In the first three-quarters of 2013-14, the UK’s organ donor register had 20,069,640 people, but only 3,740 people received a transplant. This is due to new health and safety laws and better emergency response times, which have led to a decrease in the availability of transplantable organs. The shortage of organs and finite healthcare resources has led some to argue that people who need them due to lifestyle choices should be denied transplants.
Transplanting across species invokes a powerful set of immune responses and may expose donors to previously unseen infectious agents. The transplant community has an obligation to better understand disparities and ensure that lifestyle choices do not affect clinical decisions regarding surgery. There is no widely accepted single ethical principle for the fair allocation of scarce donor organs for transplantation.
Several ethical and humanist approaches can be taken to counter the argument for the proposition, such as the principle-based approach of ethics, which emphasizes autonomy. Organ transplants should be given to anyone who has a clinical need regardless of lifestyle choice. The traditional notion of support is a luxury that should not necessarily determine access to a lifesaving transplant.
Ethical considerations should be made to ensure equitable access to the transplant waitlist, including factors such as anxiety and depression. Patients and their families face a new lifestyle after transplantation that may cause them to feel nervous, stressed, or depressed. As population health scientists, epidemiologists, clinicians, and ethicists, the transplant community has an obligation to better understand disparities and address the ethical issues surrounding organ transplantation.
📹 What Kidney Donors Need to Know: Before, During and After Donation | Q&A with Dr. Fawaz Al Ammary
Transplant nephrologist Fawaz Al Ammary discusses live kidney donation, including the evaluation process and qualifications to …
How can lifestyle choices affect a person’s health?
Lifestyle factors like tobacco use, diet, and physical activity are linked to chronic health conditions like cancer, diabetes, obesity, and cardiovascular disease. Unhealthy body weight, limited physical activity, and poor diets are linked to increased cancer incidence and mortality rates. Lifestyle factors also affect energy metabolism, cellular growth, steroid metabolism, inflammatory mediation, DNA repair, and immune function. Malnutrition increases morbidity and mortality from infectious diseases and hinders treatment response.
Yale School of Public Health researchers are using interdisciplinary and epidemiologic methods to understand the health consequences of nutrition, exercise, genetics, biomarkers, access to health services, community-based characteristics, obesity epigenetics, lifestyle interventions, breastfeeding, and climate change.
Should lifestyle choices affect access to organ transplant?
The argument against organ transplants is based on the principle of autonomy, which means people have the right to make their own decisions about their lives. This autonomy is derived from the Greek word meaning “self-governing”, meaning people are capable of making their own choices. However, some argue that preventing people from exercising free will may lead to a “nanny state”. For example, the Welsh Government has proposed banning electronic cigarettes in public places when people choose healthier alternatives.
The rise of lifestyle has only been shown to be attributed to disease in recent years. In the 1950s, smoking was considered “cool” and socially acceptable, with Hollywood icons and screen stars like James Dean and Humphrey Bogart. However, the correlation between smoking and cancer permeated public consciousness, leading many people who now need a transplant unaware of the health risks when they started smoking. Therefore, the argument against organ transplants is based on the principle of autonomy and the potential negative impact of lifestyle choices on health.
Should older people who lead unhealthy lifestyles be denied organ transplants?
Recent scholarship focuses on addiction as a treatable chronic illness, rather than flawed character. This perspective is inconsistent with the ethical principle of equal moral worth, which should not be used as an allocation principle in organ transplantation. Public preferences may diverge from expert preferences, but this does not always lead to the best allocation policy-making.
To solve the allocation dilemma, balancing and rank-ordering can be used to emphasize the weighting of prominent ethical values in the justification of allocation policies. In the context of the COVID-19 pandemic, ethicists have converged on the principle of maximizing benefits or saving the most lives. However, if support for maximizing utility is increasing, it must be balanced against justice and fairness requirements. Patients should be treated equally, regardless of sex, ethnicity, socioeconomic status, or geographical location.
Policies like the US OPTN’s 2018 donor heart allocation system can be evaluated along these lines. The change in the donor heart allocation system may have exacerbated inequitable access to heart transplantation along geographical location, but it has not led to improved posttransplant survival rates. Geographically determined disparities in access to donor organs persist, and many allocation systems are currently striving for broader geographical sharing of organs across country or regional boundaries to reduce inequitable access and improve efficiency.
What disqualifies you from organ transplant?
Most health conditions do not prevent organ donation, and age is not a factor. However, severe infections like viral meningitis, active tuberculosis, and Creutzfeldt-Jakob (Mad Cow) disease can disqualify donation. A recipient’s faith and positive outlook can transform her view of organ donation, while a family’s difficult health diagnosis can inspire understanding about organ donation in multiethnic communities. These stories highlight the importance of addressing cultural disparities in healthcare and promoting openness about organ donation and treatment needs.
