but unless the mother was not informed (minor/mental illness) or did not consent,
This is already a significant retreat from your previously stated position. (“not unless it’s going to kill you” after 24 weeks)
The complication here is that a responsible, consenting adult tacitly accepts giving up her bodily autonomy (or accepts a risk of doing so) when she has sex.
That’s a hell of an assertion. I don’t really see any reason to accept it as other than a normative statement of what you wish would happen.
That’s precisely the same reason men are required to pay child support even if they didn’t wish for a pregnancy. (Yes, I see the asymmetry; yes, it sucks).
As you say, there is an asymmetry. Garnishing a wage is a bit different, and seems appropriate to me.
Case-by-case reasoning is probably a good thing in these circs,
Yes, it is, so long as it is reasoning rather than assertions that this case is different. We have to specify how it is different, and how those differences make a difference. The easiest way for me to do this is to use analogies. This is dangerous of course, as one must keep in mind that they can ignore relevant differences while emphasizing surface similarities.
So, in this case the relevant specialness you’re calling out is that a risky activity was knowingly engaged in that created a person who needs life support for some time, as well as care and feeding far after that. So I’m going to try to set up an analogous situation, but without sex being the act (which I think is irrelevant) coming into the mix. This will also mean another difference: the person will not be “created” except metaphorically from a preëxisting person. I personally don’t see how that would be relevant, but I suppose it is possible for others to disagree.
Suppose a person is driving, and crashes into a pedestrian. This ruptures the liver of the pedestrian. A partial transplant of the driver’s liver will save the pedestrian’s life. Is the driver expected to donate their liver? Should it be required by law?
Note that the donor’s death rate for this operation is under 1%. When we compare this to the statistics for maternal death, we see it is similar to WHO’s 2005 estimate of world average of 900 per 100,000, though developed regions have it far lower at 9 per 100000.
This is already a significant retreat from your previously stated position. (“not unless it’s going to kill you” after 24 weeks)
Is it? I suppose it is. I contain multitudes. No, honestly, I just didn’t name all my caveats in the previous post (my bad). Clearly there are two people’s interests to take into consideration here. Also, as I noted, that was an ethical rather than legal argument. I don’t have any strong opinions about what the law should do wrt this question.
That’s a hell of an assertion. I don’t really see any reason to accept it as other than a normative statement of what you wish would happen.
I don’t think it’s unreasonable, although you’re right it’s not a fact statement. But I think it’s a fairly well-established principle of ethics & jurisprudence that informed consent implies responsibility. Nobody has to have unprotected sex, so if you (a consenting adult) do so, any reasonably foreseeable consequences are on your shoulders.
Suppose a person is driving, and crashes into a pedestrian. This ruptures the liver of the pedestrian. A partial transplant of the driver’s liver will save the pedestrian’s life. Is the driver expected to donate their liver? Should it be required by law?
It’s a reasonably good analogy I guess. There are two separate questions here: what should the law do, and what should the driver do. I don’t think anybody wants the law to require organ donations from people who behave irresponsibly. However, put in the driver’s shoes, and assuming the collision was my fault, I would feel obligated to donate (if, in this worst-case scenario, I am the only one who can).
There is a slight disanalogy here though, which is that an abortion is an act, whereas a failure to donate is an omission. It’s like the difference between throwing the fat guy on the tracks and just letting the train hit the fat guy.
which is that an abortion is an act, whereas a failure to donate is an omission
I’m curious to the reasoning on what the difference is, except maybe that, no better options being available (it seems) we use omission as the default strategy when consequences are not within our grasp (as watching and gathering more information will at least not worsen your later ability to come to a conclusion, with the only caveat that then it may be too late to act).
“Suppose a person is driving, and crashes into a pedestrian. This ruptures the liver of the pedestrian. A partial transplant of the driver’s liver will save the pedestrian’s life. Is the driver expected to donate their liver? Should it be required by law?”
For organ transplantations, the body biochemistries of the organ donor and acceptor must be somewhat compatible, otherwise the transplanted organ gets rejected by the immune system of the acceptor. The best transplantation results are between the identical twins. For unrelated people, there are tests to estimate the compatibility of organs, and databases. A conclusion: The driver is not generally expected to donate their liver, because in the majority of the cases, it would not help the victim.
Imagine an alternate universe, where all the human bodies are highly compatible for transplantation purposes.
Yes, I believe it might become a social norm in this alternate universe, or even a law, that the driver must donate their liver to the victim.
