Is the Ground Shifting for Organ Donation?

A few months back, I wrote a blog post called Is America Ready for an Organ Donor Market?, and my answer was “probably not.” (The post was inspired by a pair of OpEds, one by Sally Satel in the N.Y. Times and one by Richard Epstein in the Wall Street Journal.) We subsequently wrote a N.Y. Times column of our own on the subject, with a look at several ideas for increasing the availability of organs for transplant.

As much as it seemed, just a few months ago, that America isn’t ready for a market in organs, things may be moving faster than anticipated. Last Sunday, the Washington Post ran a fairly benign but forward-looking editorial. And this past Sunday, Charles Ornstein and Tracy Weber of the Los Angeles Times published a devastating critique of the United Network for Organ Sharing, which currently oversees transplants for organs throughout the U.S.

On the organ-transplant front, I would not be surprised to see the L.A. Times article move the pile a bit on this subject. On the journalism front, I wouldn’t be surprised if the article wins a Pulitzer — which is all the more impressive considering the current turmoil at the L.A. Times. FWIW, there was a great series on small-town “justice courts” in the N.Y. Times a few weeks back, by William Glaberson. It also had Pulitzer Prize written all over it.


Gaijin51

That LA Times article was interesting. There is a saying here in Japan: if you want to solve a problem, make it visible. Visible problems get solved. So, that is why it is important for the press to trumpet this kind of information.

But, at the same time, the Japanese don't have a system for organ transplantation (or maybe they do but not up to the US level). So Japanese who need organs typically go to the US to get them. Also, top Japanese transplant surgeons practice in the US. I watched an NHK special about Japanese parents who took their baby to the US to get a heart transplant.

prosa

All well and good, but the only real solution to the shortage of organs for transplant is medical research into ways of stopping organs from failing in the first place.

Don Robertson

Well, while I know our collective cultural bias is currently toward entire sureness there is an empirical science solution for every individual complaint, every individual need, and even every individual whim of those with the money to pay for it, this whole business of organ transplantation is ethicly quite unsound.

The medical ethic demands, Do no harm, which we should assume applies not just to the individual patient but also to the human species as a whole.

As a philospher, I don't approach the problem from a religious point of view, but rather a moral point of view.

I have found the moral imperative to be, Do nothing that will negatively impact upon the lives others will be able to live in the future.

From this starting point, which is the starting point for every moral action, organ transplantation is immoral because it establishes another means of transfering pathogens from one human body to another.

By this new route for disease to move within the biological niche provided by the bodies that make up the human species we create an even greater danger for every human in the future to contract a disease that has been given an enhanced opportunity to evolve while in this new pipeline.

Organ and tissue transplantation might be altruistically described as doctors caring for patients, but, it is not. It is about doctors being given the opportunity to apply their trade, and to make a living. But, if their living is made making all of our future humanity ever sicker, is it not immoral?

If one wants to take a close look at the illicit trade in human body parts, one would be horrified to find the criminal ethic with which this new business of organ and tissue transplantation is setting up shop in our culture, all the while professing the great need of suffering patients.

The end result of this business of organ and tissue transplantation will be ever more suffering for humans in the future. There simply isn't a viable moral empirical science solution to be found in the organ and tissue transplantation business.

Giving the green light here is tantamount to encouraging witchcraft because while there are demonstrable benefits to a few, the negatives for the future of the species, the greater multitude of humanity, for them the prospects that will result from the wholesale effects organ and tissue transplatation are simply too immoral to even consider anything other than applying the brakes to this abhorrent practice.
Someone had to say it. All the smart doctors are just sitting there like those monkeys, see no evil, hear no evil, speak no evil...

Don Robertson, The American Philosopher
Limestone, Maine

Home page:
An Illustrated Philosophy Primer for Young Readers
Precious Life - Empirical Knowledge
The Grand Unifying Theory & The Theory of Time
http://www.geocities.com/donaldwrobertson/index.html
Art Auctions:
http://www.artbyus.com/auctions.php?a=6&b=4807

Read more...

jheaney

What a load of bilge. Pure unadulterated tripe masquerading as intellectually profound philosopical rumination.

