Organ Donation and Opt-out Policies

[eldoctor]

A little background

The number of people needing a transplant continues to rise faster than the number of donors. About 4,100 transplant candidates are added to the national waiting list each month. Each day, about 77 people receive organ transplants. However, about 18 people die each day waiting for transplants that can't take place because of the shortage of donated organs.
There are now more than 105,000 people on the waiting list for solid organ transplants. Experts suggest that each of us could save or help as many as 50 people by being an organ and tissue donor.



http://www.womenshealth.gov/faq/organ-donation.cfm#b


Although this is 'old' data (2005), I'm sure it hasn't changed too much:
[SIZE=-1]Car Crash Stats: There were nearly 6,420,000 auto accidents in the United States in 2005. 2.9 million people were injured and 42,636 people killed. About 115 people die every day in vehicle crashes in the United States -- one death every 13 minutes.[/SIZE]


My questions are:



a) Are you an organ donor? If not, why not? (Not questioning the decision, but rather would like to know if it has to do with religion/personal choice/etc)


b) Do you think "opt-out" laws, which would mean that everybody is a donor unless they specifically choose otherwise should be implemented? The argument has been made that more people are not donating out of a lack of knowledge about the process. An article I read (will link when I find) event pointed out the opt-out system other countries use has approximately 90% of citizens listed as donor, simply because the rest chose to opt-out., Meanwhile, the same article cites a small fraction of that number of donors in the US.



tl;dr: Organ donation and opt-out laws, discuss or gtfo

---

Members don't see this ad.

 

[loveoforganic]

Yesyes

 

[wristbandMD]

a) Of course!

b) I think that opt-out laws should be implemented.

 

[theWUbear]

a) I'm an organ donor, I hope others will also consider being an organ donor

b) I believe opt-out laws would have a number of legal issues

 

[NickNaylor]

1) Yes

2) I'm against opt-out laws. I don't think it's appropriate, and I think that it would likely be struck down in the legal system.

 

[MightyMoose]

a) Yes, I'm sure a good proportion of SDN members are donors.

b) I think the idea of the opt-out law preys on those who are not well educated, which could lead to a number of issues that could get very messy in the litigious society we find ourselves in. While I wish more people were donors, I feel one needs to consciously choose to donate. Education programs through Public Health groups could be a good way to reach the people who might be potential donors that are uninformed about the process.

 

[mvenus929]

1) Yes, but my mom isn't and I can't for the life of me figure out why.

2) I agree with opt-out laws, but I don't know how well they'd work in this country.

 

[Pons Asinorum]

tl;dr: Organ donation and opt-out laws, discuss or gtfo

Since I think this is an actual, useful thread, I will post this $0.02...

For those of you saying "Yes" to are you an organ donor, please understand that being "useful" as an organ donor involves much more than just the checked box on the back of your driver's license. If you feel strongly about being an organ donor, please make sure you discuss this with your family (especially parents), significant others, close friends, etc. You really need to go the extra step by having something in writing (I know the thought of having a will is a long thing from most of your minds), even something as simple as this card:
http://organdonor.gov/donor/index.htm
as well as registering with your state:
http://organdonor.gov/donor/registry.shtm
will go a long way towards making your desire of donation a reality. The force of your DL having the organ donation box checked is not enough for an explantation team to work with.

 

[Electronegative]

I'm organ donor, but even if opt-out laws were implemented wouldn't families of the donors be able to refuse? or am I mistaking?

 

[drizzt3117]

I wonder how many people would answer yes to this if they saw how this was all handled in the hospital.

 

[IvyHopeful20]

I wonder how many people would answer yes to this if they saw how this was all handled in the hospital.

I don't really care if bored medical students play hide and seek with my penis after I die. You're dead, who gives a crap?

I understand why many people don't bother volunteering or donating stuff while they are alive. But donating organs after you die costs absolutely nothing and you get to save lives. I don't get the downside.

 

[Handinhand]

Most people, I'm assuming even on this board, think that if you're an organ donor and you die, your organs are donated. The truth is that MOST people that die are ineligible to donate their organs for one reason or another.

 

[drizzt3117]

I don't really care if bored medical students play hide and seek with my penis after I die. You're dead, who gives a crap?

I understand why many people don't bother volunteering or donating stuff while they are alive. But donating organs after you die costs absolutely nothing and you get to save lives. I don't get the downside.

I'm talking about care prior to death. There are rules about this but...

