Sure, they'd be willing to sell to the uninsured, but could the uninsured afford it? And more so, could they afford the surgery that goes with it?
Something else that has to be considered is malpractice suits. How many hundreds of suits do you think will come from angry organ buyers when their bodies reject their organs or they fail somehow? Doctors will inevitably bear the brunt of the the backlash, not the sellers. Doctors might refuse to perform transplants, or only do so with extremely worded medical liability waivers, ones that some might not want to sign. This endangers the entire system of organ donation and transplant currently at work in the country.
If organ sale was legal, the technology involved in transplants would improve, and more doctors would specialize in transplants. Also, one could offer a warranty with the sale of the organ so that it would be replaced if the body rejected it.
quote:Originally posted by Ophelia: Perhaps we should be trying to increase the availability of insurance, as opposed to decreasing the availability of organs.
I don't know how to make that happen, but a decrease in organ donors is not a part of the solution.
That sounds like a good solution to me. I could get behind that plan.
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What do you have to back that up with? Doctors have been doing transplants for decades, and a fairly high volume of them around the world. I don't see an influx of organs for sale really improving the technology (it's more procedural than it is technological) behind it.
Warranties? Who is going to insure the warranty? Heck, back that up, who will OFFER the warranty? The seller? That's impossible, unless you're talking about a corporation with a giant list of sellers matching them up to a giant list of buyers, and if one happens to fail, then that corporation will insure it and buy a replacement from another seller.
No corporation would sign on to that, it's a crapshoot on whether or not they'd end up buying more organs than they sell.
Furthermore, it devolves into Organ Ebay.
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posted
There would be organ brokers who would be capable of backing up the warranties. Who insures the warranty when you buy a big screen tv from Best Buy?
posted
Either Best Buy, if you purchase the warranty separately, or the manufacturer.
But in both cases, Best Buy and the manufacturer know what it is they are selling and can decide whether or not it is cost effective to offer a warranty on the item. Why do you think Toyota offers a TEN year warranty and Ford only offers a three year warranty? They know their product. An organ broker has no idea if the organs they are selling will actually work out or not, making a warranty a gamble.
The only thing I could see working is that an organ broker would have to be one stop shopping. They'd have to have on staff doctors to perform the surgeries, evaluate the seller and the buyer, be totally liable for the whole thing to absolve the doctor himself from any lawsuit, and then perform the surgery. It would be incredibly expensive, and very risky.
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Does a person have a right to abuse their body (let's say, jam a knife randomly into their leg)?
Does society have an obligation to help someone who has chosen to jam a knife into their leg?
Does it have less of an obligation if the person chooses to do something than if it occurs by accident?
(This is related to the warranty question; if someone knows the risks and chooses to go through with them, is society obligated to catch them if it turns out they made a bad decision?)
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Mandy asked this and no one answered, and I'd really like an answer as well.
When I told my mom I was an organ donor she got upset, because she said that if I was ever in an emergency situation no one would try as hard to save me, since they would know that if I died they'd get my organs. Is that true?
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to answer the unrelated question.... Yes, yes, no. Doctors attempt to revive suicide patients all the time.
I am insured but I am not rich by any stretch of the imagination. I worked hard to get the job I have which offers the insurance. I know many rich people who work hard for what they have as well and are just as "deserving" as anyone else, insured or not, rich or not, nice or not. I agree that anyone who needs an organ should be on the organ list. I thought that was the case. I am dismayed to hear it is not, but that is not going to make me take my name off the list to be a donor. Just because the list leaves people off doesn't mean I should let people die. Many people on the list die before they can ever receive the organ they need. Taking away my donation will only hurt those on the list. It won't change a faulty system.
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I have to hope that doctors would still try just as hard to save me. But then I think if I were a doctor and drunk guy came in after causing a car wreck that killed a family or something, I would seriously have the urge to let him die rather than save him. Maybe that is why I am not a doctor.
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blacwolve, no it is not true. I did a chaplaincy internship at a major hosptial, where the chaplain on call was part of the trauma team. And was part of the team that talked to families about organ donation. The medical people working to save folks coming into the ER didn't know whether or not they were organ donors. And even if they found out -- what would be their incentive? The ER doctors want their department to look good, and to be the best it can be, which means a higher percentage of patients saved. Not a higher number of organ donors.
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quote:Originally posted by blacwolve: Mandy asked this and no one answered, and I'd really like an answer as well.
When I told my mom I was an organ donor she got upset, because she said that if I was ever in an emergency situation no one would try as hard to save me, since they would know that if I died they'd get my organs. Is that true?
