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Opt-in/opt-out organ donors

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  • Pssst. I think Scott was not being serious when he said that.
  • Pssst. I think Scott was not being serious when he said that.
    Really? You know him better than I do, of course. However, all I've seen and heard tends to make me think that he's dead serious.
    That whole tangent was really irrelevant to the core dispute. Obviously there would only be organ donation when it was medically feasible, no matter whether you opt in or out. The point is that in the case where it is medically possible, and you are dead dead, you should not be permitted to opt out. Once you are dead dead, the doctors should be able to take your organs if they need them, and they are usable.
    See, this is a ScottWorld argument. Pete and Nuri told you how things are in the real world, and your response is to try to simply change the ground rules to make your argument seem more reasonable. Sure, if any argument you make is from the standpoint of how things exist in ScottWorld instead of the real world, you might win, but your argument will be so hypothetical it will be useless.
  • edited April 2011
    That whole tangent was really irrelevant to the core dispute. Obviously there would only be organ donation when it was medically feasible, no matter whether you opt in or out. The point is that in the case where it is medically possible, and you are dead dead, you should not be permitted to opt out. Once you are dead dead, the doctors should be able to take your organs if they need them, and they are usable.
    The key once again goes back to defining "irreversibly dead." For most brain death, this isn't an issue. The problem is, technology can progress to a point where we can continue to revert certain kinds of states that would once be considered "dead."

    Basically, if there's any chance that you could apply a technique that has any chance to save the patient's life in the next 10 minutes, you have to take that route before organ donation.

    Do that and we're all good.

    EDIT: I do see an issue with unnecessary cost, though. It's true that it's actually hard to find viable organs. Opt-out would probably alleviate the problem, but only to a degree. And if we have a mandatory program of harvesting organs from all cadavers, you're going to spend a lot more money getting organs you can't use.

    How about taking money and throwing at organ-growing research?
    Post edited by TheWhaleShark on
  • I'm pretty sure this argument will be rendered invalid pretty soon.

    Growing Kidneys in Scotland.
    Regrowing eyes
    Regrowing Hearts

    That's just in the last two weeks :-p
  • Also, motherfucking stem cells.
  • edited April 2011
    I'm pretty sure this argument will be rendered invalid pretty soon.

    Growing Kidneys in Scotland.
    Regrowing eyes
    Regrowing Hearts

    That's just in the last two weeks :-p
    Honestly, I was just going to ask about this. It seems to me that organ growing is likely to be a better option than organ donation if Scott's answer to his poorly argued position is to wait for technology to progress to the point at which his argument makes sense.

    How much are such things likely to cost? Are these only going to be a viable option for the rich and famous?

    Actually, I've just re-read the thread, and Scott's argument can be fairly restated as "If you don't donate, you're a jerk." Is that the argument that you say won the day, Scott? Is that the refutation you say was not re-refuted?
    Post edited by HungryJoe on
  • edited April 2011
    That whole tangent was really irrelevant to the core dispute.
    No it's not. You don't opt-out of the philosophy of organ donation, you opt out of the practice of organ donation. Until the regulations and practices change in such a way that you can virtually guarantee an absence of erroneous harvesting, you can't really fault someone for opting out.

    The issue doesn't lie in obvious cases of death death. That's easy. The problem lies in the gray area cases, where someone might be able to pull through, and a decision is made to stop treatment and start harvesting. Where we draw that line is the most important issue in organ donation.
    A better compromise would be for DCD to remain voluntary, while DBD would be mandatory.
    Speaking as someone who routinely writes and implements policies and procedures for a public health organization, no, this is not a good compromise. Having two different options with two different conditionals opens up the possibility of misremembering, and applying the wrong standard in the wrong place.

    Changing the standard to "brain death only" removes any and all ambiguities related to DCD harvesting. Mandatory harvesting should more than make up for that 7% organ gap.

    In cases such as these, the best route is to write the most conservative policy possible. This reduces the chances of an error, and gives you the best chance of being shielded from wrongful death liability.

    Trust me, having a bunch of policies that say "if this state, then this regulation" that must be implemented in a hurry is a bad, bad practice.
    Post edited by TheWhaleShark on
  • The issue doesn't lie in obvious cases of death death. That's easy. The problem lies in the gray area cases, where someone might be able to pull through, and a decision is made to stop treatment and start harvesting. Where we draw that line is the most important issue in organ donation.
    It's relevant to the greater issue of organ harvest as a whole, but it's irrelevant to the specific question at hand.

