Sensible Erection | Should a mental disability disqualify you for an organ transplant?

Sunday, 19 August 2012

Should a mental disability disqualify you for an organ transplant?

quote [ The question before doctors now is whether his mental problems - he has a form of autism - are severe enough to make him a bad candidate for a heart transplant. ]

It is a fascinating debate, and I'd love to get other peoples' opinions on it.

I don't think this is an issue on whether or not he 'deserves' a heart. Of course he does! Should he be denied a heart just because of a diagnosis of autism? Absolutely not.

But this is a complicated, expensive, dangerous, and high-risk-of-failure operation that requires lifelong dedication and discipline over nearly all aspects of life. His living situation and behavior, coupled with his other health issues and the fact that most of the important medications he would need would have horribly adverse reactions, he is not a very good candidate for coping and survival of the procedure. (It may even decrease his life span to do the procedure vs. not doing it). I could understand him being put lower on a list for those reasons, just like an alcoholic would be.
However, the hospital didn't just put him lower on the list. They won't put him on the list at all. And that is nothing short of monstrous. Hearts, like other organs, require many many factors to be aligned to be eligible for a person; everyone is not competing for each heart. He deserves a chance, just like anyone else.

Perhaps his best bet is to be a geriatric war criminal; they seem to get hearts easily enough.

Other news:
Pop music louder and 'all the same,' find researchers: http://entertainment.nbcnews.com/_news/2012/07/26/12973700-researchers-find-pop-music-is-too-loud-and-all-sounds-the-same?lite

Madonna being sued by anti-gay Russian activists for promoting the gay agenda and 'hurting their feelings": http://www.vancouversun.com/entertainment/Madonna+sued+anti+activists+after+Russian+concert/7107288/story.html

[politics] [by Dienes@1:39pmGMT] [+10 Interesting]

Comments

CapnSilver said @ 2:05pm GMT on 19th Aug
I know it's awful but a little part of me feels that eugenics through organ transplants is okay. It wasn't particularly long ago that all of them would be fucked.

foobar said @ 8:34pm GMT on 19th Aug
The vast majority of organ recipients would be past childbearing age.

RhesusMonkey said @ 2:24pm GMT on 19th Aug [Score:3 Underrated]
Headline: Man refused Heart Transplant due to Autism

Dr.s actual recommendation: "given his psychiatric issues, autism, the complexity of the process, multiple procedures and the unknown and unpredictable effect of steroids on behavior"

So, I see this as the US overly litigious reaction to the medical field that if mixing meds, the man dies and the family sues the doctor for performing the surgery, or the Dr's insurance would not cover the procedure due to there not being sufficient evidence of the impact of steroids on the patient, etc etc... This whole thing seems more CYA on the part of the hospital than straight-up Eugenics.

Frankly I don't know how I feel about this. I've been told that I am ineligible to donate blood due to some past medications I've taken, and that also prevents me from donating organs; I'm not sure about receiving an organ transplant though. If it was not immediately life-threatening, and I was told "too bad, so sad", I might be OK with that decision. And then quit my job and take up Formula 1 racing or something.

strangeffect said @ 2:36pm GMT on 19th Aug [Score:3]
+1 "Fuck this noise, I'm racin' me some cars"

Dienes said @ 2:52pm GMT on 19th Aug
Yeah, the headline could be better. But its not that big a stretch, as the behaviors are directly associated with the disorder and those behaviors are also directly impacting recovery and the safety of others.

I've worked in severe behavior with aggressive people with autism spectrum disorders. If a large bodied 23-year old gets aggressive, it is very difficult to block quickly and safely. Is it responsible and wise to give a medication to someone that is likely to make him dangerous to others? Especially when he requires the care of others to survive?

spazm said @ 3:30pm GMT on 19th Aug [Score:3 Underrated]
Well, it is a bit of a stretch as it does imply something different.

Headline: Should people with mental disability get an organ transplant?

Article: Should possible disadvantages of certain mentally disabled person be taken into account with consideration of organ transplant?

