I'm in kidney failure and on dialysis. Also on the kidney transplant list and was expecting this would happen pretty early on. The stopping and slowing down of procedures plus the reduction of donor organs. It could easily add an extra year into the wait time. I myself havet 1+ year in the wait list but that will probably extend to 2+ years.
To give a sense of wait time, it varies from region to region. The bay area region is pretty long wait. I think UCSF is 10+ years of wait for a type O blood recipient. In Sacramento area its a 5+ year wait. If you are type AB blood the wait is almost half the time. Some parts of the country the wait times is as short at 1 year.
Although I am somewhat eager for kidney transplant, I also know its not a cure. They might last 10-15 years before you get rejection and have to get another transplant or go back on dialysis. But the anti-rejection medications have slowly improved. Mainly been trying to stay as healthy and stable as possible.
The stay-at-home rules has also been a blessing though because I do home dialysis and that takes a lot of time so not having to travel to work means extra time is available. I even have more time for exercise. My current job has generally been flexible before but I hope more companies will offer remote work after this. Even an extra half hour lost on commute hampers my treatment schedule.
Which type are you using? I was on CPD at home (perinatal dialysis), and that worked ok for me I the UK (spent just over 4k days on the list and passed on two calls, I went on eh list before I needed dialysis)
I basically hooked up at 10 pm for a 8 hour cycle and was done by 6 am and out of the door at 7 to commute.
I would have ben ok doing manual bags but I think having to do so exchanges at work sqicked some cowokers out.
I do PD also. 9 hours on cycler while sleeping but i also have to do a manual bag for 3-4 hours in evening. That means I kind of have to be back home by 7pm. I could have gone with a full day fill but I hate the full feeling for the whole day.
So you were on the list for 4k days? That is like 10 years! Did you already have a transplant?
Ah no in the UK they now try put you on the list before you need to go on dialysis - I had managed long term decline for almost 20 years.
I also passed on the first before I was on dialysis and passed on the second as it was a "problematic" donor - they where not sure if they where HIV +ve - the Doctors send line was "don't worry we have good drugs for HIV these days"
I just did 2 10l bags in the evening and one filler to tide me over
What was the criteria to by on the list in the UK? In the US, I was put on the list when I had a GFR of 20 but that lasted only 2 years till it progressed to dialysis which is considered when GFR falls below 15. My kidney failure is due to IgA Nephropathy so it progressed despite all my attempts.
I went on dialysis when I hit about 20-25% but I had been on the list for 3 years or so before that.
It maybe the NHS has different criteria for going on the list and it my depend on consultant and the individual - but I had been seeing the nephology team since 2000 ish
How does this work? Is it possible to move and get on a different waitlist? It's hard for me to see why they would setup region-by-region waitlists. Fingers crossed for you.
This is for US but you can get on multiple lists at the same time. However you have to be able to travel to that center on a short notice. And there might be false calls where things don't work out. So most people can't list beyond the local and adjacent regions within a few hours of driving distance. However you can switch regions and carry your wait time credit over.
As for why the region-by-region setup probably because its a big country and patients can't travel from one side to another. Also its difficult to change because any change results is someone having increased wait time. And some of the states don't like to share their organ streams with others. The reality is those states with larger organ pool is because more people die there for whatever reason.
I've also been told that only a small percent of deaths result in viable organs for donation. I think like 2 out of 1000 is what a transplant coordinator told me.
A lot of the reason for the region by region waitlist is what you said, to make sure you are capable to get into the hospital within a certain amount of time to receive the organ. The other part is that it takes time to physically move an organ from the deceased to the transplanting hospital.
Time is the key here, the more time the organ is not in a living body, the less likely it is to survive transplantation. So if we didn't have regions, and you were living in San Fransisco and a kidney came from a dead biker in Florida, the likelihood of the kidney surviving is less than if that kidney came from Sacramento.
The short answer is you technically can but the ethics are foggy. On the one hand you do help even out the geographical disparity. But you're kind of buying an organ that would have gone to someone else who's probably poorer than you.
Yes like I mentioned in other reply, you can move regions and carry your wait list time. But many people are tied by job and family. Also insurance plans sometimes have preferred hospitals.
As for why I haven't tried a shorter wait region, I consider transplant as not a cure. It will eventually fail. And there are other things in progress like the UCSF artifical kidney, gene therapy research, better anti-rejection drugs. My hope is when my transplant does fail, one of these alternatives are further along. So I look at each of these things as stepping stones to extend my life.
Ever hear of the urban legends of knocking people out and stealing one of their kidneys? This would make it real.
There's a whole bunch of science fiction based on this, Larry Niven coined the term organlegger:
https://blog.oup.com/2008/02/organlegger/
UPDATE: The other article states "14% jump in fatality rates PER DISTANCE DRIVEN." So the roads are more deadly per mile, but the number of drivers has decreased so much that the overall harm is down.
I think this serves as a great lesson in statistics being converted into news stories.
The roads are safer.
The roads are deadlier.
Both are true and both are false depending upon if you are looking at the total or the per driver (and perhaps even if you are looking at per driver per minute or per driver per mile).
A better title would have been something like "Traffic fatalities in March drop to ####".
When I was in school, our statistics prof used to put up that daily chart on the bottom of the USA Today front page. He wouldn't start class until we found two or three things wrong with it. By the end of the semester, nobody in the class trusted anything from that newspaper. Great learning experience!
