The article you linked is a truly horrifying thought.
I wonder though if a change like this would reduce those cases in the long term though. If there are more organs available, wouldn't there be less pressure to harvest from any particular person?
While this is a horrifying story, I'm having a hard time seeing the relevance here. There is nothing in the article indicating that the errors were caused by the family agreeing to organ donation.
There are about a million other things done to dead bodies that will kill a mistakenly-identified-as-dead person as stone dead as removing an organ, so organ donation specifically doesn't really have a special status here outside of it being potentially the first item on the long checklist.
And it's for long-term (more than one year) residents of England, not just citizens.
The headline should read something like "As of today, all residents of England are organ donors unless they opt out" or "Organ donation law in England has changed to opt-out model."
It looks like Wales and Scotland already have this policy in place. Northern Ireland does not, but I'm not too surprised given that health is devolved to the government of the country and NI didn't have a government for 3 years. I can't tell if that's still the case.
There are many more things than organ removal done to dead bodies that would still kill a mistaken-as-dead person extremely dead, just slightly later in the process.
Is this an honest concern of yours? Do you feel like there is a significant amount of people dying because someone has decided to harvest the vital organs of someone still alive?
If that's the measure of significance, we should never do anything ever. There are risks in cars, airplanes, shaving getting out of bed, not getting out of bed, eating too much or too little, etc.
People choke on food occasionally. Should we not eat? No, that's silly.
All of those are self-induced, unlike someone harvesting your organs such as the example story that the other commenter posted.
Additionally, I tend to think that doctors do not serve our best interest and instead typically follow common or outdated practices. re: newborn circumcision, which I see as one of the most heinous acts that we still perform in the United States and allow in Europe because of ‘religious tolerance’
I can anticipate being called an antivaxxer, so I want to answer that as well. I’m not an antivaxxer by any means, but I also don’t think pumping your child with at least 7 doses of pathogens before they’re 6 months out isn’t a good thing either. I’d prefer to wait until they’re a bit older or to have longer wait times between each shot. I think this is something that also doesn’t get enough discourse because we hail doctors as all-knowing rather than viewing them with the same skepticism as other fields.
Just as a side note, those who score highest on graduate exams such as the GRE are the physicists and mathematicians. Doctors are quite low. It may suggest something about their innate ability, yet we still lionize them.
All of those things you listed do not deterministically kill you as soon as things go wrong. Plenty of people survive car crashes, shaving, eating too much or too little. Even people who accidentally choke on food survive in a lot of cases. Plus, people do those things in order to either live (eating) or to enhance their life experience (shaving, airplanes).
I am yet to hear of someone surviving after their heart or liver was removed for donation from their body. And I am also yet to hear of anyone donating their organs in hopes of enhancing their life experience.
It's an honest concern because there's no certain method to decide if somebody is dead or not. "Clinically dead" can mean anything.
In addition, my understanding is that organ transplants require a physically healthy donor for viable organs (heart beating, oxygen reaching organs), so most donors don't look or act dead until their organs are removed.
A lot of the work that Dr. Jack Kevorkian did was on research to decide when people had actually died (he was later involved in assisted-suicide to establish legal precedent for suicides.)
The US Army declined his suggestion to do blood donations from dead soldiers in combat, so it's interesting that a government agency is not in favor of such transplants. Something to think about:
So this area is far from black and white, and I fail to understand why people would be opted-in before any of these questions have been addressed.
(In the USA, harvested patients don't get paid for their organs, but my understanding is that the hospital and doctors are paid, so large amounts of money are transacted, and we know what that would lead to.)
> The US Army declined his suggestion to do blood donations from dead soldiers in combat
Well, obviously, yes, because even before any ethical concerns, that's wildly impractical in every possible sense. Soldiers are already carrying around 40-60 pounds of gear and now you want them to transport blood transfusion equipment, too?
For a take on the overall system of organ donation, science reporter Dick Teresi's book [0] covers the history of the medical definition of death, the development of organ transfer surgeries, and the subsequent developments rubrics for organ donation candidates and legal death at a biological point before cell death. He interviews medical staff and presents what I took as a key point for advocacy: that organ donors should be administered Fentanyl before extraction to prevent the documented discomfort responses that some beating heart cadavers exhibit.
This is a very very valid concern so I’m not sure why you’re being downvoted. It does happen and from a lot of experience over the last 25 years of dealing with quite frankly utter incompetence that nearly killed two members of my family from the NHS, I don’t trust there to be safeguards or procedure in place or for it to be applied to make this decision.
The state will harvest your organs upon your death without the consent of you or your family. But scrolling down a webpage is not considered enough “consent” for accepting cookies. What a joke.
I have zero problem with whatever usable organs I have remaining going to someone who can make better use of them than my cold, limp corpse. It's not like I have a need for them anymore and it could save at least one person's life. Seems like a no brainer to me.
I do have a problem with being tracked wherever I go and my data being sold on to people that have less than pure uses for it. The two things are not the same.
That’s great for you. I’m sure you can agree that there are many that do not share your view. Just wait until they harvest organs from somebody and their family throws a fit on religious or other grounds.
With regards to consent, this is the same as any other law. You consent by remaining a citizen. Does every (any?) citizen know all of the laws? No, but it's part of the deal if your parents were citizens.
If you want to leave the country, you may renounce your citizenship upon becoming an adult.
This pretty snidely disregards how difficult it is to emigrate anywhere else with a similar standard of living. De facto you are stuck in the country of your birth, barring some extraordinary effort on your part over the course of months to years.
Uh, no, you can't opt out of being governed altogether. This is why libertarianism is a thing — the state is a categorically different kind of entity due to the monopoly on violence. Tax compliance is ultimately enforced at gunpoint, just like every other law, and that's why it really fucking matters to get the laws right. Haven't we been over this?
From their FAQ: "All major religions and belief systems are open to the principles of organ donation" ... "We've worked with faith leaders and communities to build trust, raise awareness, explore questions around organ and tissue donation, and discuss how organ donation can proceed in line with faith or beliefs."
From the sound of it, I'm not sure what more they could have done. Are there many people in England who disagree with all major religions on this point?
There aren't authoritative "faith leaders" for decentralized religions like Hinduism or Buddhism. What's happened here is that a likely-Caucasian lawmaker has selectively picked out interpretations of scriptures and quotes from individuals that favor this policy, propped them up as evidence of support from all major religions, and tried to get ahead of criticism with a thinly-disguised PR play.
If your body is cold, it’s way too late to use your organs for donation. In fact, your heart has to still be beating and your organs still have to be getting oxygen.
Them’s just the facts.
Some people might be a bit more concerned, knowing those facts.
Yeah. There’s actually a saying, “You’re not dead until you’re warm and dead.”
And the supposed dead (with beating hearts) are actually put into and kept in hypothermia for a variety of reasons. Then to test whether they are “really dead,” part of the procedure is to raise them up to normal temperature before running other tests.
I'll leave organ harvesting to those who know more about it than me then :)
I'm curious though. If you have to only just be dead to have your organs harvested, how do doctors get there quickly enough for them to still be useful?
Organ donation is usually done from a living, but brain dead, person. There's no specific rush, the person can stay alive for a while.
They are killed (controversial word there...) in order to take the donation.
On a practical level, most donation comes from head injury patients, motorcycles in particular are known for providing a lot of such patients.
Hypoxia (drowning) also works (sometimes) if it's long enough to kill the brain, but not the rest of the body.