    The question here isn't about what the law says. It's not about when organs are or aren't viable. It's not about what will happen with future technologies. It's not about medical decisions.

    The question is should a person who is dead be able to deny their organs to a living person who needs them?

    It's obvious that you don't take organs from someone who isn't all the way dead yet. It's obvious that you don't take organs that aren't useful. There is no debate on these things.

    The point is that if there is a situation where an organ in a corpse can help someone else, the desires of the corpse or people who were related to the person that used to be that corpse, should have absolutely no part in making that decision.

    Basic example. You get someone in from a car accident. The medical staff put in their absolute best effort to save this person. They fail. The person is pronounced dead, and no more life saving measures will be administered. At that point they can get a list of everyone in the area who needs an organ, and just check to see if any of the ones in this body are good. On the off chance that one of them is, and the appropriate doctor(s) agree that it is the way to go, and the recipient also agrees, the wishes of the corpse or its family should play no part in that decision. In fact, now that I think about it, I think the doctors would be morally obligated to take the organ, even against the law, since they have a responsibility to save the other patient. They have no more obligation to the corpse other than to send it to the morgue.
  • edited April 2011
    Once again, the ScottWorld Fallacy: "If I ignore the real world and narrow a hypothetical down to a point where all events and actors involved comply with my wishes, my argument wins."
    Post edited by HungryJoe on
  • Once again, the ScottWorld Fallacy.
    Sometimes I feel like I'm the only one who has the ability to compartmentalize ideas. Like how when we talk about games I can separate my thoughts on the game mechanics from my thoughts of the games aesthetics.

    Is it even possible for other people to think about a moral question outside of the context of practicality, legality, etc.? The only thing worth discussing here is the morality since I'm pretty sure all of us just agree on all those other things. Wash those things out of the discussion with basic and reasonable assumptions.

    You have a person who needs an organ. You have a clearly dead person who has the organ. The doctors say a transplant is a good idea. The recipient wants the organ. The dead person and/or their family didn't want to give the organ up. Is it right or wrong to take the organ? That is the only question I am discussing. I say it is right to take it, and actually wrong NOT to take it for reasons I already clearly stated.

    Joe, I'm beginning to think you don't have conscience or morals. Your morals are just dictated by the law of the United States of America. If prohibition returned, and was popular, you would probably stop drinking and yell about how bad alcohol is. Not once in the history of these forums can I recall you answering a question from a perspective of morality. You always dodge and fall back on something else.
  • I prefer my ideas to work in the real world rather than being the sticky outcome of mental masturbation. What if there was a nuclear bomb in new york planted by a terrorist which will detonate in an hour, and you're pretty sure you've captured the guy who planted it? Would it be ethical to torture one man and possibly save millions? Except that doesn't happen, and anyone who brings up that scenario doesn't realize this is never a situation which occurs and thus not a reason to base our opinions of torture on.

    Even though you can remove all the other factors away from the equation for simplicity, your splooge isn't worth much if you don't factor everything back in.
  • edited April 2011
    The problem, Scott, is that compartmentalization does not apply everywhere in a useful fashion, let alone when you start compartmentalizing so specifically as to isolate small parts of the overall problem as you tend to do. You tend to over-compartmentalize severely, which means that your conclusions and solutions, while logical in that compartment, simply fall apart when that compartment is taken away, or even linked to another compartment, simply because by over-compartmentalizing you are excluding important facts and variables which can invalidate your conclusion - or at the least, make it utterly unworkable without trying to force that over-compartmentalization on reality, which is of course practically impossible.

    Also, if I remember rightly, there is a new type of ambulance van being trialed in new york - which is essentially an organ donor van, which waits around the corner from certain calls, and if it isn't possible to revive the person, they come in with a team of specialists, and try to keep the organs alive and try to speak to the family about organ donation. I don't remember all the details, but you can find out about it at the Freakanomics radio episode "You say Repugnant, I say...Let's do it! " which also relates quite well to this discussion.
    Post edited by Churba on
  • edited April 2011
    Scott, just because I am not an adherent of your particular morality does not mean that I am without morals. It's just that I live in the real world and am cognizant of things like property rights and privacy concerns. In fact, that's one thing that hasn't been explored at all. Both the decedent and his family have a right to privacy that you would infringe upon by forcing them into mandatory donation. That also gets around Rym's little "organ tax" argument, again without religion or sentimentality. As with your silly attempt to analogize freedom of choice in donating organs with Jim Crow laws, prohibition is not an analogue in any way. Prohibition was a new statutory infringement upon rights that were already in place. Property rights and privacy rights grant freedoms as opposed to taking them away, and they are old, traditional common law rights that form the foundation of our entire legal system.