 

[Handinhand]

Those dang ER docs at UW! Are you on rotations yet drizz?

 

[organdonor]

I am an organ donor (surprised much?) and encourage everyone to be one. I always have sign up forms in my backpack and I've done volunteer activities for my local organ procurement organization.

Opt-out laws are morally and legally wrong. How can you think you are entitled to someone else's posessions or organs without their permission? This is simple first grade stuff? And don't think I'm not sensitive to this issue, my life revolves around it. I've seen people give, receive, live, and die from this issue.

The key to upping the number of transplants is education to encourage more people to volunteer to be donors. I've come across and educated so many people that think their religion opposes it (almost none do), think their organs aren't good enough (First of all, let the surgeons decide. Even if you are a drinker your liver may be much better than that of someone who has a disease and desperately needs another one. Smoker/Drinker? I'll bet your intestines are a-ok. Got an ostomy? You can give your corneas.) or think their treatment will suffer if their doctors know they are a donor (it won't). Our organization has started doing outreach in schools to educate children on the importance of organ donation. Have kids go home and ask mom and dad "are you an organ donor?" Nothing plants that little seed in your mind like your 5 year old coming home and discussing end of life care.

 

[thewanderer]

My questions: havent done legal analysis of this, so why would there be legal issues?

Also, how could this possibly be preying upon uneducated? i think preying inherently requires some sort of harm to be done. Additionally, if there are religious issues, it could be handled like other medical relgious issues, such as jehovah's witnesses and blood transfusions. I expect the clergy will make certain to tell members about any prohibitions...

 

[organdonor]

My questions: havent done legal analysis of this, so why would there be legal issues?

Also, how could this possibly be preying upon uneducated? i think preying inherently requires some sort of harm to be done.

You're stealing their organs. That's illegal and causes harm.

Additionally, if there are religious issues, it could be handled like other medical relgious issues, such as jehovah's witnesses and blood transfusions. I expect the clergy will make certain to tell members about any prohibitions...

You would hope so, but this isn't really the case. For instance, several people have told me they are not organ donors because they are catholic. Catholicism doesn't prohibit organ donation in any way shape or form. It just doesn't come up in the Sunday sermon very often. People form their opinions off of a TV show or what one of their friends said. For many, once religion tells them something that's it, it doesn't even become a choice and it doesn't warrant thinking about anymore. Once they learn that their religion in fact doesn't prohibit it they can consider an alternative.

 

[MightyMoose]

I'm talking about care prior to death. There are rules about this but...

Are you implying that physicians will provide less care to organ donors? If so, I have never seen that. I'm sure it happens in some cases, but I'm going to go ahead and disagree with your assumption that physicians across the board would be more interested in saving life x at the cost of life y.

 

[aggie08]

An organ donor saved my Step Dad's life (double lung transplant). Hundreds of people die every year waiting on organs, he was a lucky one. I definitely agree that it should be an opt-out policy. Here's my reason: Many of the most viable organs are young people who die suddenly. While these are the most sad cases you will see as a physician, friend, parent or other family member, these kids are not at a point in their life where they start thinking about organ donation. They are not necessarily against it, they are just young and think they are invincible and don't need have a reason to become a donor if they think they cannot possibly die. This puts grieving parents in a horrible position to decide whether or not their child's organs should go to someone else. They have just gotten the worst news of their life and are suddenly in a position to make a decision that I assume is heart-wrenching.

Our donor was a 20 year old male who died in a car accident. He was not a donor on his license, but had not expressed that he would not want his organs donated either. His generous mother, through her grieving, made the decision to save my step-dad's life (along with numerous other lives). We have met her and met the others who received organs from Craig. We talked to his family about their decision and they told us how difficult it was to make such a big decision at such a bad time in their lives.

We are lucky they made that decision, but is it really the place of grieving parent to have to do that? I don't think it is.

People who don't want their organs donated feel very strongly about it. People who don't care one way or another are apathetic. This means they are very unlikely to sign up for a donation program if they really aren't passionate about donating or whole-heartedly against donating. Having an opt-out program would save more lives, while still being sensitive to the decisions of some people who feel organ donation is not right for them.

And yes, I absolutely am an organ donor.

 

[eldoctor]

Since I think this is an actual, useful thread, I will post this $0.02...

