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I know it's a bit offtopic, but why is being a donor an opt-in instead of an opt-out process? In our country, every employee has to pass a medical exam every ~

I know it's a bit offtopic, but why is being a donor an opt-in instead of an opt-out process? In our country, every employee has to pass a medical exam every ~3 years, and the same for college students. We could implement the opt-out option, give a grace period of eg. 5 years, where everyone could be explicitily asked if they want to opt-out (just sign this form) at a medical institution (or mail in, or sign a form online), and after that, everyone not opted out would become a donor. I don't care what happens to my organs after I die, but I'm one of the many who are to lazy to actually go to a proper place to fill out a proper form to become a donor.

brigandish 4y ago
Because opt-out implies that my body is not my property nor my heirs but the property of the state upon my death (and possibly before), whereas the opposite is true for opt-in. Like most rights and freedoms, opt-in protects me legally better than opt-out but makes life more difficult for the group if people use their freedoms selfishly. I would never opt-in to opt-out because I value freedom and want humans to do the difficult bit of persuasion and education instead of coercion and the nasty ramifications that can come of the state getting even a camel's nose inside the tent of owning my body (and thus the right to do things to that body). Pick any freedom/right you like and it'll be like this, whether it's speech or guns or right to silence or right to a lawyer, bodily autonomy against vaccine mandates or bodily autonomy in getting abortions… freedom is just so inconvenient for those who want what's best for the collective, but never mind the individuals who get crushed along the way to utopia. So no thanks (and that includes your generous offer of a time limited opt-out).
- saiya-jin 4y ago
  Well no, if you are actually truly in your heart subscribed to any major religion, after your death its not 'your' body anymore, just some leftover soon-to-rot garbage on the level of trimmed nails or cut hair, nothing more. In fact, its rotting garbage regardless of your beliefs, nature doesn't care about those pesky things. The other side is about saving actual lives in no small numbers, so what OP describes are tons of lives saved by just amending bureaucracy slightly, while preserving all those 'freedoms' that people like you keep repeating ad nausea anytime anything worthy is discussed. If you actually really care about those freedoms, doing 2 minute bureaucratic work (or 5 seconds) every 5 years is no brainer. But if you just have knee jerk reactions to any change, well thats another problem on your side that is no concern to rest of society.
  - SuoDuanDao 4y ago
    >Well no, if you are actually truly in your heart subscribed to any major religion, after your death its not 'your' body anymore, just some leftover soon-to-rot garbage on the level of trimmed nails or cut hair, nothing more. Confident assertion of what people unlike you must believe makes me extremely skeptical about letting anyone on your side of this debate near the levers of power.
  - brigandish 4y ago
    I'm an atheist.
- ClumsyPilot 4y ago
  > Like most rights and freedoms, opt-in protects me legally better than opt-out but makes life more difficult At that point are already dead, too late to protect you. Dead people's 'rights' is a strange legal concept, and they shouldn't not be valued above the living. Your pontification about 'mah freedom' doesnt work, because your freedom is someone else's liability. If you have the right to a fair trial by your peers, now I have to pay the salary of a judge, and I have to go on jury duty. But maybe by freedom is more important? Why am I being forced to do work in a courtroom against my will for free, is this like slavery? So you won't get a trial of your peers.
  - brigandish 4y ago
    > At that point are already dead, too late to protect you. If the implication is made before my death, in law, that I do not own my body then I am not protected when I'm alive. > Your pontification about 'mah freedom' doesnt work Please, cut that out. Go to Reddit or Twitter if you want to have discussions of that kind, but like a lot of other people on HN, I hope for basic courtesy when starting a conversation with someone.
    - gambiting 4y ago
      >>If the implication is made before my death, in law, that I do not own my body then I am not protected when I'm alive. We can all make whatever wishes we want before our deaths, but they are just suggestions not law - like OP said, dead people(corpses) are not legally people anymore, they have no rights. The law protects your body from certain things, but it's by binding the living, not by granting the rights to the dead. To put it in other words. You absolutely own your body - while you are alive. When you are not, you don't because you don't exist anymore. It's not yours, because there is no you. We have a legal system that will respect some of your remaining wishes, and hence the ability to opt-out. But there is zero reason why the list should be opt-in by default, or at least I don't see such a reason, neither in your post nor elsewhere.
      - brigandish 4y ago
        To quote myself, “Because opt-out implies that my body is not my property nor my heirs”.
ycombinete 4y ago
It's opt-out in Singapore
last_responder 4y ago
Religion
camtarn 4y ago
The UK recently changed from opt-in to opt-out.
- WelcomeShorty 4y ago
  Now let's see how fast these waiting lists for organs disappear.
gregwebs 4y ago
