5 ms·

A touching essay, but to my mind, the bioethics of organ donation that have become law (in most Western countries) are the major culprit behind organ scarcity,

A touching essay, but to my mind, the bioethics of organ donation that have become law (in most Western countries) are the major culprit behind organ scarcity, treating economic realities of supply, demand, and risk as taboo. I would 100% sign up for organ donation if it could either add a score bonus to me or my immediate family if we should ever find ourselves on the waiting list. Heck, I'd even donate blood or plasma more often too if they'd have some minor bumps.

renewiltord 2y ago
I would do it on a straight marketplace. As it is, I'm not sitting around giving up my bodily parts so that an organ procurement organization, a hospital, and a transplant surgeon are going to make a lot of money on. All of them have one thing to say to people who need organs: "pay me". So I'll join the line. If you want my organs "pay me". NOTA ruined the ability for an organ marketplace and created the resulting shortage. A lot of people have a visceral dislike for the idea of this stuff. They rationalize this with arguments that are easily rebuked. Here's Matt Yglesias on the subject https://www.slowboring.com/p/solving-problems-by-letting-people https://www.slowboring.com/p/solving-problems-by-letting-peo...
- lr4444lr 2y ago
  You're preaching to the choir, my friend. But I didn't feel like courting that battle today. Everyone in the organization transplant process except the donor benefits. And what do we have to show for that injustice? 8000 people a year dying waiting as the article states, not to mention insane costs alone due to dialysis.
  - renewiltord 2y ago
    I had a suspicion I'd met a fellow mind.
- komali2 2y ago
  Isn't this an indictment of the profitization of healthcare, rather than an argument for increasing it by paying people to donate organs? Selling organs sounds ghoulish and horrible to most people for a reason. They likely don't realize that's exactly what's happening behind the scenes - if they did, they'd think that was ghoulish and horrible as well.
  - sokoloff 2y ago
    Selling organs for a reasonable markup over direct costs seems perfectly fine to me. Hospitals don’t build and staff themselves any more than grocery stores or utilities do. Organs don’t harvest and fly themselves to the point of need unaided… If people can make a living (pun was accidental) doing this, it’s more likely to exist in a vibrant way when I or someone I love is in need of it.
DoreenMichele 2y ago
Medicine has a long history of being associated with things like the military and religion ("medicine man" being a term for a shaman, both spiritual leader and healer in tribal cultures). The military emphasizes values like honor and the good of the group over the individual while also typically making strong promises to do right by those who make sacrifices. Profit motive seems to generally be counterproductive to health. If people will donate plasma etc to get "points," this potentially encourages people to donate bad blood into the blood supply because they expect to need an organ someday. I don't know how we might a/b test something like this to see what actually works, but people have good reason to be skeptical of profit-driven or personal-gain driven processes for things of this sort.
- Atotalnoob 2y ago
  Shouldn’t the blood be tested? I really freaking hope it is… Ban the person from donating blood if the blood is bad.
  - DoreenMichele 2y ago
    It is probably a mistake to reply to this but there are bloodborne pathogens we don't keep stats on which are challenging to test for, so good luck with that.
    - Atotalnoob 2y ago
      Then how do we know we have “bad blood”?
      - DoreenMichele 2y ago
        It's possible for an individual to have a pretty good idea they aren't in good health and shouldn't really be donating without necessarily having affirmative tests for specific infections. It's a meme that homeless people sell plasma and are also alcoholic. You see jokes about stuff like that in TV shows or whatever. I don't know about you, but I don't really want my blood supply to primarily come from homeless people or relatives of people with genetic disorders at high risk of needing an organ transplant. The relatives may not have the disorder but may be carriers and may have health issues they aren't disclosing if their goal is to get points for their deathly ill loved one.
ec109685 2y ago
I agree that a bonus would be helpful, but still will donate my organs anyway.
tyre 2y ago
> I would 100% sign up for organ donation if it could either add a score bonus to me or my immediate family if we should ever find ourselves on the waiting list. Boy do I have news for you: today's the day you're going to save someone's life! https://learningcenter.kidney.org/spa/courses/resource/becoming-a-living-donor/curriculum/home/default https://learningcenter.kidney.org/spa/courses/resource/becom... From them: > If you donate at a transplant center that partners with the National Kidney Registry and for any reason, need a kidney after donation, you will be given priority for a living donor kidney. https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation https://www.kidney.org/transplantation/livingdonors/what-exp...
- tomjakubowski 2y ago
  That's a bump in the queue for having donated a kidney, not for merely signing up for the organ transplant list, like GP is suggesting.
  - ljf 2y ago
    I can't find info about it now, but I'm pretty sure in the 60s in South Africa, if you regularly donated blood you got to be bumped up the system for various ops and waiting lists, and if you had to stay in hospital you were offered a better bed/room. Sure I remember my relatives talking about that in some long ago conversation.
gj5904wj90wop 2y ago
[dead]

