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  #101  
Old 09-14-2019, 10:19 AM
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Originally Posted by Smapti
A donation", by definition, is not contingent on what one has done in the past. You're basically suggesting that unless someone has personally fed and housed the homeless, they should be allowed to go hungry if they become homeless themselves.
Not quite. What I’m suggesting is more akin to saying “If you make a point of refusing to help the homeless, then it’s a bit rich to expect people to give you money if you’re homeless”.

Personally, I don’t see anything morally wrong with that.

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Originally Posted by Smapti
I am not aware of medical institutions that perform organ transplants for free. Are you?
I’m from the UK. There’s one about a ten minute walk from my house.

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Originally Posted by Smapti
Your argument for opt-out is that it increases organ availability.

So, therefore, you'd have even better availability if there's no option at all and everyone is automatically a donor no matter what.

And once it's assumed that everyone's organs are up for grabs, well, if one person's parts can save three lives, then it's simply selfish of them to keep them to themselves, aren't they? They should be encouraged to give up their own life for the needs of the many.

And once that's acceptable, well, why ask for someone's permission before euthanizing them to save others, especially if that person is far more valuable to society? Surely President Trump's life is more valuable than that of some blue collar schlub who's too lazy and stubborn to realize that his organs are destined for a greater purpose.
I’m sorry, but this is just crazy. Just because I support one measure to increase organ supply, you think I should support every conceivable measure as well? Why?
  #102  
Old 09-14-2019, 11:51 AM
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Originally Posted by Smapti View Post
That's already how opting in is done in every state I've lived in. When you're filling out your form to get or renew your ID/license, you fill in the yes or the no on the "Do you wish to be an organ donor?" question.
Read Thaler about the power of defaults. How easy it is has not much to do with it. Signing up for a 401K when you started work was easy also, but making it a default increased the participation rate a ton. But they found that making the minimum deduction the default reduced the amount contributed because people who took 6% as the normal amount chose the default, 4%, instead.
The statistics from Europe show that most people who aren't donors by default would have no problem becoming donors if donation were the default. Since they aren't harmed by donation, and lives are saved, that's the obvious way to go.
And your images of mad surgeons chopping up people for profit just shows that you've watched way too many Frankenstein movies.
  #103  
Old 09-14-2019, 11:55 AM
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IMO, absolutely not. If you have a valid reason for not donating (basically, anything apart from “I don’ wanna!”) then you should be eligible. I just want to try and weed out the Smaptis of the world who’d gladly take a donor organ but wouldn’t deign to donate their own and pay it forward.
Some people have religious qualms about donating. Stupid, for sure, but if that is an issue you're going to have a shitstorm on your hands.

If donating would become the default we'd have plenty of potential donors and no reason to restrict choice. So I'm pro-choice in this, even though I've opted in.
  #104  
Old 09-14-2019, 12:30 PM
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Some people have religious qualms about donating.
Those people can and should opt out. Their faith communities should get involved in this and make sure all the community members know that their interpretation of the faith forbids organ donation, and know what to do in order to opt out of it.

The rest of us can stay in the donor pool, hoping that our organs will not become available until they're too old and worn-out to be any use, but recognizing that if we do unfortunately end up in an organ-donor situation then we'd want some other person(s) to be able to benefit from that.
  #105  
Old 09-14-2019, 12:36 PM
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<ETA: Never mind, I thought I was on the last page of the thread, and wasn't, so my comment doesn't make any sense in the current context.>

Last edited by TimeWinder; 09-14-2019 at 12:38 PM.
  #106  
Old 09-14-2019, 01:46 PM
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Originally Posted by Kimstu View Post
Those people can and should opt out. Their faith communities should get involved in this and make sure all the community members know that their interpretation of the faith forbids organ donation, and know what to do in order to opt out of it.

The rest of us can stay in the donor pool, hoping that our organs will not become available until they're too old and worn-out to be any use, but recognizing that if we do unfortunately end up in an organ-donor situation then we'd want some other person(s) to be able to benefit from that.
Penalizing opting out would be a problem because of the religious issue.

And it is a good time to link to what Dr. John Prine says about this issue:

Quote:
Please don't bury me
Down in that cold cold ground
No, I'd druther have "em" cut me up
And pass me all around
Throw my brain in a hurricane
And the blind can have my eyes
And the deaf can take both of my ears
If they don't mind the size
My sentiments exactly, except that my ears don't flap. But I do agree that they should give my knees to the needy.

