Bill would make Coloradans organ donors by default

[Billnew]

I believe in states rights, if the people of the state want this, then its their choice.

I do not like automatic organ donations.
But if they make sure all people know that they will be harvested after death, then someone that is strongly against this will know to opt out.

I have to wonder, how they can guarantee all hospitals will know someone
refuses organ donation on personal beliefs? If the victim dies at a hospital other then thier local one, how will they know?

I am in favor of organ donation, I prefer the person stepping forward to
do it, rather then defaulting to cutting up a person with out their consent.

Of course, my situation. I am not eligable to give blood, so I assume I cannot donate organs, Hepititis exposure. If I go to a hospital that doesn't know my history would they use my organs? (I have not tested positive for any hep virus) But have been diagnosed with hepititis.
Will possibly bad organs be harvested and implanted, because history wasn't known?

 

[Drekkan85]

I never gave consent; the government never had the common decency to ask for it.

Sex with an unconscious woman is considered rape, even though the woman never "opts out." Thus, your criticism is wrong.

Except medical procedures on the same unconscious woman AREN"T rape. If there's a car crash, and a woman is unconscious, I don't NOT give her blood because I don't know if she's a Jehovah's witness or would otherwise object (though if her preference IS clearly stated, say by a card carried on her person, then a doctor cannot give without facing legal consequences). There's implied consent. Same on the heimlich, CPR, and surgery. Absent other wishes, procedures designed to save lives and prevent suffering are deemed to be consented to.

Same here, the procedure. Comparing it to rape is wrong because in rape you have a victim who's being physically, emotionally, and mentally abused. It's a comparison that isn't apt and is done to try and elicit an emotional reaction.

 

[Nathan Poe]

I believe in states rights, if the people of the state want this, then its their choice.

I do not like automatic organ donations.
But if they make sure all people know that they will be harvested after death, then someone that is strongly against this will know to opt out.

I have to wonder, how they can guarantee all hospitals will know someone
refuses organ donation on personal beliefs? If the victim dies at a hospital other then thier local one, how will they know?

I am in favor of organ donation, I prefer the person stepping forward to
do it, rather then defaulting to cutting up a person with out their consent.

Of course, my situation. I am not eligable to give blood, so I assume I cannot donate organs, Hepititis exposure. If I go to a hospital that doesn't know my history would they use my organs? (I have not tested positive for any hep virus) But have been diagnosed with hepititis.
Will possibly bad organs be harvested and implanted, because history wasn't known?

I'm also curious about what happens if a Colorodo citizen dies out of state -- most states require informed consent for medical procedeures, including, I would think, organ donation, and there can be no presumption of informed consent with an "opt-out" program.

 

[Skaloop]

I'm also curious about what happens if a Colorodo citizen dies out of state -- most states require informed consent for medical procedeures, including, I would think, organ donation, and there can be no presumption of informed consent with an "opt-out" program.

Well, if I were trying to work out the process to cover that eventuality, I would still have official donor registration in Colorado. If people officially register because they consider it important, then when the time comes that they are in the situation to donate, the process is simpler and more streamlined. These people would also then be covered the same way they would be now if they are out of state (note on driver's license, for example). People in Colorado that don't officially register and don't officially opt-out would still become donors in Colorado, but there would be a bit more of a process involved in terms of checking records to see if they've opted out, maybe further consultation with next-of-kin, more paperwork. To ensure that possible unscrupulous behaviour would be under more scrutiny. If these people are out of state, then they would fall under that state's law and would not be used as donors. People who opt-out in Colorado would be opted out by default in other states.

That's my basic idea after a few minutes of consideration, so it's probably not perfect.

 

[Nathan Poe]

Except medical procedures on the same unconscious woman AREN"T rape. If there's a car crash, and a woman is unconscious, I don't NOT give her blood because I don't know if she's a Jehovah's witness or would otherwise object (though if her preference IS clearly stated, say by a card carried on her person, then a doctor cannot give without facing legal consequences). There's implied consent.

To save her life -- not to chop her up for spare parts.

At no point in any of this does the person actually tell the government, "Yes, you can take my organs from me." The government simply assumes it has that right, and is hoping that people will be too preoccupied or lazy to correct them. That's morally wrong on several levels, as I've discussed before.

Same on the heimlich, CPR, and surgery. Absent other wishes, procedures designed to save lives and prevent suffering are deemed to be consented to.

Saving the lives and preventing suffering of the person they are performed on -- big difference there.

At no point is there ever implied consent to save the life of a third party.

Same here, the procedure. Comparing it to rape is wrong because in rape you have a victim who's being physically, emotionally, and mentally abused.