Talking about terrible statistical presentation - I don't know if you saw this graph[1] that Georgia published displaying corona virus impact but if not... there is something a bit off with it.
That one is so bad and so obvious to anyone who takes the time to actually read the labels that it feels like a case of malicious compliance. A boss needed a chart to support a falling case count and someone made him a visually appealing one while also showing the trend is BS.
As someone who has been watching GA's charts closely over the last few weeks, I actually disagree in this case. It was one chart of several on the page, and not even the most prominent[0], the other charts were still in the right order, and this chart still showed an overall downward trend even put in the correct order. As someone who has dealt with coding lots of data into charts and making frequent changes to them and seen how bugs easily sneak in, I find mistake more likely than malice.
That's why everyone need to learn to separate fact and opinions. Ignore the conclusions, instead look at the data. Critical thinking skills are in short supply.
The news is pretty bad in that it's mostly opinions pretending to be facts/information, with occasional data sprinkled in to support their conclusions.
ive been banging on about the subjective nature of "facts" on HN for a while now. perhaps a parable from the movie Charlie Wilson's War will help:
A boy is given a horse on his 14th birthday. Everyone in the village says, “Oh how wonderful.” But a Zen master who lives in the village says, “We'll see.” The boy falls off the horse and breaks his foot. Everyone in the village says, “Oh how awful.” The Zen master says, “We'll see.” The village is thrown into war and all the young men have to go to war. But, because of the broken foot, the boy stays behind. Everyone says, “Oh, how wonderful.” The Zen master says, “We'll see.”
I'm sorry, there is no opinion in either headline. Both are correct, newsworthy and correctly presented. Here are the relevant headlines:
"Stay-at-Home Rules Reduce Fatal Collisions"
Fact. Not opinion. Correct. And important to know, because it's good that fewer people are dying.
"Emptier US roads more lethal"
Likewise a correct fact and not an opinion. And newsworthy because driving right now is more likely to get me killed, and that's something I'd like to know.
And the media got it right, in the headline even. It's posters here that are trying to conflate the two and make them seem like they say opposite things when they clearly did not.
So... which party is the one injecting opinion? It doesn't seem like the media to me. This seems like a bunch of HN commenters trying to spin up a controversy.
> Likewise a correct fact and not an opinion. And newsworthy because driving right now is more likely to get me killed, and that's something I'd like to know.
"lethal" here means more deaths per mile traveled. that might be because roads everywhere are less safe, or it might mean that a greater fraction of total miles are being driven on inherently unsafe stretches of road (with the same local fatality rates as before the crisis). fatalities include pedestrian deaths as well. maybe there is increased risk for pedestrians but not for drivers. the article doesn't say. there's certainly not enough information to say whether you personally are at greater risk driving.
Uh... the detail you're asking for is literally in the text of the article. I still don't understand why you don't think that headline is an accurate summary.
And in any case... I don't understand your criticism at all. If there are more deaths per mile traveled, then every mile driven is on average "more lethal", by definition. So if I drive to the same place I (in the sense of an average "I" across all drivers) am more likely to die. QED.
Basically, you're just criticizing grammar by conflating my use of "I" with me personally and not the abstract reader I clearly intended. Do you make similar quibbles about the abstract use of "you" or "one", or the royal "we"?
I think the argument going on here in the comments is evidence enough that the title is evidence enough that it's misleading. some of that is just HN's special brand of pedantry, but some people are raising valid points.
> And in any case... I don't understand your criticism at all. If there are more deaths per mile traveled, then every mile driven is on average "more lethal", by definition. So if I drive to the same place I (in the sense of an average "I" across all drivers) am more likely to die. QED.
my criticism is that the average deaths per mile doesn't imply anything about your risk on a typical trip for you. for one thing, the excess deaths could all be pedestrians, and the deaths per mile for drivers could be the same. in particular "So if I drive to the same place I (in the sense of an average "I" across all drivers) am more likely to die." is not implied by the information in the article, because a very possible explanation for the increased rate is that people are not driving to the same places.
let me try to construct a counterexample from my life. in normal times I drive 20 miles each way on the interstate to commute to work. once or twice a week, I drive a mile to the grocery store through a dense urban area. for the sake of the example, let's just assume the interstate has much fewer deaths per mile than city streets do (pretty sure this is true, but don't want to bother looking up a source). I, like many other people, no longer commute to work, but I still buy groceries once or twice a week. so a far greater fraction of my miles are on high-risk stretches of road. the average risk I expose myself to per mile is indeed higher, but this doesn't imply that driving to the grocery store is any more dangerous than it was before. in other words, it is a fact, but not a particularly meaningful one. it shouldn't influence your behavior.
reporting averages without some context or explanation is not very useful and people who aren't familiar with statistics are going to draw all kinds of unsupported conclusions. another random example: I live in a Very Dangerous City if you go by the overall murder rate. but if you dig into where the murders happen, they are tightly clustered in certain areas. I'm no more likely to get shot in my neighborhood than I would be in williamsburg.
> the average risk I expose myself to per mile is indeed higher, but this doesn't imply that driving to the grocery store is any more dangerous than it was before.
It doesn't mean it doesn't either. Someone would need to do the science to show it either way, and that hasn't happened.
