Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...
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To state what I'd hope to be the obvious first, opt-in vs opt-out relates to what happens to (viable) dead bodies with respect to organ harvesting. (As opposed to living donations of something you can do without, which is also addressed here.)
- opt-in - fill out a card saying you'd like to altruistically donate your organs upon death
- opt-out - your government decides to harvest the proceeds of your death unless you explicitly say 'keep your grubby hands off'
https://www.kidney-international.org/article/S0085-2538(19)30185-1/fulltext
Studies comparing opt-out and opt-in approaches to organ donation have generally suggested higher donation and transplantation rates in countries with an opt-out strategy.
This study doesn't. In fact, it found no evidence of it at all.
We compared organ donation and transplantation rates between countries with opt-out versus opt-in systems to investigate possible differences in the contemporary era.
Data! Facts! This will never do...
Data were analysed for 35 countries registered with the Organisation for Economic Co-operation and Development (17 countries classified as opt-out, 18 classified as opt-in) and obtained organ donation and transplantation rates for 2016 from the Global Observatory for Donation and Transplantation.
Compared to opt-in countries, opt-out countries had fewer living donors per million population (4.8 versus 15.7, respectively)
Oops - there goes the living donors. If your government tells you they'll view your still-warm corpse as theirs for the plundering unless you explicitly tell them not to, then their subjects/citizens get somewhat less altruistic about giving up "spare" parts when they're alive.
with no significant difference in deceased donors (20.3 versus 15.4, respectively).
All for.. no benefit.
Overall, no significant difference was observed in rates of kidney (35.2 versus 42.3 respectively), non-renal (28.7 versus 20.9, respectively), or total solid organ transplantation (63.6 versus 61.7, respectively). In a multivariate linear regression model, an opt-out system was independently predictive of fewer living donors but was not associated with the number of deceased donors or with transplantation rates.
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@PJH said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
If your government tells you they'll view your still-warm corpse as theirs for the plundering unless you explicitly tell them not to, then their subjects/citizens get somewhat less altruistic about giving up "spare" parts when they're alive.
Nice assumption of causality.
Overall, no significant difference was observed in rates of kidney (35.2 versus 42.3 respectively), non-renal (28.7 versus 20.9, respectively), or total solid organ transplantation (63.6 versus 61.7, respectively). In a multivariate linear regression model, an opt-out system was independently predictive of fewer living donors but was not associated with the number of deceased donors or with transplantation rates.
See above.
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@MrL
I'd say there's a good chance the causal relationship is that countries with low donation rates choose an opt-out system.I've never met a sane person living in a civilized country who was seriously afraid of the government taking organs from his body while alive. OTOH, I've met thousands of healthy people who've told me that they really should fill out that donation card, but haven't gotten around to actually doing so.
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@PJH I guess I'd need to read TFA but the conclusions drawn from numbers seem a bit weird (5 vs. 15 is significant, but 20 vs 15 isn't?). It's probably because of sample sizes but if the study is such that there is doubt on the significance of 25% differences, I'm not really sure bigger differences are really meaningful either. Anyway, that's not my point.
I remember reading an article recently (can't remember where right now, this may come back later...) that talked about the same idea (opt-in vs. opt-out) and that linked very strongly opt-out to countries with, widely speaking, a societal view that isn't in favour of organ giving. For (some of) those countries, switching to opt-out was a way to try and work around that.
Your article is just showing a correlation, but if what I've read is (at least partially) true, then it's not a causation. The hidden variable is the underlying society/moral views, and it may very well be that opt-out countries fare better than other opt-in countries with similar views.
In other words: humans are weird, don't assume they can be reduced to simple binary decisions on a single parameter...
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@dfdub said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
I'd say there's a good chance the causal relationship is that countries with low donation rates choose an opt-out system.
That would be my guess too.
I've never met a sane person living in a civilized country who was seriously afraid of the government taking organs from his body while alive.
Obligatory:
Monty Python - The Meaning of Life Live Organ Transplants – 06:40
— bojan6000OTOH, I've met thousands of healthy people who've told me that they really should fill out that donation card, but haven't gotten around to actually doing so.
Yep.
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@PJH After that initial post, I'm pretty sure this thread will need to be quarantined as soon as the Libertarians from the other side of the pond show up.
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@MrL said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@PJH said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
If your government tells you they'll view your still-warm corpse as theirs for the plundering unless you explicitly tell them not to, then their subjects/citizens get somewhat less altruistic about giving up "spare" parts when they're alive.
Nice assumption of causality.
Not at all.