There’s a natural consequence that would immediately solve this problem. If you are not a donator, then you can’t receive either (or at least you go to the back of the line). Such a system would probably cure your laziness but you would probably have to switch to opt in default when implementing this system.
- lazyasciiart 4y ago
  I can’t donate organs due to a chronic health issue. Now that disqualifies me from the medical treatment I am more likely to need? As a sort of reverse of your proposal, in the US (and I think elsewhere) if you volunteer as a living donor, you are at the front of the line if you ever need an organ. And, this privilege is somewhat transferable to a person of your choice.
  - D13Fd 4y ago
    Solution seems easy - make it so that you can register regardless of whether your organs are usable in practice.
    - lazyasciiart 4y ago
      Then everyone who needs an organ would register. So now you need to say this benefit is only available too far in the future to affect the calculation - and you don’t influence the healthy people either.
Hitton 4y ago
Opt-in is much safer for donors. Imagine you are wealthy guy needing organ transplant. From buying 23andMe (or similar company) data you figure out there are several potential donors. In case of opt-out you can just arrange accident to happen and you have your organ.
- hardware2win 4y ago
  It sounds like very theoretical scenerio. If somebody wants to murder somebody for his organs Why he cannot uh... do it just fine regardless of his opt status and literally take his organs without going thru "official" way? Im asking because opt in by default seems to save way, way more people than your very theoretocal, probably not happening scenerio would affect
  - Hitton 4y ago
    You can't be serious. One would be "accident", but other would be obvious murder.
    - hardware2win 4y ago
      How arranging an accident isnt murder?
      - Hitton 4y ago
        I'm not sure if you are trying to troll me, but I'll spell it out for you anyway. scenario A (opt-out) - arranging accident. involves only few people (those who arrange it), can be fairly covert scenario B (opt-in) - stealing organs from body, either extremely overt (nobody is gonna think that body with missing organs died in accident, that's why I wrote "obvious") or involving many more people (there would have to be multiple members of hospital staff involved in stealing the organs), high risk scheme (again if found that the organs were stolen, suddenly it's "obvious" it probably wasn't accident)
lazyasciiart 4y ago
A number of countries have already done this and it’s not definitive that changing to opt out systems will make a noticeable difference in actually donated organs. Most of the “this is so obvious!!!!!” studies that promise huge results are actually looking at registration numbers, but if you die in a way that makes you a good donor option, the doctors in most places will ask your next of kin about it whether or not you are registered. In some places the next of kin can even override your opt-in (or failure to opt out). So social education/opinion campaigns that increase registration and influence potential next of kin could be a better move than going opt-out.
pvaldes 4y ago
That would create perverse incentives. After a car crash, hospitals could opt for neglecting strangers for the much bigger emotional reward of saving transplant receptors that they have meet for months or years, and are much more emotionally involved with. The reward of a guaranteed transplant is not what overworked physicians should have in mind when should be focused into saving our lives. People would opt-out in mass to avoid that danger. Is as stupid as the "non-resuscitate" badge. If is forced, it also destroys the image of "each donor is a hero", that can be a small drop of comfort for his family. Even worse, it opens a door to turning young people in minorities with a compatible body into a target. It is strictly forbidden to monetize it in many countries for solid reasons.
- gambiting 4y ago
  Yeah except it's nonsense, because it doesn't happen in countries where everyone is a donor by default. No one working at the emergency department has any kind of access or knowledge to donor lists, the idea that "we need to let this guy die so we can get his kidneys" is something anyone would do is insane not because of how immoral it is, but because it's physically impossible for your normal doctor/nurse/emergency responder to even know that this guys kidneys would be a match for anyone needing them. It's not a test being done when your life is on the line, healthcare workers are overworked as it is, no one is checking your organ match when you came in from an accident. >>People would opt-out in mass to avoid that danger. So surely, if we assume what you say is true, the same risk exists if you are on the donor list voluntarily. Why would anyone be on it then? /s >>If is forced, it also destroys the image of "each donor is a hero", that can be a small drop of comfort for his family. I fail to see how it destroys that image. Your organs go and save someone else - you are still "a hero" to the receipient. Whether it was voluntary or not, doesn't change that(and if it does in your opinion change it, then surely witholding your permission must - by necessity - be one of the most evil acts you can do, no?) >>Even worse, it opens a door to turning young people in minorities with a compatible body into a target. Well now that's some complete dystopian sci-fi nonsense. What, doctors will go out and hunt young minority people on the streets to get their organs, to get that sweet emotional reward for successful transplants? Or who will do that, exactly? Please explain.
krageon 4y ago
It is opt out where I am, so I guess the answer is "it's not". We live on a world comprised of many countries, not just wherever you are.

