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gimpf comments on Undiscriminating Skepticism - Less Wrong
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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.
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.