To honour donors, we should harvest organs that have the best chance of helping others – before, not after, death
Now imagine that before the stroke our hypothetical patient had expressed a wish to donate his organs after his death. If neurologists could determine that the patient had no chance of recovery, then would that patient really be harmed if transplant surgeons removed life-support, such as ventilators and feeding tubes, and took his organs, instead of waiting for death by natural means? Certainly, the organ recipient would gain: waiting too long before declaring a patient dead could allow the disease process to impair organ function by decreasing blood flow to them, making those organs unsuitable for transplant.
But I contend that the donor would gain too: by harvesting his organs when he can contribute most, we would have honoured his wish to save other lives. And chances are high that we would be taking nothing from him of value. This permanently comatose patient will never see, hear, feel or even perceive the world again whether we leave his organs to whither inside him or not.
This might have the side-effect of putting even more people off signing up for donation. Most people I’ve talked to about it who are opposed cite horror stories about doctors prematurely “giving up” on donors to get at their organs.
Honest question, if you are cool with killing a person in a coma, based on the fact that they will never sense again, how do you feel about a person doing life in solitary? They may sense, but they aren’t able to communicate what they sense to any other human.
What exactly makes life worth its organs, in your eyes?
A person in solitary still has experiences. They just don’t interact with the outside world. People in a coma are, as far as we can tell, not conscious. There are plenty of animals that people are okay with killing and eating that are more likely to be sentient than someone in a coma.
I answered you query in a very precise way. There are tons and tons of laws and court judgements involved and no answer that fits into a few paragraphs.
I have a point here
If that’s the case you could try to make your point explicitly instead of implicitly. You could list your assumptions.
Yeah, and I’m asking, do those experiences “count”?
If organs are going from comatose humans to better ones, and we’ve decided that people who aren’t sensing don’t deserve theirs, how about people who aren’t communicating their senses? It seems like this principal can go cool places.
If we butchered some mass murderer we could save the lives of a few taxpayers with families that love them (there will be forms, and an adorableness quotient, and Love Weighting). All that the world would be out is the silent contemplation of the interior of a cell. Clearly a net gain, yeah?
So, are we stopping at “no sensing → we jack your meats”, or can we cook with gas?
It’s not about communication. It’s not even about sensing. It’s about subjective experience. If your mind worked properly but you just couldn’t sense anything or do anything, you’d have moral worth. It would probably be negative and it would be a mercy to kill you, but that’s another issue entirely. From what I understand, if you’re in a coma, your brain isn’t entirely inactive. It’s doing something. But it’s more comparable to what a fish does than a conscious mammal.
Someone in a coma is not a person anymore. In the same sense that someone who is dead is not a person anymore. The problem with killing someone is that they stop being a person. There’s nothing wrong with taking them from not a person to a slightly different not a person.
If we butchered some mass murderer we could save the lives of a few taxpayers with families that love them
A mass murderer is still a person. They think and feel like you do, except probably with less empathy or something. The world is better off without them, and getting rid of them is a net gain. But it’s not a Pareto improvement. There’s still one person that gets the short end of the stick.
Given that this is suggested to be a voluntary system, it doesn’t really matter what Walter Glannon thinks—it matters what you think.
Personally, I would be more interested in signing up for this if I was assured that the permanent damage was to the grey matter, and would be happy if this included both comas and permanent vegetative states. But YMMV.
It is worth noting here that being in solitary confinement does not necessarily prevent you from writing, receiving visitors, or making telephone calls (it depends on your local jurisdiction). Also, very few people are sentenced to be in solitary confinement until they die. In those places where this sort of sentence is permitted, it is unlikely that prisoners would be allowed any choice in their fate, but it is not obviously bad for a justly imprisoned person to choose suicide (with or without organ donation) in lieu of a life sentence.
EDIT: on re-reading, I see that this was not stated to always be a voluntary procedure; the author goes back and forth between voluntary and involuntary procedures. In involuntary cases, I agree that the simple criteria of “brain functions at a level too low to sustain consciousness but enough to sustain breathing and other critical functions without mechanical support” is too lax. I would still agree with the author in general that DDR is too strong.
There are reasons why you shouldn’t kill someone in a coma that doesn’t want to be killed when they’re in a coma even if you disagree with them about what makes life have moral value. If they agreed to have the plug pulled when it becomes clear that they won’t wake up, then it seems pretty reasonable to take out the organs before pulling the plug. And given what’s at stake, given permission, you should be able to take out their organs early and hasten their deaths by a short time in exchange for making it more likely to save someone else.
And why are you already conjecturing about what we would have wanted? We’re not dead yet. Just ask us what we want.