What factors are important in determining if you receive a transplant?
The organ is offered initially to the most suitable candidate, based on a number of factors, including medical urgency, waiting list duration, organ size, blood type, and genetic makeup.
What is the negative impact of lifestyle choices?
The use of substances like tobacco, alcohol, and illicit drugs significantly impacts health, leading to various health issues. Smoking is a leading cause of preventable deaths worldwide, increasing the risk of lung cancer, heart disease, and respiratory disorders. Excessive alcohol consumption is associated with liver disease, certain cancers, and mental health problems. Illicit drug use can lead to addiction and various physical and psychological health issues.
The complex connection between lifestyle decisions and health outcomes is highlighted in this study. The way a person eats, moves about, sleeps, manages stress, and uses drugs significantly impacts their health. Informed decisions about these lifestyle factors can either promote optimal health or contribute to it. To achieve optimal health, individuals should strive for a balanced and healthy diet, engage in regular physical activity, prioritize adequate sleep, and use effective stress management techniques.
To avoid or minimize substance use, such as tobacco, alcohol, and illicit drugs, it is crucial for overall well-being. Promoting a healthy lifestyle through informed choices is a powerful tool in the quest for a longer, healthier, and more fulfilling life. Recognizing the impact of lifestyle choices and taking proactive steps towards a healthier future can help reduce the burden of chronic diseases and improve the overall health of communities and societies.
What factors to consider before transplant?
The outcome of a transplant depends on psychological, social, and emotional factors such as stress, financial issues, and support from family and significant others. A team will discuss these aspects with you to determine your eligibility. The team includes a transplant surgeon, a transplant physician, a nurse, a social worker, a dietician, and a psychiatrist or psychologist. Other physician specialists may also be involved. The evaluation process includes blood tests to determine a good donor match, assess your priority on the donor list, and improve the chances of the donor organ not being rejected.
Why are lifestyle choices important?
The practice of maintaining a healthy lifestyle, which encompasses regular exercise, cessation of tobacco use, moderation in alcohol consumption, and the promotion of mental wellbeing, has been demonstrated to markedly diminish the likelihood of developing a range of health concerns, including cardiovascular disease, stroke, type 2 diabetes, certain forms of cancer, and respiratory disorders.
What can prevent you from getting a transplant?
The text outlines the contraindications for orthotopic heart transplants, including major systemic diseases, age inappropriateness, cancer in the last 5 years, active smoking, substance abuse, HIV, severe local or systemic infection, and severe neurologic deficits. The indications for these procedures include an end-stage heart disease that cannot be treated with other medical or surgical therapy. Absolute contraindications for adults and children include major systemic diseases, age inappropriateness, cancer in the last 5 years, active smoking, active substance abuse, HIV, severe local or systemic infection, severe neurologic deficits, and major psychiatric illness or substance abuse that cannot be managed adequately for post-transplant care.
What are the ethical dilemmas of transplant?
The debate over organ transplantation is a complex and morally complex issue that touches on the obligation of healing the sick, the blessing and burden of medical progress, the dignity and integrity of bodily life, the dangers of turning the body into just another commodity, the importance of individual consent and the limits of human autonomy, and the difficult ethical and prudential judgments required when making public policy in areas that are both morally complex and deeply important.
The current opposition to organ markets or public compensation may seem as quaint and misguided as opposition to organ transplantation itself. However, it is important to recognize that the risk of corruption and dehumanization that comes with sweeping aside old taboos, even as we seek to ameliorate suffering and cure disease by every ethical means possible. The specific question before us is: What is the most ethically responsible and prudent public policy for procuring cadaver organs? Should the current law be changed, modified, or preserved?
The number of organ transplantations performed each year is increasing, not declining. It is true that our progress has created a new form of suffering: waiting for organs, suffering months or even years on dialysis, and waiting in pain for others to die. However, it is wrong to declare that the “organ shortage” is the “cause of death” for those who die waiting for organs, and that bigger organ waiting lists mean that the quality of our healthcare is deteriorating.
Our medical system and medical advances seem to have lowered death rates, not increased them. Social welfare, measured simply as the number of patients saved with organ failure, is improving, not declining.
The “gifting” principle, described by Paul Ramsey in his classic work Patient as Person, suggests that a society will be a better human community in which giving and receiving is the rule, not taking for the sake of good to come. The positive consent called for by Gift Acts, answering the need for gifts by encouraging real givers, meets the measure of authentic community among men. If the young rarely think about their own deaths or about giving their organs upon death, then they should be constrained and enabled to do so by the institutions and practices and laws we enact.