For those of you saying "Yes" to are you an organ donor, please understand that being "useful" as an organ donor involves much more than just the checked box on the back of your driver's license. If you feel strongly about being an organ donor, please make sure you discuss this with your family (especially parents), significant others, close friends, etc. You really need to go the extra step by having something in writing (I know the thought of having a will is a long thing from most of your minds), even something as simple as this card:
http://organdonor.gov/donor/index.htm
as well as registering with your state:
http://organdonor.gov/donor/registry.shtm
will go a long way towards making your desire of donation a reality. The force of your DL having the organ donation box checked is not enough for an explantation team to work with.

Thank you for this information. I think part of the reason more people don't donate is that death is a touchy subject to talk about, and few want to consider the thought "...if i die..." If you think about it, religion aside, your organs are useless after death, and you could be saving dozens of people, which is what most of us want to do with our lives anyway. It would be great if we could increase awareness of organ donation.

Also, by filling out the information in the links you provided, you could really make life easier on your family if something happened. How are they supposed to know what you intended to donate unless you discuss it with them or have it in writing?

As for the ethical issues, I think the biggest problem at the moment is a lack of education of the majority (as always...)

 

[eldoctor]

I'm organ donor, but even if opt-out laws were implemented wouldn't families of the donors be able to refuse? or am I mistaking?

I'm not sure how that would work, but if you had some sort of will that explicitly had your wishes concerning donation then I doubt your family could refuse.

 

[eldoctor]

I'm talking about care prior to death. There are rules about this but...

I'm assuming you are implying that the healthcare team might try 'less hard' to save the patient's life if s/he is a donor? This is one of the concerns of many people against opt-out laws. Can you explain a little more?

 

[astrocreep96]

I'm an organ donor, but in all honesty the way my state handles donation bugs the **** out of me. We're supposed to call them even before addressing the issue with the family - I believe they are way too aggressive in their practices for how sensitive an issue it may be.

drizzt3117 may be encountering a similar issue.

eldoctor and others - I think you're barking up the entirely wrong tree with the issue of physicians "trying hard." There is much more to it than what you realize.

 

[eldoctor]

I am an organ donor (surprised much?) and encourage everyone to be one. I always have sign up forms in my backpack and I've done volunteer activities for my local organ procurement organization.

Opt-out laws are morally and legally wrong. How can you think you are entitled to someone else's posessions or organs without their permission? This is simple first grade stuff? And don't think I'm not sensitive to this issue, my life revolves around it. I've seen people give, receive, live, and die from this issue.

The key to upping the number of transplants is education to encourage more people to volunteer to be donors. I've come across and educated so many people that think their religion opposes it (almost none do), think their organs aren't good enough (First of all, let the surgeons decide. Even if you are a drinker your liver may be much better than that of someone who has a disease and desperately needs another one. Smoker/Drinker? I'll bet your intestines are a-ok. Got an ostomy? You can give your corneas.) or think their treatment will suffer if their doctors know they are a donor (it won't). Our organization has started doing outreach in schools to educate children on the importance of organ donation. Have kids go home and ask mom and dad "are you an organ donor?" Nothing plants that little seed in your mind like your 5 year old coming home and discussing end of life care.

How can I get involved in something like this? I thought about starting a website, maybe in a different language, but I feel like there might be more efficient efforts.

We are lucky they made that decision, but is it really the place of grieving parent to have to do that? I don't think it is.

And yes, I absolutely am an organ donor.

Thank you for sharing. Your story, and the bolded, are the main reasons why I think opt-out should be implemented. Those who truly do not want to donate will likely opt-out, and the tragic accidents like the man in your story can have happier endings.

 

[eldoctor]

I'm an organ donor, but in all honesty the way my state handles donation bugs the **** out of me. We're supposed to call them even before addressing the issue with the family - I believe they are way too aggressive in their practices for how sensitive an issue it may be.

drizzt3117 may be encountering a similar issue.

eldoctor and others - I think you're barking up the entirely wrong tree with the issue of physicians "trying hard." There is much more to it than what you realize.

I am genuinely interested in what he meant; I don't actually know how it goes down in the hospital. Did I misinterpret?

 

[astrocreep96]

I am genuinely interested in what he meant; I don't actually know how it goes down in the hospital. Did I misinterpret?

I can't speak for drizz - I'm throwing out an idea based on my opinion on the issue that may coincide with his (but obviously I have no idea).

