Regardless of what you think about the decision, the communication here has been poor. As of posting, there is no information on BBC News's front page, the UK's main source of news, as to this rule change or how to opt-out. [1] Likewise, on the UK Government's website's homepage, there is no information on this or information on how to opt-out. [2]
I haven't come across a friend or family member who knows this is happening today.
Regardless of your view on this, the communication has been poor. It was publicised when Wales moved to opt-out organ donation.
Perhaps there's some other story that's capturing the attention of the health-focused reporters at the BBC and there wasn't during Wales' rollout? Hmm?
This is a great decision. There's been a lot more interest in behavioural economics over the recent years and I remember reading one of Dan Ariety's books about this.
The key thing that increases the rate of organ donations dramatically (from 30% to almost unviversal between opt-in and opt-out) is that there's a very significant cost to choice. The more choices people have to make, even if they arrive at desired outcomes, hugely diminishes the chance that they do.
While I totally support the opt-out approach (or indeed, no option to opt out) I wonder if we need a new term - as it doesn’t seem like a ‘donation’. ‘Donation’ implies gift, and also an element of conscious choice, both of which mightn’t apply any more.
It's actually not clear if this will significantly increase donation rates. A similar change was made in Wales in 2015, and so far it hasn't made much difference either way to donation rates[0]. (As an aside, the article title should say "people living in England" not "UK citizens" - this change in law applies to England only).
The reason it didn't really make much difference in Wales seems to be because the previous system (which until today was also the system in England) was already pretty good.
Under the previous system either you were on the organ donor register (in which case next of kin had no legal option to refuse donation) or next of kin were asked to consent to donation (which most did). (There was also a register for people who definitely didn't want to be donors which also removed the right to consent from next of kin). I'm not sure what the 30% statistic you refer to is, but I'd guess it is the number of people on the "opt-in" register. In reality a larger proportion do have next of kin consent.
The new system, I think, effectively reverses that - there is a register for opting out and if you're on that then next of kin cannot consent. Likewise there is also still an opt-in register which, if you're on it, means next of kin cannot refuse consent. All that's changed, I think, is that if you're not on either register then when doctors do ask next of kin (and if the potential donor is not in an excluded group, eg under 18), if next of kin say "I don't know" then doctors will be able to take that as "yes" not "no".
I do think this is a positive change, because it means next of kin are less likely to be asked put under pressure to answer what is a very difficult and intrusive question which often they haven't previously thought about at the most difficult time. But I wouldn't assume that suddenly donor rates will increase as a result.
Sure, that's fine ... but we're talking extreme behavioural economics when, I'm guessing, the vast majority aren't even aware the switch happened today.
I support "motivated opt-in": your choice, but if you don't opt-in, you're at the end of the line for any organ needs you may find yourself with.
It tends to align nicely with ethical and religious objections as well as moral intuitions, and should expand supply while signaling proper expectations to the demand side, without simply allowing the rich to buy their way to the front of the line.
Keep in mind that for many kinds of organ transplants, you will know in advance that you have a good chance of needing one, without actually needing it yet.
The opt-out form [0] asks only for the name, phone number, DOB, address, email, etc. How do they ensure that someone else did not opt-out or opt-in on someone else’s behalf without their permission? And how are they deduplicating people with the same name and DOB? By a fuzzy match against their address? How do these things usually work in UK?
It's just a guess for this exact case, but UK government do have some access to credit history and this usually mean name plus dob plus address. And it's can use electoral roll databases for actual citizens.
Eh, I guess here comes an unpopular opinion. While the pragmatist in me is well aware of how opt-in increases donations ( although at certain point the question has to be asked whether if they coerced through law, is donation the right term for that ), I instinctively dislike government imposition here.
I do not believe ends justifies the means. And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
That's a weird analogy. TSA "opt out" is basically impossible. Have you ever tried it? It's not shame. The agents simply don't allow you to. Changing your organ donation status is not just possible, but easy.
In the organ donation case, who do you think would "shame you into compliance"? How would anyone else even know? I don't know the organ donation status of anyone else in the world, even my family and close friends, and even those who have died.
Then how would you describe a process in which people have to make it known what they want instead of leaving it up to guesswork? All alternatives explored so far just leads to death, misery, and a small portion of the population having a benefit while the rest suffers.
And anti-government in general seems to be stance that often comes with "I don't like it", but without a solution and the only thing I've seen so far is people coming up with a "let's do nothing" alternative. That's not a real alternative at all because it doesn't solve anything. Either bring something else that also works, or accept that the best we can do so far is come up with imperfect solutions.