I don't see how you get from there (which you could have said in like 5% of the prose as "the variables aren't independent") to your point that the news media shouldn't ever report on scientific results if there is the possibility of a confounded variable.
The standard you want applied would effectively mean that the media can't report on experimental science at all. So I'm going to go back to my original supposition that what you really WANT is for the media not to report on inconvenient facts, and you're hiding behind scientific pedantry to make the case.
There are at least two reasonable readings of that sentence. One is that US roads have more fatal accident risk per mile driven. Another is that the set of US roads is the scene of more total fatalities.
The second one is a more natural reading to me, but presumably not to some others.
Your definition would seem to insist that a nuclear warhead is not a "lethal" weapon, since no one has died to one in three quarters of a century. I guess "reasonable" is an opinion thing, but I think it's pretty clear that the usage in that headline is conventional and correct.
It does not insist on that, but it does mean that “saturated fats more lethal than firearms” would be plausibly correct and “saturated fats more lethal than nuclear weapons” being almost surely correct.
> “saturated fats more lethal than firearms” would be plausibly correct
Then I don't know which dialect you speak, but that's an outrageously weird interpretation. It's certainly not the way the word "lethal" is defined or interpreted in common usage among the folks I've known.
But those are both facts - less people are driving, but if you do drive you're more likely to be in an accident. Are those conclusions? Would a presentation of facts just be the data itself?
Are you more likely to be in an accident? Or are you more likely to be in an accident with a fatality?
It seems like heavy rush-hour traffic is prone to creating a large number of accidents with a low total number of fatalities. When I drive around now, I believe the risk of accident per mile is significantly lower (city dweller used to typically packed city roads), but due to higher speeds, I can’t make the same claim about lower fatality risk.
> Ignore the conclusions, instead look at the data.
Also, do not ignore the opinion, instead look for it specifically, and assume that the data has been curated to support that opinion. Then go find the gaps.
I think the biggest problem with the modern media is that all stories are reported at "equal volume." Any tidbit the media has to fill time is headlined as if it were the most important thing currently happening in the world. There's no moderation of tone or consideration for reporting an accurate overall view of the world.
It's both interesting that traffic deaths are down overall and that deaths are up per mile traveled. But I would argue that they are not anywhere near equally important news. The total lowering of traffic deaths is news. The increase in deaths per mile is an interesting bit of trivia relevant to few people and should be reported as such.
This has been especially bad with something as nuanced and data-driven as COVID. Any new number or stat gets a headline even if it has zero meaning in the grand scheme of things. I've seen news sites with two stories on the same page simultaneously proclaiming that there's no evidence that there is immunity to COVID while also proclaiming that a vaccine trial was successful.
Coincidentally, that's where oldschool print media was better, if only due to space being limited and budgeted. Computers, otoh, are only good at dealing with things that are all alike.
But also because articles were all laid out right there on the pages next to each other and could be compared in physical terms.
"The roads are safer" is not true. It's more dangerous to drive right now. There is no sense in either of these stories which it's safer to be on the roads.
Something like "the roads are killing fewer drivers" would be true.
We're not sure about that conclusion either. One other possibility is that the population currently driving on the roads right now is more prone to accidents than the population currently staying home, and so fatality rates per mile driven have gone up. Perhaps they have older cars without the latest safety features, or their cars have prior accident damage that wasn't fixed, or they skew younger with less driving experience, or they're rushing to get to their jobs, or people are out for joyrides. In that case, fatality rates among drivers staying home have dropped (to zero) and fatality rates among other drivers have probably dropped (less to collide with), but because of Simpson's Paradox overall fatality rates have gone up.
You can't know which is a better explanation unless you have data with more granularity than is typically provided by the press.
or as another poster suggested, people might be driving more accident prone routes right now. my commute to work is a 20 mile point-to-point drive down an interstate. aside from merging, there's not much that can go wrong. a trip to the nearest grocery store is a one mile drive through a dense area of the city with many pedestrians and awkward intersections. the per mile risk of the grocery run is much higher.
These reports only say "motor vehicle fatalities", not whether the drivers are the ones at risk.
In my experience, there are a lot more pedestrians blindly walking or running across the roads in the past couple months. The drop to nearly zero traffic lulled people into a false sense of security. People are treating every road like a giant sidewalk.
The whole jaywalking thing is idiotic. Let pedestrians walk. I live in San Francisco where pedestrians are going to be everywhere and it's really not that much harder. In the UK, you can just cross any non-motorway at any time and it's about whether the situation is safe. Well, fewer fatalities total, fewer fatalities per mile driven, etc. etc.
Genuinely don't think non-highway road crossing needs to be excessively regulated. Human beings will self-organize and the exceptions will not cause significant economic damage. More freedom and less regulation, please.
And that is exactly what the story is saying, which is why organ donation is down. The story does not say the roads are safer. You are drawing that conclusion yourself or being led to it by other commenters here. The words "safe" and "safer" are not present in the article.
Actually, that's the funny thing: drivers don't kill drivers. Not even collisions kill drivers. It's just that some people, post-collision, have their heart stop. So really, if you think about it, their own heart killed them. We should mark them all as suicides, honestly.
In this usage, "road" means more than the asphalt. It includes the cars on it as well as objects that could be crashed into, such as light posts, nearby trees, etc. If it is a road without a guardrail next to a cliff, it includes the ground at the bottom of cliff, since that is probably what's going to kill you, not the road itself.
