Those wishes were expressed when the person was alive, so actually, they’re the wishes of the living.
You are making the perfect the enemy of the good. By this reasoning, we should never have introduced the smallpox vaccine, since around one in a million people have a life-threatening adverse reaction.
If you have evidence that doctors are frequently making errors in which organ harvesting protocols kill living patients, please cite it. But the mere existence of a non-zero possibility of error is not a sound basis for policy.
Even if every single organ was donated, would it be possible to match up & deliver suitable organs to everyone who needs a transplant?
Would need a lot of tissue typing and a good database in place.
It could certainly be done. It’s just data and logistics. As a person not eligible for a liver transplant I wonder if my eligibility would change if there were a 10x or 100x increase in potential viable livers for transplant out there?
No, no they weren’t. We are not talking about taking organs from bodies of people who opted out, just those that didnt care enough to opt either way. They had no particular wishes.
I doubt that even if every viable organ was recovered that it would allow all those who could benefit to actually do so. It’s not just that the person has to die, they have to die in a certain and be WITHOUT certain pre-existing conditions. As a general rule, someone who has had cancer or is infected with HIV or hepatitis or a number of other things can’t donate their organs because it would be too risky for the recipient. Generally, donors have to die of a head injury that leaves the rest of the body more or less intact. The intersection of “died of head injury” and “no disqualifying conditions” is not that big a pool of people.
Certainly, increasing the number of available organs will benefit more people on the waiting lists, but I don’t think the potential supply is sufficient to fill the potential need.
And how do you know they had “no particular wishes”? You don’t. “Opt out” assumes that. The average person, particularly the average young person, doesn’t spend much time formally addressing end-of-life. It’s not uncommon for people to have no formal documentation of their wishes, which is why, when these topics occur in a medical setting doctors ask relatives and friends if the person had indicated any thoughts and feelings about these things.
IF you don’t mind the hijack or the question, can you elaborate on why you’re not eligible if it isn’t too personal to ask?
I am slowly dying of liver cirrhosis and I have my first consultation with the liver transplant center at IU hospital in Indianapolis on Friday. I guess I am just more than a casually curious person here as to what things a person may be disqualified for (other than obvious stuff like doing illegal drugs, drinking alcohol, etc).
If you really want to increase the number of organs donated, the best way to do it is to decrease road safety and decrease gun safety. Organ donation is only possible if a person dies in hospital on life support while their organs are healthy and the main causes of that are traffic accidents and (in the USA) shootings.
The same question has been and is being asked in the UK. The expert opinion is that it would make no difference at all to the number of organs available for donation here. The only scenario in which it could make a significant difference is in a country which has a very low opt-in rate.
Even in that scenario, I think that a better approach would be to try to persuade people to opt in. That’s what was done in the UK and it worked very well. I think that because I think that consent is very important. Far too important to be dismissed as unimportant, which is what an opt-out system does.
No doubt some people will assume that I won’t donate, so I think it’s relevant to point out that I have been a registered donor for everything since I was 18 and I always carry a donor card so it’s always clear (that was part of the UK campaign back then - “carry the card”). Presumably it’s more computerised nowadays, but back in the 80s things were generally less connected and a physical reminder was very useful.
Active consent and saving lives are both important. What’s your basis for imposing your personal view of their relative importance on other people?
Under either system, if somebody feels their choice is important, they are free to make it. By definition, the difference between opt-in and opt-out systems only affects people who do not feel strongly that it’s important to make a choice.
What’s yours?
Particularly since there’s no reason to believe that removing the need for consent is the only way to increase the number of transplants done, or the most effective way, or even that it would increase the number of transplants done at all.
I don’t accept the argument that consent only matters if a person meets your standards for feeling strongly enough about it.
I am not setting any standard. It seems to me that you’re the one imposing your views about consent on others. If somebody feels that their consent is important, they can express their wishes under either system. The difference between opt-in and opt-out only affects people who have not made a choice - those who, by definition, do not feel strongly enough to make one.
That’s because you hold yourself to different standards to other people. You seek to have organs harvested without consent. That is setting a standard just as much as opposing it is. You and I have different standards for how important consent is. I think consent is more important than you do. That does not mean that I have a standard and you don’t. We both have standards. Just different ones.
