“They were just laying there, so I thought, ‘These might be worth a bob or two’ and, you know, the business sort of took off…”
“Did you not think of the ethics?”
“Ethics? I’m from Camden, mate.”
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Society would better off if we didn’t use money at all, and that’s doubly true for all things medicine-related.
But in the society we live in today, it seems wrong to take possession of something of value without compensation.
They’re dead.
The next person needs it.
System seems to work fine to me.
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I don’t think of my family members’ corpses as commodities I “own” or should be allowed to sell for profit. But if I did, my family members might be reasonably concerned about me having a profit motive to turn them into corpses. For example, you could have a situation like
Doctor: Your mother’s condition is critical. Would you like us to proceed with the operation?
Me: (Flipping through medical catalog) Can I get a quick appraisal on her kidneys first?
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There are certainly all sorts of body-harvesting abuses available; but they are essentially orthogonal to whether you operate on an opt-in or opt-out system.
If you are willing to kill someone for their organs you clearly don’t have a lot of interest in honoring their consent, as well as having enough impunity or obfuscation to feel safe in running that sort of operation. Nobody in that situation is going to have much trouble ensuring that the record(if there has to be one) has an adequately plausible ‘consent’ placed in it, one way or another.
The only case where it makes a difference is among the apathetic.If you have to go out of your way to donate you’ll get fewer donors than if you have to go out of your way not to. Anyone who proposes an opt-out scheme that’s clearly designed to beat people down by attrition is an issue; but real-world implementations usually make it as easy as a checkbox on some form you would be filling out anyway, with the additional option of a declaration to that effect if you are still on speaking terms and end up in the hospital.
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It’s not just whether you kill them. It’s whether you decide to take measures to save them.
No one should have “boy we sure could use about 15 grand right about now” kicking around in the back of their head when the doctor asks if they want to consider taking a loved one off life support.
There are some things money shouldn’t dictate. One is who gets access to live-saving organ transplants. Another is whether family members decide to donate a loved one’s organs.
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While I agree with you that an opt-in donation system does nothing to stop any potential mustache-twirling organ thieves out there, I don’t think that’s much of a real problem for the same reason I don’t think voter fraud is a real problem- very little upside and huge downside for anyone doing it.
What it does address is systemic issues such as the ones I alluded to regarding unequal health outcomes. I for one would not be okay with an opt-out system in the U.S., in part, because I have no doubt that a disproportionate number of donor organs would come from the disenfranchised. You don’t need a cartoonish villain to arrive at this outcome, just our existing inequality of healthcare (see the disparate COVID-19 impact for an example) plus an opt-out system. In the U.S., the prison population is 40% black, despite black people only making up 13% of the general population. I’m not interested in seeing the same (or similarly situated) 13% provide 40% of donor organs just because it strikes technocrats as a more utilitarian outcome.
Policy can’t be made as if for an ideal world; it has to be made for the one we live in and it has to at least make an attempt at addressing second order effects.
Edit: a punctuation.
Call it a variation of a gift economy then.
Everyone donates organs at death which guarantees an organ donation should you need it. If you don’t, then consider yourself lucky when you live your life without needing anti-rejection meds, and keep the donations going.
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Anyone have an idea how much of a difference this is expected to make? I thought the main reason for the shortage was that not many people die with organs in good enough condition.
Came for… and was not disappointed…
Also:
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I regret that the U.S. will destroy itself and most likely kill me in the process, before I can watch the U.K. crash and burn.
Hah! Like anyone would want THESE organs…
(coughs weakly)
There is compensation, somebody else gets to live longer/better.
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One of several reasons for the shortage is that there is a donor reluctance among some BAME minorities and this is particularly vital in increasing the number of tissue matches for kidney transplants.
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Well, probably not as much as say, free motorbikes for all 17 year olds, but it’s still the right thing to do.
And do you think the existing shortages of organs help black and brown communities? A shortage of organs is more likely to favor those who have medical access. I would be fine banning any harvesting of organs from incarcerated individuals. Wait times are already longer for black patients for hearts than it is for white patients. https://www.heart.org/en/news/2018/11/12/wait-times-for-a-donor-heart-may-vary-by-race
This makes me regret reading Coma (and watching the movie).
My worry is less about the family of the patient wanting money than the institutions wanting it (or to save it). Medical organizations are concerned about costs and revenue.
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So this means England is going to keep sending me organs until I tell them to stop?
Also:
Family consent will still be required for organs or tissues to be retrieved, both out of consideration for the family, and to make sure additional relevant information is gathered.
It is expected to make a significant difference, especially among BAME communities whose prior opt-in rates were very low and yet whose need may be higher.
Ethnicity matters when it comes to organ transplants; in the UK, a high proportion of BAME people go on to develop high blood pressure, diabetes and certain forms of hepatitis, making them more likely to need a transplant at some point in their lives.
The BAME transplant gap comes down to two main issues: kidneys in particular are more likely to be accepted by a patient’s body if they are a similar genetic match. But historically, not enough BAME people have been registered on the organ donation list, making the chances of them finding a perfect ethnic match even harder.
It may also make a bigger difference in the short term as accidents are a majour source of organs and accidents are fewer during lockdown.
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WTF?
Why is this topic a ‘UK crash and burn’ topic? In what conceivable way does this development re organ donation lead to UK being more likely to crash and burn?
Looks like a US issue. Hardly a concern in our universal health care provision UK.
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