Overall, no significant difference was observed in rates of kidney (35.2 versus 42.3 respectively), non-renal (28.7 versus 20.9, respectively), or total solid organ transplantation (63.6 versus 61.7, respectively). In a multivariate linear regression model, an opt-out system was independently predictive of fewer living donors but was not associated with the number of deceased donors or with transplantation rates.
See above.
Indeed.
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@dfdub said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
I've never met a sane person living in a civilized country who was seriously afraid of the government taking organs from his body while alive.
Agreed. So what exactly is the "problem" that is being debated here?
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@El_Heffe The people I've seen handwringing about this were convinced that the transplant doctors would declare them dead due to a stubbed toe and then rip out their organs while still alive. Or something.
They usually ignore that in Germany
a) two doctors need to independently declare you braindead (that's what the worry is about),
b) the doctors performing the organ removal are usually not the doctors from a)
c) the commission which decides as to which organ goes where does not come into play until the change from a) to b)
d) the doctors implanting the organ usually have no idea who the doctors from a) or b) were.
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Can I be the first one to say to just legalize selling them?
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When I was getting driver's license in US, I was with my aunt at DMV, and she told me to never sign up as donor because doctors will hesitate to save my life in case of an accident so they have more organs to transplant. I'm sure she's full of shit, but I didn't want to cause family drama so I didn't sign up. I plan to change that when I get a chance.
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@Gąska Unless you've tattooed your willingness to donate organs on your face rather prominently, I don't see why any doctor would hesitate when he usually doesn't even know about your name?
Then again, I suspect (as do you) that a willingness to think through how this would work didn't factor into your aunt's thinking.
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Gąska Unless you've tattooed your willingness to donate organs on your face rather prominently, I don't see why any doctor would hesitate when he usually doesn't even know about your name?
Ever heard of driver's licenses? In Illinois, both name and donor status is written on it.
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@Gąska Yeah, but the doctors usually don't go rifling through your pockets before beginning to treat you.
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@Rhywden there's immediate help, and there's a-bit-less-immediate help. I'd imagine patient identification happens fairly early in the process.
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@Gąska If it's not immediate then "hesitation" shouldn't play a role.
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@Rhywden maybe it's just my inner Pole, but I can totally imagine the hesitation continuing for hours, when the patient is already in the hospital and awaiting operation.
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@Gąska Hospitals don't work that way. Operating theaters have time slots and you can't simply "stall" an operation.
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My own thoughts on this:
I don't necessarily believe the conclusions from that study. There might be such causation, but I'm far from convinced. The other explanation (low donor numbers lead to opt-out) seems more likely, and who knows what other confounding factors there are.On the matter itself: I carry an organ donor card with me. I don't care what happens to my body after I'm dead. Because, well, I'm dead. I also personally don't think there's any legitimate reasons to do care, as I find religion and such to be equivalent to superstition. And I don't live in a place where concerns about getting organ harvested while alive is a reasonable fear, either, this isn't China.
That being said, I am, you guessed it, an absolute defender of opt-in. It doesn't matter what I think is reasonable or not, if you have any reason at all to not want to donate organs, then that is your choice. And this choice should not get defaulted.
I find it simply unethical to make that decision opt-out. Interestingly enough, since we do currently have discussions about this in Germany, the one time you'd want the Christian Conservatives (who are in government) to hold the most conservative stance on this possible, they don't. They actually proposed the opt-out solution.
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@topspin said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
And this choice should not get defaulted.
There's a default whichever way round a country does it
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Gąska Hospitals don't work that way. Operating theaters have time slots and you can't simply "stall" an operation.
You'd be surprised what can happen when theres a little money in it to go around. If a billionaire needs a kidney in Finland, then an appendix-removal patient will get told that the surgeon removing the appendix noticed a tumor in their kidney, and decided to fix that too "while already in there", so to speak.
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Gąska Hospitals don't work that way. Operating theaters have time slots and you can't simply "stall" an operation.
You'd be surprised what can happen when theres a little money in it to go around. If a billionaire needs a kidney in Finland, then an appendix-removal patient will get told that the surgeon removing the appendix noticed a tumor in their kidney, and decided to fix that too "while already in there", so to speak.
Nobody's denying that there's a black market for human organs. But its source is not the first responder who will be at your accident or the doctor in your local emergency room. And if it is, then it won't matter whether you're a donor or not.
The legal organ donation system was designed not to allow abuse. People who are afraid of it are irrational.
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@topspin said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
who knows what other confounding factors there are.
In
everybody is in principle donor but in reality no doctor will just rip out organs and consent from family members is often searched even if it is not required by law
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@acrow Either you're just peddling vague unfounded rumours, or Finland is a third-world hell hole, from all the things you say about it.
