What the fuck? No. You tell them exactly where they fit on the list, and give them the likelihood they will get a heart. Why the fuck would you be so immoral as to engineer it so they won’t get a heart, rather than just putting them lower on the list? That’s the whole problem.
There is no reason to have a list that doesn’t include everyone, from the most likely to get a heart, to the least likely. If behaviors are taken into account, then they should get you moved up or down the list.
The idea that someone who would make the top of the list can be just as easily disqualified as someone further down the list is faulty reasoning. And it’s fixed if you get rid of the idea that you can not qualify for the list. Just rank everyone, adjusting based on different factors.
What we are dealing with are percentages, which require Bayesian reasoning. This kid is X% more likely to waste his heart. What you are advocating is like saying that a single test in a class should be pass-fail, despite everything else.
No, all factors (that are relevant) must be considered at once, and none of them are absolute.
What this all really illustrates is how stupid our organ donation system is. Right now, there is essentially no incentive to be an organ donor. That should change. There are a number of ways to do this. From least to most controversial:
Make organ donation opt-out instead of opt-in. Spain does this, and has one of the highest rates of organ donation.
Make people who are organ donors higher on the list if they need a transplant. Israel does this, and it helps. When passing their law, they worked closely with ethicists and religious leaders.
Compensate people financially for donation. A lot of people have problems with this: “it cheapens the dignity of life, blah blah blah” Do you know what really devalues life? Letting people die needlessly while perfectly good parts are buried. One country in the world has a legal organ trade, and one country in the world does not have a backlog of organs: Iran. A legal organ trade means that, for kidneys for example (where no one has to die to donate), instead of a waiting list of people wanting kidneys, there is a waiting list of people who want to donate them. What this means is that donated kidneys come from the healthiest donors, which is good for both the recipient, who gets a better kidney, and also the donor, who is left with a better kidney.
Breed people like cattle and harvest their organs when they turn 16. I don’t advocate for this option.
This happened after polls found out that many people hadn’t signed up for donation out of laziness and/or not knowing where to do it (your nearest bloodbank or your primary healthcare center). There were many cases where the family would ask “can anything be donated?” in the middle of the first shock of the death; there were cases where a delay in finding the closest relatives would flip an organ into ineligibilty. So, since people actually had a general “let’s donate” mindset, the idea was to remove what had become bureaucratic obstacles rather than humane politenesses.
At one point there were a few cases where too much insistence in finding relatives led to those relatives indignantly asking “but he WAS a blood donor! He donated on the clock for decades! And I know he had signed up for organ donation the first time he gave blood, why are you asking ME?”
He seemed to be doing quite well. Far from being disabled he was working his trade in a physically demanding job when he was unfortunately killed in a workplace accident.
Wow. It’s not often we get a claim that’s both completely incorrect and irrelevent. Let’s start with the definition of a post hoc ergo propter hoc fallacy:
In this case, A refers to the organ transplant, and B refers to his death in the commission of robbery.
We can examine the validity of this claim by looking at whether B could have occurred had A not occurred. In this case, the kid could not have possibly have committed a felony had he not received the organ transplant, because he would be dead. Thus, we can conclude that the two events are related: the organ donation is a necessary condition for the ability to be alive in the future, and is thus causually related to the commission of the crime.
In fact, the events aren’t unrelated as you claim, or even partially unrelated, but they are entirely related: given the organ transplant, the kid chose a life of crime, and had he not received the transplant, he would be dead. Ergo the organ transplant is entirely a contributory factor in the crime spree.
Next let’s look at why this is an irrelevant claim.
The purpose of my post was to point out that new information had vindicated the suspicions of those who suspected something was amiss and proved wrong those who would trust the kid. It doesn’t particularly matter if the organ transplant caused the criminality (though of course it did), but rather that the crimes indicate that the kid had a propensity for law-breaking at the time of the transplant.