To expand on my opinion - I don't think I've met a physician in my hospital that wouldn't bust their ass for each and every patient, including those that likely have no chance of survival. It has absolutely nothing to do with whether or not a physician will decide to "stop trying" with a given patient. The issue arises with the organization responsible for handling organ donation in my state - they are aggressive in how they operate such that I think it is borderline inappropriate.

 

[drizzt3117]

I think there's a couple issues. I don't like the interaction between the transplant team and the care team, I don't like how care centers do very little due diligence as to the source organs (there's a big article about organ purchasing and how the transplants are done at centers like Sinai and Penn) I don't like how it might affect some medical decisions (either consciously or unconsciously) I don't like how the lists are handled. Anyone who has taken care of chronic/terminal patients know that provider attitudes arent always as nice as you think.

 

[organdonor]

I think part of the reason more people don't donate is that death is a touchy subject to talk about, and few want to consider the thought "...if i die..."

Also, some people don't sign up to be an organ donor because they don't want to be an organ donor. Without obtaining their permission you have no way of knowing. A donated organ is a wonderful, life giving GIFT. It isn't a tax that can be taken from you whether you like it or not.

If you think about it, religion aside, your organs are useless after death, and you could be saving dozens of people, which is what most of us want to do with our lives anyway.

Exactly. I do, you do, but someone out there doesn't. What do you say to the family of the guy whose organs were just recovered and put into someone else before they could be notified? oops? doesn't really suffice. What if they want them put back in?

I'm not sure how that would work, but if you had some sort of will that explicitly had your wishes concerning donation then I doubt your family could refuse.

An objection of a family member would disqualify you as a donor. This is why it is extremely important to let your family know your wishes. Here, there is no weight assigned to a family member, such as a wife matters more than a mother. A consensus must be reached. An objection of a family member will disqualify you, as they are your decision makers if you are disabled. When you cannot speak for yourself, your family speaks for you. What they say on your behalf carries equal weight as if you had said it, unless another arrangement has been made before hand. I guess I'm trying to say that LEGALLY they could overrule you, but the more ways you make your wishes known, the more emotionally difficult you make it for them to disregard your wishes.

To those who said they would take organs without permission, sorry but you just failed ethics class. You (or anyone else) are not entitled to things that are not yours, even if that thing would improve/save your life.

 

[kami333]

An objection of a family member would disqualify you as a donor. This is why it is extremely important to let your family know your wishes. Here, there is no weight assigned to a family member, such as a wife matters more than a mother. A consensus must be reached. An objection of a family member will disqualify you, as they are your decision makers if you are disabled. When you cannot speak for yourself, your family speaks for you. What they say on your behalf carries equal weight as if you had said it, unless another arrangement has been made before hand. I guess I'm trying to say that LEGALLY they could overrule you, but the more ways you make your wishes known, the more emotionally difficult you make it for them to disregard your wishes.

That's not entirely true. There is a hierarchy of consent:
POA->spouse->adult children->parents->grandchildren->adult siblings

Granted no coordinator would consent any case where there was conflict, but legally some people have more standing than others.

 

[organdonor]

That's not entirely true. There is a hierarchy of consent:
POA->spouse->adult children->parents->grandchildren->adult siblings

Granted no coordinator would consent any case where there was conflict, but legally some people have more standing than others.

In my state for my OPO there is no consideration of this. I believe for many issues this hierarchy exists, but the OPO doesn't take it into consideration.

 

[Electronegative]

My sister would have probably been a good and viable organ donor. Insanely rare bloodtype, mid 30's, had autism but had otherwise perfectly viable organs and died in a way that would have made her organs viable. My mom even told me once she would have seriously considered donating the organs. She died in a hospital so in that account the organs could have been usable.

The glitch? The mexican legal system is designed in such a way that 99% of people that are physically apt to donate, at least in the State of Mexico will not become candidates. The reason? They have the do a necropsy which automatically makes the organs useless. The necropsy results only proved the obvious of how she died anyways.

You can juggle whether or not doing necropsies to find out how someone died vs donating viable organs is better but that's how the law works. Meanwhile, I've seen a ton of people with kidney failure die in front of my eyes because of lack of organs. The lucky kidney patients are the ones where a relative or a friend had the heart to donate their kidney. It´s amazing how healthy they suddently look after they get a new transplant and how much weight they gain like magic.

