The absence of alternatives is my concern. If we optimize for better organ replacement instead of optimizing for how to help people keep their existing organs functional, it's really an asinine thing to pretend they have some kind of meaningful choice.
"Oh, well, now that we've let your organs decline this far, you can get a transplant and maybe live. Or you are free to decline it and almost certainly die." is not a meaningful choice.
I've gotten ridiculous amounts of flak for making real choices about my health. Much of the world would like me to know I'm evil incarnate for doing prosaic things like eating better as a first line of defense.
I loathe the idea that everyone getting replacement organs is some kind of good thing to be shooting for.
I have a condition where organ replacement is fairly common. I very much wish the world invested more effort in keeping people like me actually healthy rather than celebrating the macabre prospect of giving more of us replacement organs.
So this is a problem space I've thought about a fair amount and I have zero sympathy for an argument for engineering organ replacement for everyone.
There's little reason for anyone to submit to organ harvesting to eat. The idea that our society is just enough for individuals to face that choice is kind of laughable.
Of course the best thing is to make artificial organs work, but that's not something most potential organ donors have much influence over.
Why not work on both preserving existing organs and replacing them when they can't be kept going? Not everything can be fixed. A ton of medical research is put into preserving the function of the original organs, but people will still sometimes have them fail. When that happens, isn't it good that an artificial replacement is an option, rather than it just being a guaranteed death?
There's also another consequence not mentioned in the article - right now, almost all organs for transplants come from accidents. With accidents being reduced to zero, it will be very hard to get a viable organ for a transplant - so the medical community is already sounding alarms about the need for alternative solutions to be found(such as increased investment into artificially growing new organs).
I think that organ sales are substantially more complicated than this conversation is making it, but your point here could not possibly make less sense. It should be obvious with a moment's thought that "My family and I will starve right now" is way worse than "there's a small chance my second kidney will fail and then my family will starve" (and that's without considering the effect on the person who got a transplant).
"We could very easily save your life with a transplant, but we won't because you did not choose to be an organ donor" is not something I think people in this country have the stomach for. This would be like if we didn't treat people who opt not to carry health insurance. In theory that prevents moral hazard, but in practice no society would be willing to let people with treatable ailments die.
Sorry, i just don't see those as compelling arguments. The ability or non ability to alternatively source organs doesn't logically lead to a change in consequence. If anything, our inability to fully supply donation requests makes it a greater imparative to force organ donations to save lives e.g. organ shortages with life ending consequences are a present reality.
Everything not curative for a problem that doesn't let you live without treatment is an aberration. Since organ donation is not saving people, but enabling to be dependent on donations every 10 years and immunosuppressants in between (except for cornea transplants), I don't want to enable it.
The much anticipated collapse will apply those sort of rules soon enough anyways.
What do they do now? You make it sound like there's a better alternative currently available!
The reason they would consider selling a FUTURE interest in their organs is because it would be the best option on the table. Since it's not currently available as an option, they must be choosing considerably worse option now (which is the best currently available option).
How is your alternative more just, more fair, better?
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Imagine YOUR loved one received a liver/heart/kidney in this manner, thereby saving his/her life. And in so doing it DID improve the welfare of someone loved by the donor allowing him/her to get a better education, get better housing, or something else worthwhile.
What is so horrible about that? Your insurance company would cover it and it would make the world a BETTER PLACE for everyone. By the way, the surgeon gets paid a lot of money for a complex procedure like organ transplant; what's wrong with a donor getting a tiny fraction of that for his/her contribution providing the amazing, wonderful gift of life?
If the end justifies the means, then I think it's irrelevant whether the change causes demand to be met so long as more people get the organs they need. On the other hand, if you don't believe that the end justifies the means, then it's completely irrelevant because you have to respect people's choices over their bodies (even posthumously) even if you think they are misguided or 'selfish'.
>And yet when I suggest we might try harder to help people keep their own organs more functional in that case, I'm generally given all kinds of flak
Brilliant! Why did nobody think of that /s
Major organ transplants are pretty much only performed on people for whom it is the last resort. In fact, there are not enough organs to do transplants on everybody who would need it, let alone waste on people who don't.
There are a lot of surgeries and novel treatments that don’t make any financial sense. We don’t make healthcare decisions on a P&L basis, but hopefully on some kind of cost vs expected benefit to the patient basis.
Transplanting a kidney or liver into a 20 year old has more of my support than transplanting a heart into an 85 year old.
I don't think I understand. If they could rehabilitate unsuitable donor organs and didn't have to worry about rejection, there wouldn't be a shortage. Isn't that the end game?
Maybe I'm being unfair. I would feel more charitable if I saw a concerted effort to warn potential living donors of the risks they get themselves into. There is virtually no such effort and I believe this leads at least some well-meaning people to make a life-changing decision with less than complete information.
And that is what I think is the most unfair thing, the greatest injustice, of all. To deprive an independent adult from the freedom to make an informed decision about their own health.
I'm speaking from personal experience again and this is probably coloring my views. In any case, since I will probably need kidney replacement therapy sooner or later I can say with certainty that both options, dialysis (both kinds) and transplant, just suck.
I think there's a slightly charitable reading of that opinion. Replacement organs are already in short supply, it's a real problem. By "bigger problem" he's referring to bigger than it already is, not that organ recipients dying is a worse problem than all of the organ donors dying like the status quo. It's a good problem to have, but it's still something the medical profession is going to have to grapple with when their supply dries up.
I saw you had been downvoted and I upvoted you, despite disagreeing very strongly with your opinion, because you stated your opinion without vitriol and while I might disagree I'll still fight for your right to say it as long you do so in a way that isn't hurtful.
I think the line of inquiry into replacement organs can be researched ethically but the how of the research may cross ethical lines if not done carefully. Given diseases we have, I think we need to do the research and find an ethical way to make this kind of organ production happen, if we want to extend human lifespan.
"Oh, well, now that we've let your organs decline this far, you can get a transplant and maybe live. Or you are free to decline it and almost certainly die." is not a meaningful choice.
I've gotten ridiculous amounts of flak for making real choices about my health. Much of the world would like me to know I'm evil incarnate for doing prosaic things like eating better as a first line of defense.
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