damn I typed that up in paragraphs but copy and paste has ruined it, sorry!

Opt outs are bad. What if the person opted out, but is a "John Doe" because their ID was destroyed or lost in an accident (a *very* common occurence). you would then be taking the organs of a donor who didn't want them taken for whatever reason.

Opt in is the only safe way to make certain the wishes of the departed are respected. Sure, it may mean opportunities are lost, but better lost opportunities than a person's religious rights being trampled on.

Of course I think we had this discussion once long ago.

As far as compensation... Living donors should not be compensated for donating as that would legitimative the black market and make transplants based on who had the money not who had the need, allowing the uber rich to keep buying new livers and hearts despite being repeat offenders in their habits that destroyed their organs to begin with. That is not to say the donor shouldn't have some say in who their organs go to if they are alive (or deceased for that matter). A person should be able to donate to a family member at any time despite whatever wait list there may be as well as being allowed to decline donation to a person because they feel the person is or will be a repeat offender. For instance, a non-repentant rock star that is widely known as a drug user and alcoholic could be turned down by the donor because he feels the person receiving it would just abuse and destroy the organ anyhow. Additionally, the organ donation system should have the ability to flag a donors wishes (i.e. family only, no repeat offenders, or anyone).

“...Does it take away from the altruistic nature of donation...”
It takes a fairly vile elitism to really care about this I’d have thought.

Organs should be tradable like any other commodity. The poor should have the option to take advantage of an increase in wealth for donating (either when alive or dead), and the rich should be allowed to pay in order to increase their health. People should be allowed to donate organs charitably if they wish, or donate money to fund the purchase of organs for those who cannot afford it. I do not see any category difference between an organ and another possession. Of course, organs are very important, and very scarce, but that does not make them totally unique or immune to the ethics that back our conception of property.

OK, so if we start allowing compensation for organ donation, then we eliminate (or at least reduce) the possibility that a less than wealthy individual will get an organ he or she needs to live because someone else bought them all up as commodities and won't sell them for less than a price.

Organs are not commodities because we can not, at this point in time, grow or build them. They come with a body attached and are only viable outside that body for a very small window. Now, with the advancements in science, animal organs are becoming more viable for human transplants. If you wantt o raise specific breeds for that purpose, fine. They could then be a commodity the same as pork bellies. If science reaches the point that they can grow human organs outside of a human body via some level of cloning, then those would become commodities. But right now, at two corneas or lungs or kidneys per person and one heart or liver, etc, we have to say these are not commodities to be bought but are rare resources to be rationed and distributed in a rare and equitable fashion with restrictions set by the original owners of said resources.

*fair and equitable, not rare and equitable

I think there is a movie about this, I suggest you all watch it ;)

Personally I feel that If I die and my organs can be used for transplants (or my brain for research ;)) I dont believe I need them after I die so why keep valuable or life saving assets from those who need them.
I had an example of your body being a failing corporation but in the end it didnt workout

I don't think the donor should have any say over what happens to their organ/tissue unless they donate it specifically for a particular person who is in need at that given time, especially if they are being recompensed with some form of incentive, that would only serve to over complicate the whole process I think.

@Ghost

“...Does it take away from the altruistic nature of donation...”
It takes a fairly vile elitism to really care about this I’d have thought.

I agree but this is one of the main arguments for keeping an opt in system.

There is a country, I think it's Brazil, that has an opt-out law. You carry a card *and* go on a register. The card reads "I do not want my organs to be used to save another's life AND I do not want another's organs to be used to save mine." Once you're on the register you have to give 3 years notice to come off it. Most conditions that require you to get a new organ kill you in less than 3 years. I don't know about you, but I'd think long and hard before opting to go onto that register.

I am very strongly in favour of an opt-out system. People die every day due to a shortage of organs for transplant. If we moved to an opt-out system, many, many lives would be saved.

I do understand Draugnar's concern that in an opt-out system mistakes could be made which might result in people's decision to opt-out being somehow missed, and their organs taken against their wishes. However, I feel that this could be easily overcome by having a national database of all those who had opted out, which could be accessed from every hospital, and used to check whether a given individual had opted out.

On the issue of compensating donors, I agree with Draugnar completely. Organs should NOT be treated like any other commodity. People should NOT be given a financial incentive to give up their organs, and rich people should NOT have more access to transplants than poor people. That's horrible. Everyone has an equal right to good health. You shouldn't be ABLE to pay for better health.

@ Speaker: I like the fact that Brazil's opt-out system means that if you opt out, you can't have anyone else's organs transplanted into you. I didn't know that was the case. Good old Brazil.