Using a person's body without their consent -- the analogy fits.

It's a comparison that isn't apt and is done to try and elicit an emotional reaction.

And you did an admirable job of attempting to debunk it -- alas, you came up just a bit short.

And I hardly think you're the one to criticize "eliciting an emotional reaction."

 

[Drekkan85]

To save her life -- not to chop her up for spare parts.

A life is a life - the point of the operation is still lifesaving.

At no point in any of this does the person actually tellthe government, "Yes, you can take my organs from me. The government simply assumes it has that right, and is hoping that people will be too preoccupied or lazy to correct them. That's morally wrong on several levels, as I've discussed before.

Yes they are. Citizens are informed, "We're going opt-out. If you don't tell us anything, you're telling us you're ok with being a donor. If you don't wish to be a donor, then tell us". It's not laziness per say, it's more ambivalence. It's a "I could donate... or I could NOT donate... but I don't want to waste time filling out paperwork". It's why when someone asks "how you doing" while you're walking on the street you say, "pretty good" most of the time. Going into detail is just not worth the time to you.

In the same way, people that don't feel strongly about donating, or people feeling strongly about NOT donating, will express that desire either way. It's the people in the middle that just don't care that comprise the population that would boost donor levels by switching.

Saving the lives and preventing suffering of the person they are performed on -- big difference there.

I don't see it. You're saving lives. At no cost. Period.

Using a person's body without their consent -- the analogy fits.

Except the donation lacks the critical harm component that's present in rape. Your analogy doens't fit.

And you did an admirable job of attempting to debunk it -- alas, you came up just a bit short.

Funny, I feel the same way about you and your position.

And I hardly think you're the one to criticize "eliciting an emotional reaction."

True, but in my position you really are saving lives. At zero cost. For anyone that cares, opt out is the same as opt in. For anyone that wants to make a choice, opt out is the same as opt in.

 

[Etsi]

What is Organ Harvesting?

The first step in an organ harvest is to determine that the donor patient is truly dead. The medical community defines death in a number of ways; in order to donate organs, someone must be brain dead. This means that there is no brain activity and no hope of recovery, but the patient's heart is still beating and the patient is still breathing with the assistance of a ventilator. A series of tests are conducted to confirm brain death, ensuring that the patient is truly, irrevocably dead. This can be traumatic, as the patient appears to be alive, but he or she is not; sometimes hospital staff must actually use extreme measures to keep the patient “alive” so that the organs will continue to be viable.

Who gets to decide? In my grandfather's case, they wanted to stop treatment so that he would reach this state and thus be viable for organ harvesting. The reason they wanted to stop treatment was that he was old, he was sickly and in and out of the hospital, he was seen as not having as productive a life as the potential receiver (quality of life). In Europe, we are already aware of doctor assisted suicide without patient consent...subjectively determined by a doctor's view of quality of life. Sorry, but I do not place that kind of trust in another human being on such a matter, including organ harvesting. This is the slippery slope such a bill would put us on and the type of subjective decision making that it would encourage. We've also seen that people that are believed to be brain dead or permanently comatose, can and at times do make recovery. Honestly, I don't think we understand enough of the body's healing processes, or brain processes, to make that kind of decision.

Harvest Time

Different Versions of Brain Death

The procedures used to determine brain death are by no means universally agreed upon. In Japan loss of blood pressure is required to determine brain death because the brain stem regulates blood pressure. If the patient’s circulation is still good the patient is considered to be alive. In Britain the blood pressure can be normal and the same patient declared brain dead and harvested. Bad luck.

Electroencephalography

Some of the states in the United States and some European countries require an electroencephalography (EEG) test to show that all electrical activity in the brain has stopped. Spain, on which the South Australian harvest and transplant program is based, requires two EEG tests twelve hours apart for adults and twenty-four hours for children. Two tests separated by time is protection against an initial mistake and the fact that brains don’t stop like car engines but frequently re-start by themselves.
This careful Spanish approach contrasts with Australian practice where a person can be harvested within twenty-four hours of even turning up at a public hospital so there isn’t time to do a second EEG.

But that doesn’t matter because Australian hospitals don’t use EEG testing using the argument that it is unreliable because a decomposing dead brain may give off flickers of electrical activity. Another argument, perhaps more true, is that an EEG may indicate the brain is still alive but this fact is irrelevant. Why? The key factor for declaring brain death is function, that is, whether the brain and the brain stem (section between the top of the spine and brain) can manage all the functions of the body. If it can’t then the person will probably die sooner than later so we might as well cut out their organs while the body is still healthy, or so their argument goes. This utilitarian view operates using the premise that serious brain damage causing loss of bodily function is, for practical purposes, identical to death.

