
Organ donation in England has moved to an opt-out system - new_guy
https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-in-england
======
BlackVanilla
Regardless of what you think about the decision, the communication here has
been poor. As of posting, there is no information on BBC News's front page,
the UK's main source of news, as to this rule change or how to opt-out. [1]
Likewise, on the UK Government's website's homepage, there is no information
on this or information on how to opt-out. [2]

I haven't come across a friend or family member who knows this is happening
today.

Regardless of your view on this, the communication has been poor. It was
publicised when Wales moved to opt-out organ donation.

[1] [https://www.bbc.co.uk/news](https://www.bbc.co.uk/news) [2]
[https://www.gov.uk/](https://www.gov.uk/)

~~~
jonny_eh
In this case, the poor communication should result in more lives being saved.

~~~
cameronbrown
Are you kidding me? People should have the right to make an informed choice,
however they feel about it.

~~~
wmichelin
What possible incentive could there be to hoard your organs after death?

~~~
JoshTriplett
Several:

First, there are documented studies showing that known organ donors have a
slightly lower survival rate in hospitals than non-donors do. Draw what
conclusions from that you will, but some people choose not to be a donor for
precisely that reason.

And second, if you have any plans or hopes for cryogenic preservation, that's
not particularly compatible with organ donation.

~~~
Traster
Also, just on a human level, people don't want to be chopped up and parcelled
out as used parts for other people. I don't feel that way, but I understand
how people can feel that way and we should respect their wishes.

~~~
crooked-v
...in which case it's easy to opt out, for the people who do feel that way.

~~~
stevenwliao
But they can't if they don't know it's opt-out, which is why thread OP argues
that BBC should announce this.

------
Barrin92
This is a great decision. There's been a lot more interest in behavioural
economics over the recent years and I remember reading one of Dan Ariety's
books about this.

The key thing that increases the rate of organ donations dramatically (from
30% to almost unviversal between opt-in and opt-out) is that there's a very
significant cost to choice. The more choices people have to make, even if they
arrive at desired outcomes, hugely diminishes the chance that they do.

~~~
mft_
While I totally support the opt-out approach (or indeed, no option to opt out)
I wonder if we need a new term - as it doesn’t seem like a ‘donation’.
‘Donation’ implies gift, and also an element of conscious choice, both of
which mightn’t apply any more.

~~~
casefields
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.

~~~
ebg13
> _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.

~~~
srl
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.

~~~
ebg13
What if I'd split it into two separate replies?

------
chanmad29
"Your family will still be approached and your faith, beliefs and culture will
continue to be respected."

This seems to be a good move that could help a ton of people in need, while
also giving enough wiggle room to families to deny the donation.

------
_jal
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.

~~~
balfirevic
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.

~~~
_jal
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.

~~~
Spare_account
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!)

~~~
balfirevic
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.

------
ray991
The opt-out form [0] asks only for the name, phone number, DOB, address,
email, etc. How do they ensure that someone else did not opt-out or opt-in on
someone else’s behalf without their permission? And how are they deduplicating
people with the same name and DOB? By a fuzzy match against their address? How
do these things usually work in UK?

[0]: [https://www.organdonation.nhs.uk/register-your-
decision/refu...](https://www.organdonation.nhs.uk/register-your-
decision/refuse-to-donate/refuse-donation-form/)?

~~~
SXX
It's just a guess for this exact case, but UK government do have some access
to credit history and this usually mean name plus dob plus address. And it's
can use electoral roll databases for actual citizens.

------
A4ET8a8uTh0
Eh, I guess here comes an unpopular opinion. While the pragmatist in me is
well aware of how opt-in increases donations ( although at certain point the
question has to be asked whether if they coerced through law, is donation the
right term for that ), I instinctively dislike government imposition here.

I do not believe ends justifies the means. And as always, eventually, while
the option might be technically available, just like the TSA opt out, you will
be basically shamed into compliance.

~~~
ken
That's a weird analogy. TSA "opt out" is basically impossible. Have you ever
tried it? It's not shame. The agents simply don't allow you to. Changing your
organ donation status is not just possible, but easy.

In the organ donation case, who do you think would "shame you into
compliance"? How would anyone else even know? I don't know the organ donation
status of anyone else in the world, even my family and close friends, and even
those who have died.

~~~
jkaplowitz
Yes, every time I've opted out with TSA (which I do most of the times I'm
required to go through the full-body scanners in the US rather than the TSA
Pre metal detector) I've been allowed to do so. It's often meant a long wait
for an agent to become available, but I've never been refused.

I admit to being a white male US citizen who politely requests it using the
words "I'd like to opt out" (rather than some vaguer objection) and then waits
patiently, not someone who gets angry at the officers. The ground rules aren't
the fault of the workers, only any individual bad behavior.

------
mathieuh
England is not the UK.