    In answer to your concerns about my morality, I have to say that I am deeply concerned about yours. Your morality seems to revolve around taking away freedoms from people because you think your judgment is better than theirs in various ways. I'm not that arrogant in thinking that my judgment is better than others and I'm thus not willing to substitute my judgment for others. If WindUpBird doesn't want to donate his organs, his decision should be respected. If you decide to donate your organs, that's great. The key thing is that it's a choice that people should be free to make for themselves.

    So - let's see what we have here: Arguments against mandatory donation - Property rights of decedent and family, Privacy rights of decedent and family, Technological difficulties in harvesting organs including difficulties in determining true death and difficulties in harvesting viable organs, Consequence of people wishing to retain privacy and property rights sabotaging their organs before death to avoid mandatory donation, and finally, evidence that not all the young kids are with you that this is a good policy. Sounds like some rational arguments not relying on religion or sentimentality to me.

    BTW, ignoring an argument by compartmentalizing it out of the way is not refuting the argument. You don't get to say you've refuted my argument until you show that the decedent and his family have no legal objections to mandatory organ donation based on property rights or privacy rights. Until you do that, you're just avoiding the argument.

    As long as you're living in ScottWorld, you might as well just assume that you can shit tiffany cufflinks. That would solve every problem you have, wouldn't it?
    Post edited by HungryJoe on
  • If someone is alive, their family does not own them.
    If someone is dead, does the family gain ownership?

    If someone is alive, they own themselves.
    If someone is dead, they are unable to own anything.
  • edited April 2011
    If someone is alive, their family does not own them.
    If someone is dead, does the family gain ownership?

    If someone is alive, they own themselves.
    If someone is dead, they are unable to own anything.
    If you have a will, do you expect it to be followed? Your wishes regarding your property, including the disposal of your remains, are honored after your death. What if you die without a will? There are specific protocols for who inherits. The family can dispose of the decedent's body according to their wishes in the absence of evidence that these contradict the decedent's wishes. They are constructive owners of the body.
    Post edited by HungryJoe on
  • If someone is alive, their family does not own them.
    If someone is dead, does the family gain ownership?
    Well, yes. Your body becomes essentially part of your estate, and the person who has power of attorney over your estate can decide what to do with it within reason - that's usually the family, but it can be someone else.

    I'm sure someone more lawyer-y than I could correct me on that, but if I'm understanding it right, that's the rough gist of it. For example, if WUB doesn't want to donate his organs, but his family puts their stamp of approval on it because - in this imaginary scenario - they didn't know his wish to keep his organs to himself. His organs get donated anyway, no matter what his wishes were.

    Which also makes a good point - if you WANT your organs donated, make that 100% clear to your family/person who holds power of attorney. You can put it in your will, but by the time they get around to reading it, your organs have become useless to implant.
  • edited April 2011
    Wow, you people really are completely incapable of discussing morality without thinking about the law. Here, try to answer these questions.

    Is murder right or wrong? We know it's illegal, but is it wrong? I'm sure you'll say yes, so answer this question next. Why is murder wrong? I'm curious as to who here is actually capable of answering this kind of question properly.
    Post edited by Apreche on
  • edited April 2011
    I'd just say that, in ScottWorld, no one can be murdered - end of problem. U mad?
    Post edited by HungryJoe on
  • You don't want to make this a property-rights issue.


    When it comes to death in this country, creditors have more rights to the decedent's property than the family. If the dead man owed $10,000 to Visa, Visa will get paid from the estate before the family collects anything. Organs have a financial value. If you make the body property, why shouldn't Visa insist that the organs be harvested and sold to cover the debts owed?
  • You don't want to make this a property-rights issue.


    When it comes to death in this country, creditors have more rights to the decedent's property than the family. If the dead man owed $10,000 to Visa, Visa will get paid from the estate before the family collects anything. Organs have a financial value. If you make the body property, why shouldn't Visa insist that the organs be harvested and sold to cover the debts owed?
    The decedent and his family have privacy rights regarding the remains. Visa shouldn't be able to sell the organs just like they shouldn't be able to sell the decedent's medical records
  • Wow, you people really are completely incapable of discussing morality without thinking about the law. Here, try to answer these questions.
    Scott, the only reason we are (Apparently) discussing the morality of it is because you said "It should be mandatory for everybody" and following which, HungryJoe said there is little difference between that and a person's wishes what to do with the rest of their estate.