Another factor worth considering is the wide variety of techniques used to determine brain death. Highly skilled medical experts using the latest equipment still can’t agree on the best way of determining when a person with a beating heart is actually brain dead because, apparently, they don’t know.

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[lawtonfogle]

Except medical procedures on the same unconscious woman AREN"T rape. If there's a car crash, and a woman is unconscious, I don't NOT give her blood because I don't know if she's a Jehovah's witness or would otherwise object (though if her preference IS clearly stated, say by a card carried on her person, then a doctor cannot give without facing legal consequences). There's implied consent. Same on the heimlich, CPR, and surgery. Absent other wishes, procedures designed to save lives and prevent suffering are deemed to be consented to.

And if there was an unconscious woman about to die unless someone had sex with her (don't worry how, I could think of something crazy but why worry), having sex with her would not be rape. On the other hand, if a doctor were to perform a non-life saving operation (or at least one which was reasonably considered to be life saving) on an unconscious person, while it might not be considered rape by law, it is a major violation of bodily integrity and the doctor will face harsh penalties.

Same here, the procedure. Comparing it to rape is wrong because in rape you have a victim who's being physically, emotionally, and mentally abused. It's a comparison that isn't apt and is done to try and elicit an emotional reaction.

It is more like rape of a corpse, if you want to be exact. Where is the emotional/mental abuse being they are already dead? Comparing it to rape of a living person would be like cutting out organs while they are still alive. This is far more like rape of a corpse.

 

[DeathMagus]

What is Organ Harvesting?
Who gets to decide? In my grandfather's case, they wanted to stop treatment so that he would reach this state and thus be viable for organ harvesting. The reason they wanted to stop treatment was that he was old, he was sickly and in and out of the hospital, he was seen as not having as productive a life as the potential receiver (quality of life). In Europe, we are already aware of doctor assisted suicide without patient consent...subjectively determined by a doctor's view of quality of life. Sorry, but I do not place that kind of trust in another human being on such a matter, including organ harvesting. This is the slippery slope such a bill would put us on and the type of subjective decision making that it would encourage. We've also seen that people that are believed to be brain dead or permanently comatose, can and at times do make recovery. Honestly, I don't think we understand enough of the body's healing processes, or brain processes, to make that kind of decision.

These sorts of things are a problem because of the severe shortage of viable organs, yes? With an opt-out system, your Grandfather's doctor likely wouldn't have felt a need for your grandfather's organs at all. I'm not justifying what the doctor wanted to do in any way - but an opt-out system would have likely improved your grandfather's treatment, not worsened it.

 

[grasping the after wind]

Two things about your next two messages. First, the news story with details about "people fear X" and "people fear Y" are just fear with no proof. To quote Dara O'Briain, "Zombies are at an all time low, but fear of zombies is at an all time high. That doesn't mean we need a government zombie policy". We don't make policy over pointless fear.

As for the selling organs - that is illegal, and for good reasons about incentives and coercion against the poor. As for not being able to sell something that can be given, one word, sex. That's just one other thing that can be given away but not sold.

My bold above and I think you aren't paying attention to government policies if you believe it.

Selling organs is illegal but for the life of me I can't see why. You mumbled something about incentives and coercion against the poor. I can't see what it is about organs that makes them different than any other life saving treatment all of which come with a price tag. If people or their heirs were paid for their organs there would be no shortages or waiting lists.

 

[Nathan Poe]

A life is a life - the point of the operation is still lifesaving.

A life is a life when it's not your own -- the point of an operation on me is to save my life.

Yes they are. Citizens are informed, "We're going opt-out. If you don't tell us anything, you're telling us you're ok with being a donor. If you don't wish to be a donor, then tell us". It's not laziness per say, it's more ambivalence. It's a "I could donate... or I could NOT donate... but I don't want to waste time filling out paperwork". It's why when someone asks "how you doing" while you're walking on the street you say, "pretty good" most of the time. Going into detail is just not worth the time to you.

So, the decision to harvest my organs is no more important than a greeting on the street? The analogy doesn't quite fit.

In the same way, people that don't feel strongly about donating, or people feeling strongly about NOT donating, will express that desire either way. It's the people in the middle that just don't care that comprise the population that would boost donor levels by switching.

And I still have a moral objection to the government exploiting apathy as opposed to working to fix it.

What other vices can be similarly exploited? Ignorance? Fear? Bigotry?

I don't see it. You're saving lives. At no cost. Period.

