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

Re: A kidney donor at 18 now regrets it

#81

Post by gutnor » Mon, Oct 03, 2016, 11:30 PM UTC

chrisseaton wrote: post #51

timecube wrote: post #48

Earlier quoted context omitted.

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?

I don't have worry about the welfare system not giving aid. The condition are generally often quite reasonable and there are going to be plenty of organisation to watch that over.

What I worry about, is in countries like the US/UK where "having a student debt" has somehow become a badge of honour, I can see "selling a kidney" to get through university becoming the same honourable demonstration that you are committed to do what it take to succeed.

... and by extension, show people who are not as committed. You can see it coming: "my son sold his kidney to succeed, why should we give even more to the people that are not even ready to take such a small step".

In general, we seem to expect people to take an ever growing amount of risk for the reward of maintaining their social standing. Being able to sell your body in piece is just raising the bar even higher.

Re: A kidney donor at 18 now regrets it

#82

Post by colechristensen » Mon, Oct 03, 2016, 11:32 PM UTC

JamesBarney wrote: post #73

colechristensen wrote: post #62

Earlier quoted context omitted.

You're missing a very big point 5. The quality of organs goes down. It's been extensively studied for paying for blood donations, and the consensus is widely to discourage the practice. https://www.statnews.com/2016/01/22/paid-plasma-not-blood/ http://www.radiolab.org/story/308403-blood/

The biggest difference between blood and organs is scale. Organs are sold for largest sums of money which means that there is much more money and time available to do full medical work ups and tests to verify the quality of the organs.

As well as a significantly stronger motivation to deceive in order to secure the payout. Assuming that verification procedures against a hostile donor can maintain quality vastly overestimates the tests.

Re: A kidney donor at 18 now regrets it

#83

Post by Mz » Mon, Oct 03, 2016, 11:33 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…

My initial reaction to this suggestion is horror, in part because I feel strongly that it disincentivizes finding other solutions to serious health issues. I have a condition that accounts for something like a third of all lung transplants and half of all pediatric lung transplants. I find the emphasis on heroic medical interventions instead of improved diet, prevention, etc. to be really horrifying. Pursuing improved diet, prevention, etc. has gotten me extremely good results. I never know how to convince people of that. It happens to be a fact, but it is not acceptable to really say that anywhere at all and the whole thing makes me feel postal at times.

But, please, let's stop parting people out as the easy answer and try a little harder to solve serious medical conditions some other way.

This is so very UGH.

Re: A kidney donor at 18 now regrets it

#84

Post by nostrebored » Mon, Oct 03, 2016, 11:39 PM UTC

ekianjo wrote: post #65

timecube wrote: post #48

Earlier quoted context omitted.

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

That's what's happening right now on the black market. With a real market you can ensure that this kind of things does not happen. (or at least control it)

I'm sorry, but why would you risk death to make a few thousand dollars if you're not poor? This practice significantly targets the poor and desperate. The same issues that come with legalization of prostitution and sex trafficking impact the organ trade.

So do the same failed arguments -- how has legalization and regulation of the market gone for Germany? Or rather how has it gone for German prostitutes, because from a tax revenue perspective Germany is doing wonderfully, with the perverse incentive to keep exploiting poor and trafficked women.

Re: A kidney donor at 18 now regrets it

#85

Post by delecti » Mon, Oct 03, 2016, 11:47 PM UTC

bcherny wrote: post #4

Every med student I know went through a hypochondriasis phase. I wonder what Poulson will think in a few years, once he is out of school.

That's really what this article seems to boil down to. There doesn't seem to be any concrete data that should lead a completely objective donor to worry. The issue is that the author is not completely objective (nobody is).

Re: A kidney donor at 18 now regrets it

#86

Post by TheDrizzle43 » Tue, Oct 04, 2016, 12:00 AM UTC

chrisseaton wrote: post #56

criley2 wrote: post #16

Earlier quoted context omitted.

>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. Al…

Based on my cursory research men peak physically in their mid to late 20's.

Re: A kidney donor at 18 now regrets it

#87

Post by ellyagg » Tue, Oct 04, 2016, 12:17 AM UTC

jsprogrammer wrote: post #26

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…

Are shootings and murder common in all neighborhoods? Isn't it correct to strongly associate a neighborhood with shootings and murder if you are repeatedly visiting the neighborhood due to a shooting and/or murder?

Yes, despite that you are grayed at this point, that example is not logically the same as the phenomenon under discussion.

If you talk to a lot of people with kidney failure you might conclude kidney failure is more likely than it is. This makes no sense as you are specifically looking for people with kidney failure, but humans aren't great at perspective here.

If you are looking for murder victims and a separate attribute--where these murders take place--is clearly correlated with murder victims, it is correct to notice that correlation.

Re: A kidney donor at 18 now regrets it

#88

Post by Sinaf » Tue, Oct 04, 2016, 12:17 AM UTC

vacri wrote: post #68

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…

Why not cut out the pretense and just farm poor people?

Because then there would be no possibilities for new startups to arise. I already have a good idea: Something Tinder-like for potential donors and receivers ("Let me fuck you for a kidney!", "Suck my dick for a part of my liver.", etc.)

Re: A kidney donor at 18 now regrets it

#89

Post by chetanahuja » Tue, Oct 04, 2016, 12:19 AM UTC

I wish they had included another option in the survey. What if you were given a lifetime of free health insurance in lieu of cash? This way, some organization (the govt, AMA, some independent trust) could create a large, insurable pool of all kidney donors. This scheme would work around the problem of moral hazard in both directions. On the Donor side, donors get a substantial financial reward but not in terms of cash. And if it's true that most kidney donors will live healthy lives on par with the general population, then this pool is no riskier to insure than any large company. In fact it might be a lower risk pool than the general population because the process of selecting the donor candidate involves intensive medical checks. Basically kidney donors are likely to be a healthier sample of the general population than random selection.

On the recipient/govt side, you get better outcomes for a larger number of kidney patients (and thus save lots of money on very expensive Dialysis costs). Financially, recipients (or their insurance providers) can be charged enough to cover the insurance premiums on the pool of donors without encouraging a black-market of organ donations.

It's most likely a win for Insurance companies too since they have to foot a large part of the dialysis bill too.

Re: A kidney donor at 18 now regrets it

#90

Post by vidarh » Tue, Oct 04, 2016, 12:27 AM UTC

chrisseaton wrote: post #56

criley2 wrote: post #16

Earlier quoted context omitted.

>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. Al…

It may be that it takes less effort to get you to sufficient fitness at that age, but it's nowhere near your peak. Unless you follow an elite athlete training program, it'll take you well over a decade of exercise to max out your potential. E.g. for muscle strength, most peoples bodies simply isn't capable of synthesising muscle fast enough in even a decade to max out your potential unless you use performance enhancing drugs.

You may have a point about average fitness and rate of improvement, though.