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Comment by pklausler | Hacker News Reader

Whoa, wait a sec there with your example. How would a reasonable person not want to be an organ donor??

There is a theory that organ donors get worse medical attention and have higher mortality rates in hospitals. From what I've seen it doesn't hold up well against the evidence, but it's still within the bounds of what I'd call "reasonable disagreement".

That doesn't sound reasonable at all. That theory hinges on the idea that doctors would prioritize getting organs over actually saving people's lives, which would be a truly horrific violation of the hippocratic oath.

I wonder if rendering expensive emergency aid rather than harvesting organs is significantly more profitable in the short term?

I see it just as an acknowledgement that I might not want there to be any possible cross-purposes of incentives in my own health.

Doctor's don't need to consciously change their behavior for there to be a difference in care. It's just that incentives are like really awesomely powerful things.

I don't actually see anything in the Oath that requires prioritizing your own patient to the detriment of any number of other sick people.

Perhaps a better way to say it is that it would be a very serious ethical violation.

We're generally unaware of someone's donor status. I agree that unconscious bias would be a concern (directionality unclear) if that were not true.

Religious reasons, family not wanting that to happen, etc.

If your religion forbids saving or improving the lives of others with organs you're done with, please consider alternatives.

Religion doesn't work that way. You don't go "Well, I have this set of values, so I think XYZ is the right religion for me". There are exceptions, but most of the time it's actually exactly the opposite.

If one facet of someone's faith is enough for you to dismiss their entire belief system, you clearly don't even try to understand others' differences to yourself...

Oh, I try. But in the case of organ donation, I simply fail to understand the reasoning. If you're dead, why not save a life, renew sight, or otherwise greatly improve the life of another? Are there people who think that organ donation would hurt them in an afterlife? We, at least in the first world, live in societies with freedom of conscience and belief, so people should at least think through the consequences of their choices on others. (And on themselves; if there's an afterlife, do you really want to risk being judged on the basis of having chosen to deny a chance at health and wellbeing to another person?)

Here's some research: https://www.ncbi.nlm.nih.gov/pubmed/18555116

In short, only a few religions have anything to say against being a donor at death, and a few have something against being a recipient from a dead person.

If you think your religion might affect your decision to be a donor, check with a trusted authority figure and make sure.

For sure, FWIW I'm personally an organ donor and broadly agree with your logic. Those are just some times when I feel the choice not to donate organs is valid.

A person's choice is probably always valid regardless of what it is, it's their body at the end of the day. In the normative sense I think everyone should donate their organs, but I'm not sure it can be reasonably codified.

>> How would a reasonable person not want to be an organ donor??

Because I have fundamental issues with the economics of organ donation. I do not want my organs used in million-dollar surgeries to save elderly rich people. I would much rather that money be spent more efficiently on younger/poorer people where it can save more lives. How many flu shots could be purchased for the cost of one heart transplant? I cannot change the economic realities of modern medicine, but the least I can do is not contribute my own flesh towards the problem.

"No kidney for you, little girl. It might have gone to an old person."

Yes. No kidney for her, but flu shots for 10,000 ... saving many hundreds. The reality is that saving lives is now a matter of resource allocation. Procedures such as organ transplantation take resources from far more efficient treatments that can save many more lives.

I wish I had recorded something I saw at the gym years ago. An old and obviously ill man was bragging about how his firm could hire young interns, pay them nothing, and fire them at the drop of a hat. A young man overheard, walked over to him and said "I;ll never have your money or power, I cannot stop you from being a jerk, but when your liver starts failing you aren't getting even a piece of mine." He then ripped up his organ donation card.

> The reality is that saving lives is now a matter of resource allocation. Procedures such as organ transplantation take resources from far more efficient treatments that can save many more lives.

Do you have a source for this? To me, it seems extraordinary that we're capped out of medical resources in such a way that, were someone to not have donated their organs, ~10k flu shots would be provided instead of the various potential transplants. (I tried some internet searching but everything talking about resource constraints was talking about the organs themselves, not the general medical resources).

Fifty years ago, Larry Niven had some "moral tale" SF stories where the demand for transplant organs led to capital punishment for traffic violations.

Also, technically there is no difference between cannibalism and organ transplants - ingesting the flesh of others of your species to save your life.

Except that some organ donation doesn't involve doing damage to the donor. Blood/marrow donations are different than 'solid organ' donation. A blood donation can save a life very cheaply and the recipient will live normally, without the lifelong costs/complications of carrying a donated solid organ.

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