I'd love to donate my organs and I also enjoy having a rare bloodtype to boot, but mexican law is designed in such a way that it doesn't matter whether me or my parents would allow it, the state's law won't and nobody cares to fix it. Maybe they would if a politician or a tv actor would need an organ, but rich people could just go to a different country for organs instead so it doesn't matter anyways. Meanwhile, Spain is attracting mexican doctors like the plague to go live there for become transplant organ surgeons both for the actual chance to operate because (OMG!) there's actually organs available and better pay. If patients with high blood pressure and diabetes that are poorly controlled but don't want to change to stronger meds knew how poor their life expectancy will be once their kidneys fail they'd probably switch to insulin in a heartbeat. Kidney failure and living in the small place I live in is a death sentence because there'sno dialysis.

You mean Autopsy, Necropsy is done on animals.

 

[thewanderer]

To those who said they would take organs without permission, sorry but you just failed ethics class. You (or anyone else) are not entitled to things that are not yours, even if that thing would improve/save your life.

Not sure I agree ethics inherently forbids all actions for the greater good... if so, then actions we commonly accept (taxation for education/infrastructure or the draft) are inherently immoral. I feel that the argument you posited is too strong, leading to a ultralibertarian world few would want to live it.

I think that most people would prefer a world where small donations can lead to a much greater improvement for the general populace, ASSUMING FAIR APPLICATION.

You said stealing a person's organs is a crime, which of course it is (I like my kidneys where they are, thank you very much). Yet a dead human is difficult to call a person... personhood seems to require life (at least in the body, and I doubt a dead person's soul resides within a dead body, for the dualists out there. ). Therefore, I believe the request is not overly onerous.

I feel there is a compelling argument for opt-out (unless one is against organ transplantation on oneself, one should be rationally required to donate one's organs, barring very unusual cases. This is due to both pragmatic free rider issues and also notions of fairness and rationality, particularly Kantian rationality). I dont think this should be governmentally enforced, but the benefit of the doubt should probably sit upon this side.

Only the former person (now dead) affected should have a say in organ donation. I see it as very unusual that the family should be given greater say in how the one's body is employed than the person who possessed that body. If one is on public record as being for donation, that should certainly be enough, even against family wishes. Ex. My family is a Jehovas witness, and against blood transfusions. I am not, and am unconcious, but have stated that I want a transfusion. It is obviously false that the family should have say here.

This is, of course, assuming one's body, even while dead, is not a sancrosanct, and immune to governmental interference, even in cases of public good. However, I think vaccinations and the draft are both more invasive (painful and/or time consuming) while one is alive, and benefit significantly less. The draft, certainly, is often for less public good. cough WW1, vietnam.

Being a philosophy minor, Im tempted to do a full argument for opt out just for fun, but here is a compromise position that I think is better.

Say you are extremely worried about consent... this could be carried out easily, as a question, 'Are you against being an organ donor' upon licence renewal, for example, or upon medical care if the question has not been asked in the last X years (ask parents at birth, possibly in between, and then upon age 18 or so ask the kid). Similar questions should be asked about end of life care anyway, and this burden would not seem to be excessive for those who disagree with organ transplantation.

The above question was carefully phrased to put those who dont particularly care on the donor side, due to the free rider and rationality reasons above.

 

[kami333]

In my state for my OPO there is no consideration of this. I believe for many issues this hierarchy exists, but the OPO doesn't take it into consideration.

Like I said, while legally there is a hierarchy, in practice no coordinator would consent something that might bring bad PR.
http://law.onecle.com/indiana/29/29-2-16-2.html


I was actually had a case where I was at the hospital ready to start a procurement when the physician informed me that one of the siblings didn't want it to proceed. Though I already had NoK consent, we decided to not go through with it since it looked like it could get messy (tissue was for research, not transplant so it wasn't a big consideration).

 

[thewanderer]

Being interesting in the ethics, I dont really care how poorly it is done now. I am more interested in how it should ideally be done (in our flawed world), so we know what to work towards.

EDIT: Oh, and opt out is not exactly without permission. If the consent argument flies, then we should not give blood to unknown people because a subset of the population does not agree with it (Jehovah's Witnesses).

BTW, I am not bashing upon JWs, I think people are entitled to their beliefs and that this belief, being based upon the foundation of their values, the scriptures, is not inherently irrational. I just find the beliefs to be very useful in philisophic thought experiments.

 

[eldoctor]

I feel there is a compelling argument for opt-out (unless one is against organ transplantation on oneself, one should be rationally required to donate one's organs, barring very unusual cases. This is due to both pragmatic free rider issues and also notions of fairness and rationality, particularly Kantian rationality). I dont think this should be governmentally enforced, but the benefit of the doubt should probably sit upon this side..

