We're all organ doners now...

[Angilion]

[..]The main argument that I would put forward is that the process of consent still applies here. You need to make a decision to donate when you are alive and sound of mind. There is still very much a choice to make. The onus has now shifted to the individual to make an active decision not to donate.

And the main argument I would put forward is that lack of active resistance is not consent.

The dishonesty annoys me and sets a dangerous precedent. It would be safer and more honest to acknowledge that consent is no longer required.

If the goal is to get consent from more of the unknown (but not very large) number of people who would consent but haven't done so, the safe, honest and ethical way would be to promote registering that choice. Put the choice somewhere that almost everyone will encounter it. Driver's license. Forms for registering on the electoral roll. Forms for registering with a GP. There are options. If the goal is to really push it to the max, make it mandatory to register that choice. Here's a form, you must fill it out. Same as is done with census forms and suchlike.

Removing the need for consent has no advantages over those approaches and is harmful whereas those approaches are not. It's unethical and that's particularly nasty in a profession that is so strongly geared towards maximising benefit while minimising harm. Do no harm? Promoting the idea that lack of active resistance is consent is harm. Promoting the idea that the authorities own people's bodies is harm. And it provides no benefit that could not be provided in a way that does not do harm, if it provides any benefits at all. It's just plain wrong.

 

[Malevolence]

What will vegetarians and vegans do when xenotransplantation is the norm?

 

[Angilion]

What will vegetarians and vegans do when xenotransplantation is the norm?

Decide for themselves how their ideology applies to that new scenario, if it happens.

 

[D3K]

Lack of active resistance is not consent because consent is an action, not inaction.

There is almost nothing in the day to day of life you really consent to. The person who serves you in the shop, the guy who bumped into you in the queue, the person who parked too close to your car for you to get out, the person who winked at you and licked their lips.
Individual tolerance decides which of those is acceptable. And yours implies that none is.
Now Microsoft Teams will accept your consent to record when the organiser records. You must opt-out. The same goes for your face being recorded in shops and on high streets. At ATMs. Whenever you leave your dna, fingerprints, hair, wherever you go it can be collected and scanned by the police. Did you consent? No, but will you ever know? Very unlikely unless you were a problem. The same goes for when you die.
So how do you cope in life if consent is so important?

Analogies are useful to illustrate a point, particular when very different standards are being applied based on fashion.

Your analogies illustrated nothing that resonates with me. This is not a fashion choice of the age, although it may be a technological limitation of the age. And there are no standards to discuss beyond human empathy.

 

[Angilion]

There is almost nothing in the day to day of life you really consent to. The person who serves you in the shop, the guy who bumped into you in the queue, the person who parked too close to your car for you to get out, the person who winked at you and licked their lips.
Individual tolerance decides which of those is acceptable. And yours implies that none is.

It implies that none of them are really consensual. Which isn't necessarily the same thing. I'll tolerate some things that aren't really consensual. Taxation, for example.

Now Microsoft Teams will accept your consent to record when the organiser records. You must opt-out. The same goes for your face being recorded in shops and on high streets. At ATMs. Whenever you leave your dna, fingerprints, hair, wherever you go it can be collected and scanned by the police. Did you consent? No, but will you ever know? Very unlikely unless you were a problem. The same goes for when you die.
So how do you cope in life if consent is so important?

I object when consent could be obtained but isn't. And I object when consent is not obtained and people claim that it has been. The latter is particularly bad because of the dishonesty and bad precedent. I also object when false statements and appeals to emotion are used to leverage in changes like that.

Your analogies illustrated nothing that resonates with me. This is not a fashion choice of the age, although it may be a technological limitation of the age. And there are no standards to discuss beyond human empathy.

I don't consider arguing that lack of active resistance is consent to be human empathy. You do. It's unlikely that we're going to agree about that.

 

[Clearcut]

I think it's less about selflessly helping someone to live after your death and more about their willingness to save you if a pretty little thing in the next bed needs an organ.

'we could save this guy but he's a donor and she has her whole life ahead of her'.

 

[Bear]

Your analogies illustrated nothing that resonates with me. This is not a fashion choice of the age, although it may be a technological limitation of the age. And there are no standards to discuss beyond human empathy.

