! My parents did that without consulting me!"
- kaba0 5y ago
  Is a slight psychological manipulation ethically wrong when it saves many many lives?
DoreenMichele 5y ago
Some people have organs no one in their right mind would want. For example: You have a genetic disorder. So, I wonder how stuff like that factors in. That doesn't appear to be addressed.
- onion2k 5y ago
  If you don't trust doctors to choose safe organs you probably shouldn't trust them to cut you open and try to put the organ in you either.
  - DoreenMichele 5y ago
    I have a genetic disorder. That's why it occurs to me, though I edited it out because I get a lot of flak for "talking too much about myself" and then when I edit out stuff like that, I get replies like this one that seem to think it's some sort of ugly thing to say rather than genuine curiosity rooted in a smidgen of relevant information/experience. I looked into signing up to be a bone marrow donor when my corporate employer was giving some kind of incentive. I don't qualify. Period. You cannot tell by looking at me that my DNA is miscoded but it significantly impacts organ function, and not in a good way. My ID card doesn't state I have a genetic disorder.
    - onion2k 5y ago
      Doctors test organs before using them. Obviously. Regardless of genetic disorders, the donor might have a disease that would kill the already-very-unhealthy-because-they-need-a-new-organ patient. They also test for compatibility with the patient. You can't just stick any organ in any person. Genetic disorders among donora is not a legitimate concern here.
      - tediousdemise 5y ago
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125622/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125622/ > On 7 February surgeon James Jaggers had almost completed the operation when he learnt that the organs came from a donor with type A blood, incompatible with Jesica's type O. The story became front page news. Jesica was kept on life support systems while a second transplant was sought—and, astonishingly, found. Despite the second transplant, Jesica died from irreversible brain damage on 22 February. Quite the testing they did there.
pcurve 5y ago
Opt-out has been becoming more common throughout the world. Some countries only offer conditional opt-out. In the U.S. 33% of organ donation come from motor vehicle accident. Reduced driving due to Covid put a dent on organ donation. Long term, as cars go more autonomous, vehicular related fatalities would decrease drastically. The U.S will have to follow the same model.
- klipt 5y ago
  In the very long term, I hope we can just grow organs from stem cells. That way they'd also be a perfect genetic match for the patient, so no risk of rejection.
- onion2k 5y ago
  There's a reason why some doctors call motorcycles "donor cycles". https://en.m.wiktionary.org/wiki/donorcycle#:~:text=donorcycle%20(plural%20donorcycles),risk%20of%20riding%20a%20motorcycle https://en.m.wiktionary.org/wiki/donorcycle#:~:text=donorcyc....
  - EdwardDiego 5y ago
    Yep my volunteer paramedic Mum was rather upset when I started riding. She'd seen her share of traumatic decapitations, etc.
- deleted 5y ago
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teh_infallible 5y ago
In the US, if you have a baby in the hospital, they take the placenta and sell it for the stem cells. We asked for the placenta and were told, “They took it to pathology, and really don’t like to give it back after that,” or something along those lines. So organ harvesting without consent happens in the US too
- deleted 5y ago
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tediousdemise 5y ago
If they want my organ, I’d ask them how much they want to pay me or my family for it. The medical industry gouges patients and derives exorbitant wealth from our “donations,” and there needs to be an equivalent exchange. If my hospital bill for a single night stay is 50k, they can pay me 50k for my organ. I’m certain hospitals can pay far more than that, with the amount of insurance fraud they commit.
- arp242 5y ago
  That 50k will just be charged to the recipient.
  - tediousdemise 5y ago
    What would prevent a contractual agreement that states they could not do such a thing?
  - deleted 5y ago
    [deleted]
- kelnos 5y ago
  This is actually a pretty good point. Yes, a person truly in need, often in a life-or-death situation, will benefit from that organ, but the hospital and staff performing that transplant will also benefit financially (especially here in the US where health care bills are out of control). Why shouldn't the estate of the deceased get rewarded for the deceased's generosity? (Of course, I fully expect this added cost to just get passed on to the recipient, which isn't a great outcome.)