    You came back with
    Dead people don't vote, they have no say.
    to which HungryJoe replied that it is irrelevant if a dead person votes or not, and that the law respects their desires as to what they wanted done with their estate and remains, which is usually laid out in a will, and without a will, it becomes a matter of specific procedure, while trying to take into account the wishes of the dead person as expressed prior to their death, and the wishes of the family, as much as possible.

    It was then, and only then, that you and you alone turned and started saying it's an issue of morality. So, really, what should be said is that we're incapable of Discussing morality without thinking about the law, but that you are incapable of discussing the law without bringing the subjective concept of morality into it, mostly by shouting BUT IT'S MORAL! a lot, usually every time you get beaten by the law, and combining it with a little - bollocks, can't remember the word, when you look at things in the past with modern thinking and moral concepts - but anyway, that thing, and assuming that things like, say, segregation laws were not considered moral at the time.

    Also, if you want to talk morality, then fine - You imposing your morality upon society has little impact. You may not have noticed, but the current moral consensus seems to be that the wishes of the person who previously was the owner/operator of that body are considered to be what should be done with that corpse - Or, to borrow and then pervert your own word, The dead don't get a vote, but most people are smart enough to get in early, and cast their deciding vote well before they died and lost it. Your extreme minority morality is irrelevant next to the moral consensus of society, which is to respect the wishes made by previous owner of said organs before they ceased using them.
  • edited April 2011
    The decedent and his family have privacy rights regarding the remains. Visa shouldn't be able to sell the organs just like they shouldn't be able to sell the decedent's medical records
    A person does not own his medical records. The doctor who diagnosed him owns them, because she created the records. They're her intellectual property. The person's death has no impact on the doctor's ownership of the medical records created when he lived.

    There is no right to privacy in death. Estates are handled in a public legal process known as probate. If the body is property "owned" by the deceased(when he was alive), then it goes into probate, along with everything else he owned like cars, houses, bank accounts, anime collections, etc. Creditors are notified of the decedent's death, and the assets of the deceased are sold as needed to cover his debts. Only after all creditors are satisfied, does the will begin to distribute the remaining property, but even then it is administered by the courts and is a public process.
    Post edited by hektor_rah on
  • edited April 2011
    I didn't say the person owned his medical records. He has a privacy interest in them. If you don't believe me, try getting someone's medical records without their or their family's permission, even after death.
    Post edited by HungryJoe on
  • edited April 2011
    Also, if you want to talk morality, then fine - You imposing your morality upon society has little impact. You may not have noticed, but the current moral consensus seems to be that the wishes of the person who previously was the owner/operator of that body are considered to be what should be done with that corpse - Or, to borrow and then pervert your own word, The dead don't get a vote, but most people are smart enough to get in early, and cast their deciding vote well before they died and lost it. Your extreme minority morality is irrelevant next to the moral consensus of society, which is to respect the wishes made by previous owner of said organs before they ceased using them.
    Perhaps this is the problem. I'm not looking for a practical solution to any problem. In a moral discussion I just want to know what kind of people you are. What are your morals, and what are your reasons for those morals. Obviously discussing relative morals have no actual effect on society. I just want to know what your people's morals are, and why. Yet, people seem incredibly incapable or unwilling to discuss their personal feelings on what is right and wrong, and their reasons for those feelings, without dragging in politics, religion, etc.

    When a person is dead, they no longer exist. A corpse is an object that is potentially extremely valuable. It might possibly have a priceless value on the off chance it can save or extend a life. If in this case the corpse can be used in this way then that is an extremely great good because I value human life. If the loss of one life can extend another, it doesn't get much better than that. Corpses, other than for organ donation or scientific research have little to no value. They can even be potentially hazardous if handled improperly. If an organ can be donated, there is no greater use to which it can be put. The corpse has no use for its organs any more than a cave has a use for its rocks. The family of the person that is now dead has no legitimate purpose for the corpse other than completely useless religious practices or sentimentality. Therefore, the wishes of the now dead person or their family should play no part in any decision as to whether or not the corpse's organs should be donated.

