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Comment by _jal | Hacker News Reader

I support "motivated opt-in": your choice, but if you don't opt-in, you're at the end of the line for any organ needs you may find yourself with.

It tends to align nicely with ethical and religious objections as well as moral intuitions, and should expand supply while signaling proper expectations to the demand side, without simply allowing the rich to buy their way to the front of the line.

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In that case, I support "unmotivated opt-out". If you opt-out, you don't get an organ if you need one.

That's not right. If there's an organ available and a recipient in need, it should be used rather than wasted. Regardless of the recipient's donor status. But donor status can be used as a tie-breaker.

My comment was meant to be absurd, as a counter-argument. Nearly every argument against opt-out can be turned back against itself in this way.

To be clear, I wasn't arguing against the British out-out approach; it seems mostly OK, too, and it is silly to make the perfect the enemy of the good.

There are different colors to different approaches, and they're going to have varying degrees of success in different cultures.

Keep in mind that for many kinds of organ transplants, you will know in advance that you have a good chance of needing one, without actually needing it yet.

Sure. Although it isn't ideal, selfish late-joiners still expand the pool and should be welcome. It isn't about punishing people, it is about matching needers with havers without just selling them to the highest bidder.

Selfish late-joiners will just notify their next of kin to refuse the donation anyway. They get the queue-jump bonus of being on the register and still opt out privately.

I was on the donor register since I turned 18 but my parents or wife can just refuse if that suits them on the day (although I've asked them not to!)

That sounds like a terrible policy in it's own right. Especially the part about the parents - why should they have any say in it at all after you've turned 18.

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