The difference being that organ donation happens after you're dead for most organs. If lives can be saved by scavenging the dead, that should be a normal thing.
Really? 'Knee deep?' Where are you knee deep in economics stuff? Leningrad, circa 1936? Paraphrasing: 'From each according to ability, to each according to need.' Actually, what you are 'arguing' isn't really an economics principle, it's a philosophical one called 'utilitarianism' which is the basis of socialism. Check out the book 'Justice' by Michael J. Sandel. I'd also suggest you broaden your horizons if the only people you read uniformly think that an 'opt out' system is the only guiding one of any relevance. I sure do love the 'only religious zealots would argue against it' argument. Sets up your thesis nicely, however flawed it may be. So let me proffer one argument against your utilitarian argument (and one also intrinsic to philosophy): It's called choice. You don't have to be a 'zealot' to not want to watch your loved one butchered like an animal for parts. Or maybe I'm a barbarian, who knows. The argument runs thusly: If freedom means anything, it means the ability to decide the disposition of your remains. Or do you not think so? Let's engage in an exercise, since it appears that the political correctness/Spock theory of life runs strong in you. Let's say that when your folks pass, there's a law that says all material goods will pass to those most in need. Of course, in the interest of 'fairness' some folks could opt out, but unless they're 'religious extremists' they would never dream of doing so. Because we're all about utility, and no one could ever logically argue against it. All the people you read uniformly agree, you can't even fathom the opposite argument. Sound good to you? Of course it does, it's only theoretical at this point, as you don't have children. Or do you? Care to explain to your loved ones why they won't share in your hard work, and the guy down the street whom did nothing for your family will receive your bounty, despite no actual interaction with you? Sure you do. While this isn't a terrible way to make the decision as to who lives and who dies, how do you reconcile the idea of choice. Oh wait, I get it. Let me argue it for you. "Opt out just means that you 'could' opt out.' In other words, we don't like the choices you (as a society) have made up to this point, therefore, we're going to 'presumptively' decide how you 'consented' to having your body kept on life support, despite your actual, real, live, knowing intent -which of course you could have designated at the fuckin' DMV on a Tuesday afternoon if 'it really mattered to you' and put you on life support so we can harvest every last bit of your body so that people that you never met, despite the freedom to choose the disposition of your remains, benefit. Freedom, in case you are wondering, means you do want you want. Unless. It certainly doesn't mean 'you do what society says - unless you want to do what you want.' In short, if someone wants to donate their organs upon their death, it's easy to do so. How do I know this? I'm an organ donor. That's just one argument.
Of course. Whose kidney is it but yours? You can sell your hat, which is just some piece of shit you bought so why can't you sell a kidney which took years to grow inside your own body.
Semi-related, one of my sister's good friends works in the Pathology department of one of the world renowned hospitals in Chicago. One of her job responsibilities is transportation of organs for transplant. More than a couple times a month, she is taking day trips in private jets to deliver organs. Pretty crazy stuff for a mid 20s girl.
How does the change in presumption affect choice or freedom in any way, shape or form? Right now, it's presumed that you're such a callous asshole that you'd rather have your parts rot in a wooden coffin somewhere or be burned to a cinder rather than allowing them to save the lives of your fellow human beings (sarcasm intended). You keep throwing up this bizarre idea that the freedom to make this choice is affected by the change in presumption. I can't tell if it's ironic or deliberate that you made a big deal about "opt-out" being a nasty phrase that implies all sorts of bad things, while donating organs is now "butchering a loved one like an animal for parts." Fine. So not donating is murdering fellow human beings who would have been saved with no effort from you whatsoever. The material goods analogy you drew was false. Your material goods pass to your inheritors or creditors (if there are any), unlike your organs. But in fact, if you have no inheritors, your property goes to the state, which in essence is the same as the organ donation - benefiting the public at large.
Ok, let's assume you're right. Why change the current system then if there's no effect? Wow, intended sarcasm. Thanks for clearing that up. Let me see, what's the argument against this. I'm searching. It's so difficult (sarcasm intended as well). Oh yeah. It's my fucking body. I'll do with it as I please. Or do we start down the road of 'if your body may benefit the many - well, tough shit?' How about alive? What if you're, say a callous asshole, and your parts could save 10 nuns? Should we just look the other way, since the callous asshole isn't doing anything constructive with them for society's benefit? I reiterate: If there's no effect by changing the presumption, why change it at all? Why not keep it the way it is? Unless, of course, there might be a change in the outcome based on the change in the presumption. Opt out is almost always a nasty phrase. It means that the other presumption - i.e. - you determine if you're parts are going to other people - just isn't working for the benefit of society at large. And now it's murder to not donate organs? Really? Interesting take on that right there. I either do what you want me to do (couched in terms of 'what's best for society,' of course) or I'm an asshole that's a murderer? No, you're way off here. The reason the materials goods 'presumption' stands is because pretty much every society since the dawn of time has assumed that a person wants their goods to go to their progeny. But hey, let's change the presumption since it doesn't matter. Because material goods are so much more important that your body.