If you ask my father and a few of my professors, yes. Which is one of the reasons I am not an organ donor.
quote:When I told my mom I was an organ donor she got upset, because she said that if I was ever in an emergency situation no one would try as hard to save me, since they would know that if I died they'd get my organs. Is that true?
Absolutely.
Theft of organs would potentially be a huge problem initially if organs become sellable. Can you imagine people murdering other people to take their organs? Mmmm...organ farming. The crime would inevitably drop again as supply overshot demand, I suppose. And the whole problem could be avoided if we improve DNA fingerprinting to the point of cost-effectiveness - at the cost of the privacy of our genetic material.
Also, the rich can already buy organs - a few million donated to the right people, and watch how far up the recipient list you move. Everything's for sale in America.
With all that said, I absolutely believe we should have the right to sell our organs. There need not be anything "fair" about it.
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posted
You have the moral right to self-determination, and therefore the right to sell your organs to anyone you wish. I would love to sell half my liver so I could get drunker cheaper on better booze, but there is not enough money in the world to make me prolong the life of a policeman or politician. As far as rich versus poor, f*ck the poor. I am poor myself, I still have to pay for other, lazier jerk-offs, and I have no desire to let them live longer than they already do on my hard-earned cash. It is not as if I would be giving away my organs for free to anyone but close friends. Maybe organ donation is not a risk in the ER, maybe it is, but the way I see things it cannot help and might hurt.
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I am absolutely appalled that some of you think that doctors wouldn't fight as hard for an organ donor. What, you think they fight harder for random persons they never met rather than the person lying right there in front of them? Hogwash.
And dkw is right, none of the doctors know who is an organ donor and who is not. Usually that discussion takes place when things are already going down the tubes, and it isn't usually the doctor who brings it up. Support staff or special teams of people are the ones that do that. Unless the patient's family brings it up to the doctor, in hopes that the organs will be useful if things keep going downhill. And I've had several patient families bring it up. And surgeons and ERs like to keep their survival rates up, most definitely. Those numbers get looked at.
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quote:I am absolutely appalled that some of you think that doctors wouldn't fight as hard for an organ donor. What, you think they fight harder for random persons they never met rather than the person lying right there in front of them? Hogwash.
I think you're under the mistaken impression that all doctors are moral and/or are in medicine to help people, when in reality many doctors are in medicine purely for the money, status and/or power, all of which are motives highly succeptible to external influence.
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quote:Did you read the rest of what she said? An what dkw said?
What do you think?
I have anecdotal evidence that what she said in the remainder of her post is not always true. Would you like to start an anecdotal argument? Well, my uncle's a trauma surgeon and he is routinely exposed to that information. Oh yeah? Well, my grandfather's the chief of medicine at Brand X Hospital in Nowhere, California and he says it's against policy! And yada yada yada...
But by all means, continue rolling your eyes. I'll roll mine right back.
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posted
But even if they are in it for the money/status, the doctor in the ER isn't the transplant surgeon. Even if s/he does have a patient who is waiting for a transplant, what are the chances that someone they are treating will match their particular patient? Organs go to the person on the list who needs it the most and is the best match, right? So why would the doctor treating a patient care more about getting an organ for someone else's patient than keeping their own survival statistics up. Even if you go based purely on self-interest on the doctor's part, that doesn't make sense.
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ElJay, it doesn't matter who does the transplant if the doctor doing the operating is the one receiving the money/incentives for neglecting a patient with a high-demand organ.
Given the sheer number of patients treated by an ER surgeon, will one or two deaths dramatically affect their standing in the hospital?
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Who exactly is an ER doctor going to get money FROM? And it isn't ever going to give him any power or any status to have patients die, whether they go to transplant or not.
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I'm very unclear on that as well. Your original post said "Absolutely" to if someone was currently likely to receive sub-par treatment if they were an organ donar. Do you think there is currently an incentive program in place for doctors who's patients die and donate their organs?
Edit: 'cause the quote made me see my typo. :blush:
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Let's say you're a well-connected, multi-millionaire whose child is going to need a heart transplant - and soon.
Let's arbitrarily say he's #125 on the list for a heart matched to his.
The multi-millionaire loves her son. She's willing to pay 10 million dollars if it means her son will live.
Enter well-connected person in the medical field. Well-connected person says sure, we can move your son up that list...for 15 million. Multi-millionaire mother says okay.
Well-connected medical man takes 14 of that 15 million and bribes the right people. Now corrupt doctors all over the nation are aware that if they happen to have someone in their hands who is about to die, there might be a nice chunk of change in it for them to simply look the other way.
As far as power goes - I'm not talking about power in the form of social standing. I'm talking about doctors with a God complex: the pathological hack'n'slash jockies who love that they routinely hold people's lives in their hands. That kind of power.