I think this is a very interesting issue, and one that I came across a lot in my research. I also feel it is fair that those individuals who choose to not donate should be placed at the end of the organ transplant list. Granted, I don't know if this is the case now, but it is difficult to argue that one who does not wish to donate should be entitled to someone else's organs.

 

[thewanderer]

I think this is a very interesting issue, and one that I came across a lot in my research. I also feel it is fair that those individuals who choose to not donate should be placed at the end of the organ transplant list. Granted, I don't know if this is the case now, but it is difficult to argue that one who does not wish to donate should be entitled to someone else's organs.

Haha, yeah, I think it is irrational (the worse sin for the philosopher!) to want something you are not willing to give in another's place. It is also against our intuitions of fairness, and in a rational world the above would be the case.

But, when deciding between people, should it be considered? Its a question I want to avoid, to be honest.

If forced to consider... I am personally unwilling to hold this against someone. Just as you d give treatment to an evil person, I feel we are compelled to aid people irregardless of their former irrationality.

 

[eldoctor]

Haha, yeah, I think it is irrational (the worse sin for the philosopher!) to want something you are not willing to give in another's place. It is also against our intuitions of fairness, and in a rational world the above would be the case.

But, when deciding between people, should it be considered? Its a question I want to avoid, to be honest.

If forced to consider... I am personally unwilling to hold this against someone. Just as you d give treatment to an evil person, I feel we are compelled to aid people irregardless of their former irrationality.

Should it be considered? Of course. But you have to realize that if you look at the numbers I posted in the OP, thousands of people die every year because they don't get a transplant. And I can guarantee you that many of those who DO get a transplant are not organ donors. Thus, as you said, it makes complete sense to give priority to those who would donate their organs themselves.

Does anybody know if organ donors have priority over non-organ donors in the US?

 

[organdonor]

Say you are extremely worried about consent... this could be carried out easily, as a question, 'Are you against being an organ donor' upon licence renewal, for example, or upon medical care if the question has not been asked in the last X years (ask parents at birth, possibly in between, and then upon age 18 or so ask the kid). Similar questions should be asked about end of life care anyway, and this burden would not seem to be excessive for those who disagree with organ transplantation.

The above question was carefully phrased to put those who dont particularly care on the donor side, due to the free rider and rationality reasons above.

I think this is a more feasible alternative, but I still can't support it. There will be those who do not understand the question, such as those who speak a language different from the person who is asking the question, or different from the language in which it is printed. Even non English speakers must get a drivers license and obtain medical care. How much of the insurance papers and release forms that they sign do they actually read? If noone else, this group of people would be taken advantage of. Just because you don't understand a question that was asked we are going to perform the most invasive surgery in existence? I don't think so!

The good thing about an opt-in system is that you never recover organs from someone who doesn't want it done to them, and with an opt-out system you would. Even if you would recover more organs, this would be offset by public ill will from the many patients whose organs you would steal from them and their families.

 

[jc235693]

1) I am an organ donor

2) I think an opt-out program would worth some of the moral wrongs it costs. For example the cost of stealing a dead guys organ to me is worth saving a life. But that's just me I tend to subscribe to a utilitarian code of ethics for most things.

So have any of you ever heard of the survival lottery
http://www.mnstate.edu/gracyk/courses/phil 115/Harris_on_Survival_Lottery.htm

baiscally we would all be part of a lottery and when someone needed an organ the lottery would choose someone to be killed to save the other (in most cases multiple people). While it may seem horrifying at first but if every life taken could save five wouldn't it be worth it? Of course there is the economic argument against such a lottery which claims that if people know they are likely to get a new heart or kidney they will be more likely to live riskier and more unhealthy lives thus causing the lottery to cause more death than it would prevent. If anything it is a really interesting thought experiment.

Sorry to continue my rant but I really like the ethics of this topic, what about if people could sell their organs? I mean my kidney is my property so if some guy needs a kidney and I am a match why wouldn't I be within my rights to sell him mine. I personally don't like this solution because I think it would lead to exploitation of the lower class who would be more likely to sell their organs. Just some food for thought.

 

[thewanderer]

I think this is a more feasible alternative, but I still can't support it. There will be those who do not understand the question, such as those who speak a language different from the person who is asking the question, or different from the language in which it is printed. Even non English speakers must get a drivers license and obtain medical care. How much of the insurance papers and release forms that they sign do they actually read? If noone else, this group of people would be taken advantage of. Just because you don't understand a question that was asked we are going to perform the most invasive surgery in existence? I don't think so!