  - tediousdemise 5y ago
    I would hope that legislation could protect patients from medical providers passing the costs on to them. It seems to me that the medical profession is financially imbalanced with respect to the rest of society. In the US, they are propped up by mandatory health insurance requirements and are all but guaranteed income, whether it’s from private insurance companies, taxpayer dollars (a la Medicaid/Medicare), or some poor unfortunate soul’s lifelong medical debt payments. As long as people are being born, medical problems will be a dime a dozen, and wealth earned by medical practitioners will scale with the size of the population.
armchairhacker 5y ago
If we're concerned with getting consent, but also allegedly too many people are just forgetting to opt-in: What if, before somebody gets their ID (or another process everyone goes through), we ask them "do you want to be an organ donor" and they have to say either say yes / no?
- alexbilbie 5y ago
  When I applied for my UK driving license I was able to opt in to the organ donation register then
drran 5y ago
AFAIK, mandatory "donation" to government is called "confiscation".
- awestroke 5y ago
  How is opt-out the same as mandatory? Just opt out
cryptonector 5y ago
Why can't we pay people to donate organs instead of begging or forcing them to, again?
- awestroke 5y ago
  1. Pay dead people? Why? How would that work? 2. Opt-out is not the same as forcing people 3. Dead people can't be forced to do anything, they are dead
  - cryptonector 5y ago
    1. Pay their estates, of course. (Which then gets used to pay for burial, enhance inheritance, offset death taxes, etc.) 2. I said "begging/forcing". Opt-out is forcing those who don't know, and begging those who do. Opt-in is begging. And you know, we've started with begging (not even opt-in), then added opt-in, now we're onto opt-out, which might make one wonder: what's the next step? The obvious answer is that if we continue on this path we won't even get to opt out (force). 3. Nonsense. The next of kin of a dead person gets to decide burial options, and much more. And there's no reason a living person couldn't have the right to decide what is to be done with their body after death. Does the State own you, or do you own yourself? If the latter, you get to sell your dead body; if the former, you don't get to sell your dead body.
- danparsonson 5y ago
  You'd be dead, what would you do with the money? Also, we don't charge people to receive them; organ donation is for the common good.
  - bserge 5y ago
    They'd go to the family.
  - cryptonector 5y ago
    Have you never heard of "estates"? Do you really have no clue how we deal with death? What do you think happens to a person's assets when they die? Is their body not an assert? If you could sell your dead body, it would be an asset.
zo1 5y ago
Not going to jump in with arguments on this one. But just want to mention how positively horrified I am to see all the comments here cheering organ harvesting in a democracy.
- danparsonson 5y ago
  You won't need them after you die, trust me. One (dead) person's organs can be totally life-changing for several other people but there are a shortage of donors because people forget to opt in. And if you would really prefer not to help sick people after you're dead, then you can still opt out.
- pharmakom 5y ago
  Can a dead person own anything? Who’s rights are violated if an organ is taken from a dead body? I would be horrified if people were killed for their organs or organs were taken while they are alive.
- kaba0 5y ago
  If my dead body is useful to someone, then why should it rot somewhere? It’s not like I was cared for only to have my liver harvested, so it makes zero chance to compare it to deliberate killing of people.
  - zo1 5y ago
    Because morality should not be based on what "makes sense" or is an efficient use of things. The reason I used the term "organ harvesting" is the same reason people that talk about this "opt out" thing use the term "donation". But my overall feeling is that this is yet another thing that highlights and brings to the fore that the state pretty much owns us as essentially livestock to harvest things from. At the very least, the default should be that your estate and/or your family takes ownership of your remains. Otherwise we're heading into territory where the state can say: "Why should you have a grave so your body can rot in there. It's not like we're going around killing you for your biological matter, so it's okay if we just take your body and decompose it into fertilizer to help rejuvenate the farm fields!" or "We've determined that you don't need 10% of the blood that you generate every day, so please make sure to go daily to your local "Blood donation centre" for your "voluntary donation""! The way people are cheering this "donation" on is frankly very disturbing. Yes, I know it saves lives, but so would abolishing cars to stop car accidents and so would banning all knives and having people use feeding tubes instead!
