h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

>>"Does everyone realise that only about 1% of donated organs end up being used in transplants? Most end up being cut up by students or used in experiments or, most commonly, thrown in the bin when they've been lying around too long.

Of course, this doesn't fundamentally affect the argument about whether it should be done or not."

It doesn't really have any bearing at all, without having clarification of what the 1% actually means.
Many 'donated organs' may be ones not usable for transplant, due to their condition.
Others may not be used because there's oversupply of that particular organ (demand is presumably not 2 kindeys to one heart to two corneas, etc.)
If there's actual undersupply of any organ, then more donors would be useful. Even if there is wasn't an actuial shortage of every organ, it could still be a case of the more donors, the better, since matches could be closer, and maybe less immunosuppressive drugs would be needed.

Karl, you make yourself sound very appetising, but a whole lot of recycling has taken place by the time you reach the mycoprotein on my plate. Just to go back to (what I speculate to be) the disease avoidance roots of the cannibalism taboo. Cutting out 'the middle man' would seem a very bad idea. The whole disease avoidance thing would depend on filtering out the undesirable elements through stages of the food chain/cycle. I do appreciate your kind offer, but I still have to say no.

Actually, I think the 1% does make a difference. So many people are sold on the "gift of life" line when in reality you're donating lumps of meat for students. There's no dignity in that. For myself, I may not care, but would I want my wife chopped up to be poked around in a lab or thrown in a bin?

Of course there's always the chance that, whilst dissecting a kidney a student learns something that years later may save a life, but that chance really is vanishingly small isn't it.

Does anyone feel that medical science is nearing the goal of cloning or artificially growing organs? Is this debate soon to become a moot point?

Tissues can be cloned and grown, but proper organs are generally rather complex. So...sometime in this century I would think.

<> (blicky)

Neither can I, blicky. Good point.

az

Jack, thanks for your reply (back in post 65). I don't think we disagree particularly - I've not got strong feelings either way about opt-in or opt -out systems. My point was just to try to defend those who have objections - metaphysical or just 'yuck'-related - and to argue that those objections ought to be taken seriously in a liberal society. I've no problems with people's justifications - for or against donating - being scrutinised. But that wasn't the tone of a number of earlier posts in this thread.

I think I probably misunderstood what the expression 'dog in a manger' means, so thanks for putting me right on that. But I don't think that a person who declines to give consent is a dog in a manger either. Although the organs are useless to them in the sense that they're dying, their presence or absence in the funeral rights will have an impact on family and friends, and on the state of mind of the dying person.

"Cant see the ethical difference between you dying and your bits being used by the woodland creepy crawlies, badgers mushrooms and mirco-organisms as lunch and a surgeon taking your kidneys and corneas out first to put them in someoneelse then your remains being buired in a shady glade"

I think this rather misses the point. There isn't an ethical difference here, nor was there ever claimed to be. Ethics is about motivations/intentions (right/wrong) and outcomes (good/bad), not about states of affairs. The question that you're posing here is whether there is a *practical* difference between decomposing and being eaten and being harvested for organs - ethics just isn't a property that can be applied here. And I think there is a practical difference between gradual decomposition through 'natural' means, and having bits of you walk around in another person's body.

Where ethics comes in is in how we weigh up people's wants and needs against those of others. In other words, should we respect a dying person's wish (or that of their family) not to be an organ donor, or not? The issue isn't whether there is a difference between being eaten by bacteria and having organs donated, but whether people have strong feelings that there is a difference.

And as I argued earlier. If you think that the wishes of the dead have no weight because they're dead, then consistency requires you to give no weight to wills. And if you think that the imperative to preserve life trumps the rights of individuals to make their own choices, then you must accept that it does the same for everyone else's choices too. And make Good Samaritanism compulsory.

As an undergraduate I once read a humdinger of a paper called 'The Survival Lottery', which I must write up as a guide entry one of these days....

There is of course the issue of the wishes of the deceased v. the next of kin. If the deceased had expressed a wish to be kept intact, I suspect the next of kin would respect that, however pro donation they were. Not so sure about the other way round if a grieving relative was strongly against organ donation, would they still respect the wishes of the deceased? Which should carry more weight? Does it depend whether or not the deceased was registered as a donor or merely verbally expressed a preference?

Nice clarification, Otto.

Yes, you're quite right that "where ethics comes in is in how we weigh up people's wants and needs against those of others."

I think the bottom line is that we should respect a person's wishes about what happens to their remains after they are dead no matter what we might feel is right or wrong.


az

this is the aspect of organ donation that I would like to see addressed first: that the dead person's wishes carry all the weight.

I'd be really really mad if I carried a card, my organs could be used and a member of my family countermanded my request.

Then we can start to think about an opt-out system.

>>"Actually, I think the 1% does make a difference. So many people are sold on the "gift of life" line when in reality you're donating lumps of meat for students."

The 1% is an utterly meaningless figure without a proper explanation of what it's supposed to relate to. You may have such an explanation but you haven't provided it here.
I'm also habitually skeptical about conveniently round numbers.