Suppose a person is driving, and crashes into a pedestrian. This ruptures the liver of the pedestrian. A partial transplant of the driver’s liver will save the pedestrian’s life. Is the driver expected to donate their liver. Should it be required by law?
This depends mostly upon whether you think that law should enforce doing actions which save lives with insignificant risk to the actor.
If yes, then this (quite special) case is clear-cut, given a few assumptions (liver matches and is healthy, is not already scheduled for another similarly important surgery, etc. etc.). However, at least as far as I know, this is not the case.
And I doubt it will be soon (simply did not think about whether it should yet). Just an example: In Austria by default all deceased people are potential donors—you have to file an explicit opt-out. This is quite different than for instance in Germany. Therefore we have a relatively good “source” of organs. However, though sometimes under discussion, Germany has not changed its legislation, even with the possibility to compare the numbers. Maybe for religious reasons, or freedom of whomever. I didn’t follow it that close...
If such simple matters (we are talking about already medically dead persons) do not change within years, what can be expected for such, really fundamental, decisions?
Just an example: In Austria by default all deceased people are potential donors—you have to file an explicit opt-out.
I am very much in favour of this sort of policy; it would do no end of good.
The effect of pretending to have opt-out organ donation is small. Austria is unique in really having opt-out organ donation (everywhere else, next of kin decide in practice), so it’s hard to judge the effect, but it’s not an outlier. In the 90s, Spain became the high outlier and Italy ceased being the low outlier, so rapid change is possible without doing anything ethically sensitive. graph. More Kieran Healy links here.
“Reform of the rules governing consent is often accompanied by an overhaul and improvement of the logistical system, and it is this—not the letter of the law—that makes a difference. Cadaveric organ procurement is an intense, time-sensitive and very fluid process that requires a great deal of co-ordination and management. Countries that invest in that layer of the system do better than others, regardless of the rules about presumed and informed consent.”
In our country, we have an opt-out donation, but I guess the relatives can have a veto. I have seen a physician on TV, who said some scary things openly. Our doctors are standardly overworked and underpayed. Imagine a doctor, who, towards the end of the long shift, sees a patient dying with some of the organs intact. If he decides to report the availability of the organs, he creates an extra, several hours work for himself and others, paperwork included. There is either none or very little financial reward for reporting the organs, I do not remember exactly. They might feel heroic for the first couple of times, but, eventually, they resign and stop making these reports, after they work long enough.
I have seen this on TV cca 3 years ago, do not know the current situation.
The driver could instead be made responsible for the victim’s exact medical costs or some fraction thereof, in addition to any punitive or approximated damages. This would provide adequate incentive to seek out ways to reduce those costs, including but not limited to a voluntary donation on the part of the driver or someone who owes the driver a favor.
In the abortion example, the fetus 1) is created already attached and ending ongoing life support may not be the same as requiring that someone who is not providing it provide it, 2) needs life support for an extended period, and 3) can only use the life support of one person.
This is already a significant retreat from your previously stated position. (“not unless it’s going to kill you” after 24 weeks)
That’s a hell of an assertion. I don’t really see any reason to accept it as other than a normative statement of what you wish would happen.
As you say, there is an asymmetry. Garnishing a wage is a bit different, and seems appropriate to me.
Yes, it is, so long as it is reasoning rather than assertions that this case is different. We have to specify how it is different, and how those differences make a difference. The easiest way for me to do this is to use analogies. This is dangerous of course, as one must keep in mind that they can ignore relevant differences while emphasizing surface similarities.
So, in this case the relevant specialness you’re calling out is that a risky activity was knowingly engaged in that created a person who needs life support for some time, as well as care and feeding far after that. So I’m going to try to set up an analogous situation, but without sex being the act (which I think is irrelevant) coming into the mix. This will also mean another difference: the person will not be “created” except metaphorically from a preëxisting person. I personally don’t see how that would be relevant, but I suppose it is possible for others to disagree.
Suppose a person is driving, and crashes into a pedestrian. This ruptures the liver of the pedestrian. A partial transplant of the driver’s liver will save the pedestrian’s life. Is the driver expected to donate their liver? Should it be required by law?
Note that the donor’s death rate for this operation is under 1%. When we compare this to the statistics for maternal death, we see it is similar to WHO’s 2005 estimate of world average of 900 per 100,000, though developed regions have it far lower at 9 per 100000.
Is it? I suppose it is. I contain multitudes. No, honestly, I just didn’t name all my caveats in the previous post (my bad). Clearly there are two people’s interests to take into consideration here. Also, as I noted, that was an ethical rather than legal argument. I don’t have any strong opinions about what the law should do wrt this question.
