
Self-driving cars will exacerbate organ shortages - prostoalex
http://www.slate.com/articles/technology/future_tense/2016/12/self_driving_cars_will_exacerbate_organ_shortages.html
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sigmar
>1 in 5 organ donations comes from the victim of a vehicular accident

So preventing 35,000 deaths a year, may lead to 6,000 less organ donations?
I'd take that deal.

The article goes on to talk about changing from opt-in donations, to opt-out
donations. Which seems completely orthogonal to self-driving cars, as
(regardless of projected stats on future donor numbers) we should do whatever
we can to decrease the number of people waiting on organ transplants.

~~~
thescribe
I don't know why, but the idea of moving something that is currently opt-in to
opt-out really bothers me even if it is a good cause. As the world becomes a
more free place more and more things should be opt-in.

~~~
unclenoriega
I recently had this discussion on reddit, and I don't get this position. As
long as it's as easy to opt out as it was to opt in, I see the two as
equivalent.

I suppose it could be more problematic in situations where the 'in' isn't such
an obvious good.

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throwaway287391
Re: increasing donations -- I've always wondered why it doesn't work roughly
as follows: if you're an adult who finds yourself in need of a donated organ
and are not yourself a donor, you're at the bottom of the list (below any
donors) as a potential recipient from strangers who are donors. Puts the
incentive in the right place and seems fair to me. What are the issues with
that idea?

Maybe the donor system would need to be made an opt-out rather than opt-in
system first (as the article suggests), otherwise ignorance could be an issue.

~~~
MereInterest
People are rather bad at handling low-probability events. We underestimate the
likelihood of bad events, and overestimate the likelihood of good events. If
people were purely rational, your solution would work. However, people would
underestimate the chance that they themselves will need an organ transplant,
and so the lower chance of getting a transplant if needed would not be a good
motivator.

I am strongly in favor of organ donation being opt-out, rather than opt-in.

~~~
pbhjpbhj
>I am strongly in favor of organ donation being opt-out, rather than opt-in.
//

Whilst the state assumes control of a person's body around the time of their
death, a little pre- or post- mortem, do you also consider that they should
assume control of the persons other material assets?

If you're in favour of the assumption of state possession of [portions of] a
persons body it seems logical you should also think the public should be able
to assume the good from that persons other cherry-picked assets.

To emphasise the point, suppose a landed millionaire dies, their kidneys prove
useful to someone - the state has written in to law that the persons bodily
organs will be assumed to be possessions of the state. Would not also that
persons properties, liquid assets, and other such non-bodily possessions be
beneficial. Indeed they may give far greater benefit than their organs in some
cases.

Why the organs but not the non-bodily assets?

Despite bodies being ruled as "not property" in UK law I'm of the opinion that
a person's own body should be as much as feasible theirs to control as the
other assets of that person are post-mortem. If people get to say what happens
to their house, why should they not get to say what happens to their retinas,
say?

Personally I find a greater moral good in assuming the possession of the non-
bodily assets to the state and allowing people to choose to donate their
bodies.

~~~
MereInterest
What you describe is exactly what is already implemented as an estate tax. It
makes perfect sense to do so. Furthermore, an estate tax has the benefit of
preventing a class of aristocrats from forming, by limiting the amount of
wealth that can be passed down through many generations.

Default organ donation is different in two ways. One, you can opt out at no
cost. Two, the organs would otherwise benefit nobody. In the case of an estate
tax, the assets are split between the descendents and society, and nothing is
lost. In the case of organ donation, the organs go either to recipients, or to
the worms. Clearly, the default behavior should be the one that allows some
benefit to be had.

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failrate
We are on the verge of being able to replicate organs at scale. I think that
that harvesting them from donors who have destroyed their brains in vehicular
accidents is just an unfortunate but necessary stepping stone.

~~~
amorphid
I went to the past show put on by Eureka Comedy in SF [1][2]. The speaker said
that a type of artificial pancreas now in testing is more efficient than a
healthy pancreas. If that is correct, it might become the norm at some point
to just swap out natural organs for synthetic ones, at least for those who can
afford it. Maybe organ collection and distribution will become a function of
Goodwill Industries as people donate their original natural organs.

[1] [http://www.eurekacomedy.com](http://www.eurekacomedy.com)

[2] [https://www.eventbrite.com/e/eureka-
tickets-26689373635](https://www.eventbrite.com/e/eureka-tickets-26689373635)

~~~
manmal
Does the artificial pancreas only produce insulin when blood sugar rises, or
does it also secrete digestive juices and sodium bicarbonate? If the former,
then it's surely not desirable yet to exchange a healthy pancreas for it.
Similar to taking out the gallbladder if you don't have any stones. Digestion
just works better with the real deal.

