6 ms·

> This is so simple and newspapers trying to make it into a matter for debate is actually compromising that. Even if one were to consider moral character when

by mlyle 5y ago

> This is so simple and newspapers trying to make it into a matter for debate is actually compromising that. Even if one were to consider moral character when allocating organs in general: the researchers needed someone who was sick and likely to die, ineligible for human organ transplant (here, because of severity of condition), and not so sick that there was no chance of success or useful data. So, we're already picking someone who doesn't meet the normal rules. And, of course, considering moral character when allocating organs probably isn't a great idea.

fennecfoxen 5y ago
Yeah, the Post complaint (echoed elsewhere) is basically a call for having a social credit score that can say “you’re not a good person, so we’re not going to let the doctors save you.”
- rob74 5y ago
  ...and the next step would be "we're not going to treat you for Covid because you're not vaccinated".
  - achow 5y ago
    This is not same. The non vaccinated are actively choosing to be a danger to people around them. It is like actively carrying concealed unlicensed gun which can silently and anynomously fire at people.
    - rob74 5y ago
      I'm vaccinated myself and basically I have the same opinion as you. But David Bennett also actively chose to stab someone seven times in 1988 - "only" leaving him paralyzed, but probably with the intent to kill him? Ok, he probably served time for that and it was a long time ago, so judicially you can consider him rehabilitated. My argument was that once you refuse to treat (former) criminals, that's a slippery slope. And apparently I was right, since some here seem to consider people who choose not to get vaccinated worse that violent criminals...
      - op00to 5y ago
        Worse? No. The unvaccinated are far more likely to get sick or die as a part of any medical procedure right now just because of the base risk of COVID in hospitals. If you can’t take the first step to protect yourself and others, there’s not much health care providers can do to change your mind.
    - jlawson 5y ago
      I think you're confused on what the word 'actively' means.
      - achow 5y ago
        'Actively' seems to be accurate for the scenario when one is choosing to make body conducive to incubate virus, or already incubating them (albeit unknowingly if asymptomatic). [Edit] And if you meant active in context of 'Active shooter', then still use of the word active is not wrong. Virus laden body is like carrying a concealed gun which is on 'auto pilot', it is actively spraying bullets; it IS active all the while.
        InvertedRhodium 5y ago
        I can't think of a single person I know that hasn't ducked down to the shops to pick something up when they have the flu. By your definition, they are actively attempting to cause harm to others - which is an interesting take.
        sersi 5y ago
        Even before covid, I would always wear a mask if I had a flu and would try as much as possible not to go to shops or pick up anything. A lot of people I know do the same.
        op00to 5y ago
        I haven’t “ducked down to the shops” when I’m ill. It’s not that hard to keep necessities around.
    - Razengan 5y ago
      > This is not same. > The non vaccinated are actively choosing to be a danger to people around them. > It is like actively carrying concealed unlicensed gun which can silently and anynomously fire at people. What about giving a life extension to someone who stabs other people? The recipient of the heart transplant, David Bennett, actively chose to be a danger to people around him.
      - achow 5y ago
        Yes. Why not stick to that topic. Why to conflate by bringing in vaccine one?
  - deleted 5y ago
    [deleted]
  - onion2k 5y ago
    That's different because there's no moral judgement in that position. If you refuse treatment for a condition, even a preventative one, then there's no moral imperative to offer a different treatment later. Doctors did their best to save you, but you didn't do your part. That's on you.
    - dijonman2 5y ago
      I couldn’t disagree more. Everyone deserves the same level of care.
      - deleted 5y ago
        [deleted]
      - jagger27 5y ago
        Everyone deserves care. It’s unpleasant to think about giving emergency care to people who actively refuse preventative treatments at the cost of canceled appointments and surgeries for non-COVID patients. Triaging really sucks.
      - onion2k 5y ago
        They're getting it. Everyone is offered the vaccine. If people choose not to accept that care then what happens afterwards has to be assessed and prioritized on a case by case basis. If there's an ICU bed and two patients, one who's a Covid patient who refused to protect themselves and the other someone who has something not preventable, the second one should get priority. Ideally there would be two beds, and everyone would get the care they need, but reality means choices have to be made. Refusing a vaccine should send you to the back of the queue.