To become partners in proved therapies or joint adventurers in proving therapies, could be among the most civilized and civilizing things young people can do. The moral sequels that might flow from education and action in line with the proposed Gift Acts may be of far more importance than prolonging lives routinely. The moral history of mankind is of more importance than its medical advancement, unless the latter can be joined with the former in a community of affirmative assent.
What are some factors that may support or hinder someone from considering organ donation?
Organ donation is a crucial aspect of patient care and survival, but the worldwide gap between demand and supply is a significant challenge. Brain-dead patients are the main source of organs that can be donated, but the decision to donate often requires the consent of family members, which can be complex and stressful. This mini-review aims to provide an overview of the impact of psychosocial factors on the decision-making process regarding organ donation by family members.
Factors such as sociodemographic factors, knowledge of the organ donation process, religious beliefs, concerns related to the choice to donate, and mode of communication are emphasized. The need to examine these aspects further through interventions and guidelines is emphasized, aiming to improve the organ donation application process and ensure a positive experience for the family that has to make the decision. The first evidence of applying this method to medical practice dates back to the late 19th century, when an epidermic graft was described by a Swiss surgeon.
📹 The Broken Economics of Organ Transplants
Animation by Josh Sherrington Sound by Graham Haerther Thumbnail by Simon Buckmaster Select footage courtesy the AP …
I remember a nightshift, where I was on regular duty in my city, when we suddenly get toned out at about 3 am for an “emergency, other” – which is usually the button dispatch pushed if they don’t know what’s going on from the call. So we go to our rig and I give dispatch a shout over the radio and ask them what they know, if anything. And dispatch basically goes: Well, this is kind of a special task, but I exhausted every other ressource and the helicopters can’t fly due to weather, so I need to send a regular unit for this. In my head I’m already kinda panicing, because “special tasks” in EMS are never good and “no other ressource avaible” certainly means you’re not the first choice, usually for a reason. But I also don’t have a choice, so I just say: “Go ahead!” and dispatch tells me that there is this patient on the lung transplant list who is in care at her own home – and she just got a call that she would get a transplant lung if she manages to be on the operating table within 4 hours. Problem was: That operating table was in a city that’s 3.5 hours away in normal traffic. So my buddy and I respond code 3 to the house, where the patient is already packed up and ready to go, put her into our ambulance and we drive like the mad men we are. To this day, I have no idea how I managed this, but despite heavy snowing and high winds, I pulled into the ambulance bay of our target hospital 2.5 hours later. We immediately tell the first nurse we see to ring the operating theatre and lead us there – she does so, goes white and says: “Wow guys, that has to be fate.
Can I just say, as someone who works in organ donation, that this article is really refreshing. I see a lot of well meaning but inaccurate information around organ donation. I work in the UK so obviously this doesn’t map on to our system perfectly (we’re not hampered by geography nearly as much as the US is) but I’m glad you emphasised that often times it’s not the sickest person or the person waiting the longest who gets the organ, but the person who will get the most use from it. Also, I notice you used a lot of stock footage that seems to be from Israel – their system is interesting in that whether or not you’ve signed up to be a donor is a factor in how high up the list you place as a recipient. If you opt out of donation, you’ll be lower on the list than an equivalent patient who has signed up to be an organ donor. However one thing missing from this conversation is that unless the supply of qualified surgeons (and support staff) increases in line with an increase in organs, there will always be a hard limit on the number of transplants that take place. Currently in the UK we can reach a stage where all the teams qualified to retrieve organs are already out retrieving, and the transplanting hospitals have reached their capacity for the day – this can happen with as little as 15 or so donors in a 24 hour period. When this happens organs start to go to waste – having more donors doesn’t help the people on the list if there aren’t enough surgeons to retrieve and implant the organs.
There’s an error in one of your diagrams. When someone has a kidney transplant, the reciever ends up with 3 kidneys not 2 usually. They leave the existing kidneys attached and just wire up the donor kidney. So it doesn’t replace either of the existing kidneys, unless they were removed completely due to cancer etc.