@Luhmann said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
In
everybody is in principle donor but in reality no doctor will just rip out organs and consent from family members is often searched even if it is not required by lawThis is also what I've seen/heard of the practice here (including from family members who work in hospitals). In fact, even if the donor has explicitly given consent (I think we're an opt-out country, but you can still have a card saying that you explicitly opted in), they will ask consent from the family.
There may be exceptional cases with cowboy doctors who disregarded everything but their own ideas, but those can exist equally well in opt-in or opt-out countries (if they're ready to twist rules to do things their way because of what they believe are superior motives (which can include money), then they're going to twist rules whatever they are).
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Gąska Hospitals don't work that way. Operating theaters have time slots and you can't simply "stall" an operation.
But they certainly have power to make operation go wrong, if you know what I mean...
I'm not saying this actually happens. No, wait. Actually, I'm sure this is exactly what happens, very rarely, in a few isolated cases, when a real psychopath becomes a respected surgeon. But as a general rule, it's very unlikely to happen. They have technical means to do it, but they don't do it. My aunt is being paranoid, yes.
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@dfdub Holding your internal organs dear is not irrational. Doubting government institutions is, in light of history, very healthy.
@remi said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@acrow Either you're just peddling vague unfounded rumours, or Finland is a third-world hell hole, from all the things you say about it.
The latter. ...How should I put it?.. Imagine a Soviet state that was never officially Soviet, but acted for all intents and purposes as if it was. Now, after USSR collapsed, this state trundled on, because it was not, in fact, a part of USSR. The people on ground level got on with their lives, and generally got a lifestyle comparable to West Europe. But the governmen't internal power play never got the reboot. Old money continued on as it always had. Corruption continues on in the highest places. And shouting too loud about which government people profited most from the immigrant crisis got Ilja Janitskin thrown in jail without access to his medication (for pain; he'd been on chemotherapy).
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
And shouting too loud about which government people profited most from the immigrant crisis got Ilja Janitskin thrown in jail without access to his medication (for pain; he'd been on chemotherapy).
For anyone else who is too lazy too use Google Translate: He's pissed that a "journalist" for a Breitbart-like news organization who also happens to be a member or ex-member of the Bandidos, a well-known criminal biker gang, got thrown in jail for a variety of offenses, including money laundering, criminal threats and a bunch of hate speech laws.
I want to unsubscribe from this right-wing conspiracy theory list.
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This post is deleted!
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Also, there are no official "hate speech" laws in Finland. There's a law for "inciting violence against ethnic groups", and a law for "verbal assault". Enforcement and convictions vary.
That's usually what critics call "hate speech laws".
Oh, I know that Janitskin is no angel.
Sorry, but that's a gross understatement. The minute I read "Bandidos" in his biography, I knew I wouldn't accept any philosophical argument which uses this guy as an example. They're a major player in international drug trade and human trafficking. You don't join them unless you're okay with murder.
I have trouble believing that a guy like that would just state his political opinions. He probably did a bit more than that, like openly endorsing terrorists like Breivik, didn't he? And then he deserves every hate speech law that gets thrown at him, philosophically questionable or not.
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@MrL said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Nice assumption of causality.
Nah, @PJH was just generally suggesting.
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@dfdub said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
I've never met a sane person living in a civilized country
Your post has inspired me to go out and fill out the donation card.
I'll do it eventually.
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@dfdub After a few a few moments of soul-searching, let me give you a better thought out answer.
You know the last three immigration-related news items I've posted in the Other News Today... - Garage -thread? Those news either never made mainstream news in Finland, as far as I know. I only hear of several pieces of news through the, ahem
Breitbart-like news organization
like you put it. Not just immigration-related news, but that's what's most recent, so...
And, yes I'm rather convinced that Janitskin and three others were convicted in an effort to shut down mvlehti.net . And if that is a conspiracy theory in your opinion, then I guess you're entitled to that opinion.
I do apologize for bringing this crap out outside the Garage. I forgot this thread was outside the Garage when I mentioned him.
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
two doctors need to independently declare you braindead (that's what the worry is about),
Before or after you die?
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Those news either never made mainstream news in Finland, as far as I know. I only hear of several pieces of news through the, ahem
Breitbart-like news organization
like you put it. Not just immigration-related news, but that's what's most recent, so...
I obviously don't follow Finnish news, but I have some experience with these claims about "mainstream media". Every single time our local far-right-wing party starts a Twitter/Facebook shitstorm about news that mainstream media is supposedly hiding, one of the following is true:
- A quick Google search shows a bunch of articles about it. They just didn't appear the right-wing filter bubble.
- The article is pure speculation and it later turns out that it was grossly exaggerated and/or that the perpetrator was not an immigrant after all. Those updates are obviously never mentioned by the same Twitter accounts.