Quite a difference there. The first one asks for rage while the second one requires a lot more consideration before even thinking of an opinion on the matter.

rangerx said @ 5:09pm GMT on 19th Aug
Congratulations, you have successfully decrypted modern media. Over-hyped video that might save your life coming up next, but first a word from our sponsors.

spazm said @ 5:24pm GMT on 19th Aug
Eh

happiest_sadist said @ 8:59pm GMT on 19th Aug
That's no word!

spazm said @ 9:52pm GMT on 19th Aug
They were at loss.

azazel said @ 9:06pm GMT on 19th Aug [Score:1 Informative]
Going off on a tangent here, but re: donating blood; since the 80s homosexual men weren't allowed to donate blood (actually, it was even more severe than that: any woman who had slept with a man who had slept with another man was also excluded) due to 'them gays catching the aids easier' or something -- there never was any clear reason given why this rule was put in place or why it wasn't removed. It was removed a while back though, except where I live. Because, and I quote a politician directly involved in "transitioning the hospitals to the new blood donation directives": "We don't see the need to do that, because gay male blood donors are such a small group anyway."

At least she didn't say that people might catch teh ghey if they get gay blood. But she made it very clear that homosexuals aren't important enough for her or her party.

Adam said @ 7:19pm GMT on 20th Aug
You're also not allowed to give blood if you ever had sex with someone who lived in sub-Saharan Africa. That's not what the form says, of course. It just says "Africa," and then you negotiate with the nurse about whether Egypt counts (it doesn't).

puravida said @ 6:57am GMT on 20th Aug
Corticosteroid-induced mania: Prepare for the unpredictable
http://www.jfponline.com/Pages.asp?AID=4147

Just one of dozens of links I found on the topic. Google "corticosteroid psychosis" and you'll see what I mean.

Just picture a 23 year-old autistic male, violent and manic, and you'll understand what a serious issue his can be.

Navier-Strokes said @ 3:05pm GMT on 19th Aug
This is why we need to up research in bioengineernig human organs. When supply is a non-issue, a variety of moral conundrums(e.g. organs sale black market) simply disappear. Then again, there will be those that then argue "ORGANS ARE PEOPLE, TOO!", but I'm OK with trolling them for being idiots.

wynterbourne said @ 9:01pm GMT on 19th Aug
Unfortunately, we won't be able to do this until we get those retarded "stem cell research causes abortions" fucks to shut up.

Navier-Strokes said @ 6:13am GMT on 20th Aug
Christ, don't get me started on that failboat of fucktards.
Billions in research, lost.

feeling constipated said @ 5:23pm GMT on 19th Aug
Do they guarantee retard strength?

happyman said @ 6:03pm GMT on 19th Aug
Well we can also ask Kang about this, but as a surgeon, I'll be fine with it as long as the patient is competent and able to understand how to care for him/herself post-transplantation. Obviously going into lengthy discussions with him/her and his/her carer (if they have one).

Mr. Langosta said @ 6:15pm GMT on 19th Aug [Score:1 Funny]
I'd prefer to ask Krang about it, to get the opinion of a transplanted organ itself.

michaelofoz said @ 7:13pm GMT on 19th Aug
My primary ethical views rely on elitism and the preservation of the human race. I'm probably in a limited group for these values, but that's just what I focus on. That being said, I think that an autistic person may or may not be 'worthy' of an organ donation. Whether it be based on him actually deserving the heart or just financial/risk-reward issues. If the person with the mental illness can still contribute to the advancement of life as a species in general, then by all means give him a heart. If there is someone else that would be more capable of such tasks, give them the heart first. I just think that a person that will be forever under the care of others and unable to efficiently contribute to society would be a waste of time, money, and effort.

Disclaimer: Not meant to troll, just stating my views.

sanepride said @ 7:59pm GMT on 19th Aug
A perfectly valid point of view, but who's to say whether a potential recipient deemed 'worthy', or capable of contributing to the 'advancement of life' etc., will indeed contribute in a positive way? The poster refers to a 'geriatric war criminal', which I assume is a reference to Dick Cheney. Sure his potential may have been worthy, but what about his actual contribution? Would society as a whole not benefit as much or more if his heart went to some random autistic person?

snowfox said @ 5:18am GMT on 20th Aug
Cheneys (Chenii?) are extremely rare though. If we're going to play the odds, we're better to give the person with potential the organ.

mrcucumber said @ 2:46pm GMT on 20th Aug
I say we harvest all of Dick's organs now.