Dead enough by Walter Glannon
This might have the side-effect of putting even more people off signing up for donation. Most people I’ve talked to about it who are opposed cite horror stories about doctors prematurely “giving up” on donors to get at their organs.
Honest question, if you are cool with killing a person in a coma, based on the fact that they will never sense again, how do you feel about a person doing life in solitary? They may sense, but they aren’t able to communicate what they sense to any other human.
What exactly makes life worth its organs, in your eyes?
A person in solitary still has experiences. They just don’t interact with the outside world. People in a coma are, as far as we can tell, not conscious. There are plenty of animals that people are okay with killing and eating that are more likely to be sentient than someone in a coma.
By that standard how about harvesting the organs of babies?
Planned Parenthood does this for aborted babies.
I think babies are more person-like than the animals we eat for food. I’m not an expert in that though. They’re still above someone in a coma.
More for the “shit LW people say” collection :-)
Babies aren’t sentient?
The context is that Steven Pinker arguments that animals we eat are more sentinent than babies: http://www.gargaro.com/pinker.html
What other standard do you propose?
Not harvesting the organs of living human beings?
Define living and human being.
The way the terms are defined in German law and interpreted by German courts.
which is… (trust me, I have a point here, but by not actually answering my query in a precise way your’e making it hard to make)
I answered you query in a very precise way. There are tons and tons of laws and court judgements involved and no answer that fits into a few paragraphs.
If that’s the case you could try to make your point explicitly instead of implicitly. You could list your assumptions.
Yeah, and I’m asking, do those experiences “count”?
If organs are going from comatose humans to better ones, and we’ve decided that people who aren’t sensing don’t deserve theirs, how about people who aren’t communicating their senses? It seems like this principal can go cool places.
If we butchered some mass murderer we could save the lives of a few taxpayers with families that love them (there will be forms, and an adorableness quotient, and Love Weighting). All that the world would be out is the silent contemplation of the interior of a cell. Clearly a net gain, yeah?
So, are we stopping at “no sensing → we jack your meats”, or can we cook with gas?
It’s not about communication. It’s not even about sensing. It’s about subjective experience. If your mind worked properly but you just couldn’t sense anything or do anything, you’d have moral worth. It would probably be negative and it would be a mercy to kill you, but that’s another issue entirely. From what I understand, if you’re in a coma, your brain isn’t entirely inactive. It’s doing something. But it’s more comparable to what a fish does than a conscious mammal.
Someone in a coma is not a person anymore. In the same sense that someone who is dead is not a person anymore. The problem with killing someone is that they stop being a person. There’s nothing wrong with taking them from not a person to a slightly different not a person.
A mass murderer is still a person. They think and feel like you do, except probably with less empathy or something. The world is better off without them, and getting rid of them is a net gain. But it’s not a Pareto improvement. There’s still one person that gets the short end of the stick.
I can’t tell if you have a recommendation. If you have a model to suggest, please share it.
Given that this is suggested to be a voluntary system, it doesn’t really matter what Walter Glannon thinks—it matters what you think.
Personally, I would be more interested in signing up for this if I was assured that the permanent damage was to the grey matter, and would be happy if this included both comas and permanent vegetative states. But YMMV.
It is worth noting here that being in solitary confinement does not necessarily prevent you from writing, receiving visitors, or making telephone calls (it depends on your local jurisdiction). Also, very few people are sentenced to be in solitary confinement until they die. In those places where this sort of sentence is permitted, it is unlikely that prisoners would be allowed any choice in their fate, but it is not obviously bad for a justly imprisoned person to choose suicide (with or without organ donation) in lieu of a life sentence.
EDIT: on re-reading, I see that this was not stated to always be a voluntary procedure; the author goes back and forth between voluntary and involuntary procedures. In involuntary cases, I agree that the simple criteria of “brain functions at a level too low to sustain consciousness but enough to sustain breathing and other critical functions without mechanical support” is too lax. I would still agree with the author in general that DDR is too strong.
There are reasons why you shouldn’t kill someone in a coma that doesn’t want to be killed when they’re in a coma even if you disagree with them about what makes life have moral value. If they agreed to have the plug pulled when it becomes clear that they won’t wake up, then it seems pretty reasonable to take out the organs before pulling the plug. And given what’s at stake, given permission, you should be able to take out their organs early and hasten their deaths by a short time in exchange for making it more likely to save someone else.
And why are you already conjecturing about what we would have wanted? We’re not dead yet. Just ask us what we want.
You can approximate this by writing a living will (and you should write a living will regardless of whether or not you are an organ donor.)
However, I agree there should be more finely grained levels of organ donation, and that this should be a clear option.