brigandish 4y ago

Because opt-out implies that my body is not my property nor my heirs but the property of the state upon my death (and possibly before), whereas the opposite is true for opt-in. Like most rights and freedoms, opt-in protects me legally better than opt-out but makes life more difficult for the group if people use their freedoms selfishly. I would never opt-in to opt-out because I value freedom and want humans to do the difficult bit of persuasion and education instead of coercion and the nasty ramifications that can come of the state getting even a camel's nose inside the tent of owning my body (and thus the right to do things to that body). Pick any freedom/right you like and it'll be like this, whether it's speech or guns or right to silence or right to a lawyer, bodily autonomy against vaccine mandates or bodily autonomy in getting abortions… freedom is just so inconvenient for those who want what's best for the collective, but never mind the individuals who get crushed along the way to utopia. So no thanks (and that includes your generous offer of a time limited opt-out).

saiya-jin 4y ago
Well no, if you are actually truly in your heart subscribed to any major religion, after your death its not 'your' body anymore, just some leftover soon-to-rot garbage on the level of trimmed nails or cut hair, nothing more. In fact, its rotting garbage regardless of your beliefs, nature doesn't care about those pesky things. The other side is about saving actual lives in no small numbers, so what OP describes are tons of lives saved by just amending bureaucracy slightly, while preserving all those 'freedoms' that people like you keep repeating ad nausea anytime anything worthy is discussed. If you actually really care about those freedoms, doing 2 minute bureaucratic work (or 5 seconds) every 5 years is no brainer. But if you just have knee jerk reactions to any change, well thats another problem on your side that is no concern to rest of society.
- SuoDuanDao 4y ago
  >Well no, if you are actually truly in your heart subscribed to any major religion, after your death its not 'your' body anymore, just some leftover soon-to-rot garbage on the level of trimmed nails or cut hair, nothing more. Confident assertion of what people unlike you must believe makes me extremely skeptical about letting anyone on your side of this debate near the levers of power.
- brigandish 4y ago
  I'm an atheist.
ClumsyPilot 4y ago
> Like most rights and freedoms, opt-in protects me legally better than opt-out but makes life more difficult At that point are already dead, too late to protect you. Dead people's 'rights' is a strange legal concept, and they shouldn't not be valued above the living. Your pontification about 'mah freedom' doesnt work, because your freedom is someone else's liability. If you have the right to a fair trial by your peers, now I have to pay the salary of a judge, and I have to go on jury duty. But maybe by freedom is more important? Why am I being forced to do work in a courtroom against my will for free, is this like slavery? So you won't get a trial of your peers.
- brigandish 4y ago
  > At that point are already dead, too late to protect you. If the implication is made before my death, in law, that I do not own my body then I am not protected when I'm alive. > Your pontification about 'mah freedom' doesnt work Please, cut that out. Go to Reddit or Twitter if you want to have discussions of that kind, but like a lot of other people on HN, I hope for basic courtesy when starting a conversation with someone.
  - gambiting 4y ago
    >>If the implication is made before my death, in law, that I do not own my body then I am not protected when I'm alive. We can all make whatever wishes we want before our deaths, but they are just suggestions not law - like OP said, dead people(corpses) are not legally people anymore, they have no rights. The law protects your body from certain things, but it's by binding the living, not by granting the rights to the dead. To put it in other words. You absolutely own your body - while you are alive. When you are not, you don't because you don't exist anymore. It's not yours, because there is no you. We have a legal system that will respect some of your remaining wishes, and hence the ability to opt-out. But there is zero reason why the list should be opt-in by default, or at least I don't see such a reason, neither in your post nor elsewhere.
    - brigandish 4y ago
      To quote myself, “Because opt-out implies that my body is not my property nor my heirs”.

ycombinete 4y ago

It's opt-out in Singapore

last_responder 4y ago

Religion

camtarn 4y ago

The UK recently changed from opt-in to opt-out.