All that was meant to say is that my professional and academic experience is in economics, so I am constantly surrounded by economists. And among economists, there is relatively little disagreement about this, which naturally limits my perspective. The petard you somehow believe yourself to be raising me by was literally the whole point of my post: I recognize that I seem to only be surrounded by one perspective, so I would like to hear the arguments from the other side. I'm not clear how you managed to take my expression of my own limits as advocacy or insult. My understanding is that Sandel has only discussed markets for organs, which is a different question, but I admittedly have only read his public press items rather than the book. Is this wrong? I'm literally just saying that this is the only explicitly laid out argument against it that I have heard (and I would like to hear others!). Nothing more, no matter how sensitive and cranky you are today. Also, for what it's worth, I think mandated choice might represent a superior framework and is almost certainly better if it is more politically viable. Not clear where I said or even suggested otherwise. Presumably you see the difference between transferable material goods and a non-transferable kidney. I cannot give my working kidneys to my children, presuming they are healthy. But yes, everyone has the full moral right to bodily autonomy before and after death, and nothing I have said has suggested otherwise in the least. This is a really strange argument that you believe me to have taken up. What is the question you are asking here? How allocation of already-donated organs among people who need them reconciles with some ambiguous concept of choice? What do those two things have to do with one another? The portion you quoted here seemingly has nothing to do "choice" as you've used it elsewhere in your post. In case it leads to more organs? Isn't this obvious? The hypothesis is that given survey results that show overwhelming willingness to donate vs. noticeably lower actual donation rates, there are any number of people who would be willing organ donors, but aren't out of some combination of inertia and ignorance. What people say they will do and what they actually do seems to be very different. There are any number of things I can do as I please that still make me a jerk. The existence of a moral or legal right to do something is poor argument that it ought to be done by any individual person. It's possible to be both within your moral and legal rights and an asshole. You jumped from organ donation to dystopian organ harvesting reeeeeeaaaaal fast there. Presumably you think "we assume you'll donate your organs unless you specifically say otherwise" and "we assume you will not donate you organs unless you specifically say otherwise" represents a non-semantic difference in the amount of choice. That doesn't strike me as obvious since it involves the same number of checkboxes either way. I'm not clear why a difference in outcomes is, to you, a difference in the amount of freedom, but I presume it has something to do with the definition of freedom you are using. If I try to charitably interpret your post rather than taking the tack willfully misunderstanding it in a fit of frustration, it would seem that your stance is "the state should err on the side of caution in any circumstance that involves taking assets bodily or otherwise, and thus should do its best to make sure the person is OK with it with as much certainty as possible, even if this means fewer organs." That if you're going to grab organs, you need to be absolutely, positively sure. Is this right? I don't know that i agree, but this does represent a perfectly coherent view.
TVI, I feel like your arguments are completely nonsensical here. I understand your position that someone should choose to be a donor or not, but not your arguments against opting in vs opting out. I said there was no change to the ability of a person to freely choose their participation. Obviously there is a hope that it will change the participation level. You don't seem to be grasping the parallel I'm drawing between my exaggerated sarcasm and your exaggerated comment. Obviously it's not murder to not donate organs, nor is it "butchering" to do so. My loved ones have nothing to do with the decision - it's my choice, and I'm a donor, so if they don't like my body being "butchered" then tough shit. The material goods comparison was false for the exact reason you specify: there is a use for your material goods after death. Your heirs inherit them. Do your heirs inherit your heart when you die? Your lungs? Unless you're a donor, those things are going to be dead too long to make use of them. And you still have not explained why making someone uncheck a box rather than check a box affects their freedom or ability to make a choice.
To you and MoreCowbell I ask the very simple following question: If the change in presumption doesn't matter, why change it at all? Wouldn't it require some effort, legally or otherwise, to change it? And if so, why do so if the end result is exactly the same? Or, if the change in the presumption does yield a different result, what does that say about presumptions? It's a simple question. And as always, I may be an asshole, but it's not about the messenger, it's about the message. (and fair warning, after many years of practicing law, I know for a fact that presumptions matter greatly and actually affect outcomes - one of the best things you can do as an attorney is have the presumption (or burden of proof) shifted to the other side.)
Okay. Yes. I think we have all been very clear that the hope is the end result will not be exactly the same, and that there will be more organ donors. If it does change the participation numbers, all you can take away from it is that, given a choice, people will accept the default answer. I still ask, now for the 3rd time: why does pre-populating a question with a default response of "yes" - a question they must look at no matter what the default response is - change the freedom to choose what you want to happen with your body?