I’ve narrated the scene at 5:35 for you Doctor : “Scissors, and Assistant 1, prepare to insert hunk of flesh” Assistant 1: “inserting hunk of flesh!” *inserts flesh and rotates wrist back and forth* Assistant 2: “Your Scissors, doctor.” *places scissors in Doctors hand* Doctor: “Thank you, now insert your hunk of flesh Assistant 2” Assistant 2: “You mean twirl it around like invisible pasta, like-a-dis?” Doctor: “Excellent Assistant 2, that was skillfully done and your mock Italian accent brings us levity while attempting to summon Cthulhu “
There’s another option to increase the supply of organs. You can change the form at the DMV. The way people sign up to be organ donors is by checking a box while getting their drivers license. This box is unchecked by default (an opt in form). Studies have shown that when people have a difficult choice to make, such as what to do with your organs if you die, they are more likely to choose the default option. By changing the form at the DMV to an “opt out” form by simply making the box checked by default and giving people the option to opt out if they do not want to be organ donors, it can have a big impact on the number of people signed up to be organ donors.
Nice article! I’m a PhD student in Developmental Biology, and I would like to offer one more possible solution to organ shortage: making new organs from scratch. There’s a steady improvement in the quality of Organoids – tiny organ-like collections of cells grown in a lab. I myself work with mouse kidney organoids, though one time my colleague used a wrong growth medium and they started beating, like heart does! These organoids have microstructure which is similar to proper organs, but they are still too small to function properly, and there are still problems ensuring proper blood flow throughout the organoid. Some proposed solutions suggest 3D-printing the scaffold from biocompatible material and then seeding it with thousands of organoids to achieve full-scale function. Let’s hope that in a decade or two, this technology will make organ donors obsolete!
The real broken part isn’t that people can’t afford organ transplants. It’s that most people aren’t willing to have their organs harvested for any price. Edit: People seem to think that because I said that SOME people might choose not to donate their organs for religious reasons, that I have not donated my organs for religious reasons. To be clear, I can not donate my organs for legal and health-related reasons, not religious. I was merely suggesting one of the many possible reasons why someone would choose not to and I respect that decision. Also, a lot of people have been attacking Christians and Jesus for people not donating organs. Nowhere in the Bible does it say that you can not donate organs because it is a sin. In fact, it is primarily Islamic, Jewish, Amish, and Native American communities that choose not to donate for religious reasons.
There is a (partial) solution in the middle. Compensate living donors for the costs associated with donation. Currently, if someone wants to donate a kidney to someone they love or to a stranger, they have to undergo clinical evaluation, take time off at work, travel, lodge and recover all by themselves. This costs thousands of dollars and is one of factors limiting the supply of organs. American laws don’t prohibit compensating organ donors all these expenses, and there are organizations that try to do that. But more needs to be done.
Perhaps instead of encouraging supply we should try to lower demand. Were there a way to lower organ failure rates, fewer people would need organ transplants, and so the few that still do will have ample supply. Of course this is far easier said than done, as many, many complicated factors contribute to organ health, but if there were some hypothetically effective solution to the problem, this is it.
I thought there were other forms of compensation like: People who need transplant may not be a match for a close relative but their relatives might be a match for someone else on the waiting list so if that family member is willing to donate then the original person is moved to the top of the waiting list for when a match for them becomes available
Coming from someone who is going to need a kidney transplant at some point in the future, I think a hybrid of the two systems could be good. Keep the system we have of allocating them based on need, but also allow people the buy them from living donors if they want one faster. This would help free up kidneys from deceased donors for those on the waiting list.
Interestingly enough, there’s also a hierarchy of which organs are taken first from Donors who pass in hospitals. Once the patient is declared dead, each donatable organ has already been assigned to its new home and its recovery agents are waiting at the bedside, but have to wait their turn depending on the organ. The heart always goes first no matter what with lungs coming second and the rest up to the hospital or agency’s discretion
I was once on a plane trip and at the end when we came into land, the stewardess came on the speaker to tell us that we arrived faster than scheduled because they were flying in a kidney donor and were allowed to use a faster flight lane. I feel like Sam should have worked in these “faster flight lanes” into a article about organ transplants…
Great article! One thing I would add to the debate on paying donors for organs is that they may be incentivized to lie on screen questions which would normally exclude them from donating (history of particular infectious diseases, certain drugs, etc.). This would potentially cause harm to the recipient, just another factor to consider.
This is very insightful. I actually had a liver transplant when I was ten months old and had to wait about 5 or so months, and thankfully tomorrow I’m celebrating my 21st birthday. Over the years I’ve learned a bit about my situation as I was too young to understand or even remember anything, but not from this standpoint. I never knew the logistics of everything that it entailed
absolutely agree about the second option over the iran model. there, only rich people would get kidneys, even though they’re already in their mid 70’s and will probably only use it for a few more years, while poor people would be the only ones to sell them. and even though, as you say, irans model saves more lives, but is less fair, you also have to ask how many years lived by that saved person. just using smaller numbers as an example, but if you save 30 people who will all live and extra 30 years, you’ve saved 900 years of life. whereas if you save 60 people with only 5 years left to live anyway, you’ll save more people, but you will only have saved 300 years worth of life. so even it you saved twice as many people, you’ve only saved a third as much human lifetime spent on the earth. i don’t think you hammered this point down enough in the article. the current system is just much better.