Posts: 4313 | Registered: Sep 2004
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quote:I'm very unclear on that as well. Your original post said "Absolutely" to if someone was currently likely to receive sub-par treatment if they were an oprgan donar. Do you think there is currently an incentive program in place for doctors who's patients die and donate their organs?
I didn't mean to imply that every patient - or even the majority of patients - are at risk of being mistreated by their doctors if they're organ donors, but I absolutely believe that there ARE patients who are under-treated because they're organ donors.
And yes, I believe there is an incentive system in place.
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Cute. If you stopped and thought about it for more than 5 seconds, you'd realize that far more complex systems are in place for all sorts of organizations and networks. Go google "child pornography" and read some exposes on how incredibly complex their networks are, for starters.
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posted
So are you saying that doctors would be willing to neglect their duty of care for an organ donor, but not willing to take the organ without a signed donor card?
I mean, with that much cash involved, surely it's not too difficult to bribe the pathologist doing the autopsy not to report the missing organ.
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quote:So are you saying that doctors would be willing to neglect their duty of care for an organ donor, but not willing to take the organ without a signed donor card?
I mean, with that much cash involved, surely it's not too difficult to bribe the pathologist doing the autopsy not to report the missing organ.
Certainly a possibility, although I think the potential for getting caught increases as you leave behind that kind of evidence.
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posted
I did think about it. For more than five seconds, even. And I know there are corrupt people in the world, and I wouldn't even argue with you that maybe some people get themselves or their loved ones moved up on the donor list through bribes or well-placed donations.
But I think the number of multi-millionaires in the country is pretty small, and the number of them with a kid who needs a heart transplant is even smaller. Statistically, I don't think there are enough of them around for there to be a wide network of corrupt doctors just waiting to get the word from some shadowy source to know what kind of person with what kind of available organ to watch for. Plus, it's not like there is one doctor working all alone. In a hospital, there are going to be nurses around, who are going to expect the doctor to be working to save the patient's life, and kinda curious if full measures aren't taken.
I also believe that the vast majority of doctors at least got into the field because they wanted to help people. Our shadowy network has to recruit it's doctors somehow, you know? I think the chances of them approaching the wrong person sometime and that person being absolutely appalled and saying something to a member of the press, or even a family member or friend who says something to a member of the press, is pretty damn likely.
Yes, I'm a bit of an idealist, but that is tempered with a strong streak of realist. And you just seem to be incredibly cynical. I'm frankly glad I live in my world, not yours.
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I suppose it COULD happen to someone, somewhere in America. But real life is complicated. So many doctors, so many medical people are involved in a transplant, it would be so difficult to get this done. Not to mention the risk. And has anyone been caught doing this yet? (Eljay said this much better!)
Yes, ph, you should definetely not let anyone have chance to live thanks to the use of your organs on the off chance that you'll meet up with a Godlike doctor who happens to be murderer. I hope you feel safer this way.
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quote:But I think the number of multi-millionaires in the country is pretty small, and the number of them with a kid who needs a heart transplant is even smaller. Statistically, I don't think there are enough of them around for there to be a wide network of corrupt doctors just waiting to get the word from some shadowy source to know what kind of person with what kind of available organ to watch for. Plus, it's not like there is one doctor working all alone. In a hospital, there are going to be nurses around, who are going to expect the doctor to be working to save the patient's life, and kinda curious if full measures aren't taken.
Personally, I encounter the same hypothetical questions, but I have the same hypothetical questions about all kinds of major crime networks: child pornographers, drug traffickers, importers of illegal products, recruiters for the KKK, international spy & espionage networks, etc. How do ANY of them establish the kinds of contacts they do without running into someone who will blow the whistle?
Who knows - but they do, somehow. Sometimes they get caught. Sometimes corrupt doctors do, too.
quote:Yes, I'm a bit of an idealist, but that is tempered with a strong streak of realist. And you just seem to be incredibly cynical. I'm frankly glad I live in my world, not yours.
Fair enough. I'm glad I live in mine, and I don't think yours actually exists.
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quote:Certainly a possibility, although I think the potential for getting caught increases as you leave behind that kind of evidence.
The involvement of one additional person will change how often this is attempted? Especially given what Theaca said but is really self-evident:
quote:I suppose it COULD happen to someone, somewhere in America. But real life is complicated. So many doctors, so many medical people are involved in a transplant, it would be so difficult to get this done. Not to mention the risk. And has anyone been caught doing this yet? (Eljay said this much better!)
quote:The involvement of one additional person will change how often this is attempted?
