If you were designing a vehicle to help harvest organs, you would want a high chance of causing blunt head trauma but avoid major organ damage. You would also want the victim to be thrown well clear of the vehicle to enable quick access for resuscitation, and to avoid smoke inhalation or conflagration. You would also want this vehicle to be highly attractive to fit and healthy young people. Namely, a motorcycle.
When I did my bike license the instructor outlined how different the approach to safety is between my EU country and the States. Here a helmet is required to drive. But not glasses. In US glasses are required, but no helmet. Meaning, the US cares about you not endangering other people, but you do you, whereas here they care about you not dying.
From a purely utilitarian perspective, the US approach actually makes more sense. And more donors. Win-win.
Driving is state regulated. Most states require a helmet on a motorcycle.
In general anyone making "in the US" type generalizations about stuff regulated at the state level is either misinformed and blowing smoke up your ass (more common in real life) or lying in order to support a point or agenda (more common on the internet).
I was honestly shocked when I first started seeing people without helmets here in Texas. But, sure enough, if you are over 21 you are entitled to drag your skull and exposed brain across asphalt if you so choose.
Totally, I guess the assumption is that helmets usually have eye protection, which is not necessarily the case. The argument by the instructor was that it’s dumb, and both, a helmet and eye protection should be required in case your helmet doesn’t protect the eyes.
The idea was that in case you ride without a helmet you only endanger yourself, whereas without eye protection you endanger others as well.
I know it's a bit offtopic, but why is being a donor an opt-in instead of an opt-out process?
In our country, every employee has to pass a medical exam every ~3 years, and the same for college students. We could implement the opt-out option, give a grace period of eg. 5 years, where everyone could be explicitily asked if they want to opt-out (just sign this form) at a medical institution (or mail in, or sign a form online), and after that, everyone not opted out would become a donor.
I don't care what happens to my organs after I die, but I'm one of the many who are to lazy to actually go to a proper place to fill out a proper form to become a donor.
After a car crash, hospitals could opt for neglecting strangers for the much bigger emotional reward of saving transplant receptors that they have meet for months or years, and are much more emotionally involved with. The reward of a guaranteed transplant is not what overworked physicians should have in mind when should be focused into saving our lives. People would opt-out in mass to avoid that danger. Is as stupid as the "non-resuscitate" badge.
If is forced, it also destroys the image of "each donor is a hero", that can be a small drop of comfort for his family. Even worse, it opens a door to turning young people in minorities with a compatible body into a target. It is strictly forbidden to monetize it in many countries for solid reasons.
Yeah except it's nonsense, because it doesn't happen in countries where everyone is a donor by default. No one working at the emergency department has any kind of access or knowledge to donor lists, the idea that "we need to let this guy die so we can get his kidneys" is something anyone would do is insane not because of how immoral it is, but because it's physically impossible for your normal doctor/nurse/emergency responder to even know that this guys kidneys would be a match for anyone needing them. It's not a test being done when your life is on the line, healthcare workers are overworked as it is, no one is checking your organ match when you came in from an accident.
>>People would opt-out in mass to avoid that danger.
So surely, if we assume what you say is true, the same risk exists if you are on the donor list voluntarily. Why would anyone be on it then? /s
>>If is forced, it also destroys the image of "each donor is a hero", that can be a small drop of comfort for his family.
I fail to see how it destroys that image. Your organs go and save someone else - you are still "a hero" to the receipient. Whether it was voluntary or not, doesn't change that(and if it does in your opinion change it, then surely witholding your permission must - by necessity - be one of the most evil acts you can do, no?)
>>Even worse, it opens a door to turning young people in minorities with a compatible body into a target.
Well now that's some complete dystopian sci-fi nonsense. What, doctors will go out and hunt young minority people on the streets to get their organs, to get that sweet emotional reward for successful transplants? Or who will do that, exactly? Please explain.
Of course China is a special case, not comparable to the situation in a western democratic count... oups!
"In December 2009, a 2000 the chief pathologist at the L. Greenberg National Institute of Forensic Medicine Yehuda Hiss admitted taking organs from the corpses of Israeli soldiers, Israeli citizens, Palestinians and foreign workers without their families' permission" (Wikipedia)
Yeah I'm sorry but I don't consider that a valid argument in this discussion, in fact I think you are making it in bad faith - clearly China would be doing this regardless of whether they have an opt-in or opt-out list for organ donations.