Lio 5y ago
I note with irony that that site doesn’t even let you opt out of “marketing” cookies.
3grdlurker 5y ago
Organ donation isn’t a hot issue where I’m from and I imagine that most people here will like such a policy, but I’m honestly surprised by the push back in this thread. Why? The honest question I want to ask is: do people think that they still own their bodies when they die?
- spoonjim 5y ago
  1) yes, I think you own your body when you die the same way you own your money: you can specify what should be done with it while you are alive 2) one rational argument for opting out is that if you are in a bad state, it might be rational for a doctor to let you die rather than save you, since your organs might be saving multiple people’s lives. I know I was a doctor and I had a 50 year old person in a car crash and I had 3 twentysomethings waiting for a heart liver and lungs I might want to hurry that 50 year old off this mortal coil. It would be the ethical thing to do. But if I was the 50 year old I wouldn’t like it.
  - kaba0 5y ago
    About 2, I am fairly sure it is against every oath they take, and it may very well be malpractice as well. Also, with a default opt-in, the pool to get organs from dramatically increase. And I’m not sure whether you meant that you were a doctor, or was it just a hypothetical, but usually car crash victims are not operated on by organ transplant specialists, so the doctor’s patients will not intersect, making your point purely theoretical.
    - anfogoat 5y ago
      Please take one quick glance at your country's politicians, police or intelligence services. How many oaths did they take? The fact is oaths are just hollow ceremony.
      - kaba0 5y ago
        If you want a more “rational” model of a doctor, why should he/she have a worse success rate by not saving one of his/her patients? And while there are bad, even borderline evil doctors out there, I think statistically you are much more likely to find a morally corrupt politician than a doctor, especially in countries with public healthcare.
deleted 5y ago
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toyg 5y ago
I would have supported a law like this, back in Italy, although they don’t really need it (it’s already in the top-3 European countries for number of transplants). I am not very keen on it here in UK. That’s because the medical profession here stinks of massive classism, and there have been instances of abuses like https://en.m.wikipedia.org/wiki/Alder_Hey_organs_scandal https://en.m.wikipedia.org/wiki/Alder_Hey_organs_scandal and https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-50836324 https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-50... . The chances of doctors “hurrying up” families from working-class and minority backgrounds to pull the plug, for the purposes of organ harvesting, in my opinion are substantial. Already we have situations where minorities get substandard attention (likely one of the causes, for instance, of early-natal mortality in Birmingham being more than twice the national average); this risks exacerbating the problems. Also, there are issues with forensics. Organ harvesting, from what I hear, is more likely to be followed by cremation than embalming, which makes it impossible to re-examine remains at a later date. Again, given the “tradition” of cover-ups that most nation-states carry, it seems like a dangerous slope.
renewiltord 5y ago
Makes sense in the UK to donate, I suppose, since your treatment is free. In the US, where it is fully possible that you will simply not receive an organ if you can't pay, I think it makes sense to also do the opposite and simply not offer an organ for transplant if it can't be paid for. I am interested in speaking to anyone who has had experience bypassing current "donation" laws.
gremlinsinc 5y ago
Why is it they have organ donation... But the hospital I'm guessing still charges for the harvesting, and surgery right? They should then pay something to the organ donors family... Even if it's just twice what a decent funeral costs... Wife's uncle had his eyes harvested nobody told her aunt and she had a horrible surprise at the funeral when he was highly disfigured... She probably wouldn't have cared if she'd known... But I feel like there's a black market for organs... Maybe more ppl would be okay with donation of they knew it'd help their family some.