Every time you drive by a homeless person, would it help them out if you gave them $20? (For purposes of what I'm trying to say, let's assume it would, rather than get into a separate discussion about enabling.) Do you do it sometimes, never, or all the time? Why or why not? What if every time you drove by a homeless person, your debit card was automatically debited $20 instead? When you are issued this credit card (or maybe the next time you file your tax return), you receive a form in the mail, and it reads "Would you like to support the needy or would you like to opt out?" Nonsensical? Do you really not see the difference, or are your trolling to keep the thread going?
So admittedly this was buried in the middle of my lengthy/quote filled post, but I think the answer is obvious. I very much do think presumption matters, and do think it affects outcomes: the effort involved would be minimal (change the forms at the DMV), and the amount of organs donated should in theory rise. The reason for this sort of measure would not just be that there is a shortage of donations; it is also that more people seem to say they are willing to donate that actually donate. For example, in the UK, over 90% of people say they support organ donation, but actual registration to do so is less than one third of eligible residents. The difference is less stark in the United States, presumably because we have coupled it with license applications while the UK has not, but it is still the case that stated support vastly exceeds actual donation. This leads to the question of why this is the case. Why do Americans (and others) not donate their organs if they repeatedly say they support it when asked? --It could be that these people are liars: they merely say they support donation, but they really don't. --Perhaps they are self-centered: they support donation for other people but not for themselves. --They might be ignorant as to how organ donation works. There is evidence that some people have really weird and inaccurate beliefs about the mechanics of the process. --They might simply be lazy, forgetful, or rushed. They never bother to actually make the effort to register, even if they in theory would. People are, in generally, really bad at proactively making medical choices. Did you know that only 25% of Americans have advanced directives? I find the first two unlikely to be significant factors. Perhaps you disagree. The third one is troublesome: these people would be making an active decision not to donate, presumably, but for the wrong reasons. The underlying belief of an opt out system post is that many people fall in the last category. Presumably I would in fact opt out of that were it sufficiently well advertised,* but any parallel that makes me or my heirs materially worse off seems off base. I both enjoy and need my money now. No one is taking my kidney from my living body. If the idea that dead you being kidney-less bothers you in life or would bother your dependents, that is a whole different matter, but I don't think many such people actually exist. I am not clear what "freedom" means in the contexts of these posts. Normally I would assume it simply means the ability to not be actively coerced and to make choices, which isn't being infringed here. You make a choice either way. I assume VI is using some other form of the concept, something closer to "nothing is done to you other than what you have explicit stated your agreement to." *Whether organ donation forms are "sneaky" in the fashion of fine print seems like a tangent, but I think this may be a strong argument for mandated choice models where you are required to actively state a preference one way or the other. If you think people would be tricked into something they do not wish through ignorance, an explicit requirement might be best.
First off, 100% of the comparisons that require someone to actually experience some kind of hardship (giving money, time, whatever) are not going to work. With organ donation, you're dead. Not coming back. Kaput. Shuffled off the mortal coil and all that. The donating party experiences no loss by donating. They are donating something they no longer have a use for and something which cannot possibly be of any other use to others (unless they're a donor). If you want to use your analogy, it's more like receiving form in the mail with my credit card that said, "We will donate $20 once a year to the homeless for in your name. This does not cost you money." If it's an opt-in system, you will get a lot of non-participants because they accept the default option.
I dont have a dog in this fight. Im an organ donor but I dont care if someone is or isnt. None of my business. But the response to your question is because its an ethical sleight-of-hand and creates a moral hazard. The same tactic is performed in other politicized issues. Labor unions are a perfect example. In many unions, dues are automatically deducted from a worker's pay check. The answer that anti-union groups or politicians take is to make that practice illegal and for the workers to manually hammer out a union dues check every month. This drastically reduces union membership and is crippling to that movement. Every adult with a driver's license is aware of the organ donor program. If the majority of people wanted to participate, there wouldnt be as high of a demand. Compelling good-will on someone is not good will. Its a tax.
I see where you're coming from, I just feel that there should be some consideration for level of effort. When someone sits down at the little computer to do their license form, there's a checkbox. IThe level of effort to opt-out is so small, and to me that means if we can do some good for humanity by simply overcoming the tendancy to stick with the default answers, it's worthwhile. I would not support any kind of complex or obfuscated opt-out process. If it's anything other than reviewing a checkbox that you are already sitting in front of, I agree that it raises some moral issues.
You assume that everyone thoroughly and competently reads the forms. Survey results typically show that around 10% of people aren't even aware that organ donation is a thing that exists, let alone that it is on a license form. And even more are ignorant about medical processes or what the qualifications to be a donor are. If one thinks people are making a conscious choice in all these cases, it makes other survey results showing an enthusiasm gap all the more puzzling.