I still don’t accept the argument that consent only matters if a person meets your standards for feeling strongly enough about it.
And you seek to let organs rot in the ground without consent. The consent issue is completely symmetrical.
If people feel that their consent is important, they are always free to make an active choice. The only question is what happens when people make no choice. If they have made no choice, whatever you do is going to take place without their consent. From a consent perspective, why is trashing someone’s organs without their consent any better than putting their organs to good use without their consent?
If that had strong feelings then they would opt out. If they dont care enough to do so, then that is their problem.
What next? Forced donation from living donors? Why are you so selfish to keep both your working kidneys when some have none?
Sorry - you don’t get to take other peoples’ stuff. That includes body parts.
And now, a game I like to call: “Spot the deontologist”.
Found one!
Found another one!
Seriously though this is silly. You’re taking the concept of “don’t steal” or “respect people’s bodily autonomy” and stretching it into edge cases where it completely falls apart.
Usually, stealing is bad because it harms others and reduces social cohesion, and these harms far outweigh the good that may come of stealing. In this case, “stealing” a dead person’s organs harms no-one and may save half a dozen lives, and it harms social cohesion much in the same way taxation (another form of “stealing”) does.
Usually, respecting people’s bodily autonomy is important because we all want our bodily autonomy respected, and failure to do so can lead to rather drastic negative physical or psychological harm to the person whose autonomy is being violated. In this case, there’s no such harm possible, because the person in question is dead.
If you can think of other reasons why “stealing” organs from the dead to save lives is a bad thing, by all means, be my guest, but just saying “it’s stealing, and stealing is wrong” is making the worst argument in the world, and you should stop it. Because if you actually dig down to try to figure out the reasons why stealing is wrong, chances are good that harvesting the organs of the dead simply doesn’t fit those reasons. Notice how this also resolves your slippery slope - all of the reasons why bodily autonomy is important apply to the forcible harvesting of kidneys from living people.
Pharaohs were buried with treasure because they believed in an afterlife where it would be relevant. We can safely say that this belief is, at best, baseless, and more realistically complete nonsense. You can’t simply excuse that as cultural differences.
One of them saves lots of lives, the other has no such tangible good attached.
Good doesn’t have to be tangible to be important. Consent isn’t a tangible thing. That doesn’t make it unimportant.
Removing the need for consent to organ donation only saves lots of lives if consensual donation is very low.
Even if consensual donation is very low, increasing it is a better way than removing the need to consent.
The keys to the last part are (a) education and (b) making it trivially easy to do. Neither is particularly difficult for a wealthy country with a bureacracy. Make it a question on driving licence applications, for example.
If a stranger has left their car unlocked and isn’t there, is it OK to use their car because they didn’t not give consent? They didn’t tell you that you couldn’t use their car, so by your line of argument they consented to you using their car.
I say that it isn’t - that it’s only OK if you have their consent. Not if you have their lack of explicitly not consenting. Lack of explicitly not consenting is not the same as consent.
It’s not symmetrical at all.
But that person’s relatives and friends are still very much alive.
I realize that it offends your secular approach, but there are still cultures in this world that have strong beliefs about the bodily integrity of the dead. Some of those people are your neighbors, living in the same places you do. “Harvesting” organs from the dead can certainly cause trauma to such people - but I guess life-long mental distress doesn’t matter to you, does it? After all, it’s not “tangible”.
On top of that, there are groups whose members have been in the past exploited as “resources” for other groups who might have very strong objections to involuntarily taking the organs of friends and loved ones. African-Americans, for example, have a very valid basis for feeling exploited over the centuries and might view this as another form of dehumanizing them and using them for the benefit of others against their will. Jewish people who either directly remember the Holocaust or whose relatives were butchered, with useful bits “extracted”, likewise might be squicked by presumed consent.
Do members of the above groups volunteer to be donors? Yes, they do - but a major distinction is that they are asked for permission rather than just having bits of body taken.
Maybe these things don’t matter to you - maybe you are not a member of or descendant of an exploited group. I suspect you aren’t, given how easily you dismiss their concerns.
Um… who said they didn’t?