Spain is widely considered the gold standard in organ donation because it has had the highest organ donation rate of any other country in the world for the past 26 years, with 46.9 organ donors per million people in 2019. (This compares with 26 organ donors per million people in the United States.) Unlike the United States, which has an opt-in policy, Spain has an opt-out policy, meaning citizens are automatically organ donors unless they opt out. But Spain still asks families whether they want to donate their loved ones’ organs before they’re harvested. As such, there’s no true presumed consent program. While there are a number of European countries that have a law (for presumed consent), none of them have actually relied upon them.
This whole business is all wrong – my heart tells me this emphatically. Well presented article though. And the lesson on how the free market system works, in plain simple language, with graphics, really made me ‘get it’ now. And also easy to explain to normal people out there. The very poor ends up outside of this system, with little or no hope of ever getting into the game. And this issue is FAR more important to humanity and our planet than organ transplantations that only extends the lives of a very few out of billions? And these poor creatures end up being the donors in a world that’s lost its moral compass.
The more transplants vs fairer transplants view hides a very important detail. Which is whether more or less transplants end up happening for poor people. It’s possible for this to go both ways. On one hand maybe more transplants occur across the board but mostly for the wealthy, so everyone is better off, the wealthy are just more better off. Alternatively maybe all transplants, both the additional ones and the existing ones start going only to the wealthy and the poor lose out.
This is going to sound strange, but before Quarantine hit I was in a microeconomics class where I was close to the professor and i got super depressed when we had to go digital, she was super fun and informed on this topic.. I am an econ major myself and we would often shift our discussion to healthcare and she always used examples of organ transplants here in the US. I was sort of depressed and lacking the energy to continue the field but this? This was exactly what I needed Wendover. I wont meet ya man but I really love you for making me click so fast. Thank you so much for doing this article, It was exactly what I needed. ❤️
1:30 It’s odd how you start the story in the middle, as if money were some kind of manna from heaven that is magically distributed to people out of nowhere, and the gods just happen to bestow more upon some people than others. The reason different people have different amounts of money is because different people contribute different amounts of value to the marketplace. If one guy performs life-saving organ transplants on a daily basis, and another guy literally lounges around and smokes pot…Is it really “unfair” that the first guy has more money than the second? Is that really a “breakdown” of the economic order? Would “fairness” really be that these two guys have the exact same amount of money, despite having such a vast difference in contributions to the community? 11:31 What’s wrong with allowing individuals an option to earn a significant amount of money that might change their life? If they’re truly desperate, how is it “fair” to deny them the right to make money off of their kidney? What happened to “my body, my choice?” 11:37 You admit that allowing people to be compensated for their donated organs increases the supply and eliminates waiting lists…And then you turn around and claim it makes it “harder” for poor people to get a transplant, asserting they get “priced out.” How are poor people affording organ transplants in the current system? It’s not like they’re free. They cost thousands upon thousands of dollars…because literally everyone else aside from the donor gets paid.
“The amount your willing to offer is infinite.” Well, no, if they gave up ALL of their money for an organ transplant, they would starve to death. Also, organs aren’t the most valuable thing to people that are suicidally depressed or indifferent about living. “There are more people that need organs than organs available.” A problem that would be easily fixed if we switched our organ donation system from an opt-in system to an opt-out system.
Why not have 2 systems? A dead donor list and a living donor market? The death donor market goes by need as normal (for people who cannot pay) and a living donor market for those who can. Because let’s be honest very few people are going to donate a kidney without compensation so now poor people can get a kidney (slowly though) but more people can be saved due to the paid system
Market economies aka Capitalism, is not a perfect system to achieve all of societies lofty goals like getting organs to the people who need it the most, however it is great at maximizing surpluses, which benefit everyone, distributing resources to those who are good at managing resources, and taking away resources if someone is bad at managing. Inequality has existed in every society and culture from the beginning of time, and certainly won’t be solved until we either have infinite/ near infinite resources, or robots that do all the work, and we distribute the production equally. The richer a society is overall the more inequality there will be, all things being equal. I think most people would agree that so long as we have a bottom floor, where people can afford to live a decent life (as determined by the society), then inequality isn’t a problem. Here’s something I think Wendover Productions is missing, Hospitals are already making money off organ transplants, so in that way a organ transplant is already pricing out the poorest people who have no insurance, and can’t afford the transplant itself from getting those organs. Also, if we allow people to sell their own organs, or those of their deceased relative, so long as they have a high enough score, then we will be ensuring that the people who need the organs the most are getting them, and there will be a greater supply. Another alternative would be the government could offer a flat rate for donated organs, and provide them for the list.