107 points by _red 5y ago

New? Law came into effect on 20 May 2020 and received royal on 15 March 2019. Title of the post doesn't even reflect that of the link. Want more info on the subject including a brief reason as to why visit (Spoiler: not enough donors) https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/faq/what-is-the-opt-out-system/ https://www.organdonation.nhs.uk/helping-you-to-decide/about... The UK has been trying to push people more into being donors for a while. Back in 2011 (iirc) they added questions about your status as an organ donor to the driving license application. As the UK has about 75% of the adult population holding full licenses its was a good way of getting the question atleast asked to new drivers. Also > Will you automatically take my organs if I don't opt out? > No. Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured. EDIT: Also this is law in England. Wales has had a similar opt-out system in place since 2015 (Not checked Scotland or Northern Ireland)

ninjin 5y ago
I have been a registered organ donor (full body, even for research purposes) ever since I could legally do so, which is for almost twenty years now and registering for donation in every single country I have lived. However, not seeking consent is inexcusable, regardless of how noble the cause. Reading “80% of people in England support organ donation but only 38% have opted in. This means families are often left with a difficult decision when a loved one dies.” [1], it is clear that despite a massive amount of popular support the UK government fails to communicate effectively with its populace and instead of reflecting on its failures it now opts for a nuclear option. What about those without family? What about cases where family can not be contacted in due time? What about cases where the UK bureaucracy “accidentally” approves it? I am not a fan of slippery slope arguments, but here is a case where a good cause is hijacked and corrupted by a political body, leaving someone like me that considered donation to be a no-brainer with a bitter taste in my mouth wondering how best to protest as opting out clearly will not cut it given my moral inclinations. [1]: https://www.gov.uk/government/news/opt-out-organ-donation-max-and-keira-s-bill-passed-into-law https://www.gov.uk/government/news/opt-out-organ-donation-ma...
- Crosseye_Jack 5y ago
  Yup, completely agree.. > it is clear that despite a massive amount of popular support the UK government fails to communicate effectively with its populace. I have no idea where you get that opinion from... https://www.bbc.co.uk/news/uk-politics-56818750 https://www.bbc.co.uk/news/uk-politics-56818750 (sarcasm tag, just in case :-p)
- arp242 5y ago
  The biggest problem is people who would consent, but just never bothered filling in the form. I think asking people this question when they apply for a passport would be a good middle ground, and/or maybe on the intake form for their GP, or other kinds of government interactions (voting registration might make sense in the UK specifically). People would still be able to opt-out of choosing at all, but this would catch the large group of people who just never bothered to register.
  - onetimemanytime 5y ago
    The government has many ways of getting consent, as you said: driver's licenses, passports, tax, any other interaction with the state...or even mailing a separate form to each and everyone complete with a media campaign. I am no fan of opt out since with the right opt-in they could get enough.
  - lawtalkinghuman 5y ago
    > I think asking people this question when they apply for a passport would be a good middle ground This already happens. When you apply for a driving licence, you are asked whether you would like to be put on the donor registry.
- Lio 5y ago
  I completely agree. I live in the UK, I’ve been a registered organ donor for as long as I can remember. I’ve opted out. I’m not a bag of parts that belongs to an all powerful state.
  - 5y ago

cercatrova 5y ago

Implicit opt in is the way to structure decisions you want the user to take. This is of course not only used for good things like this but also "bad" things like checkboxes that say "share my data" and are already filled in.

asimjalis 5y ago
Your organs are also your data. This could lead to a process where every dead person’s DNA is checked against outstanding criminal cases.
- exporectomy 5y ago
  Yes please. Why do you say that as if it's a bad thing?
  - ostenning 5y ago
    Because humanities neurotic need to dissect, judge, survey and quantify everything is what is edging us ever so slightly into a dystopian world?
    - exporectomy 5y ago
      A world where most crimes are solved sounds good to me. Do you think we've passed the optimum point where enough crime is solved and we don't want any more because that would make it dystopian?
- bigmattystyles 5y ago
  I’ve actually never thought of that. In most countries, does your next of kin own your corpse?
- onion2k 5y ago
  There's no DNA evidence found in the overwhelming majority of crimes. This would have almost no impact on unsolved cases. Life is not CSI.