Let's cut through the rhetorical flourishes and examine the argument, such that it is.

Transplants save lives. Valuable lives. Cherished lives. Productive lives. These lives have value and merit and deserve to be saved.

Organ donors are tested for disease to ensure that the transplant recipient does not contract any known or likely disease. This isn't the SciFi Channel. We're not dealing with alien organisms looking for a new host.

If the bumpkin philosopher is aware of any medical evidence to the contrary, then present it. If there is no evidence (and there isn't), then all the posturing is simply a ridiculous scare tactic.

Yes, more transplants mean that more transplant surgeons have the ability to "ply their trade." Wonderful. Each time they step into an operating room, another person's life is saved and another family is rescued from grief and suffering.

Where is that in your moral calculation?

Read more...

Don Robertson

jheaney says: "Transplants save lives. Valuable lives. Cherished lives. Productive lives. These lives have value and merit and deserve to be saved.

Organ donors are tested for disease to ensure that the transplant recipient does not contract any known or likely disease. [...]"

This is the extent of your argument, that you state these lives being saved are valuable, and the docotrs test for "known or likely" disease?

You offer no argument refuting anything I've said then. Transplant do not "save" lives, they extend lives, but they do so at a risk to future lives.

There are always unknown diseases even diseases as yet undeveloped enough to be recognized as disease, but which are ready to develop on this new avenue of disease propagation, tissue and organ transplantation.

And while these lives are valuable, are they more valuable than any others that can and will be lost due to the increasingly efficient means of disease propagation offered by the tissue and organ transplant avenue?

The moral argument does not only stand, it is exemplary over mostly unpracticed and unheeded medical ethics, Do no harm.

All empirical scientists before making any single step must first ask, Will my action impact upon the lives others in the future will be able live?

That is the moral imperative. To ensure lives in the future will not be negatively impacted by our actions.

Organ and tissue transplantation clearly does not meet the test.

Let me put it to you this way, the most precious life in the world today is not worth saving at the cost of even a single life in the future.

This is not a religious argument you are up against.

You are up against philosophy.

Don Robertson, The American Philosopher

Read more...

jheaney

It's apparent that I failed to adequately outfit myself to successfully combat an argument with philosophy. And nutroots philosophy at that. I armed myself with logic and evidence. Apparently I needed to complement these tools with imaginatively fabricated fears, including the prospect of "disease propagation" through new hosts.

I will concede a single point: this is a moral argument. There is a moral ledger. On one side is the ability of our medical community to perform a safe, proven and effective procedure to save an individual's life. (is there any difference between saving a life and extending a life? Don't all health restoring medical procedures extend the patient's life?)

According to our self-appointed American Philosopher, the life-saving potential of transplant surgery is offset by a risk to future lives. And the evidence to support this position is... nothing. Not a single citation from a medical journal. Not a single quote from a knowledgeable physician. Not even a scary urban myth cribbed from Snopes.com.

Transplants have been performed successfully on over 400,000 patients during the past 20 years. There is a huge amount of data collected, analyzed and reviewed each year to determine the effectiveness and efficacy of transplants. There are medical journals devoted exclusively to transplantation. There are thousands of researchers, scientists, surgeons, physicians, and transplant coordinators intimately involved on a daily basis with the procedure.

And the total amount of empirical evidence supporting Dr. Philosopher's contention: zero.

Can a disease be passed from the transplant donor to the recipient? Yes it can. There have been reported cases of the transmission of West Nile virus, hepatitis, and in one strange case, even rabies. But these diseases did not have any long term effect on the future of mankind.

Let's take a trip to a place where the good Philosopher apparently doesn't visit frequently. Let's visit the real world.

In the real world, a patient dies in a hospital and has his organs removed for transplantation. Unknown to anyone, that patient has hepatitis. His liver is transplanted to a dying patient who begins to display the symptoms of hepatitis.

Before the transplant, there was one person infected with hepatitis. After the transplant, there is still one person infected with hepatitis. Has the hepatitis changed in any way? Has if mutated into an especially virulent form of hepatitis? Has the threat to mankind and our future generations been increased? No, no and no.

