A kidney donor at 18 now regrets it • Hacker News Board

Re: A kidney donor at 18 now regrets it

#51

Post by chrisseaton » Mon, Oct 03, 2016, 9:59 PM UTC

timecube wrote: post #48

pdq wrote: post #47

This is going to rub a lot of people the wrong way as unethical, but the best way to incentivize organ donation is if the donors get paid a market price for the organ. The donor is giving up a valuable piece of their body, taking time and large medical risks in surgery, and likely reduced life expectancy. If you walk through the current process, everyone in the donation gets paid -- doctors, nurses, hospital, pharma…

A big issue with allowing organ markets is that impoverished people can practically be forced to sell their organs.

Yes, often welfare systems won't give you aid if you have assets such as cash or a home. Would your organs be considered assets?

Re: A kidney donor at 18 now regrets it

#52

Post by london888 » Mon, Oct 03, 2016, 10:02 PM UTC

Has the stepfather's brother with the new kidney not made the donor feel how valuable his gesture was?

Re: A kidney donor at 18 now regrets it

#53

Post by nothrabannosir » Mon, Oct 03, 2016, 10:16 PM UTC

pavel_lishin wrote: post #24

danso wrote: post #11

I admire the author's selflessness. At the same time, it seemed easier to be selfless as a teenager, probably for similar reasons for why it's easier to draft 18-year-olds than it is 28-year-olds. Given young persons willingness to sacrifice for the greater cause without realizing that life extends well past your 30s and 40s, I wonder if more shouldn't be done to let young donors think of the risks, so that their naï…

I've considered offering to be a kidney donor. Now that I have a kid, I'm glad I didn't - what if my kid needs it? What if my wife does?

Do you not get a "+1" for anyone of your choosing at any point in time if you donated to a stranger in the past?

Re: A kidney donor at 18 now regrets it

#54

Post by minouye » Mon, Oct 03, 2016, 10:17 PM UTC

pdq wrote: post #47

This is going to rub a lot of people the wrong way as unethical, but the best way to incentivize organ donation is if the donors get paid a market price for the organ. The donor is giving up a valuable piece of their body, taking time and large medical risks in surgery, and likely reduced life expectancy. If you walk through the current process, everyone in the donation gets paid -- doctors, nurses, hospital, pharma…

But who pays and how do you avoid adverse selection problems? In the study you cited, it sounds like compensation often comes from the recipient (in addition to a payment from the government). This seems like it would skew towards ability to pay on the recipient side, and towards the less affluent on the donor side.

Re: A kidney donor at 18 now regrets it

#55

Post by ReallyAnonymous » Mon, Oct 03, 2016, 10:17 PM UTC

As a surgeon who is 48, I will say that on my transplant rotation ( I am not a transplant surgeon ) the theory of the safety of donation was in the Vietnam War era data that said that soldiers who lost a kidney from injury were at no increased risk of renal failure as the general public given similar risk factors. I know that if you have hypertension or diabetes, it is near impossible to donate a kidney as they have a high propensity to develop renal failure. I have not researched the literature about the war data, but that is what I was told.

Re: A kidney donor at 18 now regrets it

#56

Post by chrisseaton » Mon, Oct 03, 2016, 10:17 PM UTC

criley2 wrote: post #16

danso wrote: post #11

I admire the author's selflessness. At the same time, it seemed easier to be selfless as a teenager, probably for similar reasons for why it's easier to draft 18-year-olds than it is 28-year-olds. Given young persons willingness to sacrifice for the greater cause without realizing that life extends well past your 30s and 40s, I wonder if more shouldn't be done to let young donors think of the risks, so that their naï…

>At the same time, it seemed easier to be selfless as a teenager, probably for similar reasons for why it's easier to draft 18-year-olds than it is 28-year-olds. Given young persons willingness to sacrifice for the greater cause without realizing that life extends well past your 30s and 40s I totally agree, the biological basis of this is Pre-frontal Cortex development. "The [prefrontal cortex] isn't fully developed…

> I can't understand any other context for drafting 18 year olds other than taking advantage of their youth and incomplete development

Physical fitness surely? Isn't 18 or 19 around the physical fitness peak? I'm guessing that people are on average are significantly stronger and more robust at 18 than they are at 28. I think the British Army has 26 as the limit for joining in the first place for officers at least.

