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Comment by renewiltord | Hacker News Reader

The reason I'm not an organ donor is simple. Everyone in the chain makes money: the OPO, the hospital, the doctor, and the insurance company. The only one who doesn't is my family, but they're the ones offering the scarce resource. If there were a pre-registered organ market then I would gladly opt-in if the price were sufficiently high.

If no one else will work for free, I will not either.

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> If no one else will work for free, I will not either.

If you're deceased, what sort of labor are you doing exactly?

To me, your argument seems to fall more along the lines of your body and organs being property that can be inherited by your family in the same was as cash, real estate, etc. Which is an interesting idea.

But ultimately it's called "donation" for a reason. If you donate to, say UNICEF or Red Cross, you're also the only one in the chain who doesn't get paid.

>If you're deceased, what sort of labor are you doing exactly?

Keeping the kidney healthy so that it is usable upon death?

The one piece of labor necessary to become an organ donor is to check a box when applying for or renewing your driver's license.

You have no obligation to do anything else or even think about it ever again. You can make exactly the choices you prefer without regard for your organ health, if you like.

They asked what labor you'd be doing to be compensated for upon donating an organ after death. Simply checking the box doesn't ensure that your organs are healthy enough to donate. The monetary compensation would be for keeping the organs in a healthy enough state to be actually donatable (rather than just potentially donatable, as is the case with just checking the box).

If you make life decisions that keep your organs healthy enough to donate, the primary beneficiary of that isn't the organ procurement agency, it's *you*. You'll live longer and have better health. I wouldn't call optimizing your personal wellbeing "labor" or "work."

You're not doing much of that once you're dead.

That's not a requirement to be an organ donor though. Unless you have religious beliefs about the sanctity of an intact corpse, then the only potential harm is wasted resources checking if your organs are viable.

Frequently I do things for which the reward arrives later. The labour comes first, the reward for it comes later. If someone will parasitize my labour, I will block him.

Unlike donation to UNICEF, if I don't do it, people don't call me a Nazi, a paedophile, or other such things https://web.archive.org/web/20240417004658/https://news.ycom...

But I am right, and society will turn to my view in time. For now, the rich will harvest the poor for free. But in time, at least they will have to pay them what they want. We will fix this bug.

To everyone else: I hit my rate limit responding to you all, so I'm afraid you must remain unresponded to.

As an organ transplant recipient who would have died 20 years ago without one, I hope you reconsider.

I will. Please write your representative asking to reform NOTA to permit compensation to the estate through a 20% tax on all transactions involving an organ transfer. For the $700k liver transplant, it is not unreasonable that my family receive $140k. For the $20k the OPO receives, it is not unreasonable that my family receive $4k.

Once NOTA is reformed, I will register to provide.

Fine, but you should be ineligible to receive, in that case.

Fine by me. I'm in a minority ethnic group here in the US. I'm not going to match that easily anyway.

EDIT: Sorry to you ceejayjoz, I was trying to reply to others by adding info to this because the rate limit doesn't let me but that's going to get discussions confused. I edited it out once I thought about that. So I'm fine with this so-called donation being a de-facto self-insurance pool. If the terms are like that, then I opt out.

> It's called "donation" not a "risk pool".

Unsympathetic people get fewer donations throughout society, and I'm inclined to see someone who'd rather let their organs rot in the ground or be cremated when they could save lives as... quite unsympathetic.

But doesn't that mean you're specifically planning to allow one or more members of your own minority ethnic group to die in order to prevent some other person from making some small amount of money off of you without paying into your estate?

There's a whole chain of novels by Larry Niven about what might happen when human organs enter a market economy. It assumes it works like any other closely-regulated market, producing a robust black market quickly dominated by organized crime.

Also, none of the people in the chain you list are profiting from your 'scarce resource,' but from providing skills and facilities to enable transplantation. (Insurance companies are just parasites, no argument there.)

Further, you left out the primary motivating factor behind the program: the recipient.

> There's a whole chain of novels by Larry Niven about what might happen when human organs enter a market economy. It assumes it works like any other closely-regulated market, producing a robust black market quickly dominated by organized crime.

This is like when people quote Pournelle's Law like it's a fact. The only thing this paragraph means, just like the only thing Pournelle's Law means, is that the person who wrote it is a Republican. It doesn't actually demonstrate anything factual or even related to reality.

(You can get paid for plasma and sperm donations but there isn't a black market for those.)

> Insurance companies are just parasites, no argument there.

They provide insurance, and they're probably more aligned with your interests than the rest of the supply chain is.

> (You can get paid for plasma and sperm donations but there isn't a black market for those.)

There were plasma black markets during and after the COVID pandemic [1][2][3][4][5]. There are black markets in sperm [6][7][8][9][10].

[1] https://www.indiatoday.in/india/story/exclusive-coronavirus-...

[2] https://www.al-monitor.com/originals/2020/07/iraq-coronaviru...

[3] https://www.al-monitor.com/originals/2020/06/egypt-coronavir...

[4] https://www.occrp.org/en/daily/12644-blood-plasma-black-mark...

[5] https://www.deccanchronicle.com/nation/medical-experts-warn-...

[6] https://www.dailymail.co.uk/health/article-12370461/Facebook...

[7] https://www.dailymail.co.uk/news/article-13298869/sperm-dono...

[8] https://www.dailystar.co.uk/news/world-news/wild-west-sperm-...

[9] https://worldcrunch.com/culture-society/undercover-hunt-in-i...

[10] https://www.thehelper.net/threads/seedy-world-of-the-super-s...

I feel the same way.. Why can’t my family benefit from making money from my organs?

Because then poor people are incentivized to kill themselves or their relatives to sell their organs.

A living kidney donor faces lower mortality risk than a logger but we allow people to be loggers. Explain that.

We allow people to risk their lives to provide for their families, except in this way. Unless your position is that whenever mortality risk exceeds living kidney donor mortality risk we should immediately ban the job. If so, let's ban logging. We can take this to its absurd conclusion.

On the other hand, Matt Yglesias points out why it's so much better to have a market here https://www.slowboring.com/p/solving-problems-by-letting-peo... including for kidneys

And specifically points out the plasma-donation situation as a contrast.

I imagine it's because we find it morally gross to harvest organs from the healthy poor.

I get that it leads to a lot of people dying who otherwise wouldn't die, and that's awful, but I think it's similar to prostitution. It makes sense to allow two consenting people who might agree to do something with each other for free to also do that same thing for money, but when you allow that, it tends to suddenly lead to a lot of people who are not actually very "willing." I think there are very real concerns that an "organic donation for money" industry quickly leads to a lot of trafficked people losing kidneys.

> I imagine it's because we find it morally gross to harvest organs from the healthy poor.

That is correct. The objection is solely from having a high divinity quotient in one's moral foundations causing one to rationalize visceral reactions to an obviously sensible process.

After all, the argument you then propose applies to egg donation, sperm donation, surrogacy, logging, and life insurance. People who might do it for free, might be coerced instead. And yet we have flourishing industries there and life is better for it.

Egg donation, sperm donation, life insurance, and logging are pretty different, but surrogacy is a good comparison. And, like organ harvesting, a lot of people find surrogacy for money to be morally objectional, for example the Pope, and also the governments of most countries.

The Pope protects child abusers. His opinion usually means the opposite is better.

If you donate your family don't benefit. If you don't donate, your family don't benefit. The only logic I can find here is spite.

So you've chosen to potentially sentence a patient to death because you don't like the infra around the donation process? Basically the definition of throwing the baby out with the bathwater.

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