There are an increasing amount of businesses that when you pay for their goods and services, they give you an option of donating to a charity of their choice. This is done, you would presume to make the lives of some better as generally that’s what charities do. Do you think it is acceptable to automatically assume you are ok with this and add a nominal charge to your purchase, which you can opt out of but it is assumed you want to opt in?

A more recent example of legal opt ins would be GDPR where the default is you are opted out automatically and you have to actively consent by law.

Remember Amazon used to have a check box upon checkout that would sign you up for Amazon Prime unless you unchecked the box and all the stink that caused? Is the principle of presumed consent being used in this way ok?

 

[Stumble Bum]

I think it's less about selflessly helping someone to live after your death and more about their willingness to save you if a pretty little thing in the next bed needs an organ.

'we could save this guy but he's a donor and she has her whole life ahead of her'.

Sigh... that is not how organ donation works.

 

[Stumble Bum]

There are an increasing amount of businesses that when you pay for their goods and services, they give you an option of donating to a charity of their choice. This is done, you would presume to make the lives of some better as generally that’s what charities do. Do you think it is acceptable to automatically assume you are ok with this and add a nominal charge to your purchase, which you can opt out of but it is assumed you want to opt in?

A more recent example of legal opt ins would be GDPR where the default is you are opted out automatically and you have to actively consent by law.

Remember Amazon used to have a check box upon checkout that would sign you up for Amazon Prime unless you unchecked the box and all the stink that caused? Is the principle of presumed consent being used in this way ok?

Your examples are stupid, you're trying to make a comparison to situations where it costs you something and has an impact on your current life compared to a situation where you can save lives for zero cost. You're dead, you cease to be, you have no feelings or wanting for anything anymore, but still people want to deny others a chance at life at no expense to themselves. Utterly selfish not to donate your organs.

 

[krooton]

Your examples are stupid, you're trying to make a comparison to situations where it costs you something and has an impact on your current life compared to a situation where you can save lives for zero cost. You're dead, you cease to be, you have no feelings or wanting for anything anymore, but still people want to deny others a chance at life at no expense to themselves. Utterly selfish not to donate your organs.

Indeed, a trifecta of nonsensical analogies.

 

[tom_nieto]

I think it's less about selflessly helping someone to live after your death and more about their willingness to save you if a pretty little thing in the next bed needs an organ.

'we could save this guy but he's a donor and she has her whole life ahead of her'.

So much wrong about this statement.

If you come in with a catastrophic brain injury and are brain dead you might actually exist longer as you are worked up as a potential donor rather than left to pass away without very intensive support. Note you aren’t actually alive once your brain ceases to be.

Similarly your organs aren’t much good to anyone if you’re in a prolonged unstable condition. It’s imperative that potential donors are in the best shape possible prior to organ donation. This is the same as giving complete life saving care.

The organ offering system and waiting lists are centralised, so the implanting surgeons will be offered organs from there.

 

[mid_gen]

I can't be bothered to read the whole thread, but I do hope the kebab jokes have been made already...

 

[tom_nieto]

And the main argument I would put forward is that lack of active resistance is not consent.

The dishonesty annoys me and sets a dangerous precedent. It would be safer and more honest to acknowledge that consent is no longer required.

If the goal is to get consent from more of the unknown (but not very large) number of people who would consent but haven't done so, the safe, honest and ethical way would be to promote registering that choice. Put the choice somewhere that almost everyone will encounter it. Driver's license. Forms for registering on the electoral roll. Forms for registering with a GP. There are options. If the goal is to really push it to the max, make it mandatory to register that choice. Here's a form, you must fill it out. Same as is done with census forms and suchlike.

Removing the need for consent has no advantages over those approaches and is harmful whereas those approaches are not. It's unethical and that's particularly nasty in a profession that is so strongly geared towards maximising benefit while minimising harm. Do no harm? Promoting the idea that lack of active resistance is consent is harm. Promoting the idea that the authorities own people's bodies is harm. And it provides no benefit that could not be provided in a way that does not do harm, if it provides any benefits at all. It's just plain wrong.

All of these options for registering on the organ donor register were in place previously. Driving licence, passport, GP and hospital registration. Yet still people were not registering.