And the Israeli actions were actions dictated by hate against Palestinians, not a public health policy. Again, they would have done the same regardless of whether they had an opt-in or opt-out policy.
Your argument is that laws are useless because somebody would still ignore them.
But laws are often a deterrent to undesirable conduct. Even if some bad actors could just ignore them, they know that there are consequences for doing this.
In such delicate issue as what is acceptable to do with a human corpse, a whitelist approach (only what is in this list is allowed) is much more reasonable than a blacklist approach (everything that is not in this list is allowed). People have the right to decide personally what can or can't be done with their corpses. Respecting their last wishes is necessary for keeping a high standard of human dignity in the hospitals. This means that can't be done by default.
No, I just disagree with you on this super hard. Having it be the default option is far more reasonable, being opted out by default is a mad choice dictated by something I really don't understand.
>>People have the right to decide personally what can or can't be done with their corpses.
Of course. That's why they can opt out.
>>Your argument is that laws are useless because somebody would still ignore them.
No, I'm saying that china harvesting organs from prisoners is not linked to their healthcare policy on donor donation after death. Equally what Israel was doing isn't linked to their healthcare policy either. So bringing up both of those cases in this argument is done in bad faith, because these events(or in case of China - active penal policies) are not subject to or influenced by organ donation policy, and saying that making the list opt-in by default is/or can lead to situation like in China is nonsensical at best, malicious at worst.
I can’t donate organs due to a chronic health issue. Now that disqualifies me from the medical treatment I am more likely to need?
As a sort of reverse of your proposal, in the US (and I think elsewhere) if you volunteer as a living donor, you are at the front of the line if you ever need an organ. And, this privilege is somewhat transferable to a person of your choice.
Then everyone who needs an organ would register. So now you need to say this benefit is only available too far in the future to affect the calculation - and you don’t influence the healthy people either.
A number of countries have already done this and it’s not definitive that changing to opt out systems will make a noticeable difference in actually donated organs. Most of the “this is so obvious!!!!!” studies that promise huge results are actually looking at registration numbers, but if you die in a way that makes you a good donor option, the doctors in most places will ask your next of kin about it whether or not you are registered. In some places the next of kin can even override your opt-in (or failure to opt out). So social education/opinion campaigns that increase registration and influence potential next of kin could be a better move than going opt-out.
Because opt-out implies that my body is not my property nor my heirs but the property of the state upon my death (and possibly before), whereas the opposite is true for opt-in.
Like most rights and freedoms, opt-in protects me legally better than opt-out but makes life more difficult for the group if people use their freedoms selfishly. I would never opt-in to opt-out because I value freedom and want humans to do the difficult bit of persuasion and education instead of coercion and the nasty ramifications that can come of the state getting even a camel's nose inside the tent of owning my body (and thus the right to do things to that body).
Pick any freedom/right you like and it'll be like this, whether it's speech or guns or right to silence or right to a lawyer, bodily autonomy against vaccine mandates or bodily autonomy in getting abortions… freedom is just so inconvenient for those who want what's best for the collective, but never mind the individuals who get crushed along the way to utopia.
So no thanks (and that includes your generous offer of a time limited opt-out).
Well no, if you are actually truly in your heart subscribed to any major religion, after your death its not 'your' body anymore, just some leftover soon-to-rot garbage on the level of trimmed nails or cut hair, nothing more. In fact, its rotting garbage regardless of your beliefs, nature doesn't care about those pesky things.
The other side is about saving actual lives in no small numbers, so what OP describes are tons of lives saved by just amending bureaucracy slightly, while preserving all those 'freedoms' that people like you keep repeating ad nausea anytime anything worthy is discussed.
If you actually really care about those freedoms, doing 2 minute bureaucratic work (or 5 seconds) every 5 years is no brainer. But if you just have knee jerk reactions to any change, well thats another problem on your side that is no concern to rest of society.
>Well no, if you are actually truly in your heart subscribed to any major religion, after your death its not 'your' body anymore, just some leftover soon-to-rot garbage on the level of trimmed nails or cut hair, nothing more.
Confident assertion of what people unlike you must believe makes me extremely skeptical about letting anyone on your side of this debate near the levers of power.
> Like most rights and freedoms, opt-in protects me legally better than opt-out but makes life more difficult
At that point are already dead, too late to protect you. Dead people's 'rights' is a strange legal concept, and they shouldn't not be valued above the living.