Cost, cost, cost -- the more you go on about cost, the more I'm going to ask, "So why can't we sell our organs?"

There is a cost -- you ust don't see it because it happens to be a cost you've already paid. It's hard to recognize a thief when what is being stolen is something you've already given away.

Except the donation lacks the critical harm component that's present in rape. Your analogy doens't fit.

Raping an unconscious woman (one that, for example, has been drugged) also lacks a physical harm component -- the analogy still fits.

Funny, I feel the same way about you and your position.

A pity you haven't explained it as well -- I understand the whole "no cost" idea, but I consider the loss of freedom to a government that assumes I want to -- quite literally -- give them a pound of flesh to be quite costly.

True, but in my position you really are saving lives. At zero cost.

You keep saying that as if human dignity had a price tag.

So why can't I sell my organs?

For anyone that cares, opt out is the same as opt in. For anyone that wants to make a choice, opt out is the same as opt in.

Then why make the change, except in a governmental grab for authority over our own bodies?

 

[Etsi]

These sorts of things are a problem because of the severe shortage of viable organs, yes? With an opt-out system, your Grandfather's doctor likely wouldn't have felt a need for your grandfather's organs at all. I'm not justifying what the doctor wanted to do in any way - but an opt-out system would have likely improved your grandfather's treatment, not worsened it.

I disagree. In cases such as accidents and such, I believe it would provide doctors with more of an excuse NOT to save a life.

 

[Skaloop]

I disagree. In cases such as accidents and such, I believe it would provide doctors with more of an excuse NOT to save a life.

Who is more likely to steal a loaf of bread? A person with a pantry full of bread, or a person with no bread?

Who is more likely to let someone die to get their organs? A doctor with a large supply of donor organs already harvested, or a doctor who has no other organs for donation?

 

[grasping the after wind]

Who is more likely to steal a loaf of bread? A person with a pantry full of bread, or a person with no bread?

Who is more likely to let someone die to get their organs? A doctor with a large supply of donor organs already harvested, or a doctor who has no other organs for donation?

Is a doctor who has organs at his disposal because they have been purchased from their rightful owners less ethical than one who has gotten organs through the trick of government sponsored opt -out. What is more shady a straight forward business deal where all parties are satisfied with and understand all the implications of who gets what or a sneaky assumption of consent without asking for it?

 

[Nathan Poe]

Who is more likely to steal a loaf of bread? A person with a pantry full of bread, or a person with no bread?

Who is more likely to let someone die to get their organs? A doctor with a large supply of donor organs already harvested, or a doctor who has no other organs for donation?

The problem is that donor organs don't sit on shelves somewhere waiting to be used -- if they're not transplanted within a few hours of harvesting (at most; I'm unfamiliar with the exact figures), they go bad. Everyone on the organ donor list is waiting for just the right person to die -- and soon.

So there is no "pantry full of bread," there's just a note saying "please don't steal my bread," which can be discarded or "lost," should someone get hungry enough.

 

[DeathMagus]

The problem is that donor organs don't sit on shelves somewhere waiting to be used -- if they're not transplanted within a few hours of harvesting (at most; I'm unfamiliar with the exact figures), they go bad. Everyone on the organ donor list is waiting for just the right person to die -- and soon.

So there is no "pantry full of bread," there's just a note saying "please don't steal my bread," which can be discarded or "lost," should someone get hungry enough.

Even though organs have a very short shelf life, many of the individuals on a given waiting list aren't in anywhere near the same kind of hurry. If you have a few months to live, the odds of someone dying with a compatible, useful organ who hasn't opted out is 2-3 times higher than waiting for someone who has opted in (and possibly enough to meet demand - as Belgium's opt-out policy demonstrates). Get all those people waiting for an organ off the waiting lists, and you can expect the number of "We need a heart, now!" cases to drop significantly, as many of the people who need immediate transplant were simply waiting around for months to get lucky, and didn't.

 

[Drekkan85]

So, the decision to harvest my organs is no more important than a greeting on the street? The analogy doesn't quite fit.

It's not, but the human brain doesn't work that way. When in these situations, lab test after lab test have shown humans don't think of the long term implications or moral implications of actions such as agreeing or not to donation. They overwhelming look at short term things like "I have to go and get my friends and get to the movie - screw this paperwork".

You can't change that. That's basic human neurobiology and behaviourology. This is borne out in the real world. Look at Belgium's opt-out experience. Look at the research studies I linked earlier.

And I still have a moral objection to the government exploiting apathy as opposed to working to fix it.

What other vices can be similarly exploited? Ignorance? Fear? Bigotry?

When it comes to this, you can't change basic neurobiology. Instead of moaning I propose making the best.