Right now.

foobar said @ 8:36pm GMT on 19th Aug
Civilization only exists because the rest of us are able to restrain the selfish and destructive impulses you're displaying here. That you are unable to makes you exactly the sort of burden you're describing.

sanepride said @ 9:52pm GMT on 19th Aug
There are those who would argue that the rise of civilization owes just as much to those willing to make harsh, sometimes ruthless judgments in order to advance their particular tribal units.
Personally I prefer to believe in the 'better angels' scenario, but both views have some credence.

foobar said @ 9:56pm GMT on 19th Aug
I'd point those who advance that to tribal Somalia or Afghanistan/Pakistan. Tribalism is a pretty major impediment to civilization.

sanepride said @ 12:43am GMT on 20th Aug
I was thinking along the lines of small tribes that join together to form bigger tribes.

rangerx said @ 2:02am GMT on 20th Aug
Oh man, I have that dream. Then the bigger tribe turns in to a chicken and chases you down the street. And you have no pants on.

RhesusMonkey said @ 12:35am GMT on 20th Aug
He's not heavy, he's my brother!

You can't place a value on an individual, because you don't know what they, or their progeny, are capable of. Suppose this fellow is autistic but is able to process complex mathematics that unlocks some new theorem? Or just happens to be in the right place at the right time to use his "superior strength" to foil a bank robbery?

The world is full of opportunities for all people to excel, and I hope some will exceed more than others, it does not make them more "valuable".

mrcucumber said @ 2:56pm GMT on 20th Aug
Wouldn't that depend on how you define "value"? Some would say having your mother/father/sister/husband/brother around is more valuable than foiling a bank robbery.

You play the odds in life, I guess, so you try to play them in your favour, right? What are the chances one autistic man unlocks some new theorem? Or even discovers dilithium crystals? Singling out one person and suggesting they might be the next Einstein is romantic, but not probable.

I don't think I have an opinion on this, but there are compelling arguments here against giving this guy a heart.

foobar said @ 8:32pm GMT on 19th Aug
Alcoholics aren't denied organ transplants. Alcoholics who are unable or unwilling to manage their alcoholism are.

maryyugo said @ 8:44pm GMT on 19th Aug
I remember a case of an alcoholic who received a liver transplant and then returned to drinking and got a second one. When he drank again, he was refused a third. He sued. I don't remember the outcome.

Alcoholism is a disease (probably of genetic origin) and requires medical and psychiatric treatment. But people who don't cooperate with the treatment shouldn't get organ transplants that could be used to save others, mainly because they won't work.

wynterbourne said @ 9:00pm GMT on 19th Aug
How in the hell did he get one? Shoot, where did this happen?

We had a similar case in my area. A young man who'd previously had a liver transplant had his childhood sweetheart break off their engagement. In a fit of depression he went out drinking, just enough to effectively kill his new liver. That's really not much alcohol considering how fragile transplanted livers are, just a couple of drinks can do it under the right circumstances.

He was denied a second transplant and removed from the program. Ended up committing suicide a few months later so he wouldn't have to go through all that pain again.

Most of the transplant groups I know of actually require the recipient to sign a "behavioral contract" prior to being admitted to the program. With livers, an almost universal inclusion is a clause stating that they will NEVER drink again. Being caught violating this clause is grounds for immediate removal from the program.

maryyugo said @ 5:05pm GMT on 20th Aug
I don't remember where but another issue is when. It was more than ten years ago and might not happen currently under existing regulations.

foobar said @ 9:57pm GMT on 19th Aug
I remember a case where a pig grew wings and flew off into the sunset.

In other words [Citation Needed].

wynterbourne said @ 8:37pm GMT on 19th Aug [Score:5 Underrated]
I'm going to take what is likely going to be an unpopular stance here. Yes, yes it should disqualify you for an organ transplant.

Before the beating starts, let me give a little background. A little over 14 years ago my wife had a liver transplant. She was diagnosed with autoimmune hepatitis, a genetic disorder that caused her body to view her liver as an intruder. Forgive the rambling, my blood sugar is off the chart today.

When I married her nine years ago I effectively married into the transplant community in Dallas, particularly that of Baylor Medical Center. In addition to regularly volunteering with the Simmons Transplant Institute, Twice Blessed House, and various support groups at Baylor, we had the pleasure of regularly spending extended periods (normally 30+ days at a time) there on an inpatient basis due to rejection issues and illnesses that put her liver at risk. Enough so that the staff not only know me by name, but directly ask me to assist new patients and families when I'm there.