lsiebert 5y ago

Good! organ donations save lives,restore vision to the blind, and help burn victims, and this lets people who don't have strong opinions on what happens to their body help other people, while still letting those who have strong opinions against organ donation opt out.

cskinner 5y ago
Just my personal (contraversial) opinion, but I believe that opting out of being a donor should also opt the person out of being a recipient. Include a 12 month waiting period for someone who has previously opted out, but now wants to opt back in to qualify as a recipient to reduce the ability to gain the system.
- deleted 5y ago
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- tasogare 5y ago
  Yes, let’s shame and punish people that think differently than "the good way", it will totally help the cause get more support.
  - arp242 5y ago
    There are long waiting lists for organ donors; why should I donate my organs to someone who won't return the favour? I'd rather donate them to someone who would.
  - kelnos 5y ago
    It's not just that; it's punishing people who want to benefit from a system they refuse to "pay" into.
    - dazc 5y ago
      What if I off-shore my earnings to avoid paying tax; what if I vote Republican. Does consenting to organ donation make me a worthy person despite anything else you may disagree with?

tareqak 5y ago

I like the idea of opt-in by default for organ donations. However, I am curious about the results of changing the opt-out option of “you can opt-out but you cannot receive an organ donation if you choose to opt-out”-choice would fare in the real world.

viraptor 5y ago
There would have to be a really large number of opt-outs for that to matter. Unless the opt-outs actually cause still cause a problem after this change, why do it? Trying to punish dead people doesn't sound effective.
- kelnos 5y ago
  My hope is that it would instill a sense of responsibility in some people. If you want to benefit from an organ donation if you ever need a transplant, then the responsible and fair thing to do is to donate into that system yourself when you die.
- tareqak 5y ago
  It’s not punishing dead people. It’s punishing people who benefit from organ donations but choose to not contribute their own organs i.e. those who receive organ donations from those who chose to donate their organs without themselves choosing to donate their own organs. The default-to-being—an-organ-donor/presumed consent approach has proven benefits when it comes to outcomes in medical situations that require organ donors [0][1][2]. The thing that I personally dislike about defaults like these is that it allows people to move through their life ignorant of the good that they are able to do for others and the good that others are able to do for them. In the case of an organ donation question on a driving license, I would personally like there to only be two options that are both not default: opt-in to being an organ donor and being able to receive organ donations, and opt-out to not being an organ donor and then be unable to receive donations. An answer to this question would be required (opt-in or opt-out), and not making a selection would the equivalent of submitting an incomplete driver’s license application such that the application would be rejected. [0] https://en.wikipedia.org/wiki/Default_effect#Default_setting_as_a_policy_instrument https://en.wikipedia.org/wiki/Default_effect#Default_setting... [1] https://sparq.stanford.edu/solutions/opt-out-policies-increase-organ-donation https://sparq.stanford.edu/solutions/opt-out-policies-increa... [2] https://www8.gsb.columbia.edu/sites/decisionsciences/files/files/Defaults_and_Donation_Decisions_-_Transplantation.pdf https://www8.gsb.columbia.edu/sites/decisionsciences/files/f...

ostenning 5y ago

A good cause aside, opting out of anything is a terrible practice that needs to be abolished. It’s shameful that we keep having to opt out of every facet of our lives. Life is hard enough as it is, but let’s make it harder by forcing people to have to opt out of choices they never made! Maybe it’s just the phrasing, but unless there is a proper shift away from a given default expectation, lots of people will be blind sided by this.

mbg721 5y ago
I think you've just described citizenship-by-birth anyway. Being born opts you into all sorts of crazy stuff.
- kelnos 5y ago
  I'm surprised this isn't a "sovereign citizen" argument: "I never opted into citizenship and taxes! My parents did that without consulting me!"
kaba0 5y ago
Is a slight psychological manipulation ethically wrong when it saves many many lives?