You could express it in a way that would be correct to all the pedants out there, but it might be a long convoluted sentence.
The drivers aren't necessarily more dangerous. They might just be driving more dangerously with less traffic. It's easier to die going 80 on the freeway than if you're stuck in gridlock.
I think we can at least agree that the statement "the roads are safer" is false.
Plenty of places are increased traffic but not bumper to bumper
This is all rounding numbers that have been rounded already to smooth out uniqueness of a given locale
Water is wet level conclusion that using math correctly by math rules to debate a topic that’s locally unique and out of view for people in far flung regions.
My individual odds of dying in an accident haven’t changed much. Safer or worse in some aggregate measure isn’t that useful to me today or tomorrow. Still gonna do as I do.
I wonder if that could be due to a mix-shift in who is driving (perhaps the safest drivers are disproportionately spending less time driving compared to the less safe drivers)
Speeds could be up due to less traffic density, people even more distracted. Could also be the same base rate suicide by car crash. I'd be interested to know if the fatality rate involving big trucks and passenger vehicles has changed. It could be that the fatality rate per truck mile is a constant independent of the number of passenger vehicles on the road.
With proper data sets, all of this should just fall out.
Speeds are definitely up. There's a "30 mph" road near me with a stretch that's as long and straight and remote as any highway, and even the cops are driving >50mph there now. Normally it's packed (it connects two high-density areas) so you're lucky to get near 30mph.
Sounds a bit like my street. It isn't remote, but originally developed as large 2 acre lots with far setbacks. Now a lot of infill has occurred but most homes still sit farther from the road than a typical residential neighborhood, so it feels more rural than it is.
It's signed 25mph. Normal speeds are about 30-35mph. Now, every morning starting about 5:30am, drivers are using it as their own personal drag strip trying to lay down their best 0-60 times.
Among my outings in LA, people are driving like absolute crap. Speeding to every red light, going 100 mph on the freeway, no turn signals, no one checks their blind spots, lots of swerving so maybe a lot of drunk driving, too. Every 10 minute drive I see 6 near misses.
I live on the other side of the country. I am an essential worker so I've been on the roads every day since lockdown. I am terrified of the reckless driving happening nowadays. I am considering mailing lawmakers, something really has to be done.
you're making a fundamental attribution error[0]: that people are fixed in their predisposition for safe driving rather than being situationally influenced.
the opposite bias is possible in theory, but practically irrelevant. the fundamental attribution error derives from being social animals--that we care endlessly about what other people are doing and why (to predict, and shape, the social future).
the opposite--over-attributing to the situation--typically happens to deceive (e.g., shirk responsibility), rather than being an intrinsic bias of our social environment like the fundamental attribution error is.
Both can be true – roads can be more lethal on a per-mile-traveled (or per-minute traveled) basis, but with many fewer miles/minutes traveled overall, total cumulative fatalities are down. That seems to be the case in these articles.
This sounds like it's in line with the theory of risk homeostasis or at least the Peltzmann effect.[0] The theory states that as people feel safer they will take riskier actions. In this case the roads are emptier so people feel that they can drive faster, which leads to more accidents. Note that the theory does not have much support, but there seems to be some kind of an effect like this.
Another factor could be the delay between drives; For myself, going from commuting daily to driving once or twice a week, it feels weird and I’m on more alert than usual when driving. As if I have to relearn the car is an extension of myself (in a spacial sense)
So perhaps people are essentially less used to driving, and therefore, more prone to error or less comfortable (which may increase anxiety, or hesitation for in the moment decisions)
As someone who tries to avoid driving where possible (I prefer walking, biking, public transit for reasons), driving after not having done so for several weeks or even days definitely has a noticeable degradation in skill.
The few times I've been out recently, I've definitely noticed that the other drivers on the road do not appear nearly as confident or comfortable.
Just another point of anecdotal data for what it's worth.
Heavy traffic dramatically increases the accident rate but decreases the fatality rate because it prevents people from building up enough speed to overcome their vehicle's safety features.
However, there is a hidden fatality rate in slow traffic. The number of person-hours wasted waiting for the traffic to move. It can build up to a lifetime pretty easily with enough traffic, so cumulatively the traffic jams in a major metropolitan area can waste the 750,000 hours or so of people's lifetime and virtually kill a person.
Unfortunately, I suspect support in most of the U.S. for mass transit has just taken a massive dive, since nobody wants to be in close contact with other people any more. I wonder how long that will take to wear off?
Yeah it's a bummer---the problem is commuting not mass transit, and even then the problem really is healthcare policy, as evidenced by denser cities elsewhere that have fared better now and in previous epidemics.
My temporarily hope is to switch tactics and go more streetsblog.org focusing on pedestrian and cyclist issues. It's not a sustainable policy to exclusively focus on those, but hopefully it's an acceptable lie in the short-term. (Cars being workable is also a lie, so hey, at least not stopping lower than the enemy.)
It's also predicted that if self-driving vehicles become viable and ubiquitous, you'll also see a shortage of organs since a significant amount of organ donation rely on vehicle fatalities and in theory, self driving vehicles should be safer. I'm sure its not coincidental that organ donation opt-in is closely tied with most state drivers licenses and renewals.