Your pontification about 'mah freedom' doesnt work, because your freedom is someone else's liability.
If you have the right to a fair trial by your peers, now I have to pay the salary of a judge, and I have to go on jury duty.
But maybe by freedom is more important? Why am I being forced to do work in a courtroom against my will for free, is this like slavery?
> At that point are already dead, too late to protect you.
If the implication is made before my death, in law, that I do not own my body then I am not protected when I'm alive.
> Your pontification about 'mah freedom' doesnt work
Please, cut that out. Go to Reddit or Twitter if you want to have discussions of that kind, but like a lot of other people on HN, I hope for basic courtesy when starting a conversation with someone.
>>If the implication is made before my death, in law, that I do not own my body then I am not protected when I'm alive.
We can all make whatever wishes we want before our deaths, but they are just suggestions not law - like OP said, dead people(corpses) are not legally people anymore, they have no rights. The law protects your body from certain things, but it's by binding the living, not by granting the rights to the dead.
To put it in other words. You absolutely own your body - while you are alive. When you are not, you don't because you don't exist anymore. It's not yours, because there is no you. We have a legal system that will respect some of your remaining wishes, and hence the ability to opt-out. But there is zero reason why the list should be opt-in by default, or at least I don't see such a reason, neither in your post nor elsewhere.
Opt-in is much safer for donors. Imagine you are wealthy guy needing organ transplant. From buying 23andMe (or similar company) data you figure out there are several potential donors. In case of opt-out you can just arrange accident to happen and you have your organ.
I'm not sure if you are trying to troll me, but I'll spell it out for you anyway.
scenario A (opt-out) - arranging accident. involves only few people (those who arrange it), can be fairly covert
scenario B (opt-in) - stealing organs from body, either extremely overt (nobody is gonna think that body with missing organs died in accident, that's why I wrote "obvious") or involving many more people (there would have to be multiple members of hospital staff involved in stealing the organs), high risk scheme (again if found that the organs were stolen, suddenly it's "obvious" it probably wasn't accident)
Not surprising. I remember a friend trained to be an EMT many years ago, and the textbook had a (long) chapter specifically about motorcycle crashes.
Put a bunch of motorcycles in one area (probably an area with roads that aren't designed for that kind of traffic) and you're bound to see more crashes than usual. And because they're motorcycles, expect more of them to be fatalities than you'd expect with cars.
I also expect there's alcohol involved in many of these rallies, regardless of the legality or official policy of the organizers, with a lot of people in no condition to be on their bikes.
The statistical pattern noted at large rallies is likely repeatable at places like the dragon in the Smokies on a busy summer weekend. No rally necessary - the combination of roads, terrain, and participants predicts the result.
In a similar way, a simple query of participants would predict the result:
1. Do you drink alcohol on days when riding a motorcycle?
2. Have you had professional training on your motorcycle, sponsored by your state or otherwise?
3. Have you read a motorcycle safety book by David Hough?
4. Do you follow published guidance on motorcycle safety gear?
The one downside to state training programs is that if the populace senses that completion of the program is a rubber-stamp license, safety behavior that follows will not match expectations. There were at least a few accidents during licensing at my state-subsidized training and licensing twenty years ago that didn't bode well for the required performance, the safety of the rider on public roads, or the system that licenses people.
>The one downside to state training programs is that if the populace senses that completion of the program is a rubber-stamp license
And if the license isn't just a rubber stamp people will ride without them.
People who self select to ride a motorcycle are not as unquestionably law abiding to their own inconvicnence as the general public let alone subsets like HN.
I wonder how many if those accidents have alcohol involved, and if that matters to a transplant. Do they even check? I don't remember the number, but some ludicrous fraction of motorcycle crashes are caused in part by a rider who was drinking.
A typical organ donor has a severe head injury causing brain death, however generally the liver and kidneys are intact and metabolize alcohol fine. Even if they didn't, alcohol in the organs/blood is unlikely to have a signficant effect for the beneficiary.
I'd guess most of the difference comes from drinking. I mean, you can hardly expect large events like these to be dry, but the combination is absolutely horrible from a safety point of view.
Bike rallies are generally large, crowded events that take place in rural areas or small towns with traffic infrastructure intended for much smaller populations and far less traffic, the researchers noted... The seven motorcycle rallies in the study each draw more than 200,000 visitors over the course of several days.