So when I say that I have intimate first hand knowledge of the transplant community, transplant procedures, and living with a transplant, please accept it as the truth.

Now, this is difficult to say, but there simply aren't enough organs to help everyone. It's more than having a viable organ. If you disregard all of the matching issues, say we come up with a magic pill that will make every organ compatible with every person, you just can't take one out of any organ donor.

Normally, but not always, you have to have brain death before organ death. Many of the body's organs release toxins into the system as they deteriorate that can render a heart, lung, or liver, etc... nonviable for transplantation. Roughly 2% of the total deaths in the United States occur in such a way that organs can be harvested for transplantation.

Here's a fun fact for you. Most transplants occur around holidays. Why? The number one cause of death that results in harvestable organs is the automobile accident. There's such an increase in deaths at these times, mostly due to drunk driving, that many transplant units have entire families camped out in their waiting areas just on the off chance that someone dies in the area with a matching organ.

Seriously, go up to any of the transplant floors in Roberts Hospital at the Baylor Medical Center in Dallas on one of the drinking holidays. I recommend Memorial Day, Labor Day, or Saint Patrick's Day. It'll be one of the most sobering moments in your life. Dozens of dying people, some with family and some without, sitting around hoping someone dies a violent death so they might have the chance to live.

Bring coffee and tissues, they need it.

Next, you know that scene in the movies and on television where someone carries an organ a thousand miles to for a last minute, emergency transplant? Yeah, you can forget that, it only happens VERY rarely and almost never on a major organ. Why?

Well, most organs are only viable for a few hours after death. How long they're viable depends on the organ itself, the manner of death, and how healthy the donor was. Provided the hospital knows the person is an organ donor, and it appears the person might have viable organs, they start the matching process. If they don't have anyone in their own hospital that both needs and matches a viable organ, they forward the information off to UNOS so they can check outside of that hospital's network. If they find one, they have to harvest and transport the organ. Given the time constraints you just can't transport most organs more than a few hundred miles.

This forces UNOS to search for possible recipients closest to the donor's location first. This does reduce the list of possible recipients, but dramatically improves the possibility of a successful transplantation.

And in many cases, particularly with livers, the surgeon doing the transplant is required to go harvest the organ. Sometimes there are just too many intricacies to have two teams working on the same organ. Once again this does dramatically increase the possibility of a successful transplantation, but it also makes time even much more of a factor as they now have to go get the organ.

There's a reason why most transplant centers are in major cities, attached to major hospitals that see a serious amount of Emergency Room traffic.

All of this means that there just aren't enough organs to go around. Maybe if science were just a little more advanced, if more people were willing to be organ donors, we might be able to ease up on the constraints a little. Until then, transplant centers and UNOS have to look for the person with the best chance to receive the transplant in time, survive the procedure, not reject the organ, and be able to live with the constraints put upon them by being a transplantee. Hundreds of people are left off the list each year because they can't quit smoking, won't change their diet, can't consistently take medications, or live an "unhealthy" or "unsafe" lifestyle.

In this particular there are a couple of things to consider. First, the patient cannot care for himself, this is one of the MAJOR criteria for receiving an organ. He's prone to angry outbursts, which I guarantee you get worse under steroids. He's on 19 different medications already, many of which could react with his immunosuppressants. Further, he has a history of stroke in his family, which by itself could disqualify him.

I feel for him and his family, I really do. NOBODY should have to go through this. But there are other people out there with a better chance of surviving in the long term.

wynterbourne said @ 8:38pm GMT on 19th Aug
tl,dr version:

There's too many people, not enough organs, and it can go to someone with a better chance of survival.

foobar said @ 9:54pm GMT on 19th Aug
Quite because there is a limited supply of transplanted organs it is critical that we ensure there is no bias on who can qualify for one. If temperament is a concern, he should be given a fair opportunity to demonstrate that he can maintain a cool disposition. If he can't, so be it, but a simple "no autistics" rule is unacceptable.

Why should someone agree to donate their liver if a qualified autistic person is rejected, but Steve Jobs is allowed to enter his name in every jurisdiction simply because he can afford the jet?

wynterbourne said @ 10:14pm GMT on 19th Aug [Score:2 Informative]
UNOS has internal controls to prevent this from happening.