The transmission of hepatitis to another person is tragic, but not dire. It is limited in scope to a single person, not humanity.

Let's get back to the central moral argument. Transplants save lives. I know. I've had one. I know dozens of people who lead active and productive lives because of their own transplants. Transplants save lives, restore families, demonstrate our enormous capacity for caring and epitomize the pinnacle of moral purpose. Test passed.

Read more...

ideonaFonerne

Oh? asked Jennifer, Who was it? Oh my gosh! she said out loud.

Gaijin51

That LA Times article was interesting. There is a saying here in Japan: if you want to solve a problem, make it visible. Visible problems get solved. So, that is why it is important for the press to trumpet this kind of information.

But, at the same time, the Japanese don't have a system for organ transplantation (or maybe they do but not up to the US level). So Japanese who need organs typically go to the US to get them. Also, top Japanese transplant surgeons practice in the US. I watched an NHK special about Japanese parents who took their baby to the US to get a heart transplant.

prosa

All well and good, but the only real solution to the shortage of organs for transplant is medical research into ways of stopping organs from failing in the first place.

Don Robertson

Well, while I know our collective cultural bias is currently toward entire sureness there is an empirical science solution for every individual complaint, every individual need, and even every individual whim of those with the money to pay for it, this whole business of organ transplantation is ethicly quite unsound.

The medical ethic demands, Do no harm, which we should assume applies not just to the individual patient but also to the human species as a whole.

As a philospher, I don't approach the problem from a religious point of view, but rather a moral point of view.

I have found the moral imperative to be, Do nothing that will negatively impact upon the lives others will be able to live in the future.

From this starting point, which is the starting point for every moral action, organ transplantation is immoral because it establishes another means of transfering pathogens from one human body to another.

By this new route for disease to move within the biological niche provided by the bodies that make up the human species we create an even greater danger for every human in the future to contract a disease that has been given an enhanced opportunity to evolve while in this new pipeline.

Organ and tissue transplantation might be altruistically described as doctors caring for patients, but, it is not. It is about doctors being given the opportunity to apply their trade, and to make a living. But, if their living is made making all of our future humanity ever sicker, is it not immoral?

If one wants to take a close look at the illicit trade in human body parts, one would be horrified to find the criminal ethic with which this new business of organ and tissue transplantation is setting up shop in our culture, all the while professing the great need of suffering patients.

The end result of this business of organ and tissue transplantation will be ever more suffering for humans in the future. There simply isn't a viable moral empirical science solution to be found in the organ and tissue transplantation business.

Giving the green light here is tantamount to encouraging witchcraft because while there are demonstrable benefits to a few, the negatives for the future of the species, the greater multitude of humanity, for them the prospects that will result from the wholesale effects organ and tissue transplatation are simply too immoral to even consider anything other than applying the brakes to this abhorrent practice.
Someone had to say it. All the smart doctors are just sitting there like those monkeys, see no evil, hear no evil, speak no evil...

Don Robertson, The American Philosopher
Limestone, Maine

Home page:
An Illustrated Philosophy Primer for Young Readers
Precious Life - Empirical Knowledge
The Grand Unifying Theory & The Theory of Time
http://www.geocities.com/donaldwrobertson/index.html
Art Auctions:
http://www.artbyus.com/auctions.php?a=6&b=4807

Read more...

jheaney

What a load of bilge. Pure unadulterated tripe masquerading as intellectually profound philosopical rumination.

Let's cut through the rhetorical flourishes and examine the argument, such that it is.

Transplants save lives. Valuable lives. Cherished lives. Productive lives. These lives have value and merit and deserve to be saved.

Organ donors are tested for disease to ensure that the transplant recipient does not contract any known or likely disease. This isn't the SciFi Channel. We're not dealing with alien organisms looking for a new host.

If the bumpkin philosopher is aware of any medical evidence to the contrary, then present it. If there is no evidence (and there isn't), then all the posturing is simply a ridiculous scare tactic.