Your argument about harm is not valid. Organ donors are dead. Who are you harming exactly? The family perhaps, the patients dying wishes? All of these factors are taken into account and the family has the final say. There remains an extremely compassionate process in approaching potential donors’ families. Consent is difficult as the person donating is dead and cannot actively consent to the process at the time that it is happening regardless of the law or process that is in place. If you acknowledge that consent is not required, then the wishes of the family are not taken into account, the potential donors’ wishes are not taken into account and then I would argue that this is unethical. This is a very different situation to the one that we find ourselves in currently.

I also don’t agree that there is dishonesty. The process is very clear.

 

[Bear]

Your examples are stupid, you're trying to make a comparison to situations where it costs you something and has an impact on your current life compared to a situation where you can save lives for zero cost. You're dead, you cease to be, you have no feelings or wanting for anything anymore, but still people want to deny others a chance at life at no expense to themselves. Utterly selfish not to donate your organs.

So what was keeping the vast majority of people taking two minutes out of their lives to register if it’s so utterly selfish not to donate? Are people only worth saving if it costs you nothing and only involves giving away your cast offs and costs you no time?

 

[tom_nieto]

So what was keeping the vast majority of people taking two minutes out of their lives to register if it’s so utterly selfish not to donate? Are people only worth saving if it costs you nothing and only involves giving away your cast offs and costs you no time?

I imagine the same thing that stops people voting in general elections.

 

[krooton]

So what was keeping the vast majority of people taking two minutes out of their lives to register if it’s so utterly selfish not to donate? Are people only worth saving if it costs you nothing and only involves giving away your cast offs and costs you no time?

Apathy and laziness. Oh, and the fact that most people don't really like to think about their own mortality

 

[robfosters]

Apathy and laziness. Oh, and the fact that most people don't really like to think about their own mortality

Thinking about their own mortality is a big part of it. People don’t want to think about such dark things, but that doesn’t mean they wouldn’t donate their organs. This is overcoming that stumbling block. You’re taking that horrible process away from people, but they can still opt out if they aren’t happy.

 

[Angilion]

All of these options for registering on the organ donor register were in place previously. Driving licence, passport, GP and hospital registration. Yet still people were not registering.

Presumably the people who didn't want to register.

But then you could take the next step and make it mandatory to indicate a preference. As I said in the same post:

If the goal is to really push it to the max, make it mandatory to register that choice. Here's a form, you must fill it out. Same as is done with census forms and suchlike.

What purpose does removing the need for consent serve? The claim that it will hugely increase the number of transplants done is false. The constantly repeated claim that removing the need for consent is the same thing as organ transplants is a ridiculous lie burbled out solely for the purposes of using emotion for political manipulation.

Perhaps it might be a little cheaper. Maybe.

Your argument about harm is not valid. Organ donors are dead. Who are you harming exactly?

That's a valid argument for taking away the option of opting out, which would at least be an honest and internally consistent position. Unlike the current one, which is neither. If they're dead and therefore can't be harmed and therefore what they wanted or didn't want when they were alive doesn't matter, then it doesn't matter.

The family perhaps, the patients dying wishes? All of these factors are taken into account and the family has the final say. There remains an extremely compassionate process in approaching potential donors’ families. Consent is difficult as the person donating is dead and cannot actively consent to the process at the time that it is happening regardless of the law or process that is in place. If you acknowledge that consent is not required, then the wishes of the family are not taken into account, the potential donors’ wishes are not taken into account and then I would argue that this is unethical. This is a very different situation to the one that we find ourselves in currently.

The potential donors' wishes are not taken into account under the new system. That's the whole point of it, that's the thing that makes it different to the current system. It would have been possible to get every consenting donor registered, very easily and using systems already in place. That approach was deliberately not taken because that was not the goal of the change.

Also, if the family has the final say then the patients wishes are irrelevant anyway as they are over-ruled by other people. That's a different issue of what is and what isn't ethical.

I also don’t agree that there is dishonesty. The process is very clear.

And it very clearly isn't consensual. That's the dishonesty. The main dishonesty, anyway. The other common dishonesties (it will greatly increase the number of transplants, opposition to removal of the need for consent is oppositon to transplants and means you hate children) are political tools to leverage in the system, not thing inherent in the system itself. You're a good example of the difference in that you're not using those common dishonesties to "justify" the main dishonesty.

 

[Hannah Walton]

I just got my donor card the other day