- The incident is entirely made up. Yes, this happened multiple times, and elected officials of said party have publicly embarrassed themselves by trying to talk about an incident that never happened.
Not a single actual incident was not reported on by left-leaning media. Therefore, please forgive me for doubting your claims. And we should probably stop the discussion now, since I don't want to enter garage territory.
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@dfdub said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Those news either never made mainstream news in Finland, as far as I know. I only hear of several pieces of news through the, ahem
Breitbart-like news organization
like you put it. Not just immigration-related news, but that's what's most recent, so...
I obviously don't follow Finnish news, but I have some experience with these claims about "mainstream media". Every single time our local far-right-wing party starts a Twitter/Facebook shitstorm about news that mainstream media is supposedly hiding, one of the following is true:
- A quick Google search shows a bunch of articles about it. They just didn't appear the right-wing filter bubble.
- The article is pure speculation and it later turns out that it was grossly exaggerated and/or that the perpetrator was not an immigrant after all. Those updates are obviously never mentioned by the same Twitter accounts.
- The incident is entirely made up. Yes, this happened multiple times, and elected officials of said party have publicly embarrassed themselves by trying to talk about an incident that never happened.
Not a single actual incident was not reported on by left-leaning media. Therefore, please forgive me for doubting your claims. And we should probably stop the discussion now, since I don't want to enter garage territory.
Just out of curiosity, where is "our"? This forum needs nationality-flags.
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Just out of curiosity, where is "our"? This forum needs nationality-flags.
So far, I've only revealed which country I work in and I'd like to leave it at that. If you search through my history, you'll find that post and you'll be able to narrow it down.
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
And if that is a conspiracy theory in your opinion
You're literally theorizing about a government conspiracy.
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@Gąska said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
And if that is a conspiracy theory in your opinion
You're literally theorizing about a government conspiracy.
Hm... you're right. In that case: Woohoo! I'm a conspiracy theorist!
In my defense, the case seems rather solid, unless you need solid, physical evidence. But other than that, it all fits. So, yay for nut.
Edit:
P.S.
Could I bother one of persons so empowered to move this part of the thread to the Garage, in case anyone feels like continuing the discussion on Finnish freedom of press?
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Could I bother one of persons so empowered to move this part of the thread to the Garage, in case anyone feels like continuing the discussion on Finnish freedom of press?
Just FYI: I won't follow you there. I'm not a member of the garage and not going to join it. If you truly want to have a serious discussion about this, create a Salon thread.
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@Zecc said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
two doctors need to independently declare you braindead (that's what the worry is about),
Before or after you die?
If we're talking about declaring braindeath, that's usually something you do before the body dies. It would be slightly superflous afterwards.
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@acrow said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
This forum needs nationality-flags.
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Before or after you die?
If we're talking about declaring braindeath, that's usually something you do before the body dies. It would be slightly superflous afterwards.
Sorry for making a joke. I forgot you were German.
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@dfdub said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@PJH After that initial post, I'm pretty sure this thread will need to be quarantined as soon as the Libertarians from the other side of the pond show up.
Nothing new under the sun. https://what.thedailywtf.com/topic/16784/organ-donation
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Gąska Hospitals don't work that way. Operating theaters have time slots and you can't simply "stall" an operation.
You could keep a brain dead patient on life support until you're ready to harvest. Or determine the donation status, especially if you're dealing with a John Doe.
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@Jaloopa said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@topspin said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
"And this choice should not get defaulted."There's a default whichever way round a country does it
He means the choice to donate.
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@boomzilla said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Gąska Hospitals don't work that way. Operating theaters have time slots and you can't simply "stall" an operation.
You could keep a brain dead patient on life support until you're ready to harvest. Or determine the donation status, especially if you're dealing with a John Doe.
Yeah, but that's not what he was talking about. He was talking about a patient in a critical but recoverable situation where they'd supposedly stall the operation until it became non-recoverable.
How such a practice would not end up in criminal charges and massive lawsuits eventually, that's an exercise left to the reader.
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@Zecc said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
Before or after you die?
If we're talking about declaring braindeath, that's usually something you do before the body dies. It would be slightly superflous afterwards.
Sorry for making a joke. I forgot you were German.
You know the thing about jokes? They're supposed to be funny. But I'm sure you'll manage to be funny ... eventually.
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@Rhywden said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
But I'm sure you'll manage to be funny ... eventually.
You, on the other hand...
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@boomzilla said in Nationlising your dead bodies doesn't actually work. Unintended consequences in fact...:
You could keep a brain dead patient on life support until you're ready to harvest.
If he's truly braindead, I see no problem with this. Once the brain is gone, you're gone. A body on life support is the ideal storage vessel for organs.