There aren't as many candidates for donation as you might think. There is a lot of research on how to donate from a someone with cardiac death - doing that would significantly increase the donor pool, while also removing a lot of the objections.
No one has an issue with donation from a "cold, limp corpse", the issue people have is that most donation must be taken from a living body, with brain death.
And that, I hope you agree, is a much more controversial situation.
Issues range from considering it straight out murder (after all the heart it beating, and the person is breathing), to mistakes in accurately detecting brain death, or fear of Dr's removing care in hopes of gaining donation.
> I have zero problem with whatever usable organs I have remaining going to someone who can make better use of them than my cold, limp corpse.
That's your choice and you can donate it if you want. Oh wait, you can't even donate it since you no longer have the option. By default, your organs now belong to the state so your organs aren't even yours to give away.
> Seems like a no brainer to me.
But not to me and many other people.
> I do have a problem with being tracked wherever I go and my data being sold on to people that have less than pure uses for it.
But many people have no problem with it. So since they don't have a problem we should all be tracked right? Seems like a no brianer?
Even in non-economic transactions, it seems like opt-out is generally frowned upon as a tactic. This is a very classic example of 'the ends justify the means' overriding that opinion.
That's different, or at least in my experience it's different. When I register at the DMV, it asks "Do you want to register to vote?". I can click no and be on my way.
This is a great decision. There's been a lot more interest in behavioural economics over the recent years and I remember reading one of Dan Ariety's books about this.
The key thing that increases the rate of organ donations dramatically (from 30% to almost unviversal between opt-in and opt-out) is that there's a very significant cost to choice. The more choices people have to make, even if they arrive at desired outcomes, hugely diminishes the chance that they do.
While I totally support the opt-out approach (or indeed, no option to opt out) I wonder if we need a new term - as it doesn’t seem like a ‘donation’. ‘Donation’ implies gift, and also an element of conscious choice, both of which mightn’t apply any more.
I refuse to be a donor. If they want me then make a real donation, say some money towards funeral expenses. I would sign up in a heartbeat.
And I've been plenty more altruistic when it comes to tissue donations. About 10 years ago I came up as a match to a stranger through the Be The Match Foundation. I went through the whole process and gave that lady bone marrow. So I'm not just a grubby meanie out for a buck. Everyone else in the chain is getting paid, there's no reason the donor should be left empty handed.
The reason for that is to remove the financial incentive to donate any one specific organ, so that poor people don't end up as a one-kidney one-lung underclass.
Well, in this case, it would only be the dead poor, right? We're talking about donating organs after death.
Just as it's hard to justify not being willing to donate organs (because "you're dead, what do you care"), it's also hard to justify not paying those who do on the grounds that it's exploitative.
The commenter I quoted specifically suggested money toward funeral expenses. That's the context: a recognition and respect of the value the body parts had to the owner rather than an assertion of entitlement. There isn't some weird perverse incentive in that that's going to carve out an underclass of organ growers.
This sentiment is understandable (and apparently popular), and I suppose GP deserved either a well-reasoned personal attack or a snarky reply... but I don't think it merits a snarky personal attack.
S/he's already been a living bone marrow donor, presumably already saving a life at considerable risk to oneself (it's surgery for the donor). That's already enough to deserve immunity from snarky insults.
> That's already enough to deserve immunity from snarky insults.
No, I don't think it is. This is a refusal to do something that costs literally nothing purely out of spite. If anything, that negates the good will that might have been earned by the prior act.
"I helped someone once, but I'd like everyone else to just die even though it costs me _nothing_ to save them" is not an admirable stance.
Seems reasonable to me. If organ donation is valuable enough to a society to justify infringing upon an individuals rights to collect those organs, then society can at least offer some level of compensation.
If a society no longer believes it requires the willing consent of the individual to engage in these kinds of actions.....well that opens up a few other problems.
If you want change, take action in a way that will matter. Withholding an organ donation in a way that will never be visible to the people at the relevant time isn't it.
So some poor sap who needs an organ is gonna get fucked because your "principled" stance against "the system" will keep you from donating?
You think they'd have a problem with your estate getting money? You think that marginal additional expense would cause them to be like "welp, better just die then."
I wouldn't oppose this "compensate the estate of the donor" idea at all, but to refuse to save lives as a result is insanity, especially because your refusal, and some posts about it on the internet, will amount to 0.
Hmm. What do you think about systems where you personally can't get those sort of organs (for yourself, from someone else) unless you opt into donation yourself? Would you find that adequate compensation, or would the possibility of not getting organs you need sway your decision?
As a fellow Be the Match donor, I don't understand your philosophy. As you know, going through the donation process is, aside from scheduling appts & actual donation, not that much work on your end. I spent probably 20 hrs total to donate and save someone's life. Most of that time was me lying in a bed to donate or having samples taken (with all costs covered by BTM). Compare that to the paid case manager or doctors//nurses that had to coordinate tons of resources to let me be able to donate. If anything, maybe you should reflect on why you were ok with that donation (and it being freely given) but you're not ok with doing even less as a tissue donor yet not being paid.
Your argument might satisfy a peculiar revenge fetish, but in terms of policy, the whole public is only healthier if the WHOLE public is healthier -- even the people you think are wrong. No ifs, ands, buts, or whining about fairness. The recipient's status in the program should be of no interest and strictly private until death.
If only participants in the donor program could benefit from the donor program, then people who are ineligible to donate (like under age 18) would be unwilling sacrifices on your altar to Fairness. After all, what are they contributing?
Furthermore, if I'm in need of a vital transplant, there's likely enough systemic damage from the malfunctioning organ that the organs I've got are of questionable use as future transplants.
> Your argument might satisfy a peculiar revenge fetish
A "peculiar revenge fetish" is strong words considering your argument is so weak.
> the whole public is only healthier if the WHOLE public is healthier
In general I agree, but this is definitely not an issue with transplants. The demand far exceeds supply, so the question is how you sort the queue.
Of course, refusing to be a potential organ donor also affects the health of the WHOLE public. If you refuse to be a donor, the total number of organs available for transplant is reduced.
> people who are ineligible to donate (like under age 18)
Where did you get the idea that under 18s are not eligible to be donors?
I think everyone would agree, though, that under-18s' views would not make them ineligible as recipients.
> unwilling sacrifices on your altar to Fairness
If it's not them who are getting sacrificed on the Fairness altar, it is someone else who could be a recipient.
When you are dead, your possessions are no longer yours (as you legally don't exist anymore). As part of your final sacrifice, you can give something back to a person in need.
(As a side mark, a modern Jesus would've been a donor, IMO.)
Could this meandering obfuscating "argumentation" stop? The people arguing for the law are putting up an extremely embarrassing intellectual show here.
They snipe, engage in "organ shaming", change lines of argumentation, move goalposts and generally behave like indoctrinated teenagers who picked up some lines in a course.
There is no obfuscation here. The default here, is to assume that people are good, loving people. If you would be ill, and you'd require a replacement organ or you'd die, you'd be grateful if someone who passed away would donate that organ to you.
My father, in his last ~5 years, was on kidney dialysis 3 times a week. It really hurt, seeing those people in pain, but it was the most beautiful department I ever saw of a hospital. Because people leave for quality of life, temporarily better. They come in exhausted. Heck, they often leave exhausted. But next day is gonna be better. There's no dept. which regularly provides a bigger impact on such a time based term.
Now, no my father was too old for a transplantation. He was low on the list. But I have seen young people on that dept. too. Young people of an age where normally their life is flourishing. Young people who, normally, have a full life ahead. Young people of whom my father could've been father, if you get what I mean.