Also people are married by 28. At 18 they're generally single and more able to deploy.

Re: A kidney donor at 18 now regrets it

#57

Post by chrisseaton » Mon, Oct 03, 2016, 10:19 PM UTC

nothrabannosir wrote: post #53

pavel_lishin wrote: post #24

Earlier quoted context omitted.

I've considered offering to be a kidney donor. Now that I have a kid, I'm glad I didn't - what if my kid needs it? What if my wife does?

Do you not get a "+1" for anyone of your choosing at any point in time if you donated to a stranger in the past?

How could they guarantee that? What if you need to call that right in and they can't find anyone compatible?

Re: A kidney donor at 18 now regrets it

#58

Post by simcop2387 » Mon, Oct 03, 2016, 10:20 PM UTC

kazinator wrote: post #7

I suspect that this regret probably has quite a lot to do with the recipient being the stepfather's brother. I.e. not a blood relative; kind of distant.

Not as distant as you'd think. I could actually see it being that the recipient is close enough you'll get information regularly about the person (i.e. small events that happen), rather than a complete stranger who you'd hear from only occasionally if at all.

I also wonder how much pressure he was under to help because of the match, and how much he felt that he'd be disappointing the people around him if he didn't. I know as a kid that kind of pressure would have weighed on me heavily and has lead me to have some regrets about my past (though nothing nearly this large).

Re: A kidney donor at 18 now regrets it

#59

Post by Lordarminius » Mon, Oct 03, 2016, 10:23 PM UTC

pdq wrote: post #47

This is going to rub a lot of people the wrong way as unethical, but the best way to incentivize organ donation is if the donors get paid a market price for the organ. The donor is giving up a valuable piece of their body, taking time and large medical risks in surgery, and likely reduced life expectancy. If you walk through the current process, everyone in the donation gets paid -- doctors, nurses, hospital, pharma…

While there is a short fall of viable organs for donation, the issue the author raises here is one of long term risk.

This is what gets brushed aside when the organ donation process is activated. Only now do we have results from long term study of donors and some of them as pointed out by the author are not good at all.

This problem is not confined to kidney donations for instance, is a growing body of evidence that points to long term complications from another medical procedure - laser surgery (lasix). Here many patients suffer degenerative vitreo-reinal changes over time (if you can, avoid it).

It is not actually the case that donors do not benefit from the current process. Outside the US in the largest market for kidney surgeries India, they are paid; as well as in the Thailand and the middle east. End stage renal disease is one of the worst conditions to die from, and everyone involved with an afflicted patient is desperate for a solution since they suffer almost as much as him/her.

So,No. Paying for organs will not solve this particular problem. But neither will doing nothing. One solution that can improve the number of donor organs is to make it mandatory that organs from qualified people who die violent or accidental deaths be immediately considered for transplant to those who need them. But you can guess this proposal would be (illogically imo) opposed in many countries.

Edit: On a related note, I have been mulling over an idea for a while for a startup to reduce the cost of dialysis for patients with renal disease. At present, it is prohibitively expensive and some patients require 2 sessions a week. If anyone is interested in joining me, reach out. My email address is in my profile.

Re: A kidney donor at 18 now regrets it

#60

Post by Viper007Bond » Mon, Oct 03, 2016, 10:23 PM UTC

kazinator wrote: post #7

I suspect that this regret probably has quite a lot to do with the recipient being the stepfather's brother. I.e. not a blood relative; kind of distant.

Says who? I know many people personally who are closer to their step-families than they are to their blood families. Just because someone donated some of their DNA to produce you doesn't necessarily make them worthy of being family.

Or hell, what about adopted children?