>And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
What is this? In the past five years, I've probably flown 15 times and every time, I've opted out just fine. Just stand there waiting to one side until someone comes to pat you down. The pat down is consistent across airports, and you can usually count on the TSA agent to be courteous and professional. I can't stand the agency or their dictum that they're keeping the skies safe, but individual agents seem to be decent folk.
Never had any feeling of shame from other passengers or TSA agents. Maybe I'm lucky or privileged or something.
But if you don't want to get scanned, tell the agent you want to opt out. You don't have to be a haughty prick about it. Just say, "I want to opt out, please." And when they say, "okay, stand over there," nod and say, "thank you."
It looks like Wales and Scotland already have this policy in place. Northern Ireland does not, but I'm not too surprised given that health is devolved to the government of the country and NI didn't have a government for 3 years. I can't tell if that's still the case.
And it's for long-term (more than one year) residents of England, not just citizens.
The headline should read something like "As of today, all residents of England are organ donors unless they opt out" or "Organ donation law in England has changed to opt-out model."
As interesting as this is, this seems very political and therefore not really HN material, as you can tell by how quickly the comments have turned to shit
First, the lack of a public vote on this issue is troubling.
Second, it's inappropriate for a state agency to make such personal decisions on behalf of people without asking. Choice matters, and it's each individual's choice to make.
Finally, was this even necessary? Why not simply ask the family at the time of death? If there's no surviving family, THEN the state decides. Last, not first.
What I don’t understand is while they can make everyone organ donors by default, blood donation is still restricted for men having sex with men (with temporary restrictions to blanket ban in many countries). I have heard of blood banks refusing to take blood from gay men (including doctors) who abstained for whatever restrictions they have. If they test the blood before transfusion I don’t understand the need to discriminate.
in those few countries with opt-out system I'm familiar with, they still ask for family's approval regardless opt-out system and can't imagine anyone would disrespect wish of family despite the law
so in the end the difference is just in theory and law
[+] [-] BlackVanilla|5 years ago|reply
I haven't come across a friend or family member who knows this is happening today.
Regardless of your view on this, the communication has been poor. It was publicised when Wales moved to opt-out organ donation.
[1] https://www.bbc.co.uk/news [2] https://www.gov.uk/
[+] [-] ekianjo|5 years ago|reply
[+] [-] elgenie|5 years ago|reply
[+] [-] ryanmarsh|5 years ago|reply
[+] [-] jonny_eh|5 years ago|reply
[+] [-] Barrin92|5 years ago|reply
The key thing that increases the rate of organ donations dramatically (from 30% to almost unviversal between opt-in and opt-out) is that there's a very significant cost to choice. The more choices people have to make, even if they arrive at desired outcomes, hugely diminishes the chance that they do.
[+] [-] mft_|5 years ago|reply
[+] [-] tomatocracy|5 years ago|reply
The reason it didn't really make much difference in Wales seems to be because the previous system (which until today was also the system in England) was already pretty good.
Under the previous system either you were on the organ donor register (in which case next of kin had no legal option to refuse donation) or next of kin were asked to consent to donation (which most did). (There was also a register for people who definitely didn't want to be donors which also removed the right to consent from next of kin). I'm not sure what the 30% statistic you refer to is, but I'd guess it is the number of people on the "opt-in" register. In reality a larger proportion do have next of kin consent.
The new system, I think, effectively reverses that - there is a register for opting out and if you're on that then next of kin cannot consent. Likewise there is also still an opt-in register which, if you're on it, means next of kin cannot refuse consent. All that's changed, I think, is that if you're not on either register then when doctors do ask next of kin (and if the potential donor is not in an excluded group, eg under 18), if next of kin say "I don't know" then doctors will be able to take that as "yes" not "no".
I do think this is a positive change, because it means next of kin are less likely to be asked put under pressure to answer what is a very difficult and intrusive question which often they haven't previously thought about at the most difficult time. But I wouldn't assume that suddenly donor rates will increase as a result.
[0] https://www.bbc.co.uk/news/uk-wales-42213813
[+] [-] TLightful|5 years ago|reply
[+] [-] agilebyte|5 years ago|reply
[+] [-] titzer|5 years ago|reply
[+] [-] chanmad29|5 years ago|reply
This seems to be a good move that could help a ton of people in need, while also giving enough wiggle room to families to deny the donation.