I think that in this country (UK), there is not only a dire shortage of organs but also of blood, for example blood banks in the UK almost ran out of blood in the pre-Christmas period (mid-December), even of types such as O+ which is the commonest blood type! I believe that many people don't want to give blood because they don't have time or have a 'I'll leave it to someone else' attitude. There is a very similar problem with organ donation, which is made much worse by the fact that it is not possible to donate organs while you are alive and many people, especially if they are religious, are not willing to donate organs after their death. Personally, I would be worried about the damage to my own body if I gave blood often, but I would and will be happy to donate my organs and my blood after my own death. I feel that, there should be much more advertising and support and encouragement, from the government, NHS, health pressure groups and charities, to encourage people to donate after their death.

@Jamie - the national database only works if the person can be identified. What happens when a John or Jane Doe come in dead and they only have a couple hours to pull the heart, kidneys, liver, lungs, cornea, etc.? Do you take them even though the cody hasn't been identified yet? No, it must be an opt in for religious reasons. I am a donor, so don't view this as some personal vendetta. I fully believe in donating and my old minister donated his entire body to research when he died of a rare cancer so the scientists could study everything and hopefully use what they learn to find a cure. But some religions believe that you won't enter the afterlife if your body isn't intact. We have to respect the followers of those religions and not risk violating the deceased or the deceased family's wishes or we slide down a slippery path where no one has religious freedoms anymore.

Opt Out +1

Setting aside for the moment the utter fatuousness of any religion that says that you need any of your organs after death, I think the more important requirement is to make sure that there are safeguards in place to prevent conflicts of interest in the decision over when to harvest organs. My sister-in-law was killed in a running accident three months ago and the transplant service did an amazingly thorough job of discussing all the options and implications of organ donation with her family while she remained on life support. I can't praise their professionalism enough, and my s-i-l ended up helping many patients with donations of her liver, kidneys, cornea, skin and bone marrow. But inevitably where humans are involved, judgments are subjective, and I can envisage situations where pressure on medical services for donated organs might cloud the judgment of the medical professionals involved. To that end, I consider an opt-in system the only safe one.

For similar reasons I shudder at the concept of payment for organ donation.

@Draug - My problem with that is you effectively say John Doe's religious views are as important as Patient Xs right to life?

I won't spend long on the subject of paying for organs, because its just impractical. Once organs become sufficiently valuable you'll have gangs murdering people for their organs, and selling them on the black market.

I would be interested to know how the numbers of required/donated organs would match up if we had an opt-out system for everyone who could be identified.
Also, I do wonder just how viable your claim is Draugnar. Surely someone who is in such a state you cannot identify them is unlikely to have high quality organs for transplant?

“Everyone has an equal right to good health”

You are, once again, confusing a right with a privilege.

“I won't spend long on the subject of paying for organs, because its just impractical. Once organs become sufficiently valuable you'll have gangs murdering people for their organs, and selling them on the black market.”

Why? Let’s look at this Black market. You claim that if organs are on sale, but very expensive, a Black market in organs will grow, undercutting the current market. People use the black market to reduce the cost of their organs. Compare to now, where you can’t buy organs without the wait except via the black market. Now the incentive is surely *much* stronger to turn too said black-market?

@Speaker and Jamie - Unfortunately isn´t Brasil that have this opt-out law. I would be tottally in favour and I am a donor myself. Here in Brasil who decide the donation or not is the family of the dead, so even if I want to be a donor but my family doesn´t agree with me the doctors can´t take the organs and this prevents a lot of donations. There is some law projects to change that, but our congress never votes it (probably because it´s too polemical, I guess).

Commerce in body parts and unleashing profit-seeking organ brokers on society is a horrible idea. Who is going to donate organs under such a system? The poorest of society (while the pool of altruistic donors is eliminated). We'll have a system in which the rich harvest the poor's organs, because you know the advertising for this is going to target the poor. Furthermore, the organ donating process is currently free at all stages of the process, including the medical professionals who deal with the donation process but do not get compensation. So what's going to happen with them? Are we going to have to compensate them too?

"You are, once again, confusing a right with a privilege."

Is life a right? Saying people have a right to life but health is a privilege is like saying people have a 'right' to self-defense but owning a weapon is a privilege. Now, usually the libertarians re: health are adamantly pro gun "rights", so I'm curious as to how this argument works.

@Figle - someone is in an accident out of state and gets separated from their ID. They may have died from the accident but still have very viable organs but because they were separated from their ID and aren't in that state's systems, they cannot be identified. Remember, over here it is just as easy to move from state to state as from city to city in Europe. There are no check points or customs to go through and state's have their own systems. Plus with our rights of privacy and all, unless you have been accused of committing a criminal offense, are looking *for* an organ, or have been in the service, neither your fingerprints nor your DNA are on file and, despite what NCIS and CSI would have you believe on TV, facial recognition software isn't fast enough to get results back before the organs become unviable and not everyone's photo is in a system somewhere either.

As far as the right to decide the organs. My right to my organs superceeds another priviledge to use them. I can deny anyone the use of my body at any time. I carry that right beyond the grave. You won't make me change my mind about that. I am an organ donor, but if they had the option of stating "no repeat offenders", I would absolutely excercise that right.