I haven't seen an analysis but I suspect you'll also see a lot of municipal revenue streams cut down when if self-driving cars or other transports become popular. I know a lot of small towns rely on lots of interstate traffic tickets to help balance their budgets. I suspect most those violations will decrease significantly with autonomous transport. I'm not sure how many cities/towns at large are reliant on these sort of revenue streams but I presume increased taxes would need to pickup the bill.
Cars are the only practical way to go where you want, when you want, how you want. No bus schedules, complicated connections you have to double check and run full speed between (across the whole Port Authority terminal once in my case between trains), or drop off points you have to walk long distances from once you get there.
Bikes are close but only work for short distances in good weather. Add personalized climate control, no strangers in your car, more comfortable seating than any tram, music, and I have no desire to seek alternatives. Only thing I'm left desiring is self-driving so I can use my phone or whatever, the only tangible benefit to transit that appeals to me.
Yeah, they're a bit noisy and worse for the environment and take up space. I see that as part of the price of living in a free society.
> Cars are the only practical way to go where you want, when you want, how you want.
This is more true in some areas than others. In a relatively dense city, with well-designed (and, crucially, frequent) transit systems, a whole lot of "where" and "when" you want is going to be more practical with transit, and of course cars can't help you with "how" you want if what you want is not to have to be driving. In many cities, driving my car (or renting a car, if I flew there) would have been tremendously impractical.
It's certainly convenient to have a car sometimes, and there will always be some trips for which your statement is closer to true. And if you choose to live in a place (/cough/ suburbs /cough/) where anything but cars would be impractical, then yes, cars are the only practical option. But it is far, far from the absolute that you make it out to be.
(PS I'm definitely not talking about commuter rail in the US here. Even the "good" lines are terrible by global mass transit standards. They are not "practical" except for a very tightly-constrained set of needs.)
I have some experience with NYC transit, which is what my post was based on. Crowded, sketchy, stressful (more so than congestic traffic to me), and all the points I said before. Specifically coming from upstate to the Museum of Natural History. Train ride was nice at least but it did involve running across the PA on the way back.
I've driven/been driven in NYC a few times (pre-pandemic) and it wasn't /that/ bad, but I don't think it was ever in Manhattan. Most recently was going to JFK and back from somewhere more upstate.
I looked into transit options and they were seemingly expensive (might have been a wash with crazy bridge tolls down there), had a bunch of connections, and long walking periods or uber connections adding more expense. Definitely didn't sound fun to bring luggage along.
NYC is supposed to be the country's shining example of transit, isn't it? I can't say it enamoured me. If I lived there I'd probably end up biking a lot.
The flip side of this would be to say that auto fatalities are fairly low and steadily decreasing, with a fatality rate of 1.25 per 100 million miles driven. For reference, that's 10% greater than the distance between the Earth and the Sun.
Cars are noisy and take up a ton of space. In cities bikes seem like a way better way to go, especially with e-bikes. They are quieter, safer, smaller, and healthier. Auto fatalities are only low compared to previous years of auto fatalities. Also, electric cars are still noisy. Tire noise at 35 mph is the same on both electric and IC cars.
For some short journeys in good weather - yes but as the rate of bike theft is massively more than car theft
Many offices / train staions don't have secure of street bike parking and I aint going be parking my bike on the street even if its a cheap £400mtb let alone a >£1200 Brompton
Bike theft and lack of bike parking seem like wildly cheaper and easier to solve problems than the mass of traffic infrastructure problems needed solved for cars.
Understandable concerns. Around me at least it costs about $7000 all in for the improvements for a single parking spot in the city. 2-bike lockers cost about $1000 and take up a fraction of the space.
Even people like Richard Thaler who favor "nudges" to drive behaviors, have been somewhat skeptical of opt-out [1] in this case. One of the problems is that defaults are so powerful. Therefore, in the case of an emotional decision like organ donation, it's easy for a distraught family to argue that the deceased never made an informed decision. (In the referenced column, Thaler argues for mandated choice, e.g. you have to make a choice when you renew your drivers license.)
Organ donor is an umbrella term, is not determined your organs are actually gonna be used until you die and a doctor assess the quality of your organs -including damage pre-existing conditions-, so you can be legally a "organ donor" even if they none are actually good enough.
I would not withhold blood from anyone who needs it, no matter how much of a jerk they are, but I am leaning towards the (admittedly unpopular) belief that members of society should have an obligation to donate at least a minimal amount on occasion.
Blood is a funny case because we have a huge never-ending need for fresh blood, and a great number of people (est. 1/3 to 1/2 the population) are eligible to donate, yet very few do. Globally we're so desperate for supply that, even though the WHO has set a goal of 100% non-paid volunteer donors due to safety concerns, we do still have to pay people, and America sells a lot of blood overseas to all those other countries who are too cautious to pay their donors cash outright.
Tons of people are perfectly willing to donate blood. That's not even the problem. In the aftermath of a disaster, blood centers near the disaster area often have so many donors they have to throw some of it away. People are not that afraid of needles, or unwilling to help their fellow humans. They just don't, usually.
Living in my developed country with all of its benefits has costs. I pay taxes to help fund the general welfare, and may be called to serve on a jury, or even go fight in a war. Calling on a few people to give blood doesn't sound too onerous to me.