People are not equal. Some are better than others; some are more morally worthy than others. When someone commits a crime, he harms society. This reduces or eliminates society’s obligations to him; we don’t owe him anything if he can’t follow our laws. The social contract, as you bring up, is broken when one party abandons his obligations to the other. In this case, the kid broke his obligation not to commit crime, and society’s obligation to help him was nullified. The heart is equally wasted if it goes to someone who gets themselves killed and if it goes to someone who uses it to commit crime. In fact, society would be better off it we had just thrown the organ into the trash and let him die–we would’ve saved a boatload in medical expenses and prevented crime.
The media is not a fair court, and I can’t believe that you would think that. The only thing the reversal proves is that whoever is in charge of this thing deemed the risk of someone else dying to be less than the reputation costs caused by grossly misplaced recreational outrage. And you can’t just say “morality is relative” like it’s some universally accepted axiom. Moral relativism implies objective morality is an acceptable viewpoint, for just one of many critiques.
Not due to their inmate status, but because of their history of non-compliance with medications, follow-up appointments, and inability to stay within the rules laid out by the treatment/transplant team.
Inmates get held to the same standards for transplant eligibility as non-inmates.
I’ve also approved transplants for inmates. These folks were able to demonstrate at least a minimal ability to follow the rules. Some have done well, some did less well than the young man being discussed in this thread. Them’s the breaks.
And yes, the transplant system, as run in this country, is a mess. Fame, public pressure, and money can too often twist the rules, which are far too byzantine in many cases to begin with.
Sure, let’s go all the way to the bottom of the hill. Why not consider the totality of factors in person’s life? Won’t more information allow society to better distribute scarce resources? Everyone is free to lead an unhealthy, dangerous life if they so wish, but when death comes knocking they can’t expect much help from the rest of us. Ordinary people shouldn’t have to subsidize the extreme risk taking of a small handful.
This is a zero-sum situation. An entitled focus on “Medication-Noncompliant Person A is beloved and deserves to live” overlooks the fact that “Medication-Compliant Person B is also beloved and deserves to live”, too.
[QUOTE=BigT]
The only relevant factor is whether the heart will go to waste, and it doesn’t go to waste if the person survives. Basing it on whether you like the person should never be a factor.
[/QUOTE]
This is ridiculous, of course, and this case demonstrates how it is ridiculous.
The heart in this case did go to waste. The kid should not have been put back on the waiting list, because his history of non-compliance indicated that he would not survive as long and get as much use of the heart as someone else who would not fuck it up. Because of media attention, he did receive a heart, and thus was enabled to live three years during which he committed robbery and attempted murder and then get killed.
The heart would not have been wasted if it had gone to someone who lived longer and who did not spend his time harming society. We had a set of rules, but those rules were ignored because the media is driven by sentiment and sensationalism rather than common sense.
Nobody should be denied an organ transplant on the basis of behavior, the cause of their needing a transplant, or any other judgment of their moral compass, value as a person, or worth to society.
That this kid went on to screw up does not invalidate the fact that giving him a new heart was the right thing to do.
You have to have criteria for who gets organs and who doesn’t. There are not enough to go around. Some people need organs and will not get them and will die.
Behavior, in terms of, “likelihood of complying with medical care that will improve the chance of long-term success with the transplant” seems like a very reasonable criterion to apply. It’s not a moral judgment, it’s a practical judgment about the likely outcome of their transplant.
What’s wrong with having a lottery instead of having death panels?
It is a moral judgment. It’s declaring that a given person doesn’t deserve to live because of something they might do in the future, or because they made their bed and they deserve to lay in it. Doctors should never be deciding to allow their patients to die. That’s not what we pay them for.
Because that’s not the best use of limited resources. Take military triage as an analogy: Combat medics evaluate the wounded and decide which ones should get treatment with the limited resources. It wouldn’t make sense to draw a lottery on the battlefield.
In a world of unlimited transplant organ availability, sure, give everyone who needs a transplant, a transplant. But in a world of scarce transplant organ availability, discrimination is necessary.