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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

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.
  - spoonjim 5y ago
    Oath or no, if you could save 3 young people’s lives for one old person’s life, wouldn’t you do it? If I was a doctor I would at least want to, I don’t know whether it would be feasible.
    - renewiltord 5y ago
      Well, if you're a doctor, you want to for a fee. Very few organ transplant surgeons work for free.
    - kaba0 5y ago
      As I said, you only “know” the old person dying in front of you, you are not simultaneously at a children hospital where 3 young people waits for a liver and two kidneys. Hell, not even the liver and kidney transplant happen at the same hospital. So this is indeed a purely hypothetical scenario. And while it may seem like the trolley problem, it is not, because there is a huge indirection in whether those organs can be used at all, are required at this time and whether they will truly save someone else. So instead of the still morally questionable 1-3 trolley problem you instead have one where you can either direct the trolley on a track with one person in sight or another with noone on it. And at the distance, both tracks branch randomly and most of them go through 3 young person, and maybe slightly less kills them in the second case.
- samus 5y ago
  About 1) the situation is actually comparable with the way inheritance is handled. Most people specify what to be done by issuing a will, but there is not unlimited freedom there. For example, in some countries it is difficult to completely disinherit someone. If there is no will, your property is split in some way among your relatives. The default option, if there are no heirs, is that the inheritance falls to the state. After death your organs likely won't be able to benefit your relatives, unless they are currently in a life-threatening condition themselves. Dunno how long organs can be kept around, but I doubt that there is no expiry date after which they have to be tossed out. In that case, the organ would have gone to waste by sitting in a freezer. Therefore, treating your dead body's organs similar to inheritance would make it moral to pursue the default option in most cases, which is donation to the health system. Still, there is the possibility to opt out, which is an extra effort similar to (but way less involved) than issuing a will.
- lawtalkinghuman 5y ago
  > 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 You have the freedom to specify what exactly should be done with your stuff when you die. Whether those wishes will be legally enforced will depend heavily on what they say. To test this thesis, go to a lawyer in your jurisdiction and ask them about whether it would be possible to split the proceeds of your estate in equal shares with every man in the Greater London area who wears brown shoes on a Thursday, and prepare for a short explanation of administratively workablity. Then ask about whether you could posthumously fund some international terrorist organisations. Actually, maybe don't.
  - spoonjim 5y ago
    OK, so you can’t use your money in a way that’s infeasible to achieve or in a way that gives material support to terrorism. Is there a point you’re trying to make beyond that?
    - lawtalkinghuman 5y ago
      There's plenty more where those come from. Society rightly puts limits on what you can do with your property after you are dead. By analogy, there are legitimate limits on what you can ask your successors to do with your bodily remains - and it makes perfect sense to set sensible defaults.
UweSchmidt 5y ago
The concern is, organs are most useful when the donor is still a little alive, which could affect the incentives in a hospital: You might be in a critical state and someone else really needs an organ from someone like you. On the other hand if most people are donors by default there should be sufficient supply, easing this pressure.
- EdwardDiego 5y ago
  ...well, that's a rather paranoid bit of speculation that assumes that doctors are inherently unethical.
  - toyg 5y ago
    Sadly in the UK we’ve had a bunch of instances of malpractice where doctors came off as fundamentally unethical. Add to it that state bureaucracy can often feel cruel and heartless, and you can understand why people might be suspicious.
- 3grdlurker 5y ago
  I was actually referring to the pushback centering around the consent argument, but in any case: > You might be in a critical state and someone else really needs an organ from someone like you. How often does it actually happen that an organ recipient and a matching potential donor who is in critical condition are in the exact same hospital at the same time? Is the concern for skewing the incentives real? I’m not even sure where the incentive is in your example—it’s just trading off one life for another. The hospital still wouldn’t be avoiding the potential death of a patient either way.
  - samus 5y ago
    > I’m not even sure where the incentive is in your example—it’s just trading off one life for another. The issue is that the patient needing the organ might die before the potential donor. Edit: this is under the assumption that the potential donor is very likely to die of their current condition.