[+] [-] _jal|5 years ago|reply
It tends to align nicely with ethical and religious objections as well as moral intuitions, and should expand supply while signaling proper expectations to the demand side, without simply allowing the rich to buy their way to the front of the line.
[+] [-] jonny_eh|5 years ago|reply
[+] [-] balfirevic|5 years ago|reply
[+] [-] ray991|5 years ago|reply
[0]: https://www.organdonation.nhs.uk/register-your-decision/refu...?
[+] [-] SXX|5 years ago|reply
[+] [-] A4ET8a8uTh0|5 years ago|reply
I do not believe ends justifies the means. And as always, eventually, while the option might be technically available, just like the TSA opt out, you will be basically shamed into compliance.
[+] [-] ken|5 years ago|reply
In the organ donation case, who do you think would "shame you into compliance"? How would anyone else even know? I don't know the organ donation status of anyone else in the world, even my family and close friends, and even those who have died.
[+] [-] oneplane|5 years ago|reply
And anti-government in general seems to be stance that often comes with "I don't like it", but without a solution and the only thing I've seen so far is people coming up with a "let's do nothing" alternative. That's not a real alternative at all because it doesn't solve anything. Either bring something else that also works, or accept that the best we can do so far is come up with imperfect solutions.
[+] [-] hoorayimhelping|5 years ago|reply
What is this? In the past five years, I've probably flown 15 times and every time, I've opted out just fine. Just stand there waiting to one side until someone comes to pat you down. The pat down is consistent across airports, and you can usually count on the TSA agent to be courteous and professional. I can't stand the agency or their dictum that they're keeping the skies safe, but individual agents seem to be decent folk.
Never had any feeling of shame from other passengers or TSA agents. Maybe I'm lucky or privileged or something.
But if you don't want to get scanned, tell the agent you want to opt out. You don't have to be a haughty prick about it. Just say, "I want to opt out, please." And when they say, "okay, stand over there," nod and say, "thank you."
[+] [-] RandallBrown|5 years ago|reply
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] triceratops|5 years ago|reply
How? TSA security checks happen in public. Opting out of this involves ticking a box on a form and it remains private (I assume).
[+] [-] bassman9000|5 years ago|reply
https://news.ycombinator.com/item?id=23252408
The next step is shaming those who opt-out. Which will then cement the ownership of the state over your organs.
Edit: and more:
https://news.ycombinator.com/item?id=23252636
[+] [-] mathieuh|5 years ago|reply
[+] [-] onei|5 years ago|reply
[+] [-] techsupporter|5 years ago|reply
The headline should read something like "As of today, all residents of England are organ donors unless they opt out" or "Organ donation law in England has changed to opt-out model."
[+] [-] elgenie|5 years ago|reply
[+] [-] airstrike|5 years ago|reply
[+] [-] scollet|5 years ago|reply
Regardless, everything is political, if even by its context alone, tech especially.
[+] [-] walshemj|5 years ago|reply
I did consider using a raspberry pi plus camera cliped to the waste line and a trained ML model to detect problems with peritoneal dialysis
[+] [-] prennert|5 years ago|reply
(I don't know what the law in Scotland, Wales and Northern Ireland is, might be that England is just the last of UKs nations to make opt-out standard)
[+] [-] afarrell|5 years ago|reply
[+] [-] ap77|5 years ago|reply
Second, it's inappropriate for a state agency to make such personal decisions on behalf of people without asking. Choice matters, and it's each individual's choice to make.
Finally, was this even necessary? Why not simply ask the family at the time of death? If there's no surviving family, THEN the state decides. Last, not first.
[+] [-] stuartd|5 years ago|reply
Some ammunition for those who disagree - organlegging!
http://www.technovelgy.com/ct/content.asp?Bnum=337
[+] [-] zeristor|5 years ago|reply
https://youtube.com/watch?v=Sp-pU8TFsg0
[+] [-] vinni2|5 years ago|reply
[+] [-] unknown|5 years ago|reply
[deleted]
[+] [-] tonycoco|5 years ago|reply
[+] [-] davidw|5 years ago|reply
https://www.youtube.com/watch?v=Sp-pU8TFsg0
[+] [-] caseysoftware|5 years ago|reply
- not my joke, forgot where I saw it
[+] [-] cmdshiftf4|5 years ago|reply
[+] [-] Markoff|5 years ago|reply
so in the end the difference is just in theory and law