WelcomeShorty 4y ago
Now let's see how fast these waiting lists for organs disappear.

gregwebs 4y ago

There’s a natural consequence that would immediately solve this problem. If you are not a donator, then you can’t receive either (or at least you go to the back of the line). Such a system would probably cure your laziness but you would probably have to switch to opt in default when implementing this system.

lazyasciiart 4y ago
I can’t donate organs due to a chronic health issue. Now that disqualifies me from the medical treatment I am more likely to need? As a sort of reverse of your proposal, in the US (and I think elsewhere) if you volunteer as a living donor, you are at the front of the line if you ever need an organ. And, this privilege is somewhat transferable to a person of your choice.
- D13Fd 4y ago
  Solution seems easy - make it so that you can register regardless of whether your organs are usable in practice.
  - lazyasciiart 4y ago
    Then everyone who needs an organ would register. So now you need to say this benefit is only available too far in the future to affect the calculation - and you don’t influence the healthy people either.

Hitton 4y ago

Opt-in is much safer for donors. Imagine you are wealthy guy needing organ transplant. From buying 23andMe (or similar company) data you figure out there are several potential donors. In case of opt-out you can just arrange accident to happen and you have your organ.

hardware2win 4y ago
It sounds like very theoretical scenerio. If somebody wants to murder somebody for his organs Why he cannot uh... do it just fine regardless of his opt status and literally take his organs without going thru "official" way? Im asking because opt in by default seems to save way, way more people than your very theoretocal, probably not happening scenerio would affect
- Hitton 4y ago
  You can't be serious. One would be "accident", but other would be obvious murder.
  - hardware2win 4y ago
    How arranging an accident isnt murder?
    - Hitton 4y ago
      I'm not sure if you are trying to troll me, but I'll spell it out for you anyway. scenario A (opt-out) - arranging accident. involves only few people (those who arrange it), can be fairly covert scenario B (opt-in) - stealing organs from body, either extremely overt (nobody is gonna think that body with missing organs died in accident, that's why I wrote "obvious") or involving many more people (there would have to be multiple members of hospital staff involved in stealing the organs), high risk scheme (again if found that the organs were stolen, suddenly it's "obvious" it probably wasn't accident)

lazyasciiart 4y ago

A number of countries have already done this and it’s not definitive that changing to opt out systems will make a noticeable difference in actually donated organs. Most of the “this is so obvious!!!!!” studies that promise huge results are actually looking at registration numbers, but if you die in a way that makes you a good donor option, the doctors in most places will ask your next of kin about it whether or not you are registered. In some places the next of kin can even override your opt-in (or failure to opt out). So social education/opinion campaigns that increase registration and influence potential next of kin could be a better move than going opt-out.

pvaldes 4y ago

That would create perverse incentives. After a car crash, hospitals could opt for neglecting strangers for the much bigger emotional reward of saving transplant receptors that they have meet for months or years, and are much more emotionally involved with. The reward of a guaranteed transplant is not what overworked physicians should have in mind when should be focused into saving our lives. People would opt-out in mass to avoid that danger. Is as stupid as the "non-resuscitate" badge. If is forced, it also destroys the image of "each donor is a hero", that can be a small drop of comfort for his family. Even worse, it opens a door to turning young people in minorities with a compatible body into a target. It is strictly forbidden to monetize it in many countries for solid reasons.

gambiting 4y ago
Yeah except it's nonsense, because it doesn't happen in countries where everyone is a donor by default. No one working at the emergency department has any kind of access or knowledge to donor lists, the idea that "we need to let this guy die so we can get his kidneys" is something anyone would do is insane not because of how immoral it is, but because it's physically impossible for your normal doctor/nurse/emergency responder to even know that this guys kidneys would be a match for anyone needing them. It's not a test being done when your life is on the line, healthcare workers are overworked as it is, no one is checking your organ match when you came in from an accident. >>People would opt-out in mass to avoid that danger. So surely, if we assume what you say is true, the same risk exists if you are on the donor list voluntarily. Why would anyone be on it then? /s >>If is forced, it also destroys the image of "each donor is a hero", that can be a small drop of comfort for his family. I fail to see how it destroys that image. Your organs go and save someone else - you are still "a hero" to the receipient. Whether it was voluntary or not, doesn't change that(and if it does in your opinion change it, then surely witholding your permission must - by necessity - be one of the most evil acts you can do, no?) >>Even worse, it opens a door to turning young people in minorities with a compatible body into a target. Well now that's some complete dystopian sci-fi nonsense. What, doctors will go out and hunt young minority people on the streets to get their organs, to get that sweet emotional reward for successful transplants? Or who will do that, exactly? Please explain.

krageon 4y ago

It is opt out where I am, so I guess the answer is "it's not". We live on a world comprised of many countries, not just wherever you are.