A wealthy person could, theoretically, sign up at every transplant center in the country. If they were willing to undergo all of the testing, background work, poking, and prodding necessary, they could get on the list for every hospital. This would involve an absolutely colossal investment in time and energy though, as every hospital would have to take him through a rather intensive diagnostic examination and treatment protocol before they even tried to put him on the list.

However, as soon as the multiple listings hit UNOS he'd be flagged for trying to manipulate the system, and likely be removed from the program.

Someone that wealthy would be better off either trying to bribe their way up the list, and believe me when I say that list manipulation does occur (my wife is a perfect example), or just going to a country where they could buy the organ.

pleaides said @ 6:42am GMT on 20th Aug
Thanks for sharing your story and perspective mate, very interesting.

DarkShadowRavenDragonGrrl69 said @ 5:20pm GMT on 20th Aug
Why would you think this is an unpopular stance?

spazm said @ 6:18pm GMT on 20th Aug [Score:3 Insightful]
This is one of those rare comments where a +5 is not nearly enough. Thanks for sharing this.

structured_spirits said @ 1:52am GMT on 21st Aug
I disagree strongly. The cornerstone of our society is that we are all equals, from slimiest criminal to noble philanthropist . Having a doctor decide who is more "worthy" based on any factor not specific to the procedure is immoral and unethical. A lot of dedicated people have given this issue a lot of thought. There's a reason the organ transplant list is set up like it is, and first-come-first served is the best way to keep the system from devolving into an elitist clusterfuck where the rich can go through multiple organs while the poor get nothing.

I downmodded because so many people seem to think that eugenics is once again a good idea. And that really is what you're proposing at heart. That's nazi shit is what that is.

Bob Denver said @ 5:32pm GMT on 21st Aug
You bring up a good point. But...by extension of your reasoning, a person who has attempted suicide multiple times should have an equal opportunity to receive an organ; perhaps over someone who genuinely loves life etc. This is one of those (sorry) sticky slippery slopes like four cell embryo=child or assisted suicide for those living in hell. The actions of the worst guide many of our policies.

To my mind, the matter is simple: Who will live longest and with best quality of life extrapolated from this moment, economic circumstances notwithstanding; best guess.

Another point...the cornerstone you refer to is actually that we all have equal rights; we are not equal (Stephen Hawking is an excellent example). Are organ transplants covered under rights?

structured_spirits said @ 1:23am GMT on 22nd Aug [Score:-1 Overrated]
"a person who has attempted suicide multiple times should have an equal opportunity to receive an organ; perhaps over someone who genuinely loves life etc."

Yes, and that's the way it should be. A doctor is no more likely than a fortune teller to accurately predict the future.

"To my mind, the matter is simple: Who will live longest and with best quality of life extrapolated from this moment"

Both patients will die, depending on the type of transplant more than likely in 5 years or so. In regards to "quality of life," how is a doctor or anyone else in a position to decide who would have the best quality of life. Is the joy a retarded man feels somehow less important that that of a "normal" person? The answer is no.

Finally we have this statement:
"The cornerstone you refer to is actually that we all have equal rights; we are not equal (Stephen Hawking is an excellent example). "

I think you could have some support for the previous critiques, but not this one. Our American society is in fact founded upon the principle that all men(men referring to man ie people) are created equal and are endowed with inalienable rights. I know we've all been brought up to believe we're special snowflakes and some people are more "important" because of their jobs or contributions to society or because of a birthright or because they can play basketball better. That's bullshit elitism, and again, exactly what the nazis believed. I hate to break it to you, but in the grand cosmic scheme of things, Hawking is exactly equal with everyone else, which is about worthless, just like you, me, and everyone else. So lets all be good to each other, and cue up and not try to cut line, just like we were rightly taught as youngsters.

Naruki said @ 2:52am GMT on 22nd Aug [Score:2 Insightful]
A doctor is no more likely than a fortune teller to accurately predict the future.

I'm just going to weigh in on this little bit here, and ignore the rest because frankly, if it is as fucking stupid as this, there ain't no point.

A doctor is a highly scientifically trained professional who predicts the future based on empirical evidence, statistical evidence, medical knowledge, fucking thorough examinations of the subject inside and out, psychological evaluations, et cetera ad nauseum.

A psychic is - at best - a practiced charlatan who is good at convincing you of a made up future without any evidence, just to get your money.