Cost, cost, cost -- the more you go on about cost, the more I'm going to ask, "So why can't we sell our organs?"

Because in a system of selling organs we've seen coercion and other problems in potential systems. These coercive elements are absent in the opt out system. It's all the benefit (making up for shortage of organs), without any cost.

There is a cost -- you ust don't see it because it happens to be a cost you've already paid. It's hard to recognize a thief when what is being stolen is something you've already given away.

Tell me, in dollar terms,what's the cost. Heck, tell me in CHOICE terms what's the cost. There is none. You are in EXACTLY the same position before and after; you have just as much choice and you have just as much control over your body and organs.

Raping an unconscious woman (one that, for example, has been drugged) also lacks a physical harm component -- the analogy still fits.

Except rape has lasting after effects. Harvesting dead peoples organs don't. Analogy fail.

A pity you haven't explained it as well -- I understand the whole "no cost" idea, but I consider the loss of freedom to a government that assumes I want to -- quite literally -- give them a pound of flesh to be quite costly.

Pft. I've explained myself perfectly. Zero cost, high benefit. You have yet to point to a SINGLE cost. You have the SAME amount of chocie as before. There is NO loss of freedom. If this system was MANDATORY without an opt out then you would have a point. As is, you have no point, and you haven't expressed one.

You keep saying that as if human dignity had a price tag.

What do you mean human dignity? Humans have dignity, and they have choice. They have the same amount of both under opt out or opt in.

So why can't I sell my organs?

Because selling of organs leads to exploitative markets in organs.

Then why make the change, except in a governmental grab for authority over our own bodies?

They have NO authority over your body in the proposed system.

Again, possession is determined by two things

1)Physical Control
2)Ability to exclude

There's no other element to possession. Go read Bruce Welling's "Possession in Things" as a primer (or any other first year property textbook). Those are the two elements of possession. Under an opt-out program the government lacks number 2 - since you're the one that can choose to opt out (and the government can't deny you the choice), then you possess your body, and the government doesn't.

 

[Drekkan85]

For a much better analogy than rape.

You're at a fast food place. You realized you ordered way too much, and have effectively an entire second meal that hasn't been eaten. You get up to throw it away. You know that in the old days you used to just throw away the food and it would rot. However, you could (if you wanted to) fill out pages of paperwork to donate it to people who are about to starve to death. Because many people are in a rush, they decide, screw it, I'm outta here, and don't fill out the paperwork. People are dying.

The restaurant changes policy. THey tell patrons "From now on, all discarded food will be donated to the starving people. If you don't want your food donated, feel free to fill out the following forms".

Opt in, opt out. You still have choice, and the apathetic middle will choose the default. Between feeding starving people, and wasting vital life saving aid, I know where I stand.

 

[grasping the after wind]

For a much better analogy than rape.

You're at a fast food place. You realized you ordered way too much, and have effectively an entire second meal that hasn't been eaten. You get up to throw it away. You know that in the old days you used to just throw away the food and it would rot. However, you could (if you wanted to) fill out pages of paperwork to donate it to people who are about to starve to death. Because many people are in a rush, they decide, screw it, I'm outta here, and don't fill out the paperwork. People are dying.

The restaurant changes policy. THey tell patrons "From now on, all discarded food will be donated to the starving people. If you don't want your food donated, feel free to fill out the following forms".

Opt in, opt out. You still have choice, and the apathetic middle will choose the default. Between feeding starving people, and wasting vital life saving aid, I know where I stand.

Strained analogy but let's take it a step further. Your food doesn't necessarily go to the starving but to a rich obese person who just doesn't have any fast food and greatly needs fast food. He might gulp it down without thinking and need new fast food before you know it meanwhile you are out what you paid for the fast food and if you are poor you weren't able to sell your fast food to someone and give the money to your starving family.
On a more realistic note, one of your arguments seems to be that the government has made it so inconvenient to donate organs by requiring mountains of paperwork that the government must intervene and make it inconvenient to not donate organs by requiring mountains of paperwork. Wouldn't it be easier to do away with the mountains of paperwork?

 

[Skaloop]

Wouldn't it be easier to do away with the mountains of paperwork?

Yep. Which is why I would support mandatory organ donation for all. No paperwork required!

Of course, I know that would never fly. So there will have to be a way for opting for the non-default position. Paperwork will be involved.

So with that starting point, I weight the amount of paperwork against the good done. Now, all things being equal relating to paperwork, having more organs available does more good and saves more lives than having fewer organs available. The opt-out program would provide more organs and save more lives for the same amount of paperwork than an opt-in program.