It really requires a lack of empathy, or some kind of convincing of a religion (which cannot be proven true either, and is in contrast with what Jesus would've educated), that you say that after you passed away you don't want your organs to be donated. Well, then have the balls to put in the effort to say so. Because the vast majority of people, are loving and good people.
On top of that, in The Netherlands (where the default was recently changed as well), most people are not even religious anymore (making the default donor more adequate). Plus, its an investment in a life, which should on the long term be good for the economy, as well as the happiness of families.
At least in the US, when I die, my possessions become the posesseions of my estate, with my heirs the beneficiaries, after all claims against the estate, including outstanding debts and estate taxes are satisfied. If my estate takes a significant amount of time to settle, it will need to pay income taxes, etc as well.
I don't know what a religious figure has to do with government policy with regards to human organs. At least outside of a theocracy.
How about calling it "organ reuse"? You're not donating because they're taking them away unless you explicitly say no, but reuse is fine. It's not like we need those organs anymore, except for them to rot or burn.
It's actually not clear if this will significantly increase donation rates. A similar change was made in Wales in 2015, and so far it hasn't made much difference either way to donation rates[0]. (As an aside, the article title should say "people living in England" not "UK citizens" - this change in law applies to England only).
The reason it didn't really make much difference in Wales seems to be because the previous system (which until today was also the system in England) was already pretty good.
Under the previous system either you were on the organ donor register (in which case next of kin had no legal option to refuse donation) or next of kin were asked to consent to donation (which most did). (There was also a register for people who definitely didn't want to be donors which also removed the right to consent from next of kin). I'm not sure what the 30% statistic you refer to is, but I'd guess it is the number of people on the "opt-in" register. In reality a larger proportion do have next of kin consent.
The new system, I think, effectively reverses that - there is a register for opting out and if you're on that then next of kin cannot consent. Likewise there is also still an opt-in register which, if you're on it, means next of kin cannot refuse consent. All that's changed, I think, is that if you're not on either register then when doctors do ask next of kin (and if the potential donor is not in an excluded group, eg under 18), if next of kin say "I don't know" then doctors will be able to take that as "yes" not "no".
I do think this is a positive change, because it means next of kin are less likely to be asked put under pressure to answer what is a very difficult and intrusive question which often they haven't previously thought about at the most difficult time. But I wouldn't assume that suddenly donor rates will increase as a result.
Sure, that's fine ... but we're talking extreme behavioural economics when, I'm guessing, the vast majority aren't even aware the switch happened today.
Thanks. That does say it received Royal Assent, so the legislative process has indeed finished now, the relevant preovisions just haven't come into effect yet.
As interesting as this is, this seems very political and therefore not really HN material, as you can tell by how quickly the comments have turned to shit
That seems like the kind of thing that would immediately run into confounding factors, such as the potential that people who have dangerous hobbies may be more likely to opt into organ donation because they're more aware of the possibility of death.
Broadly speaking, the first responders and emergency room workers providing emergency care neither know nor care about your organ donation preferences. Transplant work is done by separate specialists who only come into the picture after legal death.
That would be an ideal situation but someone with large amounts of money might be able to change the course of actions and big data probably could make this easier. Let say they scan their blood type, etc, then type in the condition and wait for an answer from the computer for further actions...
Someone with an unlimited amount of money wouldn't be keeping an eye on emergency rooms if they desperately needed an organ. There are other places/organizations that will play ball.
That would be either a criminal conspiracy to commit murder or an illegal organ trafficking ring, and nothing about your hypothetical secret ultra-rich criminal would be affected by default opt-in or opt-out organ donor status.
I know its scary but I think the above comments are correct. I thought the removal of some organs need to be very close to
TOD and the ER doctor would need to know beforehand if the patient was able to be harvested for for said organs. Is that correct, sorry if its not?
Any organ donation only comes into play after the declaration of legal death, at which point the body gets handed off. The ER doctor only cares inasmuch as it means that a different team than usual takes over on removing the body so he can get a different living patient in to be treated.
> The boy—though not technically brain dead—had suffered so much brain damage after a near drowning that doctors determined he would never wake from a coma. So his family decided to take him off life support and to donate his organs.
I don't see how the organ donation affected the care he received. Presumably if organ donation were not an option, the family would have chosen to withdraw life support anyway. Having the option of organ donation merely reduced the emotional pain of it by being able to help people at the same time.
Regardless of what you think about the decision, the communication here has been poor. As of posting, there is no information on BBC News's front page, the UK's main source of news, as to this rule change or how to opt-out. [1] Likewise, on the UK Government's website's homepage, there is no information on this or information on how to opt-out. [2]
I haven't come across a friend or family member who knows this is happening today.
Regardless of your view on this, the communication has been poor. It was publicised when Wales moved to opt-out organ donation.
They're not yours when you're dead. It's no different from your estate. If you don't leave a will, the state decides what to do with what you leave behind.
The first two sentences here are pretty contradictory. If they're not yours then why would you be allowed to direct what happens with them? The will doesn't execute until after you die.
The state doesn't choose what to do with my estate, it follows specific rules that are what most people would want. In Denmark, that means that your spouse or children gets the money.
They might be needed in the after life :-). Jokes aside I think individuals should have a right to do what they want with their organs. Even posthumously...
Organs are worth a lot of money. The wrong incentives may mean you end up pronounced dead when you could’ve lived because someone is collecting a fat check for your organs.
It's not about hoarding organs. If you are an exact match for some wealthy person on a transplant waitlist you might legitimately fear for your safety.
First, there are documented studies showing that known organ donors have a slightly lower survival rate in hospitals than non-donors do. Draw what conclusions from that you will, but some people choose not to be a donor for precisely that reason.
And second, if you have any plans or hopes for cryogenic preservation, that's not particularly compatible with organ donation.
An obvious complication here is that in an opt-in system, people who have more directly faced the possibility of death (extreme sports participants, people with chronic conditions, etc) may be more likely to be donors.
To get numbers with fewer confounding factors, you would need to look at an opt-out system and compare the default opt-in population with a reasonably comparative slice of people who are not automatically donors but have neither intentionally opted out, such as, in the case of the new NHS policy, 'people who have lived in England for less than 12 months before their death'.
> And second, if you have any plans or hopes for cryogenic preservation
If you're planning for cryogenic suspension after death (actually planning for it, not just idly thinking about it), filling out an opt-out form is just a minor footnote compared to the piles of other paperwork needed to set up a legal trust to preserve your body.
Also, just on a human level, people don't want to be chopped up and parcelled out as used parts for other people. I don't feel that way, but I understand how people can feel that way and we should respect their wishes.
I don’t agree that their irrational preferences trump others’ right to live, but let’s assume they do. In that case, they should automatically forfeit the right to receive transplants. Not just be put at the back of the queue, but be banned altogether.
Interesting. I understand the argument may be that you are you, but personally if I were to go through the hassle of cryonics and wake up on the other side, I'd hope to be met with the best body available for the given time.
What a loss it would be to come back and be the only one without gills!
i am sorry but your old brain is not compatible with our current bodies. unfortunately those old style bodies have fallen out of fashion and we no longer have people trained in their creation.
if only you had decided to freeze your whole body, or at least the torso, as we can replace arms and legs with prosthetics.
"sanitary fees" at funeral homes are added since they now have to store a leaky mess in their fridge. Some families might not be able to pay for extra costs, even if you're just getting cremated.