I don't claim to have the answer, but I think everyone agrees we can do a lot better than what we've got now.
The argument is fundamentally the same. The benefit outweighs the cost by a large margin. There are social and psychological reasons for not donating organs after death that apply to blood donation as well.
Setting aside the few religious exceptions, that is correct. This gets to the root of the issue. Whether the body is property of the family or of the state. I argue for the former. In the USA there has to be compensation for property taken by the state. There also has to be a public good argument in most jurisdictions as far as I know. Because the beneficiary of the organ is not the general public, but an individual, I do not see how this could work without massive revisions to state and federal law.
As far as I can tell, dead bodies aren't property in the US. They can't be stolen (although other laws would likely apply), they aren't part of the deceased's estate, etc.
One reason it could be different - your blood is yours now, but your body after death isn't yours any more, it's just a corpse, any residual rights over it should not supersede society's claim on it for the needs of the living. So this would suggest that by Kant's Categorical Imperative it's fine to only use organ donations from the dead as medical treatment on those who agree (or whom society has taken to agree) that their organs could be likewise used, because if you don't want your dead body used what right could you have to do otherwise?
We are not property of the State therefore, society has no claim on it.
If we are property of the State then all we're disagreeing on is the moment where their claims supersede our own.
The moment of death is a convenient but negotiable/re-definable point: "Well, they're brain dead already.." or "Well, their quality of life.." or "Their chance of survival.."
Or to put it another way: Do you want want [your least favorite politician] writing this policy?
> We are not property of the State therefore, society has no claim on it. If we are property of the State then...
You're trying to force this into a "We {are|aren't} property of the state". Both sound completely wrong to me, on multiple levels. It's a TypeError. You're applying words in ways that don't match.
(You might as well try to convince me that "Beethoven's 5th is either color, or black-and-white". No, those are both wrong. I'm not going to agree with any conclusions you reach starting from either condition.)
Humans aren't "property" (of themselves, or anything else). And the state doesn't own something today just because it may own it after your death (e.g., when a person without a will dies, their house may go to the state, but that in no way means their house was "property of the state" while they were alive, and definitely not that all houses are property of the state).
> Do you want want [your least favorite politician] writing this policy?
Again, that sounds like a fallacy that's trying to goad people into a false choice. I don't want my least favorite politician writing any government policy. There is no framework yet conceived under which a malicious administrator would not be able to cause great harm by instituting a policy of their own design. That doesn't mean all such policies are inherently ill-conceived.
I saw your other comment and was surprised to find the same. I had no clue it was like this. The laws are either vague or explicitly prohibit doing much of anything to a corpse outside the normal burial and cremation.
Opt out assume consent is the default position which is in general opposed the nature of consent being something given, not something that has to be withheld. I get it is for the greater good, but the mentality and treatment of consent in such a schema means the means aren't as clean. Do the ends justify the means in this case?
One option I've heard that sounds better is just force people to make a selection when they apply for a drivers license. Current you can opt in, but if you don't do anything you automatically opt out. Instead, just don't accept the form unless they opt in or out. This means the people who would donate but either miss the form or think they'll eventually sign up later (and never get around to it) are signed up.
And, if the ends do justify the means, what about requiring people to be organ donors except for the same exclusions allowed with vaccines? We effectively force vaccines for the greater good and this would be another similar case. Not like the people will miss their organs and as for the family, they won't even know unless you told them as the funeral industry routinely repairing bodies that have gone through far more than an organ donation.
You're saying "maybe we should avoid saving millions of lives a year because someone might feel really strongly that they don't want to save lives after they die, but not strongly enough to go to the effort of ticking a box on a form".
Yes, the ends justify the means. It's, like, one of the foremost global examples of an ends-justify-means cost-benefit change we could make to improve lives.
But, to rephrase your earlier comment: You're saying "maybe we should avoid saving millions of lives a year because someone might feel sad that they don't want to save lives after they die".
It's not clear to me why that would apply to the earlier comment, but not to yours. Unless it's because of the part I left out about them not feeling strongly enough about ticking a box, but then I don't see what the problem is with the original suggestion of making that box-ticking obligatory.
Disallowing opt-out hurts some of the people whose organs will be donated, while those people are still alive. If they have a strong objection which doesn't qualify for an exclusion, they have to spend their life feeling this lack of control and disrespect of their after-death wishes.
Just switching to opt-in by default has none of these problems, so that's why I support opt-in-by-default but not mandatory donation. It's not inconsistent .
> Disallowing opt-out hurts some of the people whose organs will be donated, while those people are still alive. If they have a strong objection which doesn't qualify for an exclusion, they have to spend their life feeling this lack of control and disrespect of their after-death wishes.
Doesn't opt-out also hurt people while they are alive, who are now pressured to remain vigilant about having to make sure they're not missing any forms, or their forms not being processed correctly, etc., spending their life feeling a lack of control where a single misstep results in disrespecting their after-death wishes?
And again, what's the problem with making the box-ticking obligatory e.g. when picking up a driver's licence, rather than making it opt-out?
We may have miscommunicated. I'm fine with making the box-ticking mandatory, but not the donation mandatory. In your earlier messages you asked about mandatory donation, not mandatory box-ticking.
Opt-in-by-default does have the disadvantage you mentioned, but I don't think it carries much weight. Society could solve this problem just by sending a certificate/card to people who opt-out to tell both them and medical practitioners of their choice.
