My Kidney Challenge

[Jimmy Higgins]

Interesting. So... why? Why can't a person be compelled by the state to donate an organ, especially if the compatibility is rare? What justification do you use to prevent the state from compelling a person with a rare kidney compatibility with another who's life depends on it, to donate the kidney?

It's right there in the part of my post you clipped off.

Is the concept of responsibility so difficult you don't even see it?

I'm asking why the state can't compel an unresponsible person to donate the kidney.

Please note, saying "they aren't responsible" isn't an actual answer to the question as I'm asking about the foundational reason.

 

[Jarhyn]

Interesting. So... why? Why can't a person be compelled by the state to donate an organ, especially if the compatibility is rare? What justification do you use to prevent the state from compelling a person with a rare kidney compatibility with another who's life depends on it, to donate the kidney?

It's right there in the part of my post you clipped off.

Is the concept of responsibility so difficult you don't even see it?

I'm asking why the state can't compel an unresponsible person to donate the kidney.

Please note, saying "they aren't responsible" isn't an actual answer to the question as I'm asking about the foundational reason.

Even so, I have yet to see why it's non-fungible even then... Or why there is any meaningful distinction between "no willing donors" and "no possible but unwilling donors", or why it matters to the calculus.

It all just seems some "asspull calculus" to me to post-hoc justify a view that women owe a debt to finish out a pregnancy because "unfinished ingredients = cake".

 

[TomC]

I'm asking why the state can't compel an unresponsible person to donate the kidney.

Please note, saying "they aren't responsible" isn't an actual answer to the question as I'm asking about the foundational reason.

Who says the state can't?

I would find that brutally immoral. Because I do understand the concept of personal responsibility.

Tom

 

[Jimmy Higgins]

I'm asking why the state can't compel an unresponsible person to donate the kidney.

Please note, saying "they aren't responsible" isn't an actual answer to the question as I'm asking about the foundational reason.

Who says the state can't?

I would find that brutally immoral. Because I do understand the concept of personal responsibility.

Yes, we get it, you love to bring up the term "personal responsibility", but that doesn't answer the question. I'm giving it one last try. What is being violated to make it brutally immoral?

 

[Elixir]

Define “person” as you may, though.

As many times as I've pointed out that I avoid that word, in this discussion, specifically because it's too difficult to define and you still come back with this crap?

Seems like either blatant dishonesty or you've got you ideological blinders on so firmly you don't even see what's on the screen in front of you.
Tom

Uh, if you don’t think there is any operational definition of “person” in play here, it’s pretty hypocritical to speak of or imply (by, for instance, using loaded phrases like “infanticide”) that abortion is killing people. And willfully stupid if you know there is no such operational definition and still demand that I tell you what “science says” about it.

There is NO ideology involved in falsifying the notion that a nearly invisible clump of protoplasm is a PERSON by any common definition.

 

[T.G.G. Moogly]

There is NO ideology involved in falsifying the notion that a nearly invisible clump of protoplasm is a PERSON by any common definition.

That is an accurate, defensible, rational, medically and scientifically based statement. It will be lost on someone that does not operate rationally, despite their protestations to the contrary.

 

[Elixir]

There is NO ideology involved in falsifying the notion that a nearly invisible clump of protoplasm is a PERSON by any common definition.

That is an accurate, defensible, rational, medically and scientifically based statement. It will be lost on someone that does not operate rationally, despite their protestations to the contrary.

I have come to expect that. Reiterations are mostly for my own benefit, helping to maintain a little clarity despite the frustration.

 

[Toni]

I'm asking why the state can't compel an unresponsible person to donate the kidney.

Please note, saying "they aren't responsible" isn't an actual answer to the question as I'm asking about the foundational reason.

Who says the state can't?

I would find that brutally immoral. Because I do understand the concept of personal responsibility.

Tom

I see no evidence that you DO see personal responsibility as a concept that applies to YOU personally.

I see you have an emotional response to events that happened decades ago which conveniently allowed you off the hook for any of that personal responsibility that you admire , theoretically and for other people.

Whether you agree or not, personal responsibility sometimes means personally getting an abortion. Your mother’s case was one such circumstance, but there are as many others as there are girls and women who do not wish to be pregnant or not at that time, under those circumstances. Society’s job is not to jusmdge people for making medical decisions in their own best interests. Society’s job is to create a society where all people are supported by society in such a way that there are fewer unwelcome pregnancies and fewer medical complications during pregnancy that precipitate such difficult, heart rending decisions. A huge chunk of that prevention is in truly valuing girls and women for their own sake, enough to want them to be able to grow and flourish and be as strong, independent and content as possible—and to value boys and men and all people as well.