It is not just organs, it is also things like your skin, eyes, etc. I think a lot of people would object to having their face carved out and then have it attached to another person.
I opted in for everything that can be removed while still having a body that is me that people can say goodbye to.
It's widely known that the NHS needs organ doners. That itself is not the issue for me, the new status quo of the state having the right to harvest my organs is.
How are targeted ads and Facebook notifications _opt in_, but this isn't??
> It's widely known that the NHS needs organ doners
Give it a day or two, and it too will be widely know that you can opt-out, we're discussing this on the HN front-page afterall, clearly this is no secret.
I think you can make an argument that people should have the 'right' (is there such a thing as a right held by a nonliving person?) to make an informed choice about their organs but this is certainly an ambiguous situation as to whether or not that right should be given. I personally believe that it would be entirely acceptable if it were not a choice and your organs must be donated (as usable) on death.
> I think you can make an argument that people should have the 'right' (is there such a thing as a right held by a nonliving person?) to make an informed choice about their organs but this is certainly an ambiguous situation as to whether or not that right should be given. I personally believe that it would be entirely acceptable if it were not a choice and your organs must be donated (as usable) on death.
So if families don't want the bodies of their loved ones turned over to the state, tough luck? Why does the state have a greater right to my kin than I?
What percentage of people refuse to receive a transplant because they disagree with transplantation? It's a tiny number of people. Acceptance of organ transplantation is almost universal outside of religious communities such as jehova's witnesses.
I'm not sure the point you're making. Are you saying that if you would accept an organ transplant you must also be willing to donate your organs upon death? What percentage of people refuse free money?
A hypothetical scenario, where I am interested in hearing your opinion:
A citizen recently returned from Liberia is diagnosed with Ebola and dies in the hospital. The family requests a christian burial, but the health protection agency decides against it, as the risk of disease transmission would be significant. Instead the body is treated as a biohazard and cremated, as a precaution to prevent additional deaths.
In this scenario, is it unreasonable that the state have greater right to the body than the next of kin? Should the family have been allowed to proceed with a christian burial, regardless of the potential deaths it might cause?
I think you agree that there are at least some scenarios were the state should be able to seize the rights over a body.
You might draw the line at saving people from Ebola, but I don't think it's entirely unreasonable for others to also include saving people from organ failure in that category.
I don't know about "rights", but people absolutely can exert their will from beyond the grave: think of wills, estates, etc. That's a good thing - It's not the state's business to redistribute your family's assets as it sees fit.
If a person didn't make a choice, their family should have the final say... They certainly have more of a right to the deceased's remains than the state.
To me, the central issue is about choice: Who gets to make choices about my body? Choice matters. The whole point of life is to make choices.
If I don't want my kid to be vaccinated, I must let the government know. By default, they will assume I want to get my kid vaccinated. Its the same for organ donors. It is assumed that, if you are in need, you'd want other people to donate their organs if they were passed away. It is important to act quick on such, instead of waiting for an OK from family. Those who oppose it, have to opt-out of it. Still a choice. It appears your central issue isn't about choice; it is about the default you don't agree with.
Indeed, "donate". It is immoral and unethical to kill a person with a beating heart and seize organs if that person forgot one of the 1000 various opt-outs of modern society.
The discussion is about whether it should be opt-out or opt-in. Killing a person for their organs is illegal, because killing a person is illegal. Euthanasia follows a very strict protocol.
Perhaps there's some other story that's capturing the attention of the health-focused reporters at the BBC and there wasn't during Wales' rollout? Hmm?
For sure, but people should be given the information to exercise bodily autonomy. The BBC is a public service broadcaster paid for by TV licence fees, so should aim to inform the UK population about significant issues which impact them. Sure, COVID-19 and its fallout should be reported on, but it should not (and does not need to) cause the absence of this from the homepage.
It seems like the kind of thing that should just have a small informative pamphlet mailed to everyone in the country. It's a relatively cheap, straightforward way to inform everyone.
I agree, and it's happened before. Very recently, the Prime Minister sent a letter to every household in the UK on the COVID-19 lockdown measures. [1] This would be less intensive, as it would go to all households in England, not the whole UK.
People don't need to be aware of a law which has good intentions, and does not affect them while they're alive. This is a law with good intentions because it is going to save lives, and increase the quality of life of people. The few who care about this for religious reasons or liberty reasons are in the wrong IMO, but they surely know, as they care about this issue. They'll be able to opt-out.
Regarding bodily autonomy, I feel the need to play Devil's Advocate here: if organ donation saves other lives at your own moral discomfort (because presumably you wouldn't be forced to donate organs until after death), what difference is there between this requirement and the requirement to vaccinate, wear masks, etc.? By this I mean if somebody claims bodily autonomy to oppose mandatory organ donation, should they also be able to claim it for those other "despite the public good" reasons?
Accepting your premise that all of these things are equivilent, when you change mask rules or required vaccinations, etc, you need to let everyone know. So if they don't agree, they can protest, or leave, or attempt to arrange the circumstances of their death to prevent the removal of their organs (it's haddly a donation if it's forced).
I'm trying not to argue for or against opt-in vs opt-out or no choice, that's a fine discussion to have, but this thread was more about notice.
There was extensive publication as the law was being discussed in parliament, and when it was passed.
It's more important to tell people when the green and white papers are being read and when the bill is being discussed, and then when the law is made, and there was a lot of publicity then.
If you opt out vaccination or wearing masks, you increase the risk of the entire population to get infected, since we are talking about viral diseases. This is a dishonest comparison, as situations where an organ is needed can have a myriad of reasons. It could be gene related ("predestined"), it could be self inflicted (e.g. smoking), it could be from an infection (including COVID-19), it could be from an accident (who's fault?).
The comparison is also moot because there is no opt-out of a law which forces you to wear a mask, or forces you to get vaccinated. There is an opt-out regarding organ donation. A comparison would be, that you'd be forced to wear masks everywhere, and that you'd by default get vaccinated, but you are free to decline (opt-out). Well, vaccinations in The Netherlands already work like this. Your kid gets asked to get a vaccination, and you are free to decline it. You don't have to ask the government for it though. That's opt-out as well.
I support "motivated opt-in": your choice, but if you don't opt-in, you're at the end of the line for any organ needs you may find yourself with.
It tends to align nicely with ethical and religious objections as well as moral intuitions, and should expand supply while signaling proper expectations to the demand side, without simply allowing the rich to buy their way to the front of the line.
That's not right. If there's an organ available and a recipient in need, it should be used rather than wasted. Regardless of the recipient's donor status. But donor status can be used as a tie-breaker.
To be clear, I wasn't arguing against the British out-out approach; it seems mostly OK, too, and it is silly to make the perfect the enemy of the good.
There are different colors to different approaches, and they're going to have varying degrees of success in different cultures.
Keep in mind that for many kinds of organ transplants, you will know in advance that you have a good chance of needing one, without actually needing it yet.
Sure. Although it isn't ideal, selfish late-joiners still expand the pool and should be welcome. It isn't about punishing people, it is about matching needers with havers without just selling them to the highest bidder.
Selfish late-joiners will just notify their next of kin to refuse the donation anyway. They get the queue-jump bonus of being on the register and still opt out privately.
I was on the donor register since I turned 18 but my parents or wife can just refuse if that suits them on the day (although I've asked them not to!)
That sounds like a terrible policy in it's own right. Especially the part about the parents - why should they have any say in it at all after you've turned 18.