~~~
amorphid
If I understand it correctly, the pancreas releases insulin to lower blood
sugar, but it can also release insulin when you don't have a need. Like you
might experience an insulin spike when thinking about eating a tasty dessert,
but are not actually consuming the dessert. An artificial pancreas relies on
monitoring actual blood sugar levels. It can also proactively address low
blood sugar. The speaker mentioned getting a text when her diabetic son's
blood sugar was low, and so she called the son's babysitter with instructions
to give the son some crackers. I've never received a text message from my
pancreas, or any other organ in my body.

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cm2187
As long as we don't have self driving motorbikes, there will be an ample
supply of young, healthy donors.

I have been told Motorbikes is what a surgeon, specialist in transplantation,
has in mind when he rubs his hands when it is raining outside. "It's going to
be a busy day".

Probably more relevant in Europe than in the US.

~~~
cobbzilla
indeed, I have heard paramedics refer to the vehicles as "donor-cycles"

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frik
> Much has been said about the ways we expect our oncoming fleet of driverless
> cars to change the way we live—remaking us all into passengers, rewiring our
> economy, retooling our views of ownership, and reshaping our cities and
> roads.

"retooling our views of ownership" ?

What have self-driving cars to do with car ownership? If the global economy
works there will be always ownership, there will always be companies from
somewhere that will sell cars. It's like the WWW, you can put up paywalls, but
there will always be another site powered by another business model (eg ads)
that cater the users. Or you can still buy traditional light bulbs, and
ironically the two companies that lobbied to ban light bulbs closed down their
respective business units and focus on something else. Recently John Deer and
Tesla vehicles have some kind dongle/software-as-a-service thing, where you
have to register your vehicle with an account - that can limit the after-sale
value/business. For every company that follows that plan, there will be x
other vehicle manufacturers elsewhere that stay with the normal business
model.

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Clubber
Yes, but it will also lower the demand for organs due to less crashes with
injuries. I'm not sure what the net would be.

~~~
foota
I don't have statistic handy, but I imagine most organ donation need comes
from illness.

~~~
Clubber
I found some information. The largest organ by far that is transplanted is the
kidney. I also suspect most of them are from disease rather than an impact
injury.

[https://www.organdonor.gov/statistics-
stories/statistics.htm...](https://www.organdonor.gov/statistics-
stories/statistics.html)

~~~
manmal
But, are kidneys not most often donated from relatives?

~~~
Clubber
Could be. I'm not sure if they are the most donated because almost everyone
has a spare one, or because they are in the most demand, or a mix.

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spraak
It seems likely that the artificial creation of organs could produce enough by
the time self driving cars are actually ubiquitous enough to cause a shortage

> 1 in 5 organ donations comes from the victim of a vehicular accident.

And I'm quite surprised that's true!

~~~
cm2187
I would have thought it would be more than 1 in 5. Keep in mind the organ must
be healthy for it to be suitable. That rules out a lot of diseases, people
dying of old age, etc.

~~~
manmal
I think most donations come from relatives. AFAIK some donations are also
recoverable, e.g. when only a part of the liver is transplanted and it will
regrow to its full size?

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maxerickson
_To alleviate concerns associated with commercialization, compensation could
be limited to fixed payments or to benefit packages that include insurance,
tax deductions for travel, lodging and lost wages, or paid donor leave._

Is there a coherent argument for creating a "market" where sellers are banned
from realizing the full market value of the thing they are selling? I guess
people will say gouging, but that doesn't really work for an organ market (2
kidneys are actually better than 1, there's nothing short term or unusual
about the shortage).

~~~
woofyman
Personally I wouldn't want to live in a society where poor people are
exploited for their organs so wealthier people may live.

~~~
tomjen3
So you would rather limit the oppertunities of the poor, rather than allowing
them to make a choice about their own bodies that you personally disagree
with?

~~~
woofyman
Yes...it's exploitation. Should people be allowed to sell their heart or their
eyes?

~~~
tomjen3
Have you thought it through? People will sell organs if they think that is the
best possible opportunity for them. You want to come in and deny them that
resource, which means you want to force poor people to make a choice that they
believe is worse of.

Either you hate the poor and want them to be worse of (I don't believe this)
or you think you know that persons situation better than they do. We tried a
system of tell people what to buy and sell and what to make. It was called the
Soviet Union and it was demonstrately worse.

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Daviey
Previously posted.. not sure why the dupe detector didn't pick it up,
[https://news.ycombinator.com/item?id=13284588](https://news.ycombinator.com/item?id=13284588)

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woofyman
There's still Chinese prisoner organ harvesting.

[http://www.independent.co.uk/news/world/asia/china-
carrying-...](http://www.independent.co.uk/news/world/asia/china-carrying-out-
millions-of-illegal-organ-transplants-annually-report-finds-a7107091.html)

~~~
chriscappuccio
Great opportunities ahead for America's private prison investors.

~~~
pacaro
A recurring theme in Larry Niven's writing

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antiquark
maybe Big Organ can pay google to randomly crash their AI cars. The free
market at work!

