Tuesday, August 14, 2018

Dealing with shortages of deceased donors in a future with fewer automobile accidents

Sometimes you find out that someone has already worried about something that you haven't even thought of worrying about.  I worry about some aspects of transplantation, and I sometimes think about driverless cars, but here's an article about a worry that is nowhere near the top of my list.  However the short article below (it's a comment on another article) raises some interesting points about how society may want to rethink increasing organ donation as we see (I hope) ever fewer deaths from automobile accidents:

How Do You Donate Life When People Are Not Dying: Transplants in the Age of Autonomous Vehicles

Zoe Corin, Roee Furman, Shira Lifshitz, Ophir Samuelov & Dov Greenbaum (2018) , The American Journal of Bioethics, 18:7, 27-29, DOI: 10.1080/15265161.2018.1478024

"While there are differences of opinion as to when autonomous or self-driving cars will actually invade our roads—some car manufacturers are predicting consumer-ready self-driving cars as early as 2021—there is broad consensus that their inevitability is assured. And while there are clear positive social consequences that will result from self-driving cars and trucks, there are also a number of often less appreciated negative externalities. Balanced against the saved lives, minimized commutes, reduction in pollution, and general decrease in daily stress are the driving-related job losses and the reality that there will be fewer organ donors."
"There are no quick fixes, and current laws already place significant restrictions on the organ acquisition process. Buying and selling organs is nearly universally objectionable, unethical, and illegal (Ludin 2008). Some countries even ban any benefit, or any form of valuable consideration whatsoever, in exchange for an organ (Caulfield et al. 2014
Caulfield, T.E. NelsonB. Goldfeldt, and S.Klarenbach2014Incentives and organ donation: what’s (really) legal in Canada?Canadian Journal of Kidney Health and Disease 1: 7.[Crossref][PubMed], [Google Scholar]). Some jurisdictions go even beyond this altruistic-only donor requirement, and allow live donations only among blood relatives (India 1994Government of India. 1994. Transplantation of Human Organs Act, 1994.http://wwwmedindianet/tho/thobill1asp. [Google Scholar]).
"However, even these universal attitudes have some specific exceptions: In many countries, blood donors are paid, and sperm and egg donors can receive thousands of dollars in remuneration. But just because a handful of tissue donations have been commodified (albeit sometimes obfuscated as gifts with financial consideration), it is not clear that this cash for contribution system will expand anytime soon to include other types of living donations, such as liver lobes or kidneys. To wit: While New York sperm donors can make more than a thousand dollars a month (Lewinnov 2016
Lewinnov, T201610 things to know about being a sperm donor, New York Times, Nov. 3 2016. [Google Scholar]), surrogacy contracts are still void and unenforceable by law (New York 2014New York. 2014. N.Y. Dom. REL. Law §§ 121-124 Surrogate Parenting Contracts Organ Donation and Recovery Improvement Act (2004). [Google Scholar]).
Nevertheless, in light of the need for organs, a number of jurisdictions have tried to indirectly incentivize donation, either through financial or non-financial mechanisms. Such incentives include paying for funeral costs of non-living donors, or for the out-of-pocket expenses directly associated with transplantation (US 2004)."

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