 

[Marvin Edwards]

The question is whether it is better for us all to be at the daily risk of being forced to donate an organ against our will, or whether it is better for everyone to be free of that threat.

We could, theoretically, agree to a law that would put us all at that risk, forcing the compatible donor to donate as long as it does not damage the donor's own health.

Or, we could have a law that required everyone to be a donor upon their death.

Or, we could leave things as they are, in which a person may volunteer to donate either while alive or upon their death.

 

[Jarhyn]

The question is whether it is better for us all to be at the daily risk of being forced to donate an organ against our will, or whether it is better for everyone to be free of that threat.

We could, theoretically, agree to a law that would put us all at that risk, forcing the compatible donor to donate as long as it does not damage the donor's own health.

Or, we could have a law that required everyone to be a donor upon their death.

Or, we could leave things as they are, in which a person may volunteer to donate either while alive or upon their death.

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

Most people don't care either way, but will not go through the bother of volunteering. They will also not go through the bother of revoking such.

Either way, family already gets an opportunity to object if they wish, even for opted-in donors.

Additional measures to protect corpses whose deaths were "suspect" would be important, but the real problem is that people can't be arsed, not that they object to the idea in the first place.

As I see it most correct outcomes are very close to what is already happening.

 

[TomC]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

Does this include all internal organs?
Does it include the uterus?

Must someone jump through government hoops to "op-out" of government control of that particular internal organ?
Tom

 

[Jarhyn]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

Does this include all internal organs?
Does it include the uterus?

Must someone jump through government hoops to "op-out" of government control of that particular internal organ?
Tom

A person's family still has to approve it.

Having a living medical directive and will would already be capable of covering any such problems people have.

 

[Marvin Edwards]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

Does this include all internal organs?
Does it include the uterus?

Must someone jump through government hoops to "op-out" of government control of that particular internal organ?
Tom

A person's family still has to approve it.

Having a living medical directive and will would already be capable of covering any such problems people have.

I don't think the family can legally override the advanced directive. The individuals have the right to make this decision for themselves. The only time the family can be involved is if the patient's wishes are in doubt, such as when they don't have an advance directive.

There was a famous case of a husband wanting to take his wife off of life-support, but the wife's family argued that they knew what their daughter would want better than he did. If she had registered an advance directive, her will would have been clearly stated.

 

[Loren Pechtel]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

I would like to see multiple changes:

1) Default-in.

2) The transplant list is sorted by what % of your adult life you have not been opted out. Children get the average of their parents. The 0/0 case (medically invalid before reaching 18) is treated as 100%.

3) The ability to put notes on the status. I have my driver's license marked no, not because I'm opposed but because 40 years ago a malarial mosquito bit me. In theory it was wiped out--but it returned after more than 20 years. Is it still lurking there? Who knows? They certainly shouldn't be transplanting any organs without the medical team knowing that piece of information!

 

[Jarhyn]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

I would like to see multiple changes:

1) Default-in.

2) The transplant list is sorted by what % of your adult life you have not been opted out. Children get the average of their parents. The 0/0 case (medically invalid before reaching 18) is treated as 100%.

3) The ability to put notes on the status. I have my driver's license marked no, not because I'm opposed but because 40 years ago a malarial mosquito bit me. In theory it was wiped out--but it returned after more than 20 years. Is it still lurking there? Who knows? They certainly shouldn't be transplanting any organs without the medical team knowing that piece of information!

See, this is a good approach.

When people have a reason to opt out they do, generally, and the risks of the few who are apathetic about situations like yours despite their living of it are relatively low, and lower than the risk of dying of a fucked up organ right away.

 

[Loren Pechtel]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

I would like to see multiple changes:

1) Default-in.

2) The transplant list is sorted by what % of your adult life you have not been opted out. Children get the average of their parents. The 0/0 case (medically invalid before reaching 18) is treated as 100%.

3) The ability to put notes on the status. I have my driver's license marked no, not because I'm opposed but because 40 years ago a malarial mosquito bit me. In theory it was wiped out--but it returned after more than 20 years. Is it still lurking there? Who knows? They certainly shouldn't be transplanting any organs without the medical team knowing that piece of information!

See, this is a good approach.

