Fun social engineering fact: countries that make organ donation (on death) opt-out instead of opt-in have much shorter waiting lists for organs. The USA could save thousands of lives by switching to opt-out.
Funnier social engineering fact: If it's legal for people sell their kidneys, wait lists for kidneys goes to zero[1]. Too bad only one country in the world does that.
Another fun fact. The US government spends more on dialysis than the budget for NASA.
From news sources I found, it looks like the system in Iran works exactly as one would expect: the poor and desperate end up with one less kidney while not significantly benefitting from the trade.
Which is precisely the reason such sales are outlawed worldwide.
Poor people need kidneys far more often than rich people.
Diabetes and uncontrolled high blood pressure are the top cause of kidney failure. These two conditions are far more common in the poor, and far more likely to be poorly managed.
Also if the price of a kidney relative to median income in the U.S. was similar to Iran, then a kidney would cost $15,000. This is expensive but still far cheaper than dialysis. And there is no reason an ACA plan or Medicaid wouldn't pay for it.
It is problematic yes, however so is most of medical care, poor don't get access to it as much as the rich do , whether it is countries or people.
Sadly, economics dictate a lot of people's health is going to be like. Living/Work conditions lifestyle, diet are all influenced by wealth.
Poor people work most of the dirty and unhealthy jobs that significantly cut short life spans. Wealth and lifespans are known to be strongly correlated.
As countries we are perfectly comfortable reserving vaccines blocking poor countries with patents, polluting a lot more or exploiting their labor in terrible conditions we wouldn't tolerate. Compared to what we are willing to accept already this doesn't seem worse.
If a commercial system could save more lives(probably more likely rich) it is not that much worse for poor than it already is.
Yep. I have type 1 diabetes for 27 years, and so far, no complications.
I recently contracted a shiga toxin producing E. coli strain which was cultured from my bowels. I also cultured entericocci (ETEC) but that’s not relevant to the discussion. I am lucky Shiga toxin E. coli (remember this famous Jack In The Box Breakout, FTW https://en.m.wikipedia.org/wiki/1993_Jack_in_the_Box_E._coli... ) did not affect my kidneys.
I am a dual US|European Union (Croatian) national. Croatia has one of the highest (ethical) transplant rates in the world. Let it be known that I would get it in Croatia over the USA.
I learned today that one can be a living heart donor. There is a special type of donation where a person who needs lungs gets a lungs+heart donation from a deceased donor, while the living person's healthy heart is transplanted to another person whose heart needs to be replaced. It seems this has advantages both for the lung recipient and the heart-only recipient and allows for compatibility in cases where the lungs and heart of the deceased person will not work separately for the two recipients.
Sure, but "dead" is a Humpty Dumpty word. Some organs need the donor to be legally but not colloquially dead. In other words, you are dead and your heart is still beating.
can you share a link, I'd like to learn more about this "organ shelf life". Very fascinating. Maybe I was mistakenly applying the sudden death of the brain without blood perfusion to hold likewise for every other organ. Like a heart attack when blood ceases to flow into it turns the myocardium to scar tissue. But that must not be an instant process, probably takes some time. I know temperature can keep tissues viable longer too, so that's another variable to consider.
For the brain it's pretty damn quick (minutes before significant damage). heart transplants rely on being able to run an artificial heart and lung machine to oxygenate and pump the blood while the heart is stopped, removed, and replaced.
Where I am being on an organ donor list also makes you eligible to be used as a cadaver. I’m not comfortable being prodded by med students but would give an organ.
Considering that some people have been revived without side effects after multiple hours of being brain-dead (e.g. famous example of women who drowned in icy water), how 'dead' is 'dead', in the context of being an organ donor?
I've heard it said that "you're not dead until you're warm and dead", but 6-12 hours doesn't seem like a lot of time, to make sure you're not coming back.
e.g., I drown in an icy pond, and I'm found after 5 hours. I might be revived, I might not...but the heart only has an hour before it's toast.
Clinical Death != brain dead, Clinical death has a very well defined and nearly irreversible process [1].
The longest human is known to be revived is only in the range 10-15 minutes. Brain damage is quite likely at this point. The longest for an animal is for cat - 1 Hour.
Only clinically dead people are eligible for organ transplantation
That's what I'm concerned about. Clinical death is apparently survivable.
> Reduced body temperature, or therapeutic hypothermia, during clinical death slows the rate of injury accumulation, and extends the time period during which clinical death can be survived. The decrease in the rate of injury can be approximated by the Q10 rule, which states that the rate of biochemical reactions decreases by a factor of two for every 10 °C reduction in temperature. As a result, humans can sometimes survive periods of clinical death exceeding one hour at temperatures below 20 °C.[20] The prognosis is improved if clinical death is caused by hypothermia rather than occurring prior to it; in 1999, 29-year-old Swedish woman Anna Bågenholm spent 80 minutes trapped in ice and survived with a near full recovery from a 13.7 °C core body temperature. It is said in emergency medicine that "nobody is dead until they are warm and dead."[21] In animal studies, up to three hours of clinical death can be survived at temperatures near 0 °C.[22][23]
I'd rather not be harvested too quickly, when I could have been revived without issue.
No doctor/hospital is going to harvest organs unless the person is warm and dead and all reasonable means of revival have been already tried.
Also even if revied would you even want to ? While anna as an exception didn't suffer from brain damage , it is likely, and even she had long term issues with nerve function paralysis etc.
Anna and other similar cases are a extreme rarity. policy shouldn't be made basis a one in a million chance, that's why we have vaccines enforced for example.
You can always opt-out or not opt-in depending in on jurisdiction I am sure.
There are plenty of people who opt for cryogenic storage after they die in the hope technology will evolve to revive them. That's natural step to this argument in a way , what if I could be revived some day even if not today ?
Ultimately handling life and death are intensely personal choices.
> No doctor/hospital is going to harvest organs unless the person is warm and dead
Well, that's the thing. "warm and dead" is above and beyond the criteria you referenced earlier, "clinical death". I'd hope you're right, but I'm not convinced you are. It doesn't seem like it from what I've seen.
And, the cooling factor in brain damage prevention is becoming more widely known these days. Anna wasn't just a fluke.
https://en.wikipedia.org/wiki/Organ_donation#Opt-in_versus_o...