This is actually turning into a really neat debate. On one side there's the "Sure you can have my shit, I don't care" and on the other there's a "Hey, don't just help yourself to my shit, unless I specifically say it's okay." Would changing the law to enable presumed consent, with an opt-out clause, put more organs up for grabs. Certainly. More people will probably not opt out, more so than currently opt in. Why is that? I think there are several reasons and those reasons are why I'm glad there are people who raise questions when it comes to presumed consent. For one thing, in my own opinion, I think opting out would generate some form of shaming. Either by ones self or others. Right now, I have the big red word "DONOR" written on my Minnesota drivers license. That way there's no question as to my desires and organ harvesting can happen quickly. Yay for me, huh? I'm a good person! But wait, if the laws change, will there STILL be "DONOR" on my Lic. or will that be replace with "OPT-OUT" if I choose to no longer donate? Already there's a stigma of "if you don't choose to donate, you're pretty much a dickface" so how much more will that be ratcheted up when a person actually has to opt out? No longer could they conveniently ignore it...they'd have to actively check/say no. For what ever their reasons are, and they're none of my business, some people don't want to donate This is my dad. He is not an organ donor. I know because he asked me once if I am. When I replied affirmative, he says "yeah...I've thought maybe I should be. But it weirds me out, ya know? They take everything, not just organs. Your organs, sure, but your eyes, your skin, your muscles, your tendons...I mean, by the time they were done with me all you'd have to bury is my metal knee replacement and my head. Maybe. What's left of it." And I get where he's coming from. It seems to him that if he checks "donor" he's essentially donating his whole body to be chopped up and shipped off to the four corners. In MY opinion, that would be kinda cool. I'd love knowing my parts could helps all sorts of people all over the place when I'm gone. In HIS opinion, that seems fucked up. But he's already feeling a little guilty about not donating. I'd bet a vital part of my living anatomy if he was presented with the need to opt-out...he wouldn't. He'd just *sigh* and resign himself to the fact that he's a donor now, however uncomfortable that makes him feel. Because my dad isn't a bad person. He just doesn't particularly feel comfortable donating. That's the sort of freedom I think other's are talking about that would be lost. I think more people should donate. I think there should continue to be efforts to reach out to people and not only make them aware of organ donation, but to educate them as well. I also think more people should give blood. I hate doing it, but I can pump a bag full in just under 5 minutes. Those are my choices, but others might not be so willing to do that. I don't think the law should automatically assume consent.
What you and Binary are saying is the typical utilitarian argument. But you can't logically have it both ways i.e. follow utilitarianism and protect individual liberties. First, you are admitting that 'yes, in the opt-in system, we (society) are not getting the result we think best' - i.e. more organs for donation. You speak about choice, but we have a choice now - you just don't like the choices being made. Second, you argue 'most people think this is a good thing.' Then, Second part (B) - 'people want to do it but just don't.' And what happens? People don't make the affirmative choice you (society) like. Therefore, you want to juke the numbers and take advantage of the presumption. Third, you argue that 'you make a choice either way.' Which of course begs the question - why change it? Because you (society) doesn't like the choice people are making. Four, you argue 'it doesn't impinge freedom.' So again, I come back to the concept of 'freedom.' If you can't see the difference between a consensual affirmative act on your part regarding what happens to your body (alive or dead) and a presumed consent about what happens to your body -and for the record - you aren't necessarily dead when your organs are harvested - UNLESS you decide otherwise then I don't know what to tell you. Any scheme of ordered liberty has always included the decision to decide what you do with your body during life and during death. Yes, this right is impinged in many cases, but here's the other thing. It's disingenuous to claim on the one hand that 'people are lazy, hence they don't check the box to donate so let's switch the box to the opposite to get the result we like.' If you know people are going to do that - and you don't necessarily - what you are doing is taking away the affirmative decision on the part of people to donate. Or let me put it simpler: the default you are advocating for says the following 'Your body belongs to the state (society) unless you say otherwise.' Not quite sure what definition of freedom you have, but you're correct, my definition does not include a presumption that I am the property of society (living or dead) unless I affirmatively decide I don't want to be. Freedom by it's nature is inherent, it's not granted. Why? Anything that is granted can be rescinded at the grantor's leisure. That's a privilege.
Anyone else have a fear that they'll discover the key to living healthier and doubling life expectancy right after your organs end up in 50 people? Anyone? So it's just me? Okay. I think what Binary and MoreCowbell are saying is that people are more likely to not ACTIVELY opt-out of the program than opt-in to the program. The people who really don't believe in organ donation will be aware of the process and opt-out of it. The people on the fence will just leave it and not opt out.