I don’t think it’s unreasonable, although you’re right it’s not a fact statement. But I think it’s a fairly well-established principle of ethics & jurisprudence that informed consent implies responsibility. Nobody has to have unprotected sex, so if you (a consenting adult) do so, any reasonably foreseeable consequences are on your shoulders.
It’s a reasonably good analogy I guess. There are two separate questions here: what should the law do, and what should the driver do. I don’t think anybody wants the law to require organ donations from people who behave irresponsibly. However, put in the driver’s shoes, and assuming the collision was my fault, I would feel obligated to donate (if, in this worst-case scenario, I am the only one who can).
There is a slight disanalogy here though, which is that an abortion is an act, whereas a failure to donate is an omission. It’s like the difference between throwing the fat guy on the tracks and just letting the train hit the fat guy.
I’m curious to the reasoning on what the difference is, except maybe that, no better options being available (it seems) we use omission as the default strategy when consequences are not within our grasp (as watching and gathering more information will at least not worsen your later ability to come to a conclusion, with the only caveat that then it may be too late to act).
“Suppose a person is driving, and crashes into a pedestrian. This ruptures the liver of the pedestrian. A partial transplant of the driver’s liver will save the pedestrian’s life. Is the driver expected to donate their liver? Should it be required by law?”
For organ transplantations, the body biochemistries of the organ donor and acceptor must be somewhat compatible, otherwise the transplanted organ gets rejected by the immune system of the acceptor. The best transplantation results are between the identical twins. For unrelated people, there are tests to estimate the compatibility of organs, and databases. A conclusion: The driver is not generally expected to donate their liver, because in the majority of the cases, it would not help the victim.
Imagine an alternate universe, where all the human bodies are highly compatible for transplantation purposes.
Yes, I believe it might become a social norm in this alternate universe, or even a law, that the driver must donate their liver to the victim.
This depends mostly upon whether you think that law should enforce doing actions which save lives with insignificant risk to the actor.
If yes, then this (quite special) case is clear-cut, given a few assumptions (liver matches and is healthy, is not already scheduled for another similarly important surgery, etc. etc.). However, at least as far as I know, this is not the case.
And I doubt it will be soon (simply did not think about whether it should yet). Just an example: In Austria by default all deceased people are potential donors—you have to file an explicit opt-out. This is quite different than for instance in Germany. Therefore we have a relatively good “source” of organs. However, though sometimes under discussion, Germany has not changed its legislation, even with the possibility to compare the numbers. Maybe for religious reasons, or freedom of whomever. I didn’t follow it that close...
If such simple matters (we are talking about already medically dead persons) do not change within years, what can be expected for such, really fundamental, decisions?
I am very much in favour of this sort of policy; it would do no end of good.
The effect of pretending to have opt-out organ donation is small. Austria is unique in really having opt-out organ donation (everywhere else, next of kin decide in practice), so it’s hard to judge the effect, but it’s not an outlier. In the 90s, Spain became the high outlier and Italy ceased being the low outlier, so rapid change is possible without doing anything ethically sensitive. graph. More Kieran Healy links here.
An interesting article.
“Reform of the rules governing consent is often accompanied by an overhaul and improvement of the logistical system, and it is this—not the letter of the law—that makes a difference. Cadaveric organ procurement is an intense, time-sensitive and very fluid process that requires a great deal of co-ordination and management. Countries that invest in that layer of the system do better than others, regardless of the rules about presumed and informed consent.”
In our country, we have an opt-out donation, but I guess the relatives can have a veto. I have seen a physician on TV, who said some scary things openly. Our doctors are standardly overworked and underpayed. Imagine a doctor, who, towards the end of the long shift, sees a patient dying with some of the organs intact. If he decides to report the availability of the organs, he creates an extra, several hours work for himself and others, paperwork included. There is either none or very little financial reward for reporting the organs, I do not remember exactly. They might feel heroic for the first couple of times, but, eventually, they resign and stop making these reports, after they work long enough. I have seen this on TV cca 3 years ago, do not know the current situation.
The driver could instead be made responsible for the victim’s exact medical costs or some fraction thereof, in addition to any punitive or approximated damages. This would provide adequate incentive to seek out ways to reduce those costs, including but not limited to a voluntary donation on the part of the driver or someone who owes the driver a favor.
In the abortion example, the fetus 1) is created already attached and ending ongoing life support may not be the same as requiring that someone who is not providing it provide it, 2) needs life support for an extended period, and 3) can only use the life support of one person.