    See how I did that? I said what I feel is right, and why. I'm not talking about what is illegal or what is not illegal. I'm not talking about any practical solutions or implementing this policy in our society. I'm just stating my moral position and the reasons for it. I can answer all the why questions all the way down to the last turtle. That's all I'm asking for, but I'm beginning to believe that most other people, even otherwise pretty smart ones, don't actually have such well thought-out reasons for their own moral code.
    Post edited by Apreche on
  • edited April 2011
    Perhaps this is the problem.
    No, the problem is that you're arguing morals when everyone pretty much agrees - if the organs given can save a life, It is absolutely the moral thing to do, not like you're using them any more - the argument is coming in when you come to the problem of if it is more moral to force people to do things against their will, with property which is theirs - assuming the person didn't wish to give organs, something they strongly expressed while alive - or is it moral to ignore their wishes about instructions they made about the use of their property - in fact, property which is theirs to the most absolute extent we can imagine - while it was still their property, which holds because the body is part of their estate, and still their property - after a fashion, - until the person administering the estate gives it away, sells it or destroys it - the same sort of deal how the estate of someone can do many things on their behalf, even though said person is dead. You can cry morals not law about it still being under their direction if previously specified, but then you're over-compartmentalizing - at that point, that part of the law becomes essential to the problem, because it deals with your freedoms to do with your property what you wish, and as previously mentioned, your body is the most absolute ownership of anything you can get, and that right does not end with death in the eyes of the law.

    And Yes, you do have to bring law into it - if you want to argue morals in a vacuum, that's fine, but utterly useless - because any conclusion you come to will disintegrate on contact with the real world, therefore making it nothing more than an exercise in mental and ego masturbation which will likely come to all sorts of ludicrous conclusions - for example, if someone is of either little benefit to society or is of no/negative benefit to society, would it not be moral to simply kill them and harvest their organs for the net benefit of the larger group? A homeless person is not useful to society, but say, a politician is, therefore, wouldn't it be moral to kill a homeless person to give his organs to the politician for the benefit of the many? Or maybe Kill you to save the king of a nation about to descend into war without him? What is one person's life worth vs the lives of many?

    The useful nature of organs is irrelevant. Which is more important, to attempt to save the life of a person - remember, to ignore the fact that no organ transplant is a 100% certainty, and indeed, by implanting an organ, you might even kill someone - Or to take away what John Locke would call two of the three natural rights - also known as moral rights - the Right to Estate(As your body is your property to do with what you wish and remains so until destroyed or given away) and the right to liberty(to do what you wish, unless it directly harms another person, which you cannot say is the case with organ donation, as the transplant may fail. A kidney, for example, has a 10-23% risk of acute rejection, Livers 50-60%. Over 80% of lung transplant recipients end up with chronic rejection of the organ or organs.

    Is it worth taking away what are considered Moral and inalienable rights, to MAYBE save some people? I do not believe so. I would think it moral to provide a strong incentive to donate one's organs after death - but forcing people to donate their organs is a violation of one's inalienable rights, and is therefore immoral. This even applies if you consider that the estate automatically goes to someone else upon death - except now the person with the vote on the remains is very much alive, making it an even more morally risky proposition, because you're now taking rights away from someone perfectly able to exercise them, for the sake of one person whose survival because of your removal of their rights is not guaranteed.

    But of course, Then you come to the point of Moral Objectivity Vs Moral Subjectivity. I'd wager you'd argue that this is Objectively moral. But can you prove that?
    Post edited by Churba on
  • In a moral discussion I just want to know what kind of people you are.
    My morality prioritizes finding practical solutions to real-world problems. Everything else is intellectual masturbation, and while that has its place, it does not trump problem-solving. I don't understand why you want to discuss morality outside of the context of practicality; a moral is worthless if it has no practical application and thus no ability to actually impact anything in the real world.
    The question is should a person who is dead be able to deny their organs to a living person who needs them?
    And that very distilled question necessarily spawns more questions because the issue is more complicated than that.

    And for future reference, whenever you use the phrase "you people" and mean it seriously, you just reinforce the notion that you have an irrational divorce from reality. FYI. The world is not "Scott Rubin" and "you people."
  • FATALITY!
  • FLAWLESS VICTORY!
  • Well, if you morally value extending the life of a stranger more than you value the rights of a corpse, then you must agree that there should be no choice whether or not to be an organ donor. All the other factors deciding whether or not do do an organ transplant can be made by doctors. The opinions of the corpse or the family of the person that is gone should play no part in that decision. If you were a dictator, would you not make it so?
  • In a perfect world? If the practical issues of organ harvesting did not exist? Yes.

    But that's not even really a question. It's not challenging. Of course I agree when circumstances align. So would almost anyone. The problem is that circumstances don't, and until they do, people are going to be opposed to it.
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