That you would attempt to equate these two is simply disgusting.

structured_spirits said @ 10:48pm GMT on 22nd Aug
When it comes to predicting the outcome of a procedure or round of drugs on physical health, yes a doctor has some expertise in predicting what will happen. To say a medical doctor is any more qualified than anyone else to say who will be "happier" and will have a "better quality of life" is incorrect. A doctor is trained in science, which has no ability to deal with subjective moral values like happiness etc. Doctors already understand this, which is why they offer options to patients, so that the patient can make the decision.

As far as some people being better than others, that's clearly elitism and if you don't recognize that it's wrong, then an argument is unlikely to be persuasive.

Kat said @ 8:42pm GMT on 19th Aug [Score:1 Underrated]
The system tends to seem fine until it does not benefit you.
I understand the reasoning of the family: do whatever it takes to make sure that your family member lives for as long as possible.

That being said: this is not just a case of denying someone a heart based on their mental issues...it is also a case of deeming that there is a better potential recipient out there. That could mean someone else with a lesser degree of autism, someone with less medications or mood swings, or just a person who is more physically fit.

Mostly unrelated side note: There is a woman on Facebook that I went to high school with who recently "friended" me. I can't help but notice some of the vitriol she has about gay rights, Obama, "Obamacare", and various welfare programs.

She is, however, quite adamant about her autistic son's rights and the funding that should exist for him.

wynterbourne said @ 9:08pm GMT on 19th Aug
Yeah, I know a couple of people like that. I have a couple of friends that, over the past few years, have turned into the kind of people that thoroughly embrace the most conservative parts of the Tea Party rhetoric. Welfare means you're lazy and sponging off society, Universal Healthcare will destroy the nation, being poor means that you just need to work harder, the only acceptable family unit is a mother+father+kids, that kind of crap.

They're on both housing and food assistance, and use Medicaid to take care of their youngest child's medical issues because they don't have insurance.

sherlock said @ 9:59pm GMT on 19th Aug
I dated a girl for a number of years whose mother was a staunch republican and evangelical christian. Her mom had a child with severe Down's syndrome. Her Mom opposed any sort of welfare, except of course the government assistance given to help her take care of her disabled child. She went so far as to say that "liberalism is a mental illness". The cognitive dissonance was strong with this one.

spazm said @ 10:10pm GMT on 19th Aug
Something with apples and falling not far from the tree or something?

sherlock said @ 9:56pm GMT on 19th Aug
Before we worry about this we should worry about *nationalizing* organ donation. And once we nationalize it make it opt out instead of opt in. Currently organ donation in the US is divided into regions, and each transplant center can require a full medical evaluation to be placed on their wait list. Only the wealthiest can afford to be evaluated for multiple lists, because insurance typically won't cover it. This allows the wealthiest to game the system. It's what allowed Steve Jobs, who was already in bad shape, to get a liver transplant.

foobar said @ 11:20pm GMT on 19th Aug [Score:1 WTF]
Taking organs without the consent of the donor is rather monstrous. That organ donor proponents have such little regard for the wishes of potential donors is one of the main reasons I will never be on the list.

GordonGuano said @ 11:45pm GMT on 19th Aug [Score:1 Classy Pr0n]
So can we 'ave your liver, then?

azazel said @ 12:34am GMT on 20th Aug
An opt-out program would mean that those who care about it would opt out. I can't see that as very monstrous, really. If you think your body the holy vessel of your soul, surely you can spend a few minutes filling out a form to opt out. There are other reasons why you might want to oppose an opt-out program, but "monstrous" is not one of them in my book. Why do you think it's monstrous anyway?

I also think that it's a bullshit reason for not being on the donor list, because not all organ donor proponents agrees with those views.

Personally I've been on the organ donor list (in Sweden) since I turned 18; I've also stated that they might harvest whatever they want. My gf doesn't approve, but it's not her body. Besides, I want to be cremated anyway.

foobar said @ 1:45am GMT on 20th Aug [Score:1 Funny]
Fill out this form if you don't want surprise buttsex.

azazel said @ 1:48am GMT on 20th Aug [Score:1 Underrated]
Yes, the analogy is perfect. No further explanation is needed.

foobar said @ 2:15am GMT on 20th Aug
Leave your window open tonight, I plan to lose your form.

structured_spirits said @ 2:13am GMT on 23rd Aug

sherlock said @ 5:07am GMT on 20th Aug [Score:1 Good]
Bullshit. All you have to do is put the following question on drivers license tests:

"In the event of a fatal accident, please mark the box below if you would prefer NOT to donate your organs."