Eh, I guess here comes an unpopular opinion. While the pragmatist in me is well aware of how opt-in increases donations ( although at certain point the question has to be asked whether if they coerced through law, is donation the right term for that ), I instinctively dislike government imposition here.
I do not believe ends justifies the means. And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
I would happily support the privilege of people to opt out of organ donations, as long as they are willing to irrevocably forego being the beneficiaries of an organ transplant.
Or hell, at that point, I'd happily make it opt-in.
I'm not so sure about that. I can easily imagine misguided parents angrily opting their children out - it would be cruel to deny transplant to these kids just because their parents are, well, not so bright.
I disagree. If there's an available organ and a recipient in need, it should be used regardless of the recipient's donor status. Why waste the chance to save a life? Donated organs aren't good for very long.
It's fine to use donor status as a tie-breaker if multiple recipients are in contention.
There's nearly always a shortage of organs, and people who opt out are contributing to this shortage. If you want donor status to be a tie-breaker, it will, in practice, be a ban.
The thread you linked doesn't have any shaming. It proposes a quid-pro-quo linked to willingness to be open to organ donation. Your choices remain private, so the only people who can shame you are those you choose to tell.
In addition to that, there was this:
> Will you automatically take my organs if I don't opt out?
No. Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured.[1]
The thread exposes exactly what OP was suggesting: you start by making it automatic with opt-out, instead of explicit opt-in. And the next step is to suggest you don't deserve an organ because you opted out. No one would suggest it before, if you didn't opt in.
I'll save the thread for the first time some politician uses the you're not an organ donor ammunition against another. Which will happen. Which didn't happen before.
It's a subtle but profound change, and the legislators clearly knew and sought that.
> Your family would always be involved before donation takes place
> No one would suggest it before, if you didn't opt in.
Because in an opt-in system it's possible to not be an organ donor through oversight, laziness, lack of awareness, or carelessness. In an opt-out system, you have to actively want to not be an organ donor and take steps to ensure that.
I agree that making people who opt-out completely ineligible to receive donations is not right - you should always save a life if it's possible. I also don't see the problem with putting people who opt-out in the back of the line.
None of that fits the definition of "shaming" though, which is what the original poster was concerned about.
They turned something you could do for your fellow citizens, 100% of your own volition, and consciously in 100% of the cases, into an obligation. Which, again, makes your organs, unless you opt-out, property of the state.
I also don't see the problem with putting people who opt-out in the back of the line.
I don't see a problem putting people who pay more taxes in front of the line. They contribute more to the NHS, including making transplants possible. You can even argue than keeping the wealthier alive is more beneficial to the whole system, as, if they die, they'll stop contributing.
This is a terrible idea, of course. How much, in any kind, organs or money, you contribute to the system, shouldn't dictate the attention you get. But it's freaking scary how many in this thread are suggesting exactly that.
Then how would you describe a process in which people have to make it known what they want instead of leaving it up to guesswork? All alternatives explored so far just leads to death, misery, and a small portion of the population having a benefit while the rest suffers.
And anti-government in general seems to be stance that often comes with "I don't like it", but without a solution and the only thing I've seen so far is people coming up with a "let's do nothing" alternative. That's not a real alternative at all because it doesn't solve anything. Either bring something else that also works, or accept that the best we can do so far is come up with imperfect solutions.
Why is it left to guesswork? Plenty of places make it opt-in but present the option regularly. Every time I renew my drivers license there is a clearly marked checkbox for opting-in to organ donation.
That's a weird analogy. TSA "opt out" is basically impossible. Have you ever tried it? It's not shame. The agents simply don't allow you to. Changing your organ donation status is not just possible, but easy.
In the organ donation case, who do you think would "shame you into compliance"? How would anyone else even know? I don't know the organ donation status of anyone else in the world, even my family and close friends, and even those who have died.
Yes, every time I've opted out with TSA (which I do most of the times I'm required to go through the full-body scanners in the US rather than the TSA Pre metal detector) I've been allowed to do so. It's often meant a long wait for an agent to become available, but I've never been refused.
I admit to being a white male US citizen who politely requests it using the words "I'd like to opt out" (rather than some vaguer objection) and then waits patiently, not someone who gets angry at the officers. The ground rules aren't the fault of the workers, only any individual bad behavior.
I've traveled close to 100k miles/year for ~8 years and have opted out successfully hundreds of times. When they ask why, I just stand quietly. I used to explain the legal and moral implications but the mall cops - I mean TSA - don't care.
And for a fun alternate strategy: instead of opting out, if you just say "I can't raise my arms above my head," you can skip all of it. You don't even have to explain why because they're not supposed to ask. You'll go through the metal detector and get a hand swab and you're done. Most of the time, I get through to the other side before my bags.
>And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
What is this? In the past five years, I've probably flown 15 times and every time, I've opted out just fine. Just stand there waiting to one side until someone comes to pat you down. The pat down is consistent across airports, and you can usually count on the TSA agent to be courteous and professional. I can't stand the agency or their dictum that they're keeping the skies safe, but individual agents seem to be decent folk.
Never had any feeling of shame from other passengers or TSA agents. Maybe I'm lucky or privileged or something.
But if you don't want to get scanned, tell the agent you want to opt out. You don't have to be a haughty prick about it. Just say, "I want to opt out, please." And when they say, "okay, stand over there," nod and say, "thank you."
It's not uncommon in other countries. In reality, no one takes your organs without strict approval from your family, but this kind of policy makes it easier for them to get the approval as you did not need to opt in before your death.
The difference here is that they're now asking the family if they have objections to the organs being donated, rather than asking the family if they want to donate the organs. The latter results in fewer organs available even though in logical terms it's the same question.
I'm not expert of the legalities, but is it legal to take your organs if you did not opt in?
Can your family opt in after your death? I'd say it's a difficult question and obviously made easier by making it opt out system. Anyone objecting has to opt out so majority of people will stay default which improves organ donation rates.
I'm also an opt-in donor. I would've been in favour of postponing this change by a year. It was impossible to communicate this to the public effectively in the middle of a crisis, and whilst I think people should be donors and agree with it being opt-in, I think it's pretty shifty to do it at a time where it's very likely people aren't going to be able to make an informed decision.
Why is this on the front page of a tech news aggregator? Sure, everyone has an opinion on this, but why _here_ instead of some subreddit? (and then making it to reddit front page, which is topic-agnostic)
Opt-outs are the new insidious way to impose the state/collectivist views on the individual without permission. Opt outs are a problem because not everyone may be aware of the need to opt out, and it requires additional attention and effort. The default state, without requiring any additional action from an individual, must respect individual consent and bodily autonomy - which means that no one has a right to your body or your property unless you've granted it explicitly. An opt-out situation is not that, and it doesn't matter even if a majority of constituents would prefer an opt-out model.
Moreover, the linked website's claim of universal religious support for organ donation is very suspicious. It relies on opinionated interpretation of religious texts and cherry picked quotes of support from random individuals that they've propped up as authoritative representatives of religions, when that is not really the case in reality. Religious ritualistic practices and interpretations of texts vary and there will be many for whom this permissive assumption of the state's right to an individual's organs will be a violation of their beliefs.
Libertarian paternalism. Where the default is set to be the most beneficial. Another example is you get a raise at work and instead of going into your pocket by default goes into your retirement. You still have the ability to change it. Nudge by Thaler and Sunstein talk about this and so does Daniel Kahneman in Thinking, Fast and Slow.
This mentality has actually helped other countries save more lives by default. While each person still retains the power to opt-out. And yes other countries have done this before the UK. US should do this too!
