4 ms·

And this is why I'm not an organ donor, because I knew it would eventually be pushed to this and beyond.

by nsxwolf 11y ago

msandford 11y ago
A friend of mine was a nurse who worked in an ER. I expressed similar concerns of yours to her, "organ donor might mean that the doctors don't try and save me as hard because hey, good organs!" and she was emphatic that the doctors wouldn't do this. I think the worry is that even if the particular doctors in her ER would always try their hardest, there might be other doctors in other ERs who might not. What's difficult is that there's really very little way to truthfully ascertain if someone did in fact try hard enough. How do you really quantify effort? It's very similar to programming, if someone creates a bug was it an accident or was it on purpose? You'd like to believe that it was always an accident but you can never really know for sure. What happens when organ donation is seen as a moral imperative and only a few percent of people choose not to participate? Might doctors not try as hard to save them as "punishment" for being "anti-social" or something? There are a lot of thorny ethical questions surrounding organ donation, death, and drawing hard lines where things are squishy.
- ceejayoz 11y ago
  > What happens when organ donation is seen as a moral imperative and only a few percent of people choose not to participate? Might doctors not try as hard to save them as "punishment" for being "anti-social" or something? IMO, if you want to opt-out of donation, doing so should opt-out of the receipt of donated organs as well.
  - msandford 11y ago
    Fair enough, though it's trivially gamed. Don't be an organ donor. Get sick and become an organ donor. Receive transplant. Go back on your organ donor status. The rules to more properly regulate this would be a total disaster and would ultimately end up screwing some people unjustly and giving others organs unjustly too. More what I was trying to talk about was the idea that organ donors and non-donors might receive different standards of care "because organ donors are better people" in a future where almost everyone is an organ donor and societal expectations have shifted significantly.
  - petercooper 11y ago
    What about people who don't donate blood? No blood for them?
    - ceejayoz 11y ago
      No, I think that'd cross a major ethical line. First, there's not an ongoing, nationwide shortage of blood - we have enough of it, so people aren't dying needlessly because they can't get it. Second, requiring an invasive medical procedure on a live subject is hugely different to cadaver organ donation. We already have an ethical framework in which the government at least partially controls post-death use of the body - autopsies, regulation of burials, etc.
      - petercooper 11y ago
        I wonder what keeps US blood stocks healthy. Here in the UK there seems to be an alarming story every few months about how we barely have more than a few days' stock. Even just recently: http://www.theguardian.com/uk-news/2015/jun/05/sharp-drop-new-blood-donors-uk-stocks-at-risk http://www.theguardian.com/uk-news/2015/jun/05/sharp-drop-ne... .. no-one gets anything for donating blood here though, if The Simpsons is even slightly realistic (!) sometimes people in the US give blood for cash?
        ceejayoz 11y ago
        > Here in the UK there seems to be an alarming story every few months about how we barely have more than a few days' stock. That's how they drive up supply. When it gets too low here in the US they'll actually use phone banks to call regular donors to ask them to come in. I'd imagine the UK has something similar. > if The Simpsons is even slightly realistic (!) sometimes people in the US give blood for cash? I believe it's illegal to pay donors for blood, but plasma donation can be paid. It's problematic. http://www.theatlantic.com/health/archive/2014/05/blood-money-the-twisted-business-of-donating-plasma/362012/ http://www.theatlantic.com/health/archive/2014/05/blood-mone...
- kpil 11y ago
  I think that one risk being a organ donor is quite the opposite: Over-treatment. It might not be in your best interest (a painless death) to be painfully cooled down by a freezer to reduce the fever that can occur after severe aneurysms - while waiting for the brain infarct that will induce a "brain death." The cynical might say that it's for saving your organs rather than for your survival, and it's hard to tell how much pain is experienced, but looking at the reaction of the body,it's apparent that it hurts as hell.
- JshWright 11y ago
  If an ER doctor is actively trying to save your life (i.e. you are an unstable patient in an ER), it is _very_ unlikely that they would have any idea if you're a donor or not.
Osmium 11y ago
Ultimately, if a loved one's life could be saved by an organ donation, I would want it to be, and therefore I cannot ethically and logically not be on the organ donation list myself. Any other conclusion is, to my mind, selfish and antithetical to the society I want to live in. So it's really as simple as that. I understand fears such as your own from a human point of view, and they should absolutely be addressed if they're stopping people from becoming organ donors, but I do think it's unfortunate. So many lives could be saved... Hopefully more and more countries will adopt an 'opt-out' system going forward, because it seems to make a huge difference. And as for this article, I have no problem with clarifying the definition of death. If there's no electrical activity in my brain, I see no harm (literally "no harm" in the Hippocratic sense) in removing my organs before I'm taken off life support.
dspillett 11y ago
I don't quite see the logic here. What does the medial professional gain from letting you die to try save someone else? If there is nothing to gain (no financial reward, or reputational bonus, or so on) or there is but they have the appropriate morals to turn it down, then they aren't going to risk the nagging of their own conscience and/or looking bad by letting you die. If there is something to gain (and they are mentally capable of letting themselves take advantage of that) then it is going to happen whether you are a registered donor or not. If they can convincingly let you die without recompense they can hide your organs in the paperwork so it doesn't look like a non-donor organ has intentionally been used. So whether or not you are screwed in a situation where this discussion is relevant is not at all determined by whether or not you are registered as a donor. By choosing not to donate you are not controlling any such situation in the way you hope you are. There is the grey area where, for example, you have a 20% chance of survival but with the transplant someone else has a 60% chance - then things get a but more tricky depending on your paranoia level, though IMO the chance of that is rather small (the chance of getting hit by a bus on your way home from work or shot by some loon in a movie theatre is so much higher that it doesn't make sense to be committing time to thinking about this) and to be honest I'd probably not mind all that much if it did happen... Then again some might discount my opinions here because many don't seem to understand my reasoning in the following point of view: If I were in a permanent vegetative state or riddled with dementia or similar I'd gladly shuffle and donate my organs to help several others (who still have a chance of some desirable quality of life) on the way out. The only thing stopping me registering as "FFS just let me go when I get close to that sort of state, because I'm no longer me and there is no point throwing time and money at keeping the husk that is no longer me going" is that there is no legal way of doing so.
- Lawtonfogle 11y ago
  >I don't quite see the logic here. What does the medial professional gain from letting you die to try save someone else? Cost benefit analysis to save the most people. "He is already pretty much dead. We could keep trying and maybe damage the organs, or go ahead and call time of death and get these organs to save 3 other people." For me, the bigger issue is that of the 'beating heart donor' where your organs are harvested while you are brain dead but your body is still alive. I don't trust our understanding of brain death enough to say that pain isn't felt (consider the rare cases of people who are anesthetized enough they appear unconscious to the instrumentation but are able to recall parts of the operation including sometimes feeling pain).