This is what numerous other countries do already. In Austria, which is opt out 99% give their consent. In Germany, which is opt-in, only 12% give their consent.

http://www.nytimes.com/2009/09/27/business/economy/27view.html

It's a simple rephrasing of the question that makes people more prone to understand that the sensible default is that they should donate their organs after a fatal accident.

foobar said @ 5:49am GMT on 20th Aug [Score:-1 Overrated]
If it's opt out you specifically do not have consent.

pleaides said @ 6:48am GMT on 20th Aug
It seems to me that this point leads in to an even more interesting question; if you are not an organ donor yourself should you not be excluded?

azazel said @ 1:49pm GMT on 20th Aug
That explains all those mysterious murders that's been plaguing Austria, I guess.

mrcucumber said @ 3:04pm GMT on 20th Aug
This brings up another related issue.

Why can't organs be sold at death, with the proceeds going to the family of the deceased? Provided of course is wasn't suicide (Anything remotely close would be rejected.)

If I remember correctly, tissues (ligaments, etc) can be harvested and sold for profit if you agree to donate organs. Who's profiting from this and why? If I die, and you want my heart, tendons, skin, pay for it.

This might add incentive for many to donate organs upon an untimely death, providing a bigger pool.

Naruki said @ 2:34am GMT on 21st Aug
Um, how long does it take to determine if suicide was the cause of death, compared to viability of organs?

Also, it would be a tremendous incentive... for murder.

sherlock said @ 5:09am GMT on 20th Aug
I'll also add, in the words of Louis CK: fuck you, you're dead, you don't matter anymore.

foobar said @ 5:52am GMT on 20th Aug
Except that you're actually not. Dead organs aren't transplantable.

In the words of George Carlin: fuck you, leave me plugged in.

pleaides said @ 6:49am GMT on 20th Aug
Technicality. Braindead is dead for all intents and purposes.

foobar said @ 7:29am GMT on 20th Aug
Unless they're wrong. For me, personally, the point I'd be willing to call it is passed where my organs would be viable.

theolypse said @ 7:17pm GMT on 20th Aug [Score:-2]
Then don't sign up and for god's sake stop telling people the moral way to do something charitable that you refuse to contribute to, you gasbag.

zarathustra said @ 5:17am GMT on 20th Aug
It is every citizen's final duty to go into the tanks and become one with all the people.

Chairman Sheng-ji Yang, "Ethics for Tomorrow"

RhesusMonkey said @ 12:42am GMT on 20th Aug
Opt out doesn't work, and would only lead to murdering people for their organs. Why wait for some homeless person to die naturally if they are a match? And think of the record keeping required to track every citizen and immigrant in the country!

There are a lot of things with doing at a national level, I agree. Getting a consistent means of storing electronic health records would be a great first step, or second after that whole single-payer universal health care thing.

sherlock said @ 5:18am GMT on 20th Aug [Score:1 Insightful]
Blast, I forgot about the clause in the organ donation bill that states that your murderer gets to bypass the list and claim your organs directly!

RhesusMonkey said @ 12:19pm GMT on 21st Aug
It is a statistical probability. If you have 5 people on the list who are all fighting for the same organ, then the death of a compatible person in the area would benefit one of them. If one of the individuals is wealthy enough, do they just bump themselves up the list, or do they just ensure that five compatible people are killed?

My point being, that mandatory reuse of organs will lead to some unscrupulous behavior, given that it does not in itself ensure that supply is greater than demand. If you want to get to the point where every potential recipient has an organ available, then you need to start harvesting stem cells from every birth (placental), and store that for an inevitable future where we can lab-grow replacement parts from our own DNA. Should be 100% OEM compatible, none of this aftermarket shit.

chold_numa said @ 2:24pm GMT on 21st Aug
Well I guess if he was wealthy enough, he could have the other people ahead of him on the list killed instead.

In any case, the people who are the best match for transplants are relatives. So unless people are killing off their relatives for their organs, I think you're overstating the problem a little.

wynterbourne said @ 1:30am GMT on 20th Aug [Score:1 Interesting]
I hate to tell you this, but Steve Jobs didn't put his name on multiple lists.

What he did was find a system that had a MUCH shorter waiting list than the one in his local area. IIRC, the average wait time for a liver at the new hospital was around 80% shorter than at his primary care center. He then transferred his treatment to this new hospital.