Imo there is a solution to that problem, that also works for non-redundant organs like hearts: Leave the donation-system uncommercialized as it is, but: 1. Make organ-donation opt-out instead of opt-in. Few people actively decide to register as organ-donors (myself included). But far more would be willing to donate theirs, especially if that was actually the “default” that everyone would adhere to. It’s a tremendous waste to leave perfectly healthy organs rotting away in graveyards when they could save lives. 2. If someone opts-out of the system, they are also no longer eligible to receive organs through that system. (Or at least they would automatically have a lower priority than everyone else) After all, why should someone who actively makes the decision to deny other human live-saving organs, and let others die, receive organ-donations themselves?
i honestly think the current donation system with better compensation for donators would be best. there is already an organ black market because of the scarcity so may as well moderate it to ensure the survival rate of doners is higher too and more importantly have those organs help those on a waiting list and not the highest bidder.
If we go down the Iran route of compensating organ donors. What if a cap on the price of organs say 4500 $£s (as in the article). But every donor pays a one off fee of 100 $£s This would create a national organ fund to financially assist poorer organ recipient’s to getting treatment. The fund would be means tested if your wealthy enough you’d pay full price. Depends how much is in the fund to how much assistance could be offered. Perhaps if it was a global fund? I do agree with the current system that is based on need rather than ability to pay. There’d also have to be a clause with strict criteria stating one couldn’t donate if healthy…..
1:52 actually that statement is completely false. The person with a lot of money has worked their butt off in school while the other guy was a free loader and just went through the motions at school. One person ended up as the CEO and the other a fast food worker. So really the person with a lot of money was willing to work harder to be able to afford the pineapple and they are the one that deserves it. That’s capitalism
Im glad that the article brought up the concept of money when it comes to transplants. I feel like the healthcare system in the United States, can be manipulated by those with money. I have seen and heard stories of people who have received donated organs after they have lead a life that completely willfully destroyed their organs. They received these organs instead of a person who in most peoples eyes “deserved” them more. My ethical dilemma is this; with a healthcare system based on capitalism, when do you deny someone who is willing to pay exhorbant amounts for a treatment that they don’t necessarily deserve it? If those who can and do pay for these procedures are told they cant anymore, will there be more corruption from physicians who do these procedures “under the table”. No matter how hard we try, we will always have some level of corruption. I also feel that when these procedures are more regulated by the government, then they will dictate who will then be eligible for transplant. This could also be an issue because then people in the government who don’t necessarily have any medical experience will be making medical decisions. Just look at how most hospitals operate these days. You have indiviudals who mave masters degrees in business making decsions that effect how physcicians can clinically treat a patient. I believe the system we have in place right now breeds this style of medicine “the more money you have, the better quality care you will get”. I think that we need to have a balance.
I personally think it wouldn’t be a bad idea for the government to incentivize organ donation by giving money to the next of kin if you were to die in a situation in which your organs could be used. You don’t benefit but you can help your family once you’re gone, this also doesn’t change the fact that the allocation is based on need. All you’re doing is increasing supply by increasing the amount of people enrolled. Or if you asked me a smart thing to do would make organ donation default by law and allow people to opt out, rather than the present reverse system.
The purpose of the market isn’t to make sure the person who wants something the most receives it. In the example where the rich person is willing to pay $11 and the poor person $10, you claim it’s a market failure since the rich person wants it less. It’s not. The rich person is worth more than the poor person to the economy, and therefore his needs have a higher priority. This is exactly as it should be. All people are not equal.
It’s funny how people refers to socialism as an utopia, but when you think for a second what capitalism is supposed to be, you realize it’s an utopia too. However, while that utopic nature is enough to disregard and mock socialism, those who defend capitalism try to picture it as if the system we live in was the perfect, flawless, ideal version of capitalism.
Thank you NHS, also I’m a organ donor and I’m pretty sure it’s mandatory now. When I die weather that’s in 3 weeks or hopefully 70+ years someone will make use of my organs, another reason to stay healthy . If you drink a lot of alcohol or eat a lot of fatty foods, Whether it’s a fatty liver or a damaged heart. So keep your organs nice and clean because if you die in a freak accident (car crash, or ran over) Your organs can be used to save others. Just make sure you’re not overweight and drink plenty of water, Keep your organs healthy they keep you healthy. Also minimises the risk of you needing an organ transplant which put even more strain on the list.