And this is why I'm not an organ donor, because I knew it would eventually be pushed to this and beyond.

by nsxwolf 11y ago

And this is why I'm not an organ donor, because I knew it would eventually be pushed to this and beyond.

A friend of mine was a nurse who worked in an ER. I expressed similar concerns of yours to her, "organ donor might mean that the doctors don't try and save me as hard because hey, good organs!" and she was emphatic that the doctors wouldn't do this. I think the worry is that even if the particular doctors in her ER would always try their hardest, there might be other doctors in other ERs who might not. What's difficult is that there's really very little way to truthfully ascertain if someone did in fact try hard enough. How do you really quantify effort? It's very similar to programming, if someone creates a bug was it an accident or was it on purpose? You'd like to believe that it was always an accident but you can never really know for sure. What happens when organ donation is seen as a moral imperative and only a few percent of people choose not to participate? Might doctors not try as hard to save them as "punishment" for being "anti-social" or something? There are a lot of thorny ethical questions surrounding organ donation, death, and drawing hard lines where things are squishy.

ceejayoz 11y ago
> What happens when organ donation is seen as a moral imperative and only a few percent of people choose not to participate? Might doctors not try as hard to save them as "punishment" for being "anti-social" or something? IMO, if you want to opt-out of donation, doing so should opt-out of the receipt of donated organs as well.
- msandford 11y ago
  Fair enough, though it's trivially gamed. Don't be an organ donor. Get sick and become an organ donor. Receive transplant. Go back on your organ donor status. The rules to more properly regulate this would be a total disaster and would ultimately end up screwing some people unjustly and giving others organs unjustly too. More what I was trying to talk about was the idea that organ donors and non-donors might receive different standards of care "because organ donors are better people" in a future where almost everyone is an organ donor and societal expectations have shifted significantly.
- petercooper 11y ago
  What about people who don't donate blood? No blood for them?
  - ceejayoz 11y ago
    No, I think that'd cross a major ethical line. First, there's not an ongoing, nationwide shortage of blood - we have enough of it, so people aren't dying needlessly because they can't get it. Second, requiring an invasive medical procedure on a live subject is hugely different to cadaver organ donation. We already have an ethical framework in which the government at least partially controls post-death use of the body - autopsies, regulation of burials, etc.
    - petercooper 11y ago
      I wonder what keeps US blood stocks healthy. Here in the UK there seems to be an alarming story every few months about how we barely have more than a few days' stock. Even just recently: http://www.theguardian.com/uk-news/2015/jun/05/sharp-drop-new-blood-donors-uk-stocks-at-risk http://www.theguardian.com/uk-news/2015/jun/05/sharp-drop-ne... .. no-one gets anything for donating blood here though, if The Simpsons is even slightly realistic (!) sometimes people in the US give blood for cash?
      - ceejayoz 11y ago
        > Here in the UK there seems to be an alarming story every few months about how we barely have more than a few days' stock. That's how they drive up supply. When it gets too low here in the US they'll actually use phone banks to call regular donors to ask them to come in. I'd imagine the UK has something similar. > if The Simpsons is even slightly realistic (!) sometimes people in the US give blood for cash? I believe it's illegal to pay donors for blood, but plasma donation can be paid. It's problematic. http://www.theatlantic.com/health/archive/2014/05/blood-money-the-twisted-business-of-donating-plasma/362012/ http://www.theatlantic.com/health/archive/2014/05/blood-mone...
kpil 11y ago