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.
- spoonjim 5y ago
  Oath or no, if you could save 3 young people’s lives for one old person’s life, wouldn’t you do it? If I was a doctor I would at least want to, I don’t know whether it would be feasible.
  - renewiltord 5y ago
    Well, if you're a doctor, you want to for a fee. Very few organ transplant surgeons work for free.
  - kaba0 5y ago
    As I said, you only “know” the old person dying in front of you, you are not simultaneously at a children hospital where 3 young people waits for a liver and two kidneys. Hell, not even the liver and kidney transplant happen at the same hospital. So this is indeed a purely hypothetical scenario. And while it may seem like the trolley problem, it is not, because there is a huge indirection in whether those organs can be used at all, are required at this time and whether they will truly save someone else. So instead of the still morally questionable 1-3 trolley problem you instead have one where you can either direct the trolley on a track with one person in sight or another with noone on it. And at the distance, both tracks branch randomly and most of them go through 3 young person, and maybe slightly less kills them in the second case.
samus 5y ago
About 1) the situation is actually comparable with the way inheritance is handled. Most people specify what to be done by issuing a will, but there is not unlimited freedom there. For example, in some countries it is difficult to completely disinherit someone. If there is no will, your property is split in some way among your relatives. The default option, if there are no heirs, is that the inheritance falls to the state. After death your organs likely won't be able to benefit your relatives, unless they are currently in a life-threatening condition themselves. Dunno how long organs can be kept around, but I doubt that there is no expiry date after which they have to be tossed out. In that case, the organ would have gone to waste by sitting in a freezer. Therefore, treating your dead body's organs similar to inheritance would make it moral to pursue the default option in most cases, which is donation to the health system. Still, there is the possibility to opt out, which is an extra effort similar to (but way less involved) than issuing a will.
lawtalkinghuman 5y ago
> 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 You have the freedom to specify what exactly should be done with your stuff when you die. Whether those wishes will be legally enforced will depend heavily on what they say. To test this thesis, go to a lawyer in your jurisdiction and ask them about whether it would be possible to split the proceeds of your estate in equal shares with every man in the Greater London area who wears brown shoes on a Thursday, and prepare for a short explanation of administratively workablity. Then ask about whether you could posthumously fund some international terrorist organisations. Actually, maybe don't.
- spoonjim 5y ago
  OK, so you can’t use your money in a way that’s infeasible to achieve or in a way that gives material support to terrorism. Is there a point you’re trying to make beyond that?
  - lawtalkinghuman 5y ago
    There's plenty more where those come from. Society rightly puts limits on what you can do with your property after you are dead. By analogy, there are legitimate limits on what you can ask your successors to do with your bodily remains - and it makes perfect sense to set sensible defaults.

UweSchmidt 5y ago

The concern is, organs are most useful when the donor is still a little alive, which could affect the incentives in a hospital: You might be in a critical state and someone else really needs an organ from someone like you. On the other hand if most people are donors by default there should be sufficient supply, easing this pressure.

EdwardDiego 5y ago
...well, that's a rather paranoid bit of speculation that assumes that doctors are inherently unethical.
- toyg 5y ago
  Sadly in the UK we’ve had a bunch of instances of malpractice where doctors came off as fundamentally unethical. Add to it that state bureaucracy can often feel cruel and heartless, and you can understand why people might be suspicious.
3grdlurker 5y ago
I was actually referring to the pushback centering around the consent argument, but in any case: > You might be in a critical state and someone else really needs an organ from someone like you. How often does it actually happen that an organ recipient and a matching potential donor who is in critical condition are in the exact same hospital at the same time? Is the concern for skewing the incentives real? I’m not even sure where the incentive is in your example—it’s just trading off one life for another. The hospital still wouldn’t be avoiding the potential death of a patient either way.
- samus 5y ago
  > I’m not even sure where the incentive is in your example—it’s just trading off one life for another. The issue is that the patient needing the organ might die before the potential donor. Edit: this is under the assumption that the potential donor is very likely to die of their current condition.