~~~
techsupporter
And it's for long-term (more than one year) residents of England, not just
citizens.

The headline should read something like "As of today, all residents of England
are organ donors unless they opt out" or "Organ donation law in England has
changed to opt-out model."

~~~
mathieuh
Yeah, @dang what do you think, I live in NI and when I saw this I was
surprised, but nope, it’s just someone conflating England and the UK.

Health is devolved to the contituent countries here.

~~~
rwbhn
Current title of the linked article: "Organ donation law in England has
changed".

------
airstrike
As interesting as this is, this seems very political and therefore not really
HN material, as you can tell by how quickly the comments have turned to shit

~~~
scollet
This is a government source, right? I think if it was from an inflammatory
source this comment would be a little appropriate.

Regardless, everything is political, if even by its context alone, tech
especially.

~~~
airstrike
Source doesn't matter. It's not HN material

------
prennert
England != UK

(I don't know what the law in Scotland, Wales and Northern Ireland is, might
be that England is just the last of UKs nations to make opt-out standard)

~~~
Silhouette
Opt-out is the position in Wales already.

Scotland is working on it but as far as I'm aware it hasn't completed the
required legislative process yet.

NI is still opt-in.

~~~
edh649
Apparently it became law in Scotland in July 2019, and will become opt-out in
Scotland in March 2021

[https://www.organdonation.nhs.uk/uk-laws/organ-donation-
law-...](https://www.organdonation.nhs.uk/uk-laws/organ-donation-law-in-
scotland/)

~~~
Silhouette
Thanks. That does say it received Royal Assent, so the legislative process has
indeed finished now, the relevant preovisions just haven't come into effect
yet.

------
afarrell
Yay! One less piece of life-administrivia to procrastinate on.

------
ap77
First, the lack of a public vote on this issue is troubling.

Second, it's inappropriate for a state agency to make such personal decisions
on behalf of people without asking. Choice matters, and it's each individual's
choice to make.

Finally, was this even necessary? Why not simply ask the family at the time of
death? If there's no surviving family, THEN the state decides. Last, not
first.

~~~
Fnoord
> First, the lack of a public vote on this issue is troubling.

Not like every law in the UK gets some kind of referendum first. There are
tons of laws which have been introduced which affect me, where I did not get a
vote at. That's a problem with our democratic systems, and how the ruler's of
one country affect the lives of others (e.g. via threat of war,
diseases/epidemics, economy, and so on and so forth).

------
stuartd
I’m an opt-in donor, always have been. And I think this change is good, albeit
poorly communicated.

Some ammunition for those who disagree - organlegging!

[http://www.technovelgy.com/ct/content.asp?Bnum=337](http://www.technovelgy.com/ct/content.asp?Bnum=337)

~~~
Traster
I'm also an opt-in donor. I would've been in favour of postponing this change
by a year. It was impossible to communicate this to the public effectively in
the middle of a crisis, and whilst I think people should be donors and agree
with it being opt-in, I think it's pretty shifty to do it at a time where it's
very likely people aren't going to be able to make an informed decision.

------
zeristor
“Mr Cohen? We’ve come for your liver” - Monty Python: The Meaning of Life

[https://youtube.com/watch?v=Sp-pU8TFsg0](https://youtube.com/watch?v=Sp-
pU8TFsg0)

------
vinni2
What I don’t understand is while they can make everyone organ donors by
default, blood donation is still restricted for men having sex with men (with
temporary restrictions to blanket ban in many countries). I have heard of
blood banks refusing to take blood from gay men (including doctors) who
abstained for whatever restrictions they have. If they test the blood before
transfusion I don’t understand the need to discriminate.

~~~
jcrawfordor
Blood for transfusion is screened principally using antibody tests. These
tests can be negative for up to two months for an HIV-infected person and even
longer in the case of Hep-C (retest at six months recommended to rule in/out).
So, while the antibody tests used today have a very low false-negative rate,
there remains a concern around people who may have contracted a blood-borne
disease in the the last few months.

As a gay man, I was for some time frustrated with donor exclusion policies
related to MSM. However, keep in mind - blood donation is not any benefit to
the donor, but rather to the recipient. It is in the best interest of the
recipient for blood banks to obtain blood with the lowest risk of infection.
For this reason, blood banks exclude a wide variety of donors with elevated
risks of various infectious disease (MSM, IV drug user, in the UK in a certain
time period, deployed overseas by military, etc depending on the
organization). The number of people not excluded by these policies is normally
sufficient to meet need, so it makes perfect sense for the blood banks to
stick to a policy designed "out of an excess of caution" to avoid blood with
higher risk of infectious disease.