How is organ donation supposed to be linked to medical research?
Looking at:
http://www.amrc.org.uk/index.asp?id=9955
I saw the text:
"For information on how to become an organ donor, please visit this information page on the UK Transplant website. Please note that you cannot both be an organ donor and donate your body to medical research."

http://www.uktransplant.org.uk/ukt/how_to_become_a_donor/questions/answers/answers_14.jsp
"Bodies are not accepted for teaching purposes if organs have been donated or if there has been a post-mortem examination. However, if only the corneas are to be donated, a body can be left for research."

>>"There's no dignity in that. For myself, I may not care, but would I want my wife chopped up to be poked around in a lab or thrown in a bin?"

Wouldn't that rather be your wife's business if she wishes to donate her body for teaching/research? If it's what she wanted, should your emotions take precedence over her wishes *and* the potential usefulness of her uninhabited body?

Maybe people should be allowed to nominate a charity for a donation to be sent to if their body is used for medical teaching - it must be worth *something* to the medical school.

Mea Culpa.

I went back looking for the 1% link. It had been quoted elsewhere and I had tracked it back to a medical forum. This time I tracked it back one stage further and found it had become garbled along the way:

http://www.transplant.bc.ca/odr_criteria_main.htm

"Fewer than one percent of deaths can result in potential organ donation."

This is obviously vastly different in meaning and casts doubt upon the other statements I'd found on the uses of donated organs.

I apologise for being misleading, but it was wholly unintentional.

"this is the aspect of organ donation that I would like to see addressed first: that the dead person's wishes carry all the weight."

"I think the bottom line is that we should respect a person's wishes about what happens to their remains after they are dead no matter what we might feel is right or wrong."

Now, intuitively I think you're both right, but on further reflection I find it a bit problematic. If I'm dead, I'm dead, and I have no interests or rights, because I'm dead. If there's an afterlife, then the chances are that I'd be too preoccupied with that to bother very much about what happened to my body. I can't be hurt, and I can't be benefited.

So should the desires of someone who is dead and gone take precedence over the living? Is a funeral for the person who is dead, or for those who live on?

<> (Otto)

Well, me too, frankly. Once the body is dead ... um, so what?

<>

I personally don't think so, but previously you called this 'unethical'.

az

I don't believe I said anything of the kind. Could you clarify, or perhaps point out where I've given a misleading impression?

How about changing the law on donnors too you should carry a card if you donit want your body touched that way anyone dies and dont have a card it would be ok for them to take out organs and ould save a dam lot more lives.

>>Now, intuitively I think you're both right, but on further reflection I find it a bit problematic. If I'm dead, I'm dead, and I have no interests or rights, because I'm dead. If there's an afterlife, then the chances are that I'd be too preoccupied with that to bother very much about what happened to my body. I can't be hurt, and I can't be benefited.<<

Otto, you always make such sense it makes my brain ache!

However, you've also previously connected this (I think it was you) to wills.

If I want to leave all my money to a donkey sanctuary because my idle-good-for-nothing offspring/relatives, in my opinion, don't deserve the money - they will go to court and a judge will decide for me.

If I leave all my money to my idle-good-for-nothing offspring/relatives they won't say a thing.

If I wanted to donate my organs (for whatever puropse - I'm getting older now, it will probably be for medical students to cut up) and they decided they wanted a funeral, they could prevent it.

But if I left them all my money, tied to having my body given over to the medical students they would probably take the money and to heck with a funeral.

How about, then, we have a panel of judges who sit and decide what to do with every dead persons things. We do away with wills, organ donor cards and everything...

With organ donation there's still a body to put in a coffin & have a funeral, but not if your body has gone for medical research.

A friend of ours who was a semi-humanist had his body go for research. There was no funeral, only a humanist event, celebrating his life. Probably saves a lot of money, not having a funeral.

<>

Sorry, Otto. That was me being confuzzled.

az

I do think people are getting a bit mistaken on two points here: rights of the dead and rationality.

When I die, I still have rights and I still have property. I can decide who gets my stuff once I've popped my clogs. While it might seem stupid, I'm certainly not going to watch my Buffy DVDs again, no-one can stop me from transferring them to my aunt or her cats, provided my will was done properly. I have rights over my property once I'm dead, I don't see why my body should be any different.

Secondly - rationality. It is a powerful argument in this case, you're aren't ever gonna need your kidneys or whatnot again, but people aren't forced to act rationally. Until it was stolen last year, I had a bicycle that I cherished more than anything else apart from a couple of relatives and a few good friends. I named it, I gave it a gender, I continued to repair it when it would have been cheaper, safer and easier for me to replace it. Rationally I should have binned it years ago, but no-one would have had the right to force me to get rid of it and buy a new bike. People are allowed to make irrational choices so long as they don't directky harm other people or cause serious harm to themselves.

Personally I'm in favour of an opt-out system, and we've had a good example of why on this thread - there've been a number of people who have said they would like to donate their organs but haven't got around to signing the register. Under the current system their organs would go in the bin, the ground or a big fire. If people object, let them, if it's important to them the form is very simple.

I've been on the register since I was 12, like my Buffy DVDs I'd like to see my organs go to a good home, or get used for good once I'm done using them. It doesn't bother me if they end up under the knife of some medical student - doctors need to be trained - and I'd still be saving a lives, albeit in a less direct way.

Like Sho it does really bother me that my family could counter my wishes, and might well do because their religious beliefs, but they've been fairly warned that I will haunt them if they ignored what is effectively my last wish.