I wasn't talking about the risk inherent in adding another person to a network that would already have to contain many people. I was talking about the implicit physical evidence left behind when removing organs from a person who is not designated as an organ donor: the scars, the empty spaces where there should be organs - or the falsified paperwork showing the person IS an organ donor.
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posted
Compared to the falsified papers needed to move someone up on the list, the possible record left in the charts of the person denied proper care?
You're stating that it's more likely that a doctor would kill someone than take an organ from a dead person. I find that pretty unlikely either would happen, but I'm not sure how you arrive at the conclusion that the former is more likely than the latter.
Posts: 26071 | Registered: Oct 2003
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quote:Compared to the falsified papers needed to move someone up on the list, the possible record left in the charts of the person denied proper care?
The falsified papers would need to exist whether the victims were organ donors or not.
And yes, I think the record is less dangerous than falsifying papers. In one instance you have the possibility of information being left off of a chart - that's assuming, of course, that the doctor was actually modifying a documented course of treatment in order to kill the patient, as opposed to simply not trying during an operation or purposely mishandling a drug.
quote:You're stating that it's more likely that a doctor would kill someone than take an organ from a dead person.
No, I'm saying it's more likely that a doctor would kill someone and take their organs with permission than kill someone and take their organs without permission.
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quote:Originally posted by erosomniac: And yes, I believe there is an incentive system in place.
Do you believe this due to anecdotal evidence, someone telling you there is, or just that's how you believe the world works? I'm just curious.
--------
Also, in your scenario, what happens if the corrupt doctor lets a patient die and they end up not being a match for the millionaire's son? Do they still get a smaller payoff, to compensate for the risk they took in the attempt? Or are they SOL and have to hope another likely canidate comes along before some other unethical doctor hits the jackpot?
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quote:Do you believe this due to anecdotal evidence, someone telling you there is, or just that's how you believe the world works? I'm just curious.
Both.
quote:Also, in your scenario, what happens if the corrupt doctor lets a patient die and they end up not being a match for the millionaire's son? Do they still get a smaller payoff, to compensate for the risk they took in the attempt? Or are they SOL and have to hope another likely canidate comes along before some other unethical doctor hits the jackpot?
Presumably, the information on blood typing, tissue matching and whatever other details are necessary to ensure a match would be available to the doctors under the "employ" of an organ brokering agency. I don't know how much of that information is readily available to a doctor about possible victims as they become available.
If they messed up, I have absolutely no idea what would happen. I'd imagine the compensation chart looks very similar to that of a salesman who works on comission: if the organ is sold, they get paid. If it isn't, they don't.
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posted
Actually, I was asking because I was hoping some of the medical professionals on board could refute it, and I could use that to calm my mother's fears.
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posted
Theaca said pretty strongly that she doesn't believe it happens. She's pretty much the only doctor posting regularly on Hatrack these days, CT isn't around much.
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posted
Certainly Theaca's and dkw's posts ought to assauge any fears that it's a systemic occurence and that there's no real likelihood of being an organ donor reducing your chance of receiving the best possible care.
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quote:Either Best Buy, if you purchase the warranty separately, or the manufacturer.
Precisely. So it would be possible to purchase a warranty on organs from the organ broker who sold them to you.
-pH
That's just silly. The broker is skimming a fee form the seller and the buyer off each transaction, that's how he makes his money. He certainly isn't going to risk all that just to offer a warranty. It'll be the industry standard NOT to offer a warranty, then no one has to bother with it. Likewise, there's no insurance provider in America that would insure that kind of sale.
The price of healthcare in America would skyrocket if they had to.
Posts: 21898 | Registered: Nov 2004
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posted
I know, but you're ignoring the biggest problem with that. Those retailers have the benefit of knowing the RELIABILITY of their product. They know that if they offer a warranty on a Aquos plasma tv, it will be good, because they know how EVERY plasma tv is made. They are all identical except for the one in a thousand that has a factory defect. They can accept that kind of risk.
But how can they afford to accept the risk when every transplant is different, there is no reliability, they have no idea if the donor is healthy enough or the organ is healthy enough or the recipiant is healthy enough, or if the doctor is good enough, or if it just plain old doesn't work, regardless of how well everything looked like it was going.
There's just way too much risk and unknown factors involved for them to make any sort of logical positive step towards a blanket warranty on all sales. They'd have to do it on a case by case basis, which I don't see happening either.
Patient 1:
"Everything looks great, we'd like to offer you a warranty."
Patient 2:
"Whoops, sorry, can't afford to take a risk on you with a warranty....but good luck anyway!"
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posted
How accurate are we right now at predicting the success of a transplant? Isn't it possible that the accuracy would improve if there was some further incentive?
posted
It is your contention then, that doctors will get better at performing transplants only if there is a massive financial incentive involved?
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