Because of improved accuracy and affordability of antibody testing, the
exclusion period for MSM was reduced to 12 months (from lifetime). Because of
an abnormal blood shortage related to COVID-19, FDA has temporarily reduced
the exclusion for MSM and individuals with tattoos/piercings to 3 months. 3
months is actually cutting it somewhat close as far as reliable detection of
antibodies, so the period will likely be increased again post-crisis to
maintain a wide margin of safety.

Organs are evaluated for suitability based on guidelines that are similar to,
and often stricter than, blood donation.

~~~
vinni2
The 3 months or 12 months deferral in reality is useless. As I said there are
many documented instances where people abstained for 3 months and the blood
banks still turned them down and Gay people with coronavirus antibodies are
not eligible to donate too [0]. In [0] they also make good arguments on why
the ban should be lifted. And people like me who are monogamous gay
relationship feel discriminated and who expects not to have sex with their
spouse for 3 months?

[0]
[https://m.youtube.com/watch?v=DLtpWaIzQ8U](https://m.youtube.com/watch?v=DLtpWaIzQ8U)

------
tonycoco
This might be the world's worst "unsubscribe" button ever.

------
davidw
No one has posted this yet? Feels kind of necessary...

[https://www.youtube.com/watch?v=Sp-
pU8TFsg0](https://www.youtube.com/watch?v=Sp-pU8TFsg0)

------
caseysoftware
That means when you die, you drop loot.

\- not my joke, forgot where I saw it

~~~
al_chemist
Increased loot rate usually increases farming.

------
cmdshiftf4
The mental gymnastics statists perform to justify the actions of their beloved
state never fails to amaze.

~~~
ayaa
It is indeed sad that we live in an age with barely any humanistic ideals.
Everything is utilitarian, people belong to the wealthy and the ruling
classes, swallow the manufactured consent and believe the propaganda that they
are free.

Actual personhood is for the 1%, it would be instructive to know how many of
them opt out in the UK.

Then again, the geriatric ruling class who think that they possess other
people's bodies can safely do nothing: _Their_ organs are not fit to be
harvested anyway.

------
Markoff
in those few countries with opt-out system I'm familiar with, they still ask
for family's approval regardless opt-out system and can't imagine anyone would
disrespect wish of family despite the law

so in the end the difference is just in theory and law

------
LargoLasskhyfv
IMO this is an institutionalised form of cannibalism, and while it may help
some people in need of an organ donation, setting the wrong incentive.

By that i mean relieving of the pressure to develop truly compatible
artificial replacement parts, no matter if they are "grown" on some substrate,
or completely mechanical, not having to take immunosupressors afterwards, and
so on.

Crude & Backwards.

~~~
dennis_jeeves
Fully agree. It's one of those things which will have terrible unintended
consequences, even if the supposed intent is good. It sure will be a boost to
the organ trade.

------
11thEarlOfMar
Since when is it Ok to exploit the uninformed?

------
yndoendo
Libertarian paternalism. Where the default is set to be the most beneficial.
Another example is you get a raise at work and instead of going into your
pocket by default goes into your retirement. You still have the ability to
change it. Nudge by Thaler and Sunstein talk about this and so does Daniel
Kahneman in Thinking, Fast and Slow.

This mentality has actually helped other countries save more lives by default.
While each person still retains the power to opt-out. And yes other countries
have done this before the UK. US should do this too!

~~~
mathieuh
How are those two things in any way the same?

~~~
crooked-v
They make the default behavior something that benefits most people (everyone's
better off if old people have enough money to exit the job market gracefully,
for example), while still making it easy to act otherwise if someone
specifically wants to do so.

------
dntbnmpls
Think about what this means, your body by default belongs to the state. You
are born as state property, not an individual with bodily autonomy and rights.
You have to ask for that right.

This kind of sick mentality has crossed the atlantic into america with more
"liberals" demanding opt out. What's striking is that the "liberals" who
scream about consent are the same ones who want to take it away from
individuals. The same ones who scream "my body, my choice" are happy to take
that choice from individuals and give it to the state.

So this is no longer organ donation. It's organ confiscation/theft. Of course
the state media which rants about china's "organ theft" are all supportive of
this.

------
ManoSinkosika
that is a good step

------
exabrial
This is kinda jacked up

~~~
r00fus
Why?

~~~
exabrial
What happened to my body my choice?

------
coronadisaster
Do you have a better chance of surviving a big accident if you opt out?

~~~
crooked-v
Broadly speaking, the first responders and emergency room workers providing
emergency care neither know nor care about your organ donation preferences.
Transplant work is done by separate specialists who only come into the picture
after legal death.