I argue that we do the same thing with JWs by giving blood to them unless we are told beforehand. Are we not morally responsible for hurting them if we accidentally give them blood as a policy? Yes, we'd lose more lives, but this is Man's bodily integrity and beliefs we'd save!

Is there a morally relevant reason why organ donation is different from the above? I feel it is less onerous, as the person is dead.

To be honest, we ignore people's values all the time. I am against almost all war, but am forced, upon pain of IRS, to give money to support it, because it is seen as a public good (I'd debate it, but its beyond the scope of the thread). Half the country wanted to not bail out banks, why are they forced to pay for that? Why is this case different?

@jc2,

That lottery case is the one flaw I find in utilitarianism, unfortunately. It seems to me people have certain inalienable rights, and life is included in those (property is not, as taxation demonstrates, but certainly has limited rights).

Utilitarian with side constraints (ie. cant violate human rights) seems most likeable to me, although I have doubts about the rationality of said option (for reasons that took me a whole 8 page paper to elaborate!)

Selling organs is more interesting, and I've heard reasonable arguments for it, although I personally find it creepy. And the effect on society might be problematic, although I've heard rebuttals to this point (and cant remember well enough to have an opinion)

 

[organdonor]

1) I am an organ donor

2) I think an opt-out program would worth some of the moral wrongs it costs. For example the cost of stealing a dead guys organ to me is worth saving a life. But that's just me I tend to subscribe to a utilitarian code of ethics for most things.

So have any of you ever heard of the survival lottery
http://www.mnstate.edu/gracyk/courses/phil 115/Harris_on_Survival_Lottery.htm

baiscally we would all be part of a lottery and when someone needed an organ the lottery would choose someone to be killed to save the other (in most cases multiple people). While it may seem horrifying at first but if every life taken could save five wouldn't it be worth it? Of course there is the economic argument against such a lottery which claims that if people know they are likely to get a new heart or kidney they will be more likely to live riskier and more unhealthy lives thus causing the lottery to cause more death than it would prevent. If anything it is a really interesting thought experiment.

Sorry to continue my rant but I really like the ethics of this topic, what about if people could sell their organs? I mean my kidney is my property so if some guy needs a kidney and I am a match why wouldn't I be within my rights to sell him mine. I personally don't like this solution because I think it would lead to exploitation of the lower class who would be more likely to sell their organs. Just some food for thought.

Google "A Modest Proposal" and watch "Soylent Green" before you buy a ticket for that lottery.

Lower classes do not deserve to be organ farms for the rest of us. Neither does anyone else, which is why an opt-out system would never work. My own family member died waiting for an organ transplant, but I could have never condoned him receiving an organ for which the donor or the donors family did not specifically in writing give consent.

It sounds like you and I and most people reading this are in agreement that we would donate our organs. But there are people out there, who you will encounter in medicine, who think differently than you. You cannot subject them to your views.

Does non maleficence (do no harm) have any bearing here?

"utilitarian code of conduct" is an oxymoron.

 

[thewanderer]

Google "A Modest Proposal" and watch "Soylent Green" before you buy a ticket for that lottery.

Lower classes do not deserve to be organ farms for the rest of us. Neither does anyone else, which is why an opt-out system would never work. My own family member died waiting for an organ transplant, but I could have never condoned him receiving an organ for which the donor or the donors family did not specifically in writing give consent.

It sounds like you and I and most people reading this are in agreement that we would donate our organs. But there are people out there, who you will encounter in medicine, who think differently than you. You cannot subject them to your views.

Does non maleficence (do no harm) have any bearing here?

"utilitarian code of conduct" is an oxymoron.

First, I agree with the above (although A modest proposal is not utilitarian, and soylent green probably isn't either, but I don't know the numbers behind it), although I dare you to give me a flawless moral system! I've been searching for a while, and have problems with all that have been elaborated to me.

his proposal is to practice it fairly, as a draft should be conducted, so using the "hurt the poor" arg is strawmanning. Although in reality it would probably end that way, its not what he argued (lets read our opposition charitably!).

Plus, that was brought up more for the benefit of the readers than as a serious arg, as its a fun argument against U-ism.