And I agree with both Ghost and Putin. I'll explain it this. Natural health is a right (i.e. not havign your life ended early by simple curable diseases or by individuals who would take it from you violently), but artificially extending life is a priviledge. If your body is ailing for whatever reason and there is no medical cure beyond stealign organs from another previously healthy body, then your natural life has ended and yo have no right to exert control over another's organs without their or their family's consent.

@Putin - People do have a right to self-defense but owning a weapon is a priviledge. What's your point. The laws here in the states are written just that way, which is why you have to pass several security checks (not be a felon at one point for one, and usually never have been even accused of domestic violence) to buy a gun. So, the right to life does *not* include a right to healthcare that tramples on another's rights to decide what happens to their organs.

Would you argue that a person doesn't have a right to specify where their personal property and financial assets go when they die? Then why shouldn't they say where *all* their property goes, *including* their body and it's organs?

If we go down the slippery slope of saying we don't have control of our bodies (they are our property after all) after we die, then we start into the territory where death puts everything up for grabs and we can't care for our families after we are gone.

Opt-in or Opt-out both have the potential to vilate the rights of families and donor, but opt-out has potential for abuse, so I'll go for opt-in. For profit organ donation would bring about a nightmare situation. The medical society already has far to much financial pressure on it already, temptation for abuse by some would be to great. The recent increased understanding of stemcells, precursor cells and how to manipulate them will make this a none issue probley in less than 20yrs.

One day, if we're not careful, we'll find that our life insurance policies gives our (dead) bodies to the insurance companies, who will sell parts to the highest bidder.

Repo

@Akilies
I believe you're referring to 'Never Let Me Go.' I haven't seen the movie, but the book upon which it's based is amazing -- probably one of the best works of late twentieth century.

“The poorest of society (while the pool of altruistic donors is eliminated)”

Correct, and the poorest will be much wealthier as a consequence, better able to feed themselves, get good accommodation and give their children a good start in life. After all, it will be their choice to do it, so they won’t if they don’t think it is worth it.

As for altruistic donators, why do you say that? Does paid work stop people from volunteering? Do pharmaceutical companies stop donation to medical research? No, of course not!

“Furthermore, the organ donating process is currently free at all stages of the process, including the medical professionals who deal with the donation process but do not get compensation. So what's going to happen with them? Are we going to have to compensate them too?”

If they wish to demand pay, they can, if not, they can do it for free. At every stage it should be the person’s choice that matters.

“Is life a right? Saying people have a right to life but health is a privilege is like saying people have a 'right' to self-defense but owning a weapon is a privilege. Now, usually the libertarians re: health are adamantly pro gun "rights", so I'm curious as to how this argument works.”

The right to life is not the right to have your life supported, but rather the right to not have it taken away from you. You have the right not to be actively killed, but not the right to be saved from death- that is a privilege that people can grant you.

“For profit organ donation would bring about a nightmare situation. The medical society already has far to much financial pressure on it already...”

This is emphatically untrue. The insurance model of healthcare that the US government mandates is causing healthcare providers to not be under enough financial pressure. That’s why heathcare costs are not dropping as you would expect, except in areas not covered by insurance, e.g. cosmetic surgery.

The cosmetic surgery analogy is spurious. Cosmetic surgery is by definition elective. Of course elective procedures are going to be more subject to price competition because people can 'shop around' if it's not an essential matter for their health. Besides, cosmetic surgery costs have not actually decreased, but have increased, over the course of this decade.

People can shop around for necessary surgery on the basis of price- the only time this is not an option is for emergency care.

"Correct, and the poorest will be much wealthier as a consequence, better able to feed themselves, get good accommodation and give their children a good start in life. After all, it will be their choice to do it, so they won’t if they don’t think it is worth it."

Doing things out of economic deprivation and desperation is not a matter of 'choice'. It's about as much a matter of 'choice' as having poor people sell themselves into indentured servitude, or having poor families sell their children into sex slavery. That's the kind of 'choice' we're talking about. It's a matter of taking advantage of the vulnerable in conditions of desperation for the profit of the rich. The classic 'work or starve' "choice" that market ideologues offer up as their illusion of 'freedom'.

"As for altruistic donators, why do you say that? Does paid work stop people from volunteering? Do pharmaceutical companies stop donation to medical research? No, of course not!"

Altruistic donation, as it currently is done, is a deeply personal thing. If it becomes a 'market', just like any other economic transaction, this demeans the enterprise and will turn people away from altruistic donations. Marketizing body parts would lead to barrages of advertisements by organ harvesters/brokers to pressure people to donate. This will also turn people off.

"Does paid work stop people from volunteering?"

Do Wal Mart employees "volunteer" to work at Wal Mart for free in addition to their paid labor? No, people volunteer to do things they have a great interest in if they have free time. If they were compensated for doing the same work, they would surely take the compensation.

Pharmaceutical companies get the benefit of over-priced patented drugs that come out of this 'donated' research money, and can use the donations as a tax write-off.