After death, isn't consent (in terms of donation-to-the-state) the default? If I buy a house and then die without having written a will ("opting out"), the government can indeed take it.
Yes, in that case they would normally try to give it to my heirs first, but my heirs have no right of ownership of my organs.
Agreed, it's a missed opportunity - Especially considering that organ donation just became opt-in for all of England as of the 20th of may. Seems like a relevant story to tie-in.
I get that argument but I fear that the organ donation system in general can lead to really perverse incentives in some cases. If you show up to the ER alive but on deaths door and the doc knows you will be a good donor will they work as hard to save you?
As well as the great reasons already given, they don’t know what your donor status is or the quality of your organs. Your family still has the right to deny harvesting.
Wales switched to opt out a few years ago and the rest of the UK is changing now.
The organ donation does lead to perverse incentives, though cases of ER malpractice of the sort you describe are so exceedingly rare that any steps you take to solve this will save more live by being primarily focused on alleviating people's fear rather than reducing the minuscule number of actual cases.
The real issues of perverse incentives having a significant impact has to do more with for-profit companies that participate in the market for body parts and the state of interdependence that now exists with our understaffed medical examiners. There are far more cases of aggressive organ harvesting interfering with criminal investigations than ER doctors letting people die to collect the organs.
This comes up from time to time as a counter argument to opt-out, and it makes me sick.
That ER doc you're talking about has spent their entire life working their fingers to the bone to help others. They are beyond committed and passionate about saving every possible life, even when it's detrimental to their own health.
To suggest they might not work hard to save someone right in front of them is insulting and horrible.
> To suggest they might not work hard to save someone right in front of them is insulting and horrible.
Counter-argument in the form of a question: does one life matter as much as (or more than) three or four that might be saved from that one life's organs? Especially if the one that's clinging to life might've ended up in that position as a consequence of their own actions, such as by way of an at-fault car crash?
I'd argue that the doctor's responsibility is to save any life presented to them regardless of how, but I won't put it past anyone to do the calculus above.
(this may appear to meet the textbook definition of a strawman argument, but I'd venture that this is--by virtue of how many organs can come from one person--a real enough possibility to warrant consideration)
Coming back to the calculus performed: if the odds of survival are much less than certain, what's the point at which a doctor, thinking algorithmically rather than with a mission, decides that there's more value in lives saved from a patient's organs than in trying to save the primary patient and potentially losing organ viability (or just time) if the mission fails?
I'm pretty certain the vast majority of doctors will obey the Hippocratic Oath as intended. I'm also somewhat certain that a minority subset of doctors will interpret the Oath differently than others, and this is the most impossible assertion to falsify because very few surgeons/teams will admit this short of a certifiably anonymous survey... if that.
Orrrrrr maybe just like every other industry we should acknowledge that there are bad actors and/or people who make questionable judgments about the best way to 'help others'?
Look at even the mental health profession, where in all cases Doctors are supposed to be 'helping others'. And yet I know that I could never see my housemate's doctor and get the same set of meds that I get seeing mine.
We both have very similar conditions, and yet the life outcomes are vastly different in that change in meds. Yet housemate's doc insists they are doing the 'morally right' thing.
Edit: FWIW, my interactions with Doctors and Pre-med students outside of the actual medical profesison and the stories I've heard do nothing to help my assessment.
While I'm an organ donor and don't take the supposed risks of that seriously, I don't think your argument is a good one. Not all surgeons are wonderful people. They're only human after all.
A simple web search for "surgeon charged with" will reveal that sometimes surgeons do things they shouldn't, just like members of any other profession. How do you square "They are beyond committed and passionate" with surgeons who rape their patients, or knowingly perform unnecessary surgeries out of greed? You can't.
This is far too much power for the govt or healthcare industry to have over people. A lot of people won't know they need to opt-out, and the opt-out can be, or become, very burdensome.
I know you want to stop wasting valuable organs from dead people that could go to help living people - and I do too! I just don't want people to lose agency over their own lives and body parts.
Then there are the wicked, amoral, heartless people - like me - who think people should be free to sell their organs if they want to. I would personally sell any of my organs (after I'm dead) for $1 each. But as a form of protest against the current system, I won't ever willingly donate them.
While I don't think being able to sell your organs is immoral or unethical, there are practical ramifications that makes it difficult to agree with your position.
If organ selling is legalized, poor people will be coerced by force or by money. And they may not realize the full health implications of that until much later, where they have no recourse.
As a society, we generally try to prevent people from entering such unfair contracts, e.g, you can't agree to become a slave, or establishing ceiling on interest rates to limit predatory lending. People willing to sell their organs are probably desperate enough to agree to anything, and saving them is worthwhile.
And I'm sure your little rebellion against The System may feel good, but here's what I think you should do. Go to your nearest dialysis clinic and offer to keep people strapped to a dialysis machine for 5 hours, 3 days per week company.
It might occur to you that your childish ideas about "sticking it to the man" is ignorant horseshit.
This is all basically a "greater good" argument end of the day that you either agree that if your body can be used to help others then it should be or the alternative is you are a selfish ass. There is honestly no inbetween here.
I think the best part it is that we're stopping to think about our behavior in general.
So much of what we do is inertial, normalized insanity that bears some introspection.