Last edited by Voyager; 09-14-2019 at 01:47 PM.
  #107  
Old 09-14-2019, 02:09 PM
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Penalizing opting out would be a problem because of the religious issue.
People opting out for religious reasons would be just as opposed to receiving donated organs as they are to donating organs.
  #108  
Old 09-14-2019, 02:11 PM
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Whenever this comes up I always wonder where people who can't donate - cancer history, some viral disease, other anomaly - would stand in such a system? Unable to contribute means you can't get on the list?
They can still opt in, even if their organs turn out to be not actually usable.
  #109  
Old 09-14-2019, 02:18 PM
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I frankly don't give a shit if someone opts out for religious reasons, because the idea squicks them out or because the full moon is on Capricorn retrograde with Aquarius on a field of pink unicorns. It's their right to choose what to do. There's societies which have decided that donation is the default, others that have decided you need papers, some where the opinions of relatives are taken into account absent paperwork, others where if it's not in writing it doesn't matter what anybody says. Ideally? Ideally there would be no opting either way because donations wouldn't be needed... ideally, I want my flying car and my teleporter.
  #110  
Old 09-14-2019, 02:23 PM
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Originally Posted by Broomstick View Post
Whenever this comes up I always wonder where people who can't donate - cancer history, some viral disease, other anomaly - would stand in such a system? Unable to contribute means you can't get on the list?
Changes to technology mean that people who didn't use to be eligible now are; sometimes, for organs which weren't transplantable just a couple of decades ago. As an old song says, "science advances so quickly it is totally barbaric". Many people who would have been eligible if they'd died in a car crash end up not being because of the circumstances of their death: which organs will or will not be eligible when any of us dies is not something that can be determined the minute we sign up. So, anybody who wants to sign up should just sign up and eventually Lady Luck will throw the dice, like she does for all of us.
  #111  
Old 09-14-2019, 03:54 PM
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The thing is that, if we can get more people involved in the system, all of this could be moot because we'd be far less likely to end up with organ shortages.
Color me skeptical on that point, too.

It's not enough to just be dead, a prospective organ donor needs to have died in a manner that leaves their organs intact will killing the person. They also need to be found soon enough that their body can be effectively put on life support until their organs can be harvested. That's a small minority of deaths right there.

THEN you have to match donor with recipient. It is entirely possible that you could have a viable organ that matches no needy would-be recipient.

So yes, going to opt-out will make for a shorter waiting list, but you'll still have a waiting list and you'll still have some people dying before a match can be found.
  #112  
Old 09-15-2019, 04:56 PM
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The comments in this thread are more melodramatic than the reality.

The purpose of opt-out is to increase the discussion and likelihood of donation. But in practice, nothing would be likely be taken without readdressing the point with the patient before dying, if possible. (You are currently listed as an organ donor. Is that something you are still interested in?). It would also likely be readdressed with the family, ideally before death, but afterwards as well. (Mr. Slartibartfast expressed a wish to donate his eyes. We will honour his wish unless the family have any objections).

Patients and families can make any decision they want, and change their minds at any time, for any reason. But they can also receive a significant amount of closure and satisfaction from a donation, and this can give comfort in what are sometimes distressing circumstances.
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  #113  
Old 09-16-2019, 12:35 AM
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Originally Posted by Smapti View Post
That's already how opting in is done in every state I've lived in. When you're filling out your form to get or renew your ID/license, you fill in the yes or the no on the "Do you wish to be an organ donor?" question.
And now it'll be the opposite -- do you wish NOT to be an organ donor?

See, easy peasy!
  #114  
Old 09-16-2019, 02:55 AM
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Does anyone know if, in the UK system actually under discussion, there needs to be an actual decision made? I'm in the UK and renew my license every ten years, so I'm not sure that's a viable time to ask the question.

I suspect that it is that the assumption will be that you will donate unless you have taken the effort to specifically Opt Out. Perhaps you can get a card for your wallet.

All to the good in my opinion, although I wouldn't be behind any scheme that denied organs to people who had opted out.
  #115  
Old 09-16-2019, 03:47 AM
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@Teuton: your questions answered:

https://www.organdonation.nhs.uk/hel...pt-out-system/

https://www.organdonation.nhs.uk/reg...your-decision/

Last edited by PatrickLondon; 09-16-2019 at 03:48 AM.
  #116  
Old 09-16-2019, 05:43 AM
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So, as I suspected, if there is no record of a choice you have "deemed consent" given.
  #117  
Old 09-16-2019, 05:47 AM
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All to the good in my opinion, although I wouldn't be behind any scheme that denied organs to people who had opted out.
While I 100% support making organ donation opt-out, and am an organ donor myself, I'm also 100% against any sorta "scheme" to punish non-donors.
  #118  
Old 09-16-2019, 05:47 AM
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So, as I suspected, if there is no record of a choice you have "deemed consent" given.
That's pretty much the definition of "opt out."
  #119  
Old 09-16-2019, 05:55 AM
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That's pretty much the definition of "opt out."
It is, and it's how I expected it to work (and how I want it to work, lest there be any doubt), but earlier talk in the thread was about regularly asking you on a driving license form or similar, and not acting on it if you never got asked.
  #120  
Old 09-17-2019, 11:54 AM
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Why stop with organs? Why not mandate annual blood donation too? Don't donate blood? Go to the end of the list if you need a transfusion.

Not a good idea, punishing non-donors.
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Last edited by BwanaBob; 09-17-2019 at 11:54 AM.
  #121  
Old 09-17-2019, 12:38 PM
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Why stop with organs? Why not mandate annual blood donation too? Don't donate blood? Go to the end of the list if you need a transfusion.
On most days there is not a life-threatening shortage of blood on hand, so this is really a non-issue.

But let us suppose for the sake of discussion that blood were just as scarce as organs.

Many people aren't allowed to donate blood because of various risk factors. A lot of those risk factors are just "shit happens" kind of stuff, but many of those risk factors come down to voluntary activities (e.g. recently getting piercings or tattoos, travel outside of the US that puts you at risk of various diseases like malaria or CJD). Should people be put at the end of the line for blood transfusions if they were excluded from donating?

And then there is a pool of people for whom blood donation is extremely traumatic. They are eligible to donate, but the nausea and/or fainting they experience makes most of them choose to never donate again, despite their strong desire to be of service. Would we put them at the end of the line too?
  #122  
Old 09-17-2019, 12:53 PM
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I am not aware of medical institutions that perform organ transplants for free. Are you?
The biggest chunk of last sunday's cover in one of my regional newspapers was celebrating 50 years of our kidney donation program. Every single kidney transplant in that program has been and shall continue to be free at point of delivery (or prepaid with taxes, if you prefer). The double-recipient grandmother playing with her grandbaby on that cover with daughter, son-in-law and son looking on didn't have any out of pocket costs unless you want to count the cost of flowers delivered to her room from the hospital's flower shop.
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  #123  
Old 09-17-2019, 07:00 PM
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Originally Posted by BwanaBob View Post
Why stop with organs? Why not mandate annual blood donation too? Don't donate blood? Go to the end of the list if you need a transfusion.

Not a good idea, punishing non-donors.
I disagree with the idea of punishing donors, but this isn't a good analogy. The last time I donated blood, my fellow donors were alive and thus did not have to decide about donating in advance.

OTOH, when I started donating at least you got blood free if you needed it if you were a donor, but had to pay if you were not. That was just about 50 years ago.
  #124  
Old 09-18-2019, 02:34 AM
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earlier talk in the thread was about regularly asking you on a driving license form or similar, and not acting on it if you never got asked.
That's how our present opt-in system works, and if you register you get a "registered donor" card to carry in your wallet in case you don't look properly before crossing the road. But there's still a shortage.

They still say they will, after the change, consult family members in the (statistically unlikely) event of asking for organs, but presumably, in law, only strong religious objection would have much effect in the absence of a prior registered opt-out. Squeamishness or "grandad wouldn't have liked it" won't work. And I suppose the register will carry forward existing registered opt-ins.
  #125  
Old 09-18-2019, 03:29 AM
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That's how our present opt-in system works, and if you register you get a "registered donor" card to carry in your wallet in case you don't look properly before crossing the road. But there's still a shortage.
Even with opt-out there will continue to be a shortage. Simply not enough people healthy enough to be donors die in a manner that allows for donation. The waiting list will be shorter, but there will still be a waiting list.
  #126  
Old 09-18-2019, 02:53 PM
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Why stop with organs? Why not mandate annual blood donation too?
I am a blood donor and I was a registered organ donor already before the opt-out system was announced - but I think there is an important difference between organ donation and blood donation.

Blood donation is not risk-free to the donor. When you donate blood, you choose to accept those risks. I don't believe it would be fair to have those risks imposed upon you (even though they are mostly both mild and fairly unlikely)

Quote:
Don't donate blood? Go to the end of the list if you need a transfusion.

Not a good idea, punishing non-donors.
Agreed. There is no point in punishing non-donors, and I personally thing it would be morally and ethically wrong to do so. Healthcare (within the system we are discussing here) should be something to which everyone has fair access without qualification.
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