I have a beautiful story of kidney live donors. A couple who has been friends of my family forever found out the husband had PKD years ago. When they tested close family for living donors, his wife matched. She lost 70 lbs to donate to her husband! The operation happened last year. However. Last month they were both diagnosed with COVID-19, someone brought it into their house. He had it very rough, but is slowly getting better. He was taken off a ventilator last week.
I suggest promoting organ donation by rewarding donors in governmental ways; Maybe if they work on government they might get a better score on reallocations or getting better chances of promotion, For others it could mean free basic universal healthcare or reduction in criminal punishments or bonus scores on offical nation wide exams
Worth noting about the intro: The world produces enough food to feed 10 billion people, however, much of it gets wasted and millions go hungry precisely because of this market rationing system, where milk would sooner go to a rich man’s cat than a poor man’s child, even though there’s enough milk for everybody. It HAS to be monetized too, over the course of this pandemic millions of gallons of milk have been dumped each day because nobody’s buying and it’s cheaper to do that than store it until it goes sour or to just give it to whoever needs it.
5:00 I was very lucky to fall in this category, but mainly because I was.. 1. 18 months 2. Was not on dialysis since birth Now people may say it’s cruel to not put a newborn on dialysis but that was a good thing because I soon will be celebrating 31 years post transplant but there is two more factors to consider.. I was a 100% match with my mother, and I take my post transplant meds faithfully.. Now that said, IRAN has a good system and imo we need to adopt this system but I don’t really see that happening because of our political structure and business models.
No offense, but if I die in say a crash, I should be able to sell off whatever organs are left over for profit and all the money should go to my estate (ie people I will it to). That would be a substantial amount that could pay for education, pay off a mortgage, etc. Long live the free market and fuck busy body politicians who mandate that you can only GIVE AWAY something so valuable.
So, you would rather have 10 people die horribly than 2 people die as long as the 10 people doing the dying are from group 1 instead of 2. The difference between group 1 and group 2 is that society, as a whole, finds group 1 more valuable. Steve Jobs, as an example, has more money because millions of people find his work valuable. As much as I like to think that plenty of people value me, there would not be a lot of people willing to stand in line to pay hundreds of dollars for what I can make. My family values me. My employer values me. But society, as a whole, values(valued) Steve Jobs more. Of course, valuable people help everyone. Your website might not even exist if it weren’t for the iPhone and certainly wouldn’t be viable without key irreplaceable people. On top of that, wealthy people directly help society just by willing to spend more money. Take airbags, for example. They exist, in part, due to the expectation of being able to sell them in luxury cars before migrating them to nearly all cars. The high spenders helped make that happen. What you’re suggesting is that since some people are valued more, this is bad and the solution is to create a system where more of these valuable people die. In your analogy of pineapples, the person who is able to make, transport, and sell the best tasting pineapples should be punished, by death so that a much smaller group of people who sell rotten pineapples that no one wants to buy can live. This isn’t equality, it’s just envy, as old as time.
Surely there is a system that balances both styles? Like organs donated thw traditional way from people who have died are distributed fairly on an as-need basis, however people still have the option to willingly sell their spare organs on a free market, and these are kept separate to the traditional donations
Okay but on the pineapple analogy, if everyone is aware that they could have a pineapple at a time they chose, or if they knew they could have a banana, what if they had the ability to have both then they may only take, one, only in our system do people want to take more than they need because, when something is free in a society where you have to pay for everything, then it is something that might get abused etc.
I mean you could just use tax dollars for compensation to stimulate demand, while still keeping the more moral allocation system. if you think about it as just another treatment that your nation’s universal health system pays for with tax dollars, it’s pretty straight forward. Though this would be less intuitive for the USA for obvious reasons..
I was expecting him to say flight can solve the broken economics of organ transplants. No, really. Scientists have already demonstrated that it’s possible to 3D print human organs in space because there is no pull of gravity to mess with intricate structures. If you found a way of getting the cost of space travel waaaay down, you could print biologically ideal organs for hundreds of thousands of people in need, thus increasing organ supply (abundance) and making a profit. It would save lives and stimulate your wallet: both good outcomes, especially if the cost falls enough for the non-rich to afford them. The big problem is that sending one astronaut to space is about $60M, not factoring in housing and related resources. If you had, say, 4 professionals to operate the equipment, run the printers, and perform real-time debugging and stuff, the operation might be, say, $300M to print 100 hearts in a few months. You’re trying to make a profit, so you price the operation at $500M. That means everyone has to pay $5M per heart — it’s crazy, especially once you factor in the risks associated with rocketry. If you’re doing a 12 hour trip back to Earth, not all the hearts will make it back alive, so these become losses. Ultimately, we need a cheap, safe, way of getting people and resources to space for 3D organ printing to take off. And maybe even to get to the point where private companies can build their own private labs, say with spin gravity, to perform increasingly complex medical operations in space.