    - jlawson 5y ago
      Absolutely not, that's not how it works. You won't be denied tramua treatment for a gunshot because your doc told you to stop playing with guns. You won't be refused heart medicine because you didn't stop eating bacon when your doctor told you to 5 years earlier. You won't be denied ER treatment because you were drunk when you crashed your car. There is no rule where we have to treat all patients equally (including mass murderers) except those who didn't accept n earlier-offered treatment or who did something that caused their own medical condition (i.e which probably includes most medical conditions). Medical care is not an exploding offer. Honestly - shame on you for trying to sneak in an absurd exception just so you can abuse the medical system to hurt people you don't like. That's not what hospitals are for.
  - op00to 5y ago
    I’m all for providing telemedicine to those who choose not to be vaccinated against COVID (compared to those who medically can it be vaccinated). But letting them into health care facilities? Nah, get your shots and come back.
- corobo 5y ago
  There was an episode of Star Trek Voyager that had this system in place, ep 7x5 Critical Care Naturally it was corrupt
- renewiltord 5y ago
  We already have that laundered through something else. Like if you’re a drinker you won’t get a liver.
  - mlyle 5y ago
    That's not a moral judgment: that's a judgment about whether you're likely to not wreck the new organ and have a good outcome.
    - _delirium 5y ago
      That's a common rationalization for the moral judgment, but without evidence. "Recent studies have shown similar survival rates among individuals who undergo LT [liver transplant] for ALD [alcoholic liver disease] and those who undergo LT for other chronic causes of end-stage liver disease." [1] [1] https://pubmed.ncbi.nlm.nih.gov/30018475/ https://pubmed.ncbi.nlm.nih.gov/30018475/
      - deleted 5y ago
        [deleted]
      - mlyle 5y ago
        As your link says, there's an association between sobriety and liver transplant outcome. As your link also says, in most areas, you can receive a liver for ALD; there's just a 6 month sobriety rule. So we know: - 6 months of sobriety increase odds of ongoing subsequent sobriety - Sobriety improves LT transplant outcomes. Many believe, without strong numerical evidence either way: - 6 months of sobriety before procedure improves outcome of LT transplantation. Fewer believe: - A 6 month sobriety requirement is an unnecessary impediment to transplantation. Your paper says: "An interval of sobriety prior to LT is very desirable from a medical point of view. Abstinence may markedly improve liver function" i.e. in many cases, if people could stop drinking, they might not even need the liver!
  - omgitsabird 5y ago
    That is not a universal statement[0]. They may get lower priority in many cases, but MELD[1] or a similar model is used to determine who gets priority for liver transplant. [0] https://www.hopkinsmedicine.org/news/articles/destigmatizing-liver-transplant-for-patients-with-alcohol-use-disorder https://www.hopkinsmedicine.org/news/articles/destigmatizing... [1] https://en.wikipedia.org/wiki/Model_for_End-Stage_Liver_Disease https://en.wikipedia.org/wiki/Model_for_End-Stage_Liver_Dise...
lisper 5y ago
Considering a person's criminal record is not the same as considering their moral character.
- GameOfFrowns 5y ago
  >Considering a person's criminal record is not the same as considering their moral character. Although some might argue that there was a certain correlation between the two. https://www.nbcnews.com/news/crime-courts/anthony-stokes-teen-who-got-heart-transplant-dies-car-chase-n334001 https://www.nbcnews.com/news/crime-courts/anthony-stokes-tee...
enchiridion 5y ago
It probably happens more than you think. Organs are doled out based on a rating system as evaluated by a small review board In the case of ties, the question of who “deserves” the organ is relevant to the board members. Uncomfortable but true. Also doesn’t really apply here as this guy had a last ditch experimental operation. The family in the article just wanted revenge.
- bertil 5y ago
  The organ board base their decision on likelihood that the receiver will benefit from the transplant (for a long time), so some habits that are medically relevant are taken into account: smoking, drinking, taking drugs, and when AIDS was a concern, having sex with people who might transmit it. All those also come a moral judgement so many people assumed that the board was making a moral judgement. They are not: having other conditions complicating the process is relevant; being old too. Being a crimimal is morally relevant but doesn’t come into the judgement of the board. For lack of a better word, they are maximising the duration of the organ.
  - enchiridion 5y ago
    Yes, most of the time that’s true, and just about everything you mentioned can be boiled down to a single number. Genuine ties do happen though, and at the end of the day the board is human.