Hardly surprising to me. I paid accident claims for a few years. One vehicle, low speed car crash and people wanted us to pay their physical therapy/chiro treatments. One vehicle, low speed motorcycle crash and people wanted us to pay their surgery.
I will note once again that I wish we would do more to find other answers. Organ donation gets called "the gift of life" but some people reject the donated organs and die slowly and gruesomely over a period of weeks. If they don't reject them, it's crazy expensive, very hard on the body and you will be on anti-rejection drugs the rest of your life.
I'm not against saving lives and giving people a second chance. I just think this is a procedure that gets a lot of hype and it takes away from us pursuing something that might be better overall but just can't compete in the click-bait headline department.
> I just think this is a procedure that gets a lot of hype and it takes away from us pursuing something that might be better overall but just can't compete in the click-bait headline department.
What does it take away? It is a procedure of last resort. Doctors don’t plop in new major organs willy nilly. If there is any chance to fix what is wrong with the patient through other means they try that.
There is much more energy spent on protecting peoples organs (the ones they were born with) than on replacing organs. As it should be. It is just when a doctor swaps a medication or lowers a dose to prevent kidney or liver injury that doesn’t sound as dramatic and attention grabbing as a huge life saving operation.
Even in the “headline grabbing” department lab grown organs are much more catchy and futuristic.
Again: the total number of organ transplants in the US is 40 000 per year. For a population of 330 million people
> But I'm very well aware that no one actually cares to hear my point of view.
What is your point of view? Is it this: "I just think this is a procedure that gets a lot of hype and it takes away from us pursuing something that might be better overall"?
This is patently false because we spend significantly more effort on "something that's better overall": anything from preventive medicine to non-invasive treatments to ...
To give you my first hand experience: I had a non-malignant tumor removed from the esophagus 10 years ago. Even 20 years ago the way to do it was by cutting you up from the side, with 20% mortality rate. Now it's done in 15 minutes through a tube, with a check up a week later.
But if we trust your experience, nothing is done to do better, everything is diverted to organ transplants.
Would you at least like to qualify your first hand experience, then? Two people now are telling you they care about your perspective. I'm curious as well because it differs significantly from mine, too.
There has been a ridiculous pile on. People are quite hostile, not "curious", and I don't see any reason to believe that trying to discuss my firsthand experience in this discussion will be in any way productive. I'm trying to step away from the discussion because I don't believe any good can possibly come from engaging with such a hostile atmosphere.
You never discussed anything to begin with. You had several statements with zero intent to support them. Including this:
--- start quote ---
> There is much more energy spent on protecting peoples organs (the ones they were born with) than on replacing organs.
That's the narrative the world would like to believe for various reasons, but it doesn't fit my firsthand experience at all.
--- end quote ---
The reason the people "piled on" (that is, exactly two people replied) is that this doesn't match other people's firsthand experiences, and doesn't correlate with any available stat and metric.
> I just think this is a procedure that gets a lot of hype and it takes away from us pursuing something that might be better overall
Growing organs from your DNA seems like the thing that would clearly work, if it could be done. Seems people are working on it. Some google results talk about growing those organs in genetically-modified pigs (!). Don't know how far away it is.
Ideally, your umbilical cord should be frozen at birth, a non-IPSC line of stem cells created and frozen ready to restore you, and your full genome sequenced.
In the distant future, people will have spare organs ready should they be gravely injured.
That's not at all the kind of alternative I have in mind and would be of essentially zero use in cases of organ transplant for people with genetic disorders. (Edit: For example, cystic fibrosis accounted for a third of all adult lung transplants in the US and half of all pediatric lung transplants last I checked.)
Would it really? If you're doing genetic engineering already and you know what the genetic disorder is, it seems like you could then engineer a version of your DNA without the disorder and grow an organ from that.
I think if the new DNA kept the DNA encoding for the HLA markers there wouldn't be any rejection risk. HLA markers allow the immune system to tell which cells belong to your own body. When they do transplants, they check for HLA compatibility much as possible.
In my understanding, rejection is mostly due to things like cell surface proteins. It looks like cystic fibrosis is in fact a mutation in a surface protein, but at least it's only one. I'm guessing that's manageable...
The downvoting of your thoughtful (but minority opinion) post is evidence of the hype you mention. I think it's part of the postmodern rationalist ersatz religion that still holds a lot of sway on the internet to affect a disattachment from one's own body parts in the event of death.