They make the default behavior something that benefits most people (everyone's better off if old people have enough money to exit the job market gracefully, for example), while still making it easy to act otherwise if someone specifically wants to do so.
The "libertarian" bit should be respected if we're talking about modifying choice architectures. When life is full of various burdens, when people are busy, when information may not readily reach everyone, things are different. People may simply need to know that they even need to be on the lookout for something like this, because assumed consent and assumed right to your body seems unconscionable to many.
273 comments
[ 3.1 ms ] story [ 272 ms ] threadhttps://www.cbsnews.com/news/hospital-errors-lead-to-dead-pa...
I wonder though if a change like this would reduce those cases in the long term though. If there are more organs available, wouldn't there be less pressure to harvest from any particular person?
Moving out is the best opt-out ever. (until pandemic hits and you can't move out)
Nonsense. Absolute and utter nonsense.
There's an opt-out.
That was the spammer's excuse 10 years ago.
As long as the opt-out is respected I also don't see what's totalitarian about it.
You're picking one horror story because it fits your parameters, and pretending it's something to worry about. It's not. Cheers.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117251/
Unlike this state mandated organ seizure, if you haven't heard the news and opt-out of yet another thing.
The headline should read something like "As of today, all residents of England are organ donors unless they opt out" or "Organ donation law in England has changed to opt-out model."
Health is devolved to the contituent countries here.
There are many more things than organ removal done to dead bodies that would still kill a mistaken-as-dead person extremely dead, just slightly later in the process.
You could argue, the number is so low the benefits outweighs the costs, but that's not your stance.
Fact, its > 0.
If that's the measure of significance, we should never do anything ever. There are risks in cars, airplanes, shaving getting out of bed, not getting out of bed, eating too much or too little, etc.
People choke on food occasionally. Should we not eat? No, that's silly.
Additionally, I tend to think that doctors do not serve our best interest and instead typically follow common or outdated practices. re: newborn circumcision, which I see as one of the most heinous acts that we still perform in the United States and allow in Europe because of ‘religious tolerance’
I can anticipate being called an antivaxxer, so I want to answer that as well. I’m not an antivaxxer by any means, but I also don’t think pumping your child with at least 7 doses of pathogens before they’re 6 months out isn’t a good thing either. I’d prefer to wait until they’re a bit older or to have longer wait times between each shot. I think this is something that also doesn’t get enough discourse because we hail doctors as all-knowing rather than viewing them with the same skepticism as other fields.
Just as a side note, those who score highest on graduate exams such as the GRE are the physicists and mathematicians. Doctors are quite low. It may suggest something about their innate ability, yet we still lionize them.
I am yet to hear of someone surviving after their heart or liver was removed for donation from their body. And I am also yet to hear of anyone donating their organs in hopes of enhancing their life experience.
In addition, my understanding is that organ transplants require a physically healthy donor for viable organs (heart beating, oxygen reaching organs), so most donors don't look or act dead until their organs are removed.
A lot of the work that Dr. Jack Kevorkian did was on research to decide when people had actually died (he was later involved in assisted-suicide to establish legal precedent for suicides.)
The US Army declined his suggestion to do blood donations from dead soldiers in combat, so it's interesting that a government agency is not in favor of such transplants. Something to think about:
https://en.wikipedia.org/wiki/Jack_Kevorkian
So this area is far from black and white, and I fail to understand why people would be opted-in before any of these questions have been addressed.
(In the USA, harvested patients don't get paid for their organs, but my understanding is that the hospital and doctors are paid, so large amounts of money are transacted, and we know what that would lead to.)
Well, obviously, yes, because even before any ethical concerns, that's wildly impractical in every possible sense. Soldiers are already carrying around 40-60 pounds of gear and now you want them to transport blood transfusion equipment, too?
[0] https://www.amazon.com/The-Undead-Dick-Teresi-audiobook/dp/B...
Thus I will opt out.
I do have a problem with being tracked wherever I go and my data being sold on to people that have less than pure uses for it. The two things are not the same.
I see what you did there.
Like, if organ donation is the default, at the very best, it's extra work for people who want not to donate their organs after death.
OTOH if organ donation is not the default, dramatically fewer organs are available to people in need, and many of them will die.
How are we supposed to weigh these competing harms?
If you want to leave the country, you may renounce your citizenship upon becoming an adult.
Uh, no, you can't opt out of being governed altogether. This is why libertarianism is a thing — the state is a categorically different kind of entity due to the monopoly on violence. Tax compliance is ultimately enforced at gunpoint, just like every other law, and that's why it really fucking matters to get the laws right. Haven't we been over this?
> If you want to leave the country, you may renounce your citizenship upon becoming an adult.
You are being very generous, and indeed this is one of the last remaining freedoms we have that people in the eastern block did not.
Where to go though if all countries compete in becoming the most oppressive one?
> Your family will still be approached and your faith, beliefs and culture will continue to be respected.
From the sound of it, I'm not sure what more they could have done. Are there many people in England who disagree with all major religions on this point?
Them’s just the facts.
Some people might be a bit more concerned, knowing those facts.
And the supposed dead (with beating hearts) are actually put into and kept in hypothermia for a variety of reasons. Then to test whether they are “really dead,” part of the procedure is to raise them up to normal temperature before running other tests.
It’s complicated.
I'm curious though. If you have to only just be dead to have your organs harvested, how do doctors get there quickly enough for them to still be useful?
They are killed (controversial word there...) in order to take the donation.
On a practical level, most donation comes from head injury patients, motorcycles in particular are known for providing a lot of such patients.
Hypoxia (drowning) also works (sometimes) if it's long enough to kill the brain, but not the rest of the body.
There aren't as many candidates for donation as you might think. There is a lot of research on how to donate from a someone with cardiac death - doing that would significantly increase the donor pool, while also removing a lot of the objections.
And that, I hope you agree, is a much more controversial situation.
Issues range from considering it straight out murder (after all the heart it beating, and the person is breathing), to mistakes in accurately detecting brain death, or fear of Dr's removing care in hopes of gaining donation.
That's your choice and you can donate it if you want. Oh wait, you can't even donate it since you no longer have the option. By default, your organs now belong to the state so your organs aren't even yours to give away.
> Seems like a no brainer to me.
But not to me and many other people.
> I do have a problem with being tracked wherever I go and my data being sold on to people that have less than pure uses for it.
But many people have no problem with it. So since they don't have a problem we should all be tracked right? Seems like a no brianer?
If we're willing to say "opt-out is wrong when buying a product", how can we say "opt-out is right when it comes to your own body"?
Actually, it's quite encouraged in many cases. See 'motor voter' laws that automatically register citizens to vote when they get an ID, for example.
This seems to be a good move that could help a ton of people in need, while also giving enough wiggle room to families to deny the donation.
The key thing that increases the rate of organ donations dramatically (from 30% to almost unviversal between opt-in and opt-out) is that there's a very significant cost to choice. The more choices people have to make, even if they arrive at desired outcomes, hugely diminishes the chance that they do.
And I've been plenty more altruistic when it comes to tissue donations. About 10 years ago I came up as a match to a stranger through the Be The Match Foundation. I went through the whole process and gave that lady bone marrow. So I'm not just a grubby meanie out for a buck. Everyone else in the chain is getting paid, there's no reason the donor should be left empty handed.
There's real money floating about at every step except for the one where they acquire the organ from the deceased's estate. It's a fair point.