I would be opposed to non-voluntary kidney harvesting as well.
Yes, and let’s just ignore the emotional pain, distress, and horror the living relatives and friends of the jigsaw people might be subjected to. It’s not “tangible”, therefore it doesn’t exist. [/sarcasm] :rolleyes:
Okay. Why is consent important? I have a pretty good idea of why I care about consent and why it matters to me, but the thing is, all of the reasons consent matters are grounded in actual real things. It’s not just that consent is important, it’s that if I’m pressed, I can say, "Okay, consent is important in context X because without consent, context X becomes a huge net harm to the parties participating. But this is always grounded in reality, in the reality involved. It’s not some arbitrary dictate, and if there’s a case where ignoring consent is, after careful consideration, a good thing… Well, then in that case we ignore consent. (For one of my favorite fictional examples of this, check out Procedure 110 Montauk.) (Yes I realize this can go wrong, which is why we need to be really, really, really careful in deciding cases like this.)
I consent (enthusiastically!) to having my organs harvested when I die. I also just recently lost my wallet, and have yet to make a new piece of paper saying “I consent to organ donation” to stick in it. Ergo, according to the government, if I get hit by a bus today, my organs won’t go on to save lives. It turns out consensual donation is pretty low, but we can raise it substantially by switching from an opt-in to an opt-out system. To quote one of my favorite bloggers:
A few countries, such as Spain, had a very clever idea - why not switch to opt-out organ donations? In opt-out organ donations, everyone is signed up to donate organs after death by default. If you don’t want to, you can fill out some forms and carry a little card and then you don’t have to. It’s the opposite of our own system.
In America, this was rejected on the grounds that someone might accidentally forget to fill out the forms, and then die, and then their organs would be used to save someone else’s life when they hadn’t consented to that.
So on the one hand, we have the lives of a thousand people a year, plus the suffering of many more. On the other, we have the (still entirely theoretical) fear that maybe someone might both really not want their organs given away, but apparently not enough to sign a form saying so, and so would be really upset about losing their organs if they were able to be upset about things which they’re not because they happen to be dead at the time.
Sure, distress is tangible. The correct solution for that is to educate people. Imagine you had a large sector of society who was tangibly and permanently traumatized by the tax system. Do we, as a result, remove the tax system? No! We look into why these people react that way and look for solutions that don’t break down the way the government functions. Hell, forget irrational trauma based on nonsensical beliefs, the police regularly shoots and kills unarmed, innocent people. We don’t get rid of the police, or even make them stop toting guns, in order to save those lives.
These kinds of tradeoffs exist in any system. The question is, what is the better deal for society as a whole? At the moment, the tradeoff you’re buying into is preventing the hypothetical trauma of a hypothetical group of people of unknown size with horribly irrational beliefs and accepting that, because we avoid that trauma, there’s going to be substantially less resources available for life-saving operations with long waiting lists.
And I realize I’m switching unclearly between “opt-out” and “you can’t even opt-out” (which IMHO is an entirely reasonable position to hold), so if you add the ability to opt out, the hypothetical group is cut down to “those whose families would be traumatized by their organs being taken but don’t care enough to keep a note about it in their wallet”. Which seems like it would be a very small subset.
To put it bluntly, I think that tradeoff is completely insane.
That’s tragic. So again, this tradeoff - certain people have concerns about it based on their ethnic history (concerns which, given the universal nature of this policy, really aren’t particularly rational), vs. the lives of people waiting on the organ donor lists who die of otherwise treatable diseases.
I don’t think this is a tough call.
Hi there, descendant of two different jewish families. Also: capable of telling the difference between the government of the BRD and Josef Mengele.
You seemed to imply that if we allow for the non-voluntary harvesting of the kidneys of the dead, there’s nothing to stop us from non-voluntarily harvesting the kidneys of the living. And I disputed that.
Trauma is real. A person traumatized by a relative’s dead body being reused for other purposes is tragic. I will freely admit that. Regardless of how irrational the basis for trauma is, harm is harm, and it’s tragic. Is it as tragic as, say, the person traumatized by their relative dying of liver failure? Plus that dead relative?
Again, you’d have to be crazy to take that tradeoff.