DoreenMichele 5y ago

Some people have organs no one in their right mind would want. For example: You have a genetic disorder. So, I wonder how stuff like that factors in. That doesn't appear to be addressed.

onion2k 5y ago
If you don't trust doctors to choose safe organs you probably shouldn't trust them to cut you open and try to put the organ in you either.
- DoreenMichele 5y ago
  I have a genetic disorder. That's why it occurs to me, though I edited it out because I get a lot of flak for "talking too much about myself" and then when I edit out stuff like that, I get replies like this one that seem to think it's some sort of ugly thing to say rather than genuine curiosity rooted in a smidgen of relevant information/experience. I looked into signing up to be a bone marrow donor when my corporate employer was giving some kind of incentive. I don't qualify. Period. You cannot tell by looking at me that my DNA is miscoded but it significantly impacts organ function, and not in a good way. My ID card doesn't state I have a genetic disorder.
  - onion2k 5y ago
    Doctors test organs before using them. Obviously. Regardless of genetic disorders, the donor might have a disease that would kill the already-very-unhealthy-because-they-need-a-new-organ patient. They also test for compatibility with the patient. You can't just stick any organ in any person. Genetic disorders among donora is not a legitimate concern here.
    - tediousdemise 5y ago
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125622/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125622/ > On 7 February surgeon James Jaggers had almost completed the operation when he learnt that the organs came from a donor with type A blood, incompatible with Jesica's type O. The story became front page news. Jesica was kept on life support systems while a second transplant was sought—and, astonishingly, found. Despite the second transplant, Jesica died from irreversible brain damage on 22 February. Quite the testing they did there.

pcurve 5y ago

Opt-out has been becoming more common throughout the world. Some countries only offer conditional opt-out. In the U.S. 33% of organ donation come from motor vehicle accident. Reduced driving due to Covid put a dent on organ donation. Long term, as cars go more autonomous, vehicular related fatalities would decrease drastically. The U.S will have to follow the same model.

klipt 5y ago
In the very long term, I hope we can just grow organs from stem cells. That way they'd also be a perfect genetic match for the patient, so no risk of rejection.
onion2k 5y ago
There's a reason why some doctors call motorcycles "donor cycles". https://en.m.wiktionary.org/wiki/donorcycle#:~:text=donorcycle%20(plural%20donorcycles),risk%20of%20riding%20a%20motorcycle https://en.m.wiktionary.org/wiki/donorcycle#:~:text=donorcyc....
- EdwardDiego 5y ago
  Yep my volunteer paramedic Mum was rather upset when I started riding. She'd seen her share of traumatic decapitations, etc.
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teh_infallible 5y ago

In the US, if you have a baby in the hospital, they take the placenta and sell it for the stem cells. We asked for the placenta and were told, “They took it to pathology, and really don’t like to give it back after that,” or something along those lines. So organ harvesting without consent happens in the US too

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tediousdemise 5y ago

If they want my organ, I’d ask them how much they want to pay me or my family for it. The medical industry gouges patients and derives exorbitant wealth from our “donations,” and there needs to be an equivalent exchange. If my hospital bill for a single night stay is 50k, they can pay me 50k for my organ. I’m certain hospitals can pay far more than that, with the amount of insurance fraud they commit.