This happens every day in the transplant system. My own wife had this done for her. In her case, her condition was deteriorating to the point where there was zero chance of her surviving down in Houston. For reasons I won't get into now, though I will give a quick thanks to George W. Bush, she was able to get transferred to the Baylor system in Dallas. They didn't have that many liver patients on the list at that time so her percentages shot up greatly.

sherlock said @ 5:17am GMT on 20th Aug
Ok, but it still stands that the wealthy are able to put their names on multiple lists. And at least in theory if there were just a single centralized list your prioritization of transplants would always be equal or better than having multiple lists.

wynterbourne said @ 7:08am GMT on 20th Aug
It doesn't work that way.

Even if they were willing to sign up in multiple systems, do all the necessary travel, undergo multiple sets of diagnostic panels, and run concurrent (and dangerously interactive) treatment protocols, the UNOS system would still pick it up.

I'm not aware of a transplant program in the country that doesn't put the patient's information into the UNOS system. When multiple entries for the same person are detected, normally identified by Social Security or Visa number, an inquiry is sent out to every hospital that submitted data. That level of fraud flat out gets you removed from the UNOS system and removed from pretty much every transplant program.

This is why Transplant Tourism has become so commonplace these days. It's much more cost effective for someone needing a speedy transplant to go to a country such as India, China, Thailand, or even The Phillippines. The laws are much more lax there, and it's quite literally possible to buy your way up the transplant list.

snowfox said @ 5:24am GMT on 20th Aug
Not a fan. My organs are a commodity. It just seems wrong to me that the hospital, surgeons, and recipient should benefit from my death, but not my own family.

mrcucumber said @ 3:10pm GMT on 20th Aug
I totally agree.

thehollowmen said @ 11:06pm GMT on 19th Aug [Score:3 Underrated]
I am the other end here, I'm bipolar and given the choice, I'd refuse an organ transplant.

I am listed as an organ donor, and I don't have anything against the procedure. I work in a lab that tries to match people to organs.

But an organ is a valuable thing, a lifesaver for somebody.

And I go off the rails too often to accept such a gift. I've been in hospital twice this year (been a bad year), and it is only by luck and attentive flatmates that I'm not in the ground. Unless there is a huge change, I probably will not have a life expectancy longer than any disease requiring a transplant.

And I am sure that would be taken into account with any transplant list I'd be on.

Fingers crossed the new meds will work out, and some people will say I'm being morbid but I think I am being realistic

In regard to this story, we don't know the circumstances of what is happening. It seems that autism isn't the only problem; police have been called and we haven't any details on that. Balances are made and we aren't privy to all the information in this case. Maybe he has an decreased life expectancy, maybe his HLA/MHC classes make it near impossible to find a donor. Maybe there are other people with those classes higher on the list, and it being rare enough they'd require a busload of people to crash going to a family reunion to clear that list.

A lot of maybes and we don't know what is going on.

X said @ 10:52am GMT on 20th Aug
There would be much less of a wait list if you could legally sell extraneous organs in north america. In some countries (Iran, for example) you can legally sell a kidney or a liver lobe. The money it brings (80,000+ USD for a kidney, more for a liver lobe) would be enough to get a lot of people out of debt, and able to get their finances together (maybe).

I'm not saying I'd trade a kidney for an ipad, but if I could pay off my car and house and start my newly married life without debt, that would be enough of a bonus to give up an organ that I don't really need, since donating one of those doesn't shorten your life.

The morals of taking money from those in need doesn't bother me either, nor does the fact that rich people would benefit more, because they could afford the organs. If the rich people are out of the normal donation system, then there's more there for the general populace.

Bob Denver said @ 10:27pm GMT on 21st Aug
Yeah...the free market and money solves everything. (sigh)

structured_spirits said @ 10:05pm GMT on 20th Aug
No. See how simple that was.

dietcoke said @ 11:06pm GMT on 26th Aug
If you are able to be gainfully employed, and you pay taxes, then yes they deserve equal treatment.
I do feel that those who have never had a job, (adults only of course) or have never been able to take care of themselves and must rely on others; those people should not qualify for organ transplant unless they are fully covered by insurance.
If they are a welfare case, then tbss, if you cannot work now, you probably will not work after a transplant and the organs should go to those who actually can contribute to the greater good.