by mlyle 5y ago

fennecfoxen 5y ago

Yeah, the Post complaint (echoed elsewhere) is basically a call for having a social credit score that can say “you’re not a good person, so we’re not going to let the doctors save you.”

rob74 5y ago
...and the next step would be "we're not going to treat you for Covid because you're not vaccinated".
- achow 5y ago
  This is not same. The non vaccinated are actively choosing to be a danger to people around them. It is like actively carrying concealed unlicensed gun which can silently and anynomously fire at people.
  - rob74 5y ago
    I'm vaccinated myself and basically I have the same opinion as you. But David Bennett also actively chose to stab someone seven times in 1988 - "only" leaving him paralyzed, but probably with the intent to kill him? Ok, he probably served time for that and it was a long time ago, so judicially you can consider him rehabilitated. My argument was that once you refuse to treat (former) criminals, that's a slippery slope. And apparently I was right, since some here seem to consider people who choose not to get vaccinated worse that violent criminals...
    - op00to 5y ago
      Worse? No. The unvaccinated are far more likely to get sick or die as a part of any medical procedure right now just because of the base risk of COVID in hospitals. If you can’t take the first step to protect yourself and others, there’s not much health care providers can do to change your mind.
  - jlawson 5y ago
    I think you're confused on what the word 'actively' means.
    - achow 5y ago
      'Actively' seems to be accurate for the scenario when one is choosing to make body conducive to incubate virus, or already incubating them (albeit unknowingly if asymptomatic). [Edit] And if you meant active in context of 'Active shooter', then still use of the word active is not wrong. Virus laden body is like carrying a concealed gun which is on 'auto pilot', it is actively spraying bullets; it IS active all the while.
      - InvertedRhodium 5y ago
        I can't think of a single person I know that hasn't ducked down to the shops to pick something up when they have the flu. By your definition, they are actively attempting to cause harm to others - which is an interesting take.
        sersi 5y ago
        Even before covid, I would always wear a mask if I had a flu and would try as much as possible not to go to shops or pick up anything. A lot of people I know do the same.
        op00to 5y ago
        I haven’t “ducked down to the shops” when I’m ill. It’s not that hard to keep necessities around.
  - Razengan 5y ago
    > This is not same. > The non vaccinated are actively choosing to be a danger to people around them. > It is like actively carrying concealed unlicensed gun which can silently and anynomously fire at people. What about giving a life extension to someone who stabs other people? The recipient of the heart transplant, David Bennett, actively chose to be a danger to people around him.
    - achow 5y ago
      Yes. Why not stick to that topic. Why to conflate by bringing in vaccine one?
- deleted 5y ago
  [deleted]
- onion2k 5y ago
  That's different because there's no moral judgement in that position. If you refuse treatment for a condition, even a preventative one, then there's no moral imperative to offer a different treatment later. Doctors did their best to save you, but you didn't do your part. That's on you.
  - dijonman2 5y ago
    I couldn’t disagree more. Everyone deserves the same level of care.
    - deleted 5y ago
      [deleted]
    - jagger27 5y ago
      Everyone deserves care. It’s unpleasant to think about giving emergency care to people who actively refuse preventative treatments at the cost of canceled appointments and surgeries for non-COVID patients. Triaging really sucks.
    - onion2k 5y ago
      They're getting it. Everyone is offered the vaccine. If people choose not to accept that care then what happens afterwards has to be assessed and prioritized on a case by case basis. If there's an ICU bed and two patients, one who's a Covid patient who refused to protect themselves and the other someone who has something not preventable, the second one should get priority. Ideally there would be two beds, and everyone would get the care they need, but reality means choices have to be made. Refusing a vaccine should send you to the back of the queue.
  - jlawson 5y ago
    Absolutely not, that's not how it works. You won't be denied tramua treatment for a gunshot because your doc told you to stop playing with guns. You won't be refused heart medicine because you didn't stop eating bacon when your doctor told you to 5 years earlier. You won't be denied ER treatment because you were drunk when you crashed your car. There is no rule where we have to treat all patients equally (including mass murderers) except those who didn't accept n earlier-offered treatment or who did something that caused their own medical condition (i.e which probably includes most medical conditions). Medical care is not an exploding offer. Honestly - shame on you for trying to sneak in an absurd exception just so you can abuse the medical system to hurt people you don't like. That's not what hospitals are for.
- op00to 5y ago
  I’m all for providing telemedicine to those who choose not to be vaccinated against COVID (compared to those who medically can it be vaccinated). But letting them into health care facilities? Nah, get your shots and come back.
corobo 5y ago
There was an episode of Star Trek Voyager that had this system in place, ep 7x5 Critical Care Naturally it was corrupt
renewiltord 5y ago
We already have that laundered through something else. Like if you’re a drinker you won’t get a liver.
- mlyle 5y ago
  That's not a moral judgment: that's a judgment about whether you're likely to not wreck the new organ and have a good outcome.
  - _delirium 5y ago
    That's a common rationalization for the moral judgment, but without evidence. "Recent studies have shown similar survival rates among individuals who undergo LT [liver transplant] for ALD [alcoholic liver disease] and those who undergo LT for other chronic causes of end-stage liver disease." [1] [1] https://pubmed.ncbi.nlm.nih.gov/30018475/ https://pubmed.ncbi.nlm.nih.gov/30018475/
    - deleted 5y ago
      [deleted]
    - mlyle 5y ago
      As your link says, there's an association between sobriety and liver transplant outcome. As your link also says, in most areas, you can receive a liver for ALD; there's just a 6 month sobriety rule. So we know: - 6 months of sobriety increase odds of ongoing subsequent sobriety - Sobriety improves LT transplant outcomes. Many believe, without strong numerical evidence either way: - 6 months of sobriety before procedure improves outcome of LT transplantation. Fewer believe: - A 6 month sobriety requirement is an unnecessary impediment to transplantation. Your paper says: "An interval of sobriety prior to LT is very desirable from a medical point of view. Abstinence may markedly improve liver function" i.e. in many cases, if people could stop drinking, they might not even need the liver!
- omgitsabird 5y ago
  That is not a universal statement[0]. They may get lower priority in many cases, but MELD[1] or a similar model is used to determine who gets priority for liver transplant. [0] https://www.hopkinsmedicine.org/news/articles/destigmatizing-liver-transplant-for-patients-with-alcohol-use-disorder https://www.hopkinsmedicine.org/news/articles/destigmatizing... [1] https://en.wikipedia.org/wiki/Model_for_End-Stage_Liver_Disease https://en.wikipedia.org/wiki/Model_for_End-Stage_Liver_Dise...