Just as it's hard to justify not being willing to donate organs (because "you're dead, what do you care"), it's also hard to justify not paying those who do on the grounds that it's exploitative.
You refuse to save lives at literally no cost to yourself or anyone you know unless someone pays your family off?
> there's no reason the donor should be left empty handed
The donor is dead! Hands don't get any emptier!
> So I'm not just a grubby meanie out for a buck.
Ok, let's see...
Cost to you? 0.
Cost to your family? 0.
Benefit to others? You could save several lives.
Will only do it for? Money.
Yup, no conflict there.
No, I don't think it is. This is a refusal to do something that costs literally nothing purely out of spite. If anything, that negates the good will that might have been earned by the prior act.
"I helped someone once, but I'd like everyone else to just die even though it costs me _nothing_ to save them" is not an admirable stance.
But nobody is forcing you to save lives at no cost to yourself (again, because you'll be dead) -- go ahead and opt out.
If a society no longer believes it requires the willing consent of the individual to engage in these kinds of actions.....well that opens up a few other problems.
So some poor sap who needs an organ is gonna get fucked because your "principled" stance against "the system" will keep you from donating?
You think they'd have a problem with your estate getting money? You think that marginal additional expense would cause them to be like "welp, better just die then."
I wouldn't oppose this "compensate the estate of the donor" idea at all, but to refuse to save lives as a result is insanity, especially because your refusal, and some posts about it on the internet, will amount to 0.
If only participants in the donor program could benefit from the donor program, then people who are ineligible to donate (like under age 18) would be unwilling sacrifices on your altar to Fairness. After all, what are they contributing?
Furthermore, if I'm in need of a vital transplant, there's likely enough systemic damage from the malfunctioning organ that the organs I've got are of questionable use as future transplants.
A "peculiar revenge fetish" is strong words considering your argument is so weak.
> the whole public is only healthier if the WHOLE public is healthier
In general I agree, but this is definitely not an issue with transplants. The demand far exceeds supply, so the question is how you sort the queue.
Of course, refusing to be a potential organ donor also affects the health of the WHOLE public. If you refuse to be a donor, the total number of organs available for transplant is reduced.
> people who are ineligible to donate (like under age 18)
Where did you get the idea that under 18s are not eligible to be donors?
I think everyone would agree, though, that under-18s' views would not make them ineligible as recipients.
> unwilling sacrifices on your altar to Fairness
If it's not them who are getting sacrificed on the Fairness altar, it is someone else who could be a recipient.
Trolling, or did you just not RTFA?
"Anyone can register a decision to become an organ donor after death, there is no age limit."
https://www.merriam-webster.com/dictionary/donor
Apparently not to the statists of HN though!
(As a side mark, a modern Jesus would've been a donor, IMO.)
Yes, he probably would have. But he would not have forced other people to opt-out. This is what people do not understand in this thread.
They snipe, engage in "organ shaming", change lines of argumentation, move goalposts and generally behave like indoctrinated teenagers who picked up some lines in a course.
My father, in his last ~5 years, was on kidney dialysis 3 times a week. It really hurt, seeing those people in pain, but it was the most beautiful department I ever saw of a hospital. Because people leave for quality of life, temporarily better. They come in exhausted. Heck, they often leave exhausted. But next day is gonna be better. There's no dept. which regularly provides a bigger impact on such a time based term.
Now, no my father was too old for a transplantation. He was low on the list. But I have seen young people on that dept. too. Young people of an age where normally their life is flourishing. Young people who, normally, have a full life ahead. Young people of whom my father could've been father, if you get what I mean.
It really requires a lack of empathy, or some kind of convincing of a religion (which cannot be proven true either, and is in contrast with what Jesus would've educated), that you say that after you passed away you don't want your organs to be donated. Well, then have the balls to put in the effort to say so. Because the vast majority of people, are loving and good people.
On top of that, in The Netherlands (where the default was recently changed as well), most people are not even religious anymore (making the default donor more adequate). Plus, its an investment in a life, which should on the long term be good for the economy, as well as the happiness of families.
I don't know what a religious figure has to do with government policy with regards to human organs. At least outside of a theocracy.
The reason it didn't really make much difference in Wales seems to be because the previous system (which until today was also the system in England) was already pretty good.
Under the previous system either you were on the organ donor register (in which case next of kin had no legal option to refuse donation) or next of kin were asked to consent to donation (which most did). (There was also a register for people who definitely didn't want to be donors which also removed the right to consent from next of kin). I'm not sure what the 30% statistic you refer to is, but I'd guess it is the number of people on the "opt-in" register. In reality a larger proportion do have next of kin consent.
The new system, I think, effectively reverses that - there is a register for opting out and if you're on that then next of kin cannot consent. Likewise there is also still an opt-in register which, if you're on it, means next of kin cannot refuse consent. All that's changed, I think, is that if you're not on either register then when doctors do ask next of kin (and if the potential donor is not in an excluded group, eg under 18), if next of kin say "I don't know" then doctors will be able to take that as "yes" not "no".
I do think this is a positive change, because it means next of kin are less likely to be asked put under pressure to answer what is a very difficult and intrusive question which often they haven't previously thought about at the most difficult time. But I wouldn't assume that suddenly donor rates will increase as a result.
[0] https://www.bbc.co.uk/news/uk-wales-42213813
(I don't know what the law in Scotland, Wales and Northern Ireland is, might be that England is just the last of UKs nations to make opt-out standard)
Scotland is working on it but as far as I'm aware it hasn't completed the required legislative process yet.
NI is still opt-in.
https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-...
I did consider using a raspberry pi plus camera cliped to the waste line and a trained ML model to detect problems with peritoneal dialysis
Regardless, everything is political, if even by its context alone, tech especially.
I don't see how the organ donation affected the care he received. Presumably if organ donation were not an option, the family would have chosen to withdraw life support anyway. Having the option of organ donation merely reduced the emotional pain of it by being able to help people at the same time.
I haven't come across a friend or family member who knows this is happening today.
Regardless of your view on this, the communication has been poor. It was publicised when Wales moved to opt-out organ donation.
[1] https://www.bbc.co.uk/news [2] https://www.gov.uk/
First, there are documented studies showing that known organ donors have a slightly lower survival rate in hospitals than non-donors do. Draw what conclusions from that you will, but some people choose not to be a donor for precisely that reason.
And second, if you have any plans or hopes for cryogenic preservation, that's not particularly compatible with organ donation.
An obvious complication here is that in an opt-in system, people who have more directly faced the possibility of death (extreme sports participants, people with chronic conditions, etc) may be more likely to be donors.
To get numbers with fewer confounding factors, you would need to look at an opt-out system and compare the default opt-in population with a reasonably comparative slice of people who are not automatically donors but have neither intentionally opted out, such as, in the case of the new NHS policy, 'people who have lived in England for less than 12 months before their death'.
> And second, if you have any plans or hopes for cryogenic preservation
If you're planning for cryogenic suspension after death (actually planning for it, not just idly thinking about it), filling out an opt-out form is just a minor footnote compared to the piles of other paperwork needed to set up a legal trust to preserve your body.
I believe they only freeze the head with the brain intact, when one opts for cryonics.
What a loss it would be to come back and be the only one without gills!
I opted in for everything that can be removed while still having a body that is me that people can say goodbye to.
How are targeted ads and Facebook notifications _opt in_, but this isn't??
Give it a day or two, and it too will be widely know that you can opt-out, we're discussing this on the HN front-page afterall, clearly this is no secret.
Give it a generation and no one will care either.