~~~
coronadisaster
That would be an ideal situation but someone with large amounts of money might
be able to change the course of actions and big data probably could make this
easier. Let say they scan their blood type, etc, then type in the condition
and wait for an answer from the computer for further actions...

~~~
crooked-v
That would be either a criminal conspiracy to commit murder or an illegal
organ trafficking ring, and nothing about your hypothetical secret ultra-rich
criminal would be affected by default opt-in or opt-out organ donor status.

~~~
ladzoppelin
I know its scary but I think the above comments are correct. I thought the
removal of some organs need to be very close to TOD and the ER doctor would
need to know beforehand if the patient was able to be harvested for for said
organs. Is that correct, sorry if its not?

~~~
crooked-v
Any organ donation only comes into play after the declaration of legal death,
at which point the body gets handed off. The ER doctor only cares inasmuch as
it means that a different team than usual takes over on removing the body so
he can get a different living patient in to be treated.

------
bassman9000
I'm an organ donor. Opted in.

If living in England, would now opt out. The de-facto approach can't be your
organs belong to the NHS.

~~~
saberdancer
It's not uncommon in other countries. In reality, no one takes your organs
without strict approval from your family, but this kind of policy makes it
easier for them to get the approval as you did not need to opt in before your
death.

~~~
rootusrootus
If they have to get permission from your family anyway, then why bother with
asking the donor at all? Just always ask the family and be done with it.

~~~
crooked-v
The difference here is that they're now asking the family if they have
objections to the organs being donated, rather than asking the family if they
want to donate the organs. The latter results in fewer organs available even
though in logical terms it's the same question.

~~~
saberdancer
I'm not expert of the legalities, but is it legal to take your organs if you
did not opt in?

Can your family opt in after your death? I'd say it's a difficult question and
obviously made easier by making it opt out system. Anyone objecting has to opt
out so majority of people will stay default which improves organ donation
rates.

------
_threads
Is this RGPD compliant ?

------
TheRealPomax
Why is this on the front page of a tech news aggregator? Sure, everyone has an
opinion on this, but why _here_ instead of some subreddit? (and then making it
to reddit front page, which is topic-agnostic)

------
arthurcolle
How many people will die because their organs get preserved before they
actually die?

~~~
jjoonathan
Ooh, I know the answer to this one: zero.

~~~
ummonk
Meanwhile downthread we have this link where had the patient been slower to
recover she would have been killed by organ harvesting.
[https://www.cbsnews.com/news/hospital-errors-lead-to-dead-
pa...](https://www.cbsnews.com/news/hospital-errors-lead-to-dead-patient-
opening-eyes-during-organ-harvesting/)

~~~
crooked-v
That has nothing to do with opt-in or opt-out, just the incompetence of a
specific hospital. It's also an article from 2013.

~~~
read_if_gay_
It is related to opt out because now you have to opt out to avoid this. Also
not sure why you make it seem like 2013 is the middle ages or something.

~~~
crooked-v
> now you have to opt out to avoid this

There are many more things than organ removal done to dead bodies that would
still kill a mistaken-as-dead person extremely dead, just slightly later in
the process.

------
throwawaysea
Opt-outs are the new insidious way to impose the state/collectivist views on
the individual without permission. Opt outs are a problem because not everyone
may be aware of the need to opt out, and it requires additional attention and
effort. The default state, without requiring any additional action from an
individual, _must_ respect individual consent and bodily autonomy - which
means that no one has a right to your body or your property unless you've
granted it explicitly. An opt-out situation is not that, and it doesn't matter
even if a majority of constituents would prefer an opt-out model.

Moreover, the linked website's claim of universal religious support for organ
donation is very suspicious. It relies on opinionated interpretation of
religious texts and cherry picked quotes of support from random individuals
that they've propped up as authoritative representatives of religions, when
that is not really the case in reality. Religious ritualistic practices and
interpretations of texts vary and there will be many for whom this permissive
assumption of the state's right to an individual's organs will be a violation
of their beliefs.

------
amekp
More totalitarianism. People are treated like a mixture between children and
cattle.

[https://www.cbsnews.com/news/hospital-errors-lead-to-dead-
pa...](https://www.cbsnews.com/news/hospital-errors-lead-to-dead-patient-
opening-eyes-during-organ-harvesting/)

~~~
tobib
While this is a horrifying story, I'm having a hard time seeing the relevance
here. There is nothing in the article indicating that the errors were caused
by the family agreeing to organ donation.

~~~
ummonk
Had the family not agreed to organ donation, they wouldn’t have planned to
harvest the organs in the first place.

