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> I'd argue that where welfare of two beings is affected, you need to consider the rights of both. About 5,000 people die in the US annually while waitlisted f

> I'd argue that where welfare of two beings is affected, you need to consider the rights of both. About 5,000 people die in the US annually while waitlisted for a kidney transplant; they are deemed medically eligible and a donation would give them more quality adjusted life years, but there is not a willing donor available. Consider, pairwise, the rights of two particular people: a person on the waitlist who will die unless they receive a kidney but who is below the cutoff line; and a healthy adult who lives next door to the sick person, who has two kidneys, and who could relatively safely donate one of them. The law currently forbids the sick person from paying the healthy person money in exchange for their kidney. This prevents coercion[1] which could endanger the health of the healthy person. In other words, the law prioritizes the healthy person infinitely and does not prioritize the welfare of the sick person. Do you think this setup is correct? Or should we make legal changes that would balance the rights of sick people against those of healthy people? Under your proposed framework, should we sometimes allow sick people who have money to pay healthy people for their organs, buying a chance to live? [1] Some discussion here: https://www.npr.org/transcripts/698563807 https://www.npr.org/transcripts/698563807

brigandish 4y ago
I heard this argument a couple of years ago via Youtube video and I liked its novelty (instead of having sides talk past each other it's gladdening to see some thought put into things). That being said, for me, it fails on the responsibility front. The healthy person did not cause the sickness, is not the sick one's parent and did not in any way "give" life, so to speak. If we reimagine the sick neighbour's predicament so that her husband and child both need a new kidney and the healthy neighbour convinces her to give them up because the he has a special room in his house where she can convalesce and regrow her kidneys. Should the healthy neighbour now be allowed to withdraw the offer after the sick neighbour had donated both kidneys? That kind of situation seems to align with some of the factors at play a bit better.
- mherdeg 4y ago
  Yeah ... I'm fortunate that neither I nor my immediate family are immediately affected by this decision, which affords me the luxury of thinking about the ethics in the abstract. > If we reimagine the sick neighbour's predicament so that her husband and child both need a new kidney and the healthy neighbour convinces her to give them up because the he has a special room in his house where she can convalesce and regrow her kidneys. Should the healthy neighbour now be allowed to withdraw the offer after the sick neighbour had donated both kidneys? While I'm totally willing to engage in this kind of Talmudic thought experiment, is there a way you could recast your question to be more biologically plausible? For example, suppose you offer to donate a kidney to your child, who is suffering from a fatal, heritable condition for which you carry a recessive gene. You thought that you were incurring a 0.007% risk of mortality (the average). During the surgery, the surgeon performing the extraction discovers that you have unexpected extra risk factors and their process will not work; they stop. They tell you that they can try again, but the new procedure they need to use will incur a 10% chance of your death. There is no other donor, and your child will die. 1 - Should you be allowed to withdraw your consent for the surgery? 2 - Should your child's wealthy spouse be allowed to pay you money to continue with the surgery?
  - brigandish 4y ago
    > is there a way you could recast your question to be more biologically plausible? It's a thought experiment, isn't the point that it is unencumbered by what is plausible? The reason for setting it up that way is to put responsibility for the sick person's life onto the healthy person through an action they took. I have no current alternative. > 1 - Should you be allowed to withdraw your consent for the surgery? Yes, the circumstances have changed. > 2 - Should your child's wealthy spouse be allowed to pay you money to continue with the surgery? I'm not against it but I can see why there could be rules against it.
    - mherdeg 4y ago
      > It's a thought experiment, isn't the point that it is unencumbered by what is plausible? The reason for setting it up that way is to put responsibility for the sick person's life onto the healthy person through an action they took. I have no current alternative. > … > If we reimagine the sick neighbour's predicament so that her husband and child both need a new kidney and the healthy neighbour convinces her to give them up because the he has a special room in his house where she can convalesce and regrow her kidneys. Should the healthy neighbour now be allowed to withdraw the offer after the sick neighbour had donated both kidneys? > That kind of situation seems to align with some of the factors at play a bit better. I'll admit that my preference for ethical questions to be realistic is an irrational preference. I don't know why I feel this way but I think we get answers which are more likely to be meaningful if we start with scenarios that could plausibly happen. Let me try revisiting the one you propose: Suppose there is a healthy person whose husband and child both need kidneys. Donating her kidneys to them both would ordinarily kill her -- people need at least one kidney to live, and she only has two. But her neighbor says "if you donate your kidneys to your family, I'll let you live in a special room in my house where you can regrow your kidneys". Let's say this process takes 40 weeks, and at about week 10 the neighbor says "I don't want you in my house any more -- please leave". Should the neighbor be allowed to say this, even if this means the formerly healthy person will require daily dialysis, and may indeed die? I wonder whether the answer changes on why the neighbor is saying "get out": * What if the neighbor themself has suddenly developed kidney failure, no transplants are available, and the only thing that will save them is an immediate 30-week stay in the special room? * Does the answer to the above change if the room's special-ness is tied to the neighbor being alive (if they die, no one else can ever use it to regrow organs)? * What if the neighbor's own infant child has suddenly developed kidney failure, no transplants are available, and the only thing that will save them is an immediate 30-week stay in the special room; should they be allowed to evict the recovering kidney donor? Does the answer change if the kidney donor has a 1% chance of surviving on dialysis until the room is available again? 10%? 99%? * If the neighbor is just being selfish and wants their room to be empty because they've decided think it looks better when it's tidy, should that be forbidden? * One way or another, if the room is empty at the end of the 40 weeks, should the state use eminent domain to seize the room and force the neighbor to take in gravely ill people from local hospitals, housing them until they are well, for as long as the room is working? When I have interrogated these views personally I have found that some things may be wrong to do, but society should still be structured in such a way that people may sometimes do wrong things.