renewiltord 2y ago

I would do it on a straight marketplace. As it is, I'm not sitting around giving up my bodily parts so that an organ procurement organization, a hospital, and a transplant surgeon are going to make a lot of money on. All of them have one thing to say to people who need organs: "pay me". So I'll join the line. If you want my organs "pay me". NOTA ruined the ability for an organ marketplace and created the resulting shortage. A lot of people have a visceral dislike for the idea of this stuff. They rationalize this with arguments that are easily rebuked. Here's Matt Yglesias on the subject https://www.slowboring.com/p/solving-problems-by-letting-people https://www.slowboring.com/p/solving-problems-by-letting-peo...

lr4444lr 2y ago
You're preaching to the choir, my friend. But I didn't feel like courting that battle today. Everyone in the organization transplant process except the donor benefits. And what do we have to show for that injustice? 8000 people a year dying waiting as the article states, not to mention insane costs alone due to dialysis.
- renewiltord 2y ago
  I had a suspicion I'd met a fellow mind.
komali2 2y ago
Isn't this an indictment of the profitization of healthcare, rather than an argument for increasing it by paying people to donate organs? Selling organs sounds ghoulish and horrible to most people for a reason. They likely don't realize that's exactly what's happening behind the scenes - if they did, they'd think that was ghoulish and horrible as well.
- sokoloff 2y ago
  Selling organs for a reasonable markup over direct costs seems perfectly fine to me. Hospitals don’t build and staff themselves any more than grocery stores or utilities do. Organs don’t harvest and fly themselves to the point of need unaided… If people can make a living (pun was accidental) doing this, it’s more likely to exist in a vibrant way when I or someone I love is in need of it.

DoreenMichele 2y ago

Medicine has a long history of being associated with things like the military and religion ("medicine man" being a term for a shaman, both spiritual leader and healer in tribal cultures). The military emphasizes values like honor and the good of the group over the individual while also typically making strong promises to do right by those who make sacrifices. Profit motive seems to generally be counterproductive to health. If people will donate plasma etc to get "points," this potentially encourages people to donate bad blood into the blood supply because they expect to need an organ someday. I don't know how we might a/b test something like this to see what actually works, but people have good reason to be skeptical of profit-driven or personal-gain driven processes for things of this sort.

Atotalnoob 2y ago
Shouldn’t the blood be tested? I really freaking hope it is… Ban the person from donating blood if the blood is bad.
- DoreenMichele 2y ago
  It is probably a mistake to reply to this but there are bloodborne pathogens we don't keep stats on which are challenging to test for, so good luck with that.
  - Atotalnoob 2y ago
    Then how do we know we have “bad blood”?
    - DoreenMichele 2y ago
      It's possible for an individual to have a pretty good idea they aren't in good health and shouldn't really be donating without necessarily having affirmative tests for specific infections. It's a meme that homeless people sell plasma and are also alcoholic. You see jokes about stuff like that in TV shows or whatever. I don't know about you, but I don't really want my blood supply to primarily come from homeless people or relatives of people with genetic disorders at high risk of needing an organ transplant. The relatives may not have the disorder but may be carriers and may have health issues they aren't disclosing if their goal is to get points for their deathly ill loved one.

ec109685 2y ago

I agree that a bonus would be helpful, but still will donate my organs anyway.

tyre 2y ago

> I would 100% sign up for organ donation if it could either add a score bonus to me or my immediate family if we should ever find ourselves on the waiting list. Boy do I have news for you: today's the day you're going to save someone's life! https://learningcenter.kidney.org/spa/courses/resource/becoming-a-living-donor/curriculum/home/default https://learningcenter.kidney.org/spa/courses/resource/becom... From them: > If you donate at a transplant center that partners with the National Kidney Registry and for any reason, need a kidney after donation, you will be given priority for a living donor kidney. https://www.kidney.org/transplantation/livingdonors/what-expect-after-donation https://www.kidney.org/transplantation/livingdonors/what-exp...

tomjakubowski 2y ago
That's a bump in the queue for having donated a kidney, not for merely signing up for the organ transplant list, like GP is suggesting.
- ljf 2y ago
  I can't find info about it now, but I'm pretty sure in the 60s in South Africa, if you regularly donated blood you got to be bumped up the system for various ops and waiting lists, and if you had to stay in hospital you were offered a better bed/room. Sure I remember my relatives talking about that in some long ago conversation.

gj5904wj90wop 2y ago

[dead]