arp242 5y ago
That 50k will just be charged to the recipient.
- tediousdemise 5y ago
  What would prevent a contractual agreement that states they could not do such a thing?
- deleted 5y ago
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kelnos 5y ago
This is actually a pretty good point. Yes, a person truly in need, often in a life-or-death situation, will benefit from that organ, but the hospital and staff performing that transplant will also benefit financially (especially here in the US where health care bills are out of control). Why shouldn't the estate of the deceased get rewarded for the deceased's generosity? (Of course, I fully expect this added cost to just get passed on to the recipient, which isn't a great outcome.)
- tediousdemise 5y ago
  I would hope that legislation could protect patients from medical providers passing the costs on to them. It seems to me that the medical profession is financially imbalanced with respect to the rest of society. In the US, they are propped up by mandatory health insurance requirements and are all but guaranteed income, whether it’s from private insurance companies, taxpayer dollars (a la Medicaid/Medicare), or some poor unfortunate soul’s lifelong medical debt payments. As long as people are being born, medical problems will be a dime a dozen, and wealth earned by medical practitioners will scale with the size of the population.

armchairhacker 5y ago

If we're concerned with getting consent, but also allegedly too many people are just forgetting to opt-in: What if, before somebody gets their ID (or another process everyone goes through), we ask them "do you want to be an organ donor" and they have to say either say yes / no?

alexbilbie 5y ago
When I applied for my UK driving license I was able to opt in to the organ donation register then

drran 5y ago

AFAIK, mandatory "donation" to government is called "confiscation".

awestroke 5y ago
How is opt-out the same as mandatory? Just opt out

cryptonector 5y ago

Why can't we pay people to donate organs instead of begging or forcing them to, again?

awestroke 5y ago
1. Pay dead people? Why? How would that work? 2. Opt-out is not the same as forcing people 3. Dead people can't be forced to do anything, they are dead
- cryptonector 5y ago
  1. Pay their estates, of course. (Which then gets used to pay for burial, enhance inheritance, offset death taxes, etc.) 2. I said "begging/forcing". Opt-out is forcing those who don't know, and begging those who do. Opt-in is begging. And you know, we've started with begging (not even opt-in), then added opt-in, now we're onto opt-out, which might make one wonder: what's the next step? The obvious answer is that if we continue on this path we won't even get to opt out (force). 3. Nonsense. The next of kin of a dead person gets to decide burial options, and much more. And there's no reason a living person couldn't have the right to decide what is to be done with their body after death. Does the State own you, or do you own yourself? If the latter, you get to sell your dead body; if the former, you don't get to sell your dead body.
danparsonson 5y ago
You'd be dead, what would you do with the money? Also, we don't charge people to receive them; organ donation is for the common good.
- bserge 5y ago
  They'd go to the family.
- cryptonector 5y ago
  Have you never heard of "estates"? Do you really have no clue how we deal with death? What do you think happens to a person's assets when they die? Is their body not an assert? If you could sell your dead body, it would be an asset.

zo1 5y ago

Not going to jump in with arguments on this one. But just want to mention how positively horrified I am to see all the comments here cheering organ harvesting in a democracy.

danparsonson 5y ago
You won't need them after you die, trust me. One (dead) person's organs can be totally life-changing for several other people but there are a shortage of donors because people forget to opt in. And if you would really prefer not to help sick people after you're dead, then you can still opt out.
pharmakom 5y ago
Can a dead person own anything? Who’s rights are violated if an organ is taken from a dead body? I would be horrified if people were killed for their organs or organs were taken while they are alive.
kaba0 5y ago
If my dead body is useful to someone, then why should it rot somewhere? It’s not like I was cared for only to have my liver harvested, so it makes zero chance to compare it to deliberate killing of people.
- zo1 5y ago
  Because morality should not be based on what "makes sense" or is an efficient use of things. The reason I used the term "organ harvesting" is the same reason people that talk about this "opt out" thing use the term "donation". But my overall feeling is that this is yet another thing that highlights and brings to the fore that the state pretty much owns us as essentially livestock to harvest things from. At the very least, the default should be that your estate and/or your family takes ownership of your remains. Otherwise we're heading into territory where the state can say: "Why should you have a grave so your body can rot in there. It's not like we're going around killing you for your biological matter, so it's okay if we just take your body and decompose it into fertilizer to help rejuvenate the farm fields!" or "We've determined that you don't need 10% of the blood that you generate every day, so please make sure to go daily to your local "Blood donation centre" for your "voluntary donation""! The way people are cheering this "donation" on is frankly very disturbing. Yes, I know it saves lives, but so would abolishing cars to stop car accidents and so would banning all knives and having people use feeding tubes instead!