Yes, more transplants mean that more transplant surgeons have the ability to "ply their trade." Wonderful. Each time they step into an operating room, another person's life is saved and another family is rescued from grief and suffering.

Where is that in your moral calculation?

Read more...

Don Robertson

jheaney says: "Transplants save lives. Valuable lives. Cherished lives. Productive lives. These lives have value and merit and deserve to be saved.

Organ donors are tested for disease to ensure that the transplant recipient does not contract any known or likely disease. [...]"

This is the extent of your argument, that you state these lives being saved are valuable, and the docotrs test for "known or likely" disease?

You offer no argument refuting anything I've said then. Transplant do not "save" lives, they extend lives, but they do so at a risk to future lives.

There are always unknown diseases even diseases as yet undeveloped enough to be recognized as disease, but which are ready to develop on this new avenue of disease propagation, tissue and organ transplantation.

And while these lives are valuable, are they more valuable than any others that can and will be lost due to the increasingly efficient means of disease propagation offered by the tissue and organ transplant avenue?

The moral argument does not only stand, it is exemplary over mostly unpracticed and unheeded medical ethics, Do no harm.

All empirical scientists before making any single step must first ask, Will my action impact upon the lives others in the future will be able live?

That is the moral imperative. To ensure lives in the future will not be negatively impacted by our actions.

Organ and tissue transplantation clearly does not meet the test.

Let me put it to you this way, the most precious life in the world today is not worth saving at the cost of even a single life in the future.

This is not a religious argument you are up against.

You are up against philosophy.

Don Robertson, The American Philosopher

Read more...

jheaney

It's apparent that I failed to adequately outfit myself to successfully combat an argument with philosophy. And nutroots philosophy at that. I armed myself with logic and evidence. Apparently I needed to complement these tools with imaginatively fabricated fears, including the prospect of "disease propagation" through new hosts.

I will concede a single point: this is a moral argument. There is a moral ledger. On one side is the ability of our medical community to perform a safe, proven and effective procedure to save an individual's life. (is there any difference between saving a life and extending a life? Don't all health restoring medical procedures extend the patient's life?)

According to our self-appointed American Philosopher, the life-saving potential of transplant surgery is offset by a risk to future lives. And the evidence to support this position is... nothing. Not a single citation from a medical journal. Not a single quote from a knowledgeable physician. Not even a scary urban myth cribbed from Snopes.com.

Transplants have been performed successfully on over 400,000 patients during the past 20 years. There is a huge amount of data collected, analyzed and reviewed each year to determine the effectiveness and efficacy of transplants. There are medical journals devoted exclusively to transplantation. There are thousands of researchers, scientists, surgeons, physicians, and transplant coordinators intimately involved on a daily basis with the procedure.

And the total amount of empirical evidence supporting Dr. Philosopher's contention: zero.

Can a disease be passed from the transplant donor to the recipient? Yes it can. There have been reported cases of the transmission of West Nile virus, hepatitis, and in one strange case, even rabies. But these diseases did not have any long term effect on the future of mankind.

Let's take a trip to a place where the good Philosopher apparently doesn't visit frequently. Let's visit the real world.

In the real world, a patient dies in a hospital and has his organs removed for transplantation. Unknown to anyone, that patient has hepatitis. His liver is transplanted to a dying patient who begins to display the symptoms of hepatitis.

Before the transplant, there was one person infected with hepatitis. After the transplant, there is still one person infected with hepatitis. Has the hepatitis changed in any way? Has if mutated into an especially virulent form of hepatitis? Has the threat to mankind and our future generations been increased? No, no and no.

The transmission of hepatitis to another person is tragic, but not dire. It is limited in scope to a single person, not humanity.

Let's get back to the central moral argument. Transplants save lives. I know. I've had one. I know dozens of people who lead active and productive lives because of their own transplants. Transplants save lives, restore families, demonstrate our enormous capacity for caring and epitomize the pinnacle of moral purpose. Test passed.

Read more...

ideonaFonerne

Oh? asked Jennifer, Who was it? Oh my gosh! she said out loud.