Anyhow, are we not all subjected to views we disagree with? My args above, for ex. We have a fundamental difference in this, and I'm curious why you feel that beliefs about organs should be treated differently.

 

[iwantMD]

If you are a organ donor, physicians will be looking forward to your death to save bunch of others. I just find it creepy.


Dr. X: Is he dead yet?
Dr. Y: Not yet
Dr. X: Damn

 

[thewanderer]

If you are a organ donor, physicians will be looking forward to your death to save bunch of others. I just find it creepy.


Dr. X: Is he dead yet?
Dr. Y: Not yet
Dr. X: Damn

haha, and if you have money so will your family (for much worse reasons) 😉

we just gotta have faith in humanity (which doctors presumably are!), hard as it can be

 

[eldoctor]

If you are a organ donor, physicians will be looking forward to your death to save bunch of others. I just find it creepy.


Dr. X: Is he dead yet?
Dr. Y: Not yet
Dr. X: Damn

 

[jc235693]

Google "A Modest Proposal" and watch "Soylent Green" before you buy a ticket for that lottery.

Lower classes do not deserve to be organ farms for the rest of us. Neither does anyone else, which is why an opt-out system would never work. My own family member died waiting for an organ transplant, but I could have never condoned him receiving an organ for which the donor or the donors family did not specifically in writing give consent.

It sounds like you and I and most people reading this are in agreement that we would donate our organs. But there are people out there, who you will encounter in medicine, who think differently than you. You cannot subject them to your views.

Does non maleficence (do no harm) have any bearing here?

"utilitarian code of conduct" is an oxymoron.

I think non maleficence has a great bearing on this issue. I am arguing that you are doing harm by not using those organs. So by not using the organs you are letting people die when they could otherwise be saved, which I think is doing harm. By not having an opt-out system (or a system simply where everyone has to give up their organs) you placing a higher value on a person's property rights than the value of a person's life. This is why it may be justified to take someone's organs against their will.

I am not saying this type of system should be instituted immediately or that it could ever be instituted, I am just trying to argue that by letting people take their organs to the grave we are already doing a great harm and if we recognize this harm what are the options to lessen the harm i.e. would an opt-out system do more good (save more lives) than bad (taking organs from those who may not have wanted them taken)

 

[gravitywave]

he's dead serious (hahaha). honestly, this exact conversation has taken place in an OR somewhere while the harvest team waited to start their work. yes they're called "harvest teams." a little medical semantics there for ya....

much of Europe is opt-out. it's a little more communitarian over there.

 

[sustentacular]

You said stealing a person's organs is a crime, which of course it is (I like my kidneys where they are, thank you very much). Yet a dead human is difficult to call a person... personhood seems to require life (at least in the body, and I doubt a dead person's soul resides within a dead body, for the dualists out there. ). Therefore, I believe the request is not overly onerous.

When a person dies their body becomes the property of their next of kin unless otherwise stipulated in a will/etc. Therefore the organs are not being "stolen" so to speak from the decedent but from their next of kin.

I have heard of a policy called "no known objection" that's been used to harvest organs from someone with no NoK. Anyone familiar with this?

 

[engineeredout]

In my freshman year of college, we had to select from one of many one credit once a week meeting courses that each had different topics. I picked the one on organ donation, and the guy running it was pretty passionate, as he was a young guy (~40) who had had a heart transplant himself.

When we went around the room saying if we were donors and why/why not, I got to see people give so many of the answers that you think comedians only joke about. People who actually believe that the paramedic who finds you in a car wreck is gonna go "**** he's an organ donor, I can go get coffee right now and wait for him to die".

People are *****s. An opt-out policy should be the norm.

 

[thewanderer]

When a person dies their body becomes the property of their next of kin unless otherwise stipulated in a will/etc. Therefore the organs are not being "stolen" so to speak from the decedent but from their next of kin.

I have heard of a policy called "no known objection" that's been used to harvest organs from someone with no NoK. Anyone familiar with this?

Its true if you are treating the body as a object... but then couldn't you legally do a 100% inheritance tax on biological remains? Now its not stealing... it's "taxation" or, as I believe Pratchett says, 'governments demanding money with menaces.'

The government has a legitimate interest in the general wellbeing, and so seems to have a claim here. Eminent domain, taxation, draft; this seems little different to me.

Perhaps it is stealing, but then so is taxation. We don't like it, but we do like what it gives us (roads are nice, as is education).

hmm, am interested in no known objection... seems opt-outy to me.