Fairness over money. I am poor guy in Denmark. I only have a chance in this life because of equal opportunities here. I am an organ donor, I applied as soon as I returned from studying in Beijing. I was 24 back then. I support the Australian model. Where you need to report to be taken off the list. What happend in Beijing was a teacher was asking me and a fellow student if there was anything she could do for her friend’s father who had stage 4 liver cancer. She told us that the hospital demanded 160 thousand Yuan for a liver, but that they could get it within a week. Firstly, yes China does commit organ harvesting for profit. Secondly, we had to tell her, that it would be a waste of money, since it was stage 4.
Interesting that the article uses the word Tranche to describe eligibility of organ recipients. They use the term “Healthy Tranche” to describe those eligible recipients most likely to qualify for an available compatible organ. Or just plain Tranche for other “not so eligible” potential recipients. I’ll list a couple of definitions of tranche listed by internet search. Tranche – 1. A portion of a total, especially a block of assets such as cash or security. 2. A cut or slice of meat. Both from the American Heritage Dictionary of the English Language. Tranche – 1. a division or a portion of a pool or whole; specifically : an issue of bonds deriving from a pool of obligations (such as securitized mortgage debt) that differentiated from other issues especially by maturity or rate of return. Obviously this is primarily a word, Tranche, used in the financial sector. Interesting? I wonder why that would be the case? Watch the article from 8:28 to 8:32. Look at the logo, markings and ID symbol on the back of the two cute nurses pushing the gurney. I wonder? Is that why the term Tranche is being used. Are these patients being financialized or monetized in some fashion? Lots of talk of money and finances in the first part of this article. Personally, I have No Idea. These are just observations I found interesting and disturbing at the same time.
What about a system where people in need of a transplant could donate to a fund that would pay donors, but that money is distributed rather than going to YOUR donor. So if Rich McRich is #73 on the list, and donates a million dollars, the program would incentivize the next 100 or so donors with $10,000, therefore increasing supply without decreasing inequality.
Okay but when you offer somebody 100 pineapples they are more likely to respond “What? What the heck am I going to do with 100 pineapples? Can I just have like, 2? Maybe 3?” The fact is, people will take enough of things to satisfy their needs, but not more than that (unless they can sell the extra because under capitalism they need to have money in order to get what they need in the future)
How about a system where some money is allocated to a fund, from which the government pays for the organs (just like the Iranians did) instead of the people. This will increase the number of donated organs. But it should keep the current waiting lists and unequal transplants. This is kinda best of both worlds. The US already has a massive defense budget, using a couple hundred million dollars for organs (maybe even less) is nothing for the US’ GDP.
Laughs in proper English In fairness I am a kidney transplant patient. I actually have both of my original kidneys still in my body although they didn’t properly form at birth. You also forgot to mention two things. The first is that a receiver can arrange to take a kidney directly from someone. So for example I received a transplant from my mum. You also didn’t mention that kidney patients are likely to need multiple transplants. My mother gave me her kidney aged 42, so the kidney in my body is now 58 given its been 16 years. In the UK at least they tend to ‘replace’ ageing kidneys, especially in younger patients like me when it begins to fail. Therefore I will need 2/3 more transplants in my life, so demand will be further increased by that.
Maybe there’s a middle ground in terms of incentivization; like Singapore which makes you an organ donor by default with an opt-out system–where you’re placed last for transplant priority if you aren’t a donor. Or a small income tax cut for being an organ donor. Cause tbh I’d rather have an innocent young poor girl get her transplant and live on instead of jackass Chad from some predatory stock trading company buying her out of the transplant so he can go on fucking over more people🤷♂️
What the fuck being able to earn more money than someone else and therefore outbid them is not a breakdown of capitalism, are you serious? You ALREADY said that people are motivated to produce what’s more scarce for monetary reasons, which can ONLY be to have more purchasing power. If there was a system whereby you paid percentages of your money rather than absolute amounts, there would be no reason to attempt to earn more, so the supply side would collapse, and that’s even ignoring things like being able to pay 99% of your money ad infinitum until you have a penny left.
Lab grown organs is having a lot of progress in recent years. It’s forecasted that in 30-40 years time some lab-made organs will be able to fully function safely inside a human. But it will likely take up to 75 years untill capacity can provide enough organs for people and also cover more organs. Future generations will be blessed with fewer risk and diseases and longer life-spans. Will be very interresting to see what future holds up for us, but sadly many of us wont live long enough to benefit it :p