I think that one risk being a organ donor is quite the opposite: Over-treatment. It might not be in your best interest (a painless death) to be painfully cooled down by a freezer to reduce the fever that can occur after severe aneurysms - while waiting for the brain infarct that will induce a "brain death." The cynical might say that it's for saving your organs rather than for your survival, and it's hard to tell how much pain is experienced, but looking at the reaction of the body,it's apparent that it hurts as hell.
JshWright 11y ago
If an ER doctor is actively trying to save your life (i.e. you are an unstable patient in an ER), it is _very_ unlikely that they would have any idea if you're a donor or not.

Osmium 11y ago

Ultimately, if a loved one's life could be saved by an organ donation, I would want it to be, and therefore I cannot ethically and logically not be on the organ donation list myself. Any other conclusion is, to my mind, selfish and antithetical to the society I want to live in. So it's really as simple as that. I understand fears such as your own from a human point of view, and they should absolutely be addressed if they're stopping people from becoming organ donors, but I do think it's unfortunate. So many lives could be saved... Hopefully more and more countries will adopt an 'opt-out' system going forward, because it seems to make a huge difference. And as for this article, I have no problem with clarifying the definition of death. If there's no electrical activity in my brain, I see no harm (literally "no harm" in the Hippocratic sense) in removing my organs before I'm taken off life support.

dspillett 11y ago

I don't quite see the logic here. What does the medial professional gain from letting you die to try save someone else? If there is nothing to gain (no financial reward, or reputational bonus, or so on) or there is but they have the appropriate morals to turn it down, then they aren't going to risk the nagging of their own conscience and/or looking bad by letting you die. If there is something to gain (and they are mentally capable of letting themselves take advantage of that) then it is going to happen whether you are a registered donor or not. If they can convincingly let you die without recompense they can hide your organs in the paperwork so it doesn't look like a non-donor organ has intentionally been used. So whether or not you are screwed in a situation where this discussion is relevant is not at all determined by whether or not you are registered as a donor. By choosing not to donate you are not controlling any such situation in the way you hope you are. There is the grey area where, for example, you have a 20% chance of survival but with the transplant someone else has a 60% chance - then things get a but more tricky depending on your paranoia level, though IMO the chance of that is rather small (the chance of getting hit by a bus on your way home from work or shot by some loon in a movie theatre is so much higher that it doesn't make sense to be committing time to thinking about this) and to be honest I'd probably not mind all that much if it did happen... Then again some might discount my opinions here because many don't seem to understand my reasoning in the following point of view: If I were in a permanent vegetative state or riddled with dementia or similar I'd gladly shuffle and donate my organs to help several others (who still have a chance of some desirable quality of life) on the way out. The only thing stopping me registering as "FFS just let me go when I get close to that sort of state, because I'm no longer me and there is no point throwing time and money at keeping the husk that is no longer me going" is that there is no legal way of doing so.

Lawtonfogle 11y ago
>I don't quite see the logic here. What does the medial professional gain from letting you die to try save someone else? Cost benefit analysis to save the most people. "He is already pretty much dead. We could keep trying and maybe damage the organs, or go ahead and call time of death and get these organs to save 3 other people." For me, the bigger issue is that of the 'beating heart donor' where your organs are harvested while you are brain dead but your body is still alive. I don't trust our understanding of brain death enough to say that pain isn't felt (consider the rare cases of people who are anesthetized enough they appear unconscious to the instrumentation but are able to recall parts of the operation including sometimes feeling pain).