When people have a reason to opt out they do, generally, and the risks of the few who are apathetic about situations like yours despite their living of it are relatively low, and lower than the risk of dying of a fucked up organ right away.

The reason I consider it important is that if it's still hiding out and my immune system is simply keeping it in check (which must have happened for over 20 years) it would likely get transplanted--and when it caused an infection in the recipient it would likely not be on the radar. Our local lab can't even test for it and antibiotics aren't going to stop it--the result could easily be very bad for the recipient.

 

[TomC]

1) Default-in.

This is the part I have trouble with. I'm very uninclined to give the government that kind of power.

What I'd support is remaining an opt-in arrangement, but sweeten the deal a bit. I suspect that a small tax deduction would be sufficiently attractive to get millions of the kind of people you want to voluntarily sign up to do so. The young healthy people, who don't think much about mortality. The kind that don't much bother with motorcycle helmets or gun safety or things like that either.
Tom

 

[laughing dog]

I do not think anyone should be forced to donate an organ. That makes anyone a mandatory organ donor which is treating them like an object rather than a person. Organ donations require invasive surgery on the donor which may cause complications.

 

[Toni]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

I would like to see multiple changes:

1) Default-in.

2) The transplant list is sorted by what % of your adult life you have not been opted out. Children get the average of their parents. The 0/0 case (medically invalid before reaching 18) is treated as 100%.

3) The ability to put notes on the status. I have my driver's license marked no, not because I'm opposed but because 40 years ago a malarial mosquito bit me. In theory it was wiped out--but it returned after more than 20 years. Is it still lurking there? Who knows? They certainly shouldn't be transplanting any organs without the medical team knowing that piece of information!

Loren, I’m certain that you are aware, but prior to transplantation, blood is screened for transmissible disease in addition to the testing typing and cross match, and HLA groups, If the donor is known to have had a malaria infection, a highly sensitive test is performed to determine if there is any remaining plasmodium. If you’ve been properly treated you should not still have any plasmodium burden.

if everyone became a donor unless they opted out, not everyone would be a suitable organ donor, depending on age, cause of death, where the person was when they died, and of course if they carried any number of transmissible viral disease or had other conditions.

All organ donors are screened for transmissible viral diseases and increasingly for some parasitic diseases as well. These tests must be carried out and results reported in a very short time frame or the organs are useless.

This sort of testing is highly regulated to ensure the safety of any organs or blood used in transplants or transfusions.

 

[Jarhyn]

Or we could make a change in some places that is already implemented: changing the default of consent to "yes" rather than "no" and continuing to have a volunteer situation but with "opt-out" rather than "opt-in"

I would like to see multiple changes:

1) Default-in.

2) The transplant list is sorted by what % of your adult life you have not been opted out. Children get the average of their parents. The 0/0 case (medically invalid before reaching 18) is treated as 100%.

3) The ability to put notes on the status. I have my driver's license marked no, not because I'm opposed but because 40 years ago a malarial mosquito bit me. In theory it was wiped out--but it returned after more than 20 years. Is it still lurking there? Who knows? They certainly shouldn't be transplanting any organs without the medical team knowing that piece of information!

Loren, I’m certain that you are aware, but prior to transplantation, blood is screened for transmissible disease in addition to the testing typing and cross match, and HLA groups, If the donor is known to have had a malaria infection, a highly sensitive test is performed to determine if there is any remaining plasmodium. If you’ve been properly treated you should not still have any plasmodium burden.

if everyone became a donor unless they opted out, not everyone would be a suitable organ donor, depending on age, cause of death, where the person was when they died, and of course if they carried any number of transmissible viral disease or had other conditions.

All organ donors are screened for transmissible viral diseases and increasingly for some parasitic diseases as well. These tests must be carried out and results reported in a very short time frame or the organs are useless.

This sort of testing is highly regulated to ensure the safety of any organs or blood used in transplants or transfusions.

And either way, even 10% of a 100% (a wildly high percentage) increase of orgain donations ending badly due to missed screens would be preferable.

In reality the numbers will be closer to 1% and 1000%, but it would take an inverse to the increase in tainted vs available to be a bad thing on net, a completely unrealistic outcome. You would need the increase in tainted to outstrip the fulfilled demand.

Far more people would still be dying of no organs than tainted ones even were we to increase the supply at the expense of higher taint.

There is no available world where opt-out hurts people more than opt-in. Not even concerted trolls trying to taint the supply on purpose would yield such an outcome.