So if families don't want the bodies of their loved ones turned over to the state, tough luck? Why does the state have a greater right to my kin than I?
A citizen recently returned from Liberia is diagnosed with Ebola and dies in the hospital. The family requests a christian burial, but the health protection agency decides against it, as the risk of disease transmission would be significant. Instead the body is treated as a biohazard and cremated, as a precaution to prevent additional deaths.
In this scenario, is it unreasonable that the state have greater right to the body than the next of kin? Should the family have been allowed to proceed with a christian burial, regardless of the potential deaths it might cause?
I think you agree that there are at least some scenarios were the state should be able to seize the rights over a body.
You might draw the line at saving people from Ebola, but I don't think it's entirely unreasonable for others to also include saving people from organ failure in that category.
What does this have to do at all with the topic at hand?
If a person didn't make a choice, their family should have the final say... They certainly have more of a right to the deceased's remains than the state.
To me, the central issue is about choice: Who gets to make choices about my body? Choice matters. The whole point of life is to make choices.
Indeed, "donate". It is immoral and unethical to kill a person with a beating heart and seize organs if that person forgot one of the 1000 various opt-outs of modern society.
No one here wants to forbid opt-in.
But you are deliberately diverting again, so I assume stupidity or bad faith.
I don't understand why these passive aggressive pseudo-innocent comments are tolerated here.
> Euthanasia follows a very strict protocol.
Was directly preceded by:
> Killing a person for their organs is illegal, because killing a person is illegal.
Which was a response to:
> It is immoral and unethical to kill a person with a beating heart
[1] https://www.gov.uk/government/publications/pm-letter-to-nati...
Surprise!
I'm trying not to argue for or against opt-in vs opt-out or no choice, that's a fine discussion to have, but this thread was more about notice.
It's more important to tell people when the green and white papers are being read and when the bill is being discussed, and then when the law is made, and there was a lot of publicity then.
The comparison is also moot because there is no opt-out of a law which forces you to wear a mask, or forces you to get vaccinated. There is an opt-out regarding organ donation. A comparison would be, that you'd be forced to wear masks everywhere, and that you'd by default get vaccinated, but you are free to decline (opt-out). Well, vaccinations in The Netherlands already work like this. Your kid gets asked to get a vaccination, and you are free to decline it. You don't have to ask the government for it though. That's opt-out as well.
It tends to align nicely with ethical and religious objections as well as moral intuitions, and should expand supply while signaling proper expectations to the demand side, without simply allowing the rich to buy their way to the front of the line.
There are different colors to different approaches, and they're going to have varying degrees of success in different cultures.
I was on the donor register since I turned 18 but my parents or wife can just refuse if that suits them on the day (although I've asked them not to!)
I do not believe ends justifies the means. And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
https://news.ycombinator.com/item?id=23252408
The next step is shaming those who opt-out. Which will then cement the ownership of the state over your organs.
Edit: and more:
https://news.ycombinator.com/item?id=23252636
Or hell, at that point, I'd happily make it opt-in.
It's fine to use donor status as a tie-breaker if multiple recipients are in contention.
EDIT: Plus the other reply about children.
In addition to that, there was this:
> Will you automatically take my organs if I don't opt out? No. Your family would always be involved before donation takes place, so it is really important that you choose whether you want to be a donor and discuss what you want to happen with your family, so your decision is clear and they can have peace of mind knowing that your decision is being honoured.[1]
1. https://www.organdonation.nhs.uk/helping-you-to-decide/about...
I'll save the thread for the first time some politician uses the you're not an organ donor ammunition against another. Which will happen. Which didn't happen before.
It's a subtle but profound change, and the legislators clearly knew and sought that.
> Your family would always be involved before donation takes place
That's nice, what will happen if:
a) you don't have close family
b) they can't be contacted fast enough
Because in an opt-in system it's possible to not be an organ donor through oversight, laziness, lack of awareness, or carelessness. In an opt-out system, you have to actively want to not be an organ donor and take steps to ensure that.
I agree that making people who opt-out completely ineligible to receive donations is not right - you should always save a life if it's possible. I also don't see the problem with putting people who opt-out in the back of the line.
None of that fits the definition of "shaming" though, which is what the original poster was concerned about.
They turned something you could do for your fellow citizens, 100% of your own volition, and consciously in 100% of the cases, into an obligation. Which, again, makes your organs, unless you opt-out, property of the state.
I also don't see the problem with putting people who opt-out in the back of the line.
I don't see a problem putting people who pay more taxes in front of the line. They contribute more to the NHS, including making transplants possible. You can even argue than keeping the wealthier alive is more beneficial to the whole system, as, if they die, they'll stop contributing.
This is a terrible idea, of course. How much, in any kind, organs or money, you contribute to the system, shouldn't dictate the attention you get. But it's freaking scary how many in this thread are suggesting exactly that.
Ideally a default opt-in system would increase supply sufficiently that no one in need will go without.
1. https://optn.transplant.hrsa.gov/learn/about-transplantation...
And anti-government in general seems to be stance that often comes with "I don't like it", but without a solution and the only thing I've seen so far is people coming up with a "let's do nothing" alternative. That's not a real alternative at all because it doesn't solve anything. Either bring something else that also works, or accept that the best we can do so far is come up with imperfect solutions.
In the organ donation case, who do you think would "shame you into compliance"? How would anyone else even know? I don't know the organ donation status of anyone else in the world, even my family and close friends, and even those who have died.
I admit to being a white male US citizen who politely requests it using the words "I'd like to opt out" (rather than some vaguer objection) and then waits patiently, not someone who gets angry at the officers. The ground rules aren't the fault of the workers, only any individual bad behavior.
And for a fun alternate strategy: instead of opting out, if you just say "I can't raise my arms above my head," you can skip all of it. You don't even have to explain why because they're not supposed to ask. You'll go through the metal detector and get a hand swab and you're done. Most of the time, I get through to the other side before my bags.
How? TSA security checks happen in public. Opting out of this involves ticking a box on a form and it remains private (I assume).
What is this? In the past five years, I've probably flown 15 times and every time, I've opted out just fine. Just stand there waiting to one side until someone comes to pat you down. The pat down is consistent across airports, and you can usually count on the TSA agent to be courteous and professional. I can't stand the agency or their dictum that they're keeping the skies safe, but individual agents seem to be decent folk.
Never had any feeling of shame from other passengers or TSA agents. Maybe I'm lucky or privileged or something.
But if you don't want to get scanned, tell the agent you want to opt out. You don't have to be a haughty prick about it. Just say, "I want to opt out, please." And when they say, "okay, stand over there," nod and say, "thank you."
If living in England, would now opt out. The de-facto approach can't be your organs belong to the NHS.
Can your family opt in after your death? I'd say it's a difficult question and obviously made easier by making it opt out system. Anyone objecting has to opt out so majority of people will stay default which improves organ donation rates.
Some ammunition for those who disagree - organlegging!
http://www.technovelgy.com/ct/content.asp?Bnum=337
Moreover, the linked website's claim of universal religious support for organ donation is very suspicious. It relies on opinionated interpretation of religious texts and cherry picked quotes of support from random individuals that they've propped up as authoritative representatives of religions, when that is not really the case in reality. Religious ritualistic practices and interpretations of texts vary and there will be many for whom this permissive assumption of the state's right to an individual's organs will be a violation of their beliefs.
This mentality has actually helped other countries save more lives by default. While each person still retains the power to opt-out. And yes other countries have done this before the UK. US should do this too!