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Comment by casefields | Hacker News Reader

I refuse to be a donor. If they want me then make a real donation, say some money towards funeral expenses. I would sign up in a heartbeat.

And I've been plenty more altruistic when it comes to tissue donations. About 10 years ago I came up as a match to a stranger through the Be The Match Foundation. I went through the whole process and gave that lady bone marrow. So I'm not just a grubby meanie out for a buck. Everyone else in the chain is getting paid, there's no reason the donor should be left empty handed.

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> I refuse to be a donor. If they want me then make a real donation, say some money towards funeral expenses.

You refuse to save lives at literally no cost to yourself or anyone you know unless someone pays your family off?

> there's no reason the donor should be left empty handed

The donor is dead! Hands don't get any emptier!

> So I'm not just a grubby meanie out for a buck.

Ok, let's see...

Cost to you? 0.

Cost to your family? 0.

Benefit to others? You could save several lives.

Will only do it for? Money.

Yup, no conflict there.

This sentiment is understandable (and apparently popular), and I suppose GP deserved either a well-reasoned personal attack or a snarky reply... but I don't think it merits a snarky personal attack.

What if I'd split it into two separate replies?

  You refuse to save lives

S/he's already been a living bone marrow donor, presumably already saving a life at considerable risk to oneself (it's surgery for the donor). That's already enough to deserve immunity from snarky insults.

> That's already enough to deserve immunity from snarky insults.

No, I don't think it is. This is a refusal to do something that costs literally nothing purely out of spite. If anything, that negates the good will that might have been earned by the prior act.

"I helped someone once, but I'd like everyone else to just die even though it costs me _nothing_ to save them" is not an admirable stance.

If you want change, take action in a way that will matter. Withholding an organ donation in a way that will never be visible to the people at the relevant time isn't it.

So some poor sap who needs an organ is gonna get fucked because your "principled" stance against "the system" will keep you from donating?

You think they'd have a problem with your estate getting money? You think that marginal additional expense would cause them to be like "welp, better just die then."

I wouldn't oppose this "compensate the estate of the donor" idea at all, but to refuse to save lives as a result is insanity, especially because your refusal, and some posts about it on the internet, will amount to 0.

Hmm. What do you think about systems where you personally can't get those sort of organs (for yourself, from someone else) unless you opt into donation yourself? Would you find that adequate compensation, or would the possibility of not getting organs you need sway your decision?

As a fellow Be the Match donor, I don't understand your philosophy. As you know, going through the donation process is, aside from scheduling appts & actual donation, not that much work on your end. I spent probably 20 hrs total to donate and save someone's life. Most of that time was me lying in a bed to donate or having samples taken (with all costs covered by BTM). Compare that to the paid case manager or doctors//nurses that had to coordinate tons of resources to let me be able to donate. If anything, maybe you should reflect on why you were ok with that donation (and it being freely given) but you're not ok with doing even less as a tissue donor yet not being paid.

So why do you refuse to be a donor?

> Everyone else in the chain is getting paid

There's real money floating about at every step except for the one where they acquire the organ from the deceased's estate. It's a fair point.

The reason for that is to remove the financial incentive to donate any one specific organ, so that poor people don't end up as a one-kidney one-lung underclass.

Well, in this case, it would only be the dead poor, right? We're talking about donating organs after death.

Just as it's hard to justify not being willing to donate organs (because "you're dead, what do you care"), it's also hard to justify not paying those who do on the grounds that it's exploitative.

...at which point you've got the same perverse incentives as life insurance policies back before 'we don't pay out in the case of suicide' clauses.

Ah, that's a good point, and retrospectively obvious. I missed that.

The commenter I quoted specifically suggested money toward funeral expenses. That's the context: a recognition and respect of the value the body parts had to the owner rather than an assertion of entitlement. There isn't some weird perverse incentive in that that's going to carve out an underclass of organ growers.

If you're refusing to be a donor, would you also refuse to accept a transplant if you needed one? Seems only fair

Your argument might satisfy a peculiar revenge fetish, but in terms of policy, the whole public is only healthier if the WHOLE public is healthier -- even the people you think are wrong. No ifs, ands, buts, or whining about fairness. The recipient's status in the program should be of no interest and strictly private until death.

If only participants in the donor program could benefit from the donor program, then people who are ineligible to donate (like under age 18) would be unwilling sacrifices on your altar to Fairness. After all, what are they contributing?

Furthermore, if I'm in need of a vital transplant, there's likely enough systemic damage from the malfunctioning organ that the organs I've got are of questionable use as future transplants.

> Your argument might satisfy a peculiar revenge fetish

A "peculiar revenge fetish" is strong words considering your argument is so weak.

> the whole public is only healthier if the WHOLE public is healthier

In general I agree, but this is definitely not an issue with transplants. The demand far exceeds supply, so the question is how you sort the queue.

Of course, refusing to be a potential organ donor also affects the health of the WHOLE public. If you refuse to be a donor, the total number of organs available for transplant is reduced.

> people who are ineligible to donate (like under age 18)

Where did you get the idea that under 18s are not eligible to be donors?

I think everyone would agree, though, that under-18s' views would not make them ineligible as recipients.

> unwilling sacrifices on your altar to Fairness

If it's not them who are getting sacrificed on the Fairness altar, it is someone else who could be a recipient.

> Where did you get the idea that under 18s are not eligible to be donors?

Trolling, or did you just not RTFA?

https://www.organdonation.nhs.uk/helping-you-to-decide/about...

"Anyone can register a decision to become an organ donor after death, there is no age limit."

In most cases, the organ donor will be "empty handed" because they're already dead.

But nobody is forcing you to save lives at no cost to yourself (again, because you'll be dead) -- go ahead and opt out.

Seems reasonable to me. If organ donation is valuable enough to a society to justify infringing upon an individuals rights to collect those organs, then society can at least offer some level of compensation.

If a society no longer believes it requires the willing consent of the individual to engage in these kinds of actions.....well that opens up a few other problems.

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