lisper 5y ago

Considering a person's criminal record is not the same as considering their moral character.

GameOfFrowns 5y ago
>Considering a person's criminal record is not the same as considering their moral character. Although some might argue that there was a certain correlation between the two. https://www.nbcnews.com/news/crime-courts/anthony-stokes-teen-who-got-heart-transplant-dies-car-chase-n334001 https://www.nbcnews.com/news/crime-courts/anthony-stokes-tee...

enchiridion 5y ago

It probably happens more than you think. Organs are doled out based on a rating system as evaluated by a small review board In the case of ties, the question of who “deserves” the organ is relevant to the board members. Uncomfortable but true. Also doesn’t really apply here as this guy had a last ditch experimental operation. The family in the article just wanted revenge.

bertil 5y ago
The organ board base their decision on likelihood that the receiver will benefit from the transplant (for a long time), so some habits that are medically relevant are taken into account: smoking, drinking, taking drugs, and when AIDS was a concern, having sex with people who might transmit it. All those also come a moral judgement so many people assumed that the board was making a moral judgement. They are not: having other conditions complicating the process is relevant; being old too. Being a crimimal is morally relevant but doesn’t come into the judgement of the board. For lack of a better word, they are maximising the duration of the organ.
- enchiridion 5y ago
  Yes, most of the time that’s true, and just about everything you mentioned can be boiled down to a single number. Genuine ties do happen though, and at the end of the day the board is human.