Lio 5y ago

I note with irony that that site doesn’t even let you opt out of “marketing” cookies.

3grdlurker 5y ago

Organ donation isn’t a hot issue where I’m from and I imagine that most people here will like such a policy, but I’m honestly surprised by the push back in this thread. Why? The honest question I want to ask is: do people think that they still own their bodies when they die?

spoonjim 5y ago
1) yes, I think you own your body when you die the same way you own your money: you can specify what should be done with it while you are alive 2) one rational argument for opting out is that if you are in a bad state, it might be rational for a doctor to let you die rather than save you, since your organs might be saving multiple people’s lives. I know I was a doctor and I had a 50 year old person in a car crash and I had 3 twentysomethings waiting for a heart liver and lungs I might want to hurry that 50 year old off this mortal coil. It would be the ethical thing to do. But if I was the 50 year old I wouldn’t like it.
- kaba0 5y ago
  About 2, I am fairly sure it is against every oath they take, and it may very well be malpractice as well. Also, with a default opt-in, the pool to get organs from dramatically increase. And I’m not sure whether you meant that you were a doctor, or was it just a hypothetical, but usually car crash victims are not operated on by organ transplant specialists, so the doctor’s patients will not intersect, making your point purely theoretical.
  - anfogoat 5y ago
    Please take one quick glance at your country's politicians, police or intelligence services. How many oaths did they take? The fact is oaths are just hollow ceremony.
    - kaba0 5y ago
      If you want a more “rational” model of a doctor, why should he/she have a worse success rate by not saving one of his/her patients? And while there are bad, even borderline evil doctors out there, I think statistically you are much more likely to find a morally corrupt politician than a doctor, especially in countries with public healthcare.

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toyg 5y ago

I would have supported a law like this, back in Italy, although they don’t really need it (it’s already in the top-3 European countries for number of transplants). I am not very keen on it here in UK. That’s because the medical profession here stinks of massive classism, and there have been instances of abuses like https://en.m.wikipedia.org/wiki/Alder_Hey_organs_scandal https://en.m.wikipedia.org/wiki/Alder_Hey_organs_scandal and https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-50836324 https://www.bbc.co.uk/news/uk-england-stoke-staffordshire-50... . The chances of doctors “hurrying up” families from working-class and minority backgrounds to pull the plug, for the purposes of organ harvesting, in my opinion are substantial. Already we have situations where minorities get substandard attention (likely one of the causes, for instance, of early-natal mortality in Birmingham being more than twice the national average); this risks exacerbating the problems. Also, there are issues with forensics. Organ harvesting, from what I hear, is more likely to be followed by cremation than embalming, which makes it impossible to re-examine remains at a later date. Again, given the “tradition” of cover-ups that most nation-states carry, it seems like a dangerous slope.

renewiltord 5y ago

Makes sense in the UK to donate, I suppose, since your treatment is free. In the US, where it is fully possible that you will simply not receive an organ if you can't pay, I think it makes sense to also do the opposite and simply not offer an organ for transplant if it can't be paid for. I am interested in speaking to anyone who has had experience bypassing current "donation" laws.

gremlinsinc 5y ago

Why is it they have organ donation... But the hospital I'm guessing still charges for the harvesting, and surgery right? They should then pay something to the organ donors family... Even if it's just twice what a decent funeral costs... Wife's uncle had his eyes harvested nobody told her aunt and she had a horrible surprise at the funeral when he was highly disfigured... She probably wouldn't have cared if she'd known... But I feel like there's a black market for organs... Maybe more ppl would be okay with donation of they knew it'd help their family some.