brigandish 4y ago

I heard this argument a couple of years ago via Youtube video and I liked its novelty (instead of having sides talk past each other it's gladdening to see some thought put into things). That being said, for me, it fails on the responsibility front. The healthy person did not cause the sickness, is not the sick one's parent and did not in any way "give" life, so to speak. If we reimagine the sick neighbour's predicament so that her husband and child both need a new kidney and the healthy neighbour convinces her to give them up because the he has a special room in his house where she can convalesce and regrow her kidneys. Should the healthy neighbour now be allowed to withdraw the offer after the sick neighbour had donated both kidneys? That kind of situation seems to align with some of the factors at play a bit better.

mherdeg 4y ago
Yeah ... I'm fortunate that neither I nor my immediate family are immediately affected by this decision, which affords me the luxury of thinking about the ethics in the abstract. > If we reimagine the sick neighbour's predicament so that her husband and child both need a new kidney and the healthy neighbour convinces her to give them up because the he has a special room in his house where she can convalesce and regrow her kidneys. Should the healthy neighbour now be allowed to withdraw the offer after the sick neighbour had donated both kidneys? While I'm totally willing to engage in this kind of Talmudic thought experiment, is there a way you could recast your question to be more biologically plausible? For example, suppose you offer to donate a kidney to your child, who is suffering from a fatal, heritable condition for which you carry a recessive gene. You thought that you were incurring a 0.007% risk of mortality (the average). During the surgery, the surgeon performing the extraction discovers that you have unexpected extra risk factors and their process will not work; they stop. They tell you that they can try again, but the new procedure they need to use will incur a 10% chance of your death. There is no other donor, and your child will die. 1 - Should you be allowed to withdraw your consent for the surgery? 2 - Should your child's wealthy spouse be allowed to pay you money to continue with the surgery?
- brigandish 4y ago
  > is there a way you could recast your question to be more biologically plausible? It's a thought experiment, isn't the point that it is unencumbered by what is plausible? The reason for setting it up that way is to put responsibility for the sick person's life onto the healthy person through an action they took. I have no current alternative. > 1 - Should you be allowed to withdraw your consent for the surgery? Yes, the circumstances have changed. > 2 - Should your child's wealthy spouse be allowed to pay you money to continue with the surgery? I'm not against it but I can see why there could be rules against it.
  - mherdeg 4y ago
    > It's a thought experiment, isn't the point that it is unencumbered by what is plausible? The reason for setting it up that way is to put responsibility for the sick person's life onto the healthy person through an action they took. I have no current alternative. > … > If we reimagine the sick neighbour's predicament so that her husband and child both need a new kidney and the healthy neighbour convinces her to give them up because the he has a special room in his house where she can convalesce and regrow her kidneys. Should the healthy neighbour now be allowed to withdraw the offer after the sick neighbour had donated both kidneys? > That kind of situation seems to align with some of the factors at play a bit better. I'll admit that my preference for ethical questions to be realistic is an irrational preference. I don't know why I feel this way but I think we get answers which are more likely to be meaningful if we start with scenarios that could plausibly happen. Let me try revisiting the one you propose: Suppose there is a healthy person whose husband and child both need kidneys. Donating her kidneys to them both would ordinarily kill her -- people need at least one kidney to live, and she only has two. But her neighbor says "if you donate your kidneys to your family, I'll let you live in a special room in my house where you can regrow your kidneys". Let's say this process takes 40 weeks, and at about week 10 the neighbor says "I don't want you in my house any more -- please leave". Should the neighbor be allowed to say this, even if this means the formerly healthy person will require daily dialysis, and may indeed die? I wonder whether the answer changes on why the neighbor is saying "get out": * What if the neighbor themself has suddenly developed kidney failure, no transplants are available, and the only thing that will save them is an immediate 30-week stay in the special room? * Does the answer to the above change if the room's special-ness is tied to the neighbor being alive (if they die, no one else can ever use it to regrow organs)? * What if the neighbor's own infant child has suddenly developed kidney failure, no transplants are available, and the only thing that will save them is an immediate 30-week stay in the special room; should they be allowed to evict the recovering kidney donor? Does the answer change if the kidney donor has a 1% chance of surviving on dialysis until the room is available again? 10%? 99%? * If the neighbor is just being selfish and wants their room to be empty because they've decided think it looks better when it's tidy, should that be forbidden? * One way or another, if the room is empty at the end of the 40 weeks, should the state use eminent domain to seize the room and force the neighbor to take in gravely ill people from local hospitals, housing them until they are well, for as long as the room is working? When I have interrogated these views personally I have found that some things may be wrong to do, but society should still be structured in such a way that people may sometimes do wrong things.