For example, it's interesting to hear so many people talk about how they miss shopping. I'm the same way, and it made me think ... wait a minute, I've saved more money in the past two months than I have in years, I don't feel like I'm missing any tangible goods ... maybe rampant consumerism is, in aggregate, bad for me?
Same with dining out, which I did with incredible frequency.
All of this makes me think not just about my behavior, but the massive drivers behind making us all want to spend money on things we don't need in the pursuit of manufactured pleasure.
I've been getting all my retail therapy out at the grocery store.
It's interesting to think about what long term effects this will have on shopping, particularly retail stores long term. This was a good piece on it: https://www.wsj.com/articles/a-coronavirus-bull-market-for-g... This will definitely impact the way people interact/eat in NYC.
Should we also be condemning our local gastropub for charging $15 for a burger? Shouldn't they be charging the same as White Castle? People gotta eat after all.
These are customized. I mean, if this were the only company selling facemasks, sure, $15 is a lot. But for somebody who wants to jazz up their facemask, maybe $15 makes sense. I'm not interested in that but maybe somebody is.
$15 is the starting price, affiliates can charge what they like.
If burgers were a thing people could use in a pandemic to reduce transmission and they let affiliates put a design on the bun and upcharge to get a sliver of profit I think this might be a fair analog.
I dunno, I think this is a missed opportunity for some good pr, or at least not look like they're exploiting a crisis even further.
But, again, it's not like this is the only company selling masks. It's not price gouging if there are tons of lower cost alternatives. They're offering an upgraded experience, some people are going to want that, and that's ok.
If I were complaining about price gouging in a hurricane and you came strolling around and told me "hey, that's how economics works" I'd say you missed the point entirely.
In other words, my issue isn't with the mechanics of capitalism.
There's been a lot of press about delivery services gouging restaurants now that a majority of them are being forced to use them.
I did see the other day Chipolte is doing their own delivery service now which is awesome. Not sure why more places ditch Grubhub and Doordash and just have their own in house delivery service. It's so much cheaper than outsourcing to companies who've been gouging restaurants and the consumer.
There will be an equilibrium between these things, and it's not necessarily just “gouging” if delivery services increase prices, given that the actual supply of drivers (as has been reported here before) is strained.
Basically contract delivery services have a premium to begin with, to take the delivery business off your hands. If you have dramatically more orders per day, it can actually make sense to have your own delivery people; especially since your managers have all the time in the world to focus on delivery now that your dine-in is closed or restricted.
Even if you have a high order volume, a delivery service should still have more deliveries near a given destination and be able to improve margins by grouping those together for delivery.
I may be the only person in my apartment complex ordering Chipotle for dinner tonight, but there are going to be several others ordering something.
That is a common assumption for people to make about delivery services, but it is not that correct with prepared food delivery, where it is unlikely that you will line up even two pickups without compromising the freshness/hotness of at least one of the orders; often this is difficult even if both of the pickups are from the same establishment.
Now, unlikely and difficult don't mean impossible but there's more to it than meets the eye.
There are tons of examples of this (my local car dealership is running a deal on getting your car detailed right now). It seems odd that you picked probably the least egregious example possible, a company selling face masks.
It's a good lesson for those that naively think the world is (largely) uncoupled, where you can shut down / remove one part, and nothing around it is affected.
I remember talking with some ex-colleague of mine some 3 months ago, just before the pandemic hit us (where I live, that is) - we were talking about how this would impact business, and to my big surprise he was very cool about the situation. I had to remind him that he (working in marketing, living in a tourist city) was only approximately two edges away from the businesses most in danger of getting pummeled by the virus.
But, no, it was only "hysteria". Lo and behold, 6 weeks later he's temporarily laid off, because the businesses he's making ads for are closing down, because they again were supplying stuff to the travel industry, among others.
And we're going to see a lot more of that, in the upcoming months. The reach is wide, and the aftershock is long.
And these same people think they will just be hired right away and things will spool right back up. With nearly 40 million people claiming unemployment. Things that took years to build crumbled in weeks. It will take years again.
I wonder about the alternative timeline scenario where America didn’t have such high levels of the pre-existing conditions that make covid deadly (>98% of covid deaths in MA are due to/with preexisting conditions).
It's a shame for the people who need transplants, but reducing accidents is overall an improvement. Fewer people are dying overall. If we were approaching this from the opposite direction, nobody would suggest that increasing the number of cars on the road would be good because it would increase the pool of organ donors.
The bigger issue is buried in the middle of the article: we lost out on possible transplants because of lack of COVID-19 tests. There's no upside to that.
I've put on weight, lost a lot of fitness and strength, the stress is taking a mental toll and I skipped a cancer screening test. Its really affecting my health and I'm nowhere near the virus.
This has also been discussed as a consequence of every car becoming fully autonomous someday. Crashes will be way down. We need to keep making progress on lab grown organs.
Wow I read that headline wrong. I read it as 'Oregon Transplants..." and was wondering what reduced collisions had to do with people moving into state.
I've definitely noticed a lot more bad drivers on the road recently. I think I've hit my dashcam button more times in the last month than I have in all the years combined.
Saw a stat from ICBC the public insurance auto insurer in British Columbia. There's usually around 15,000 "accidents" (let's call them car crashes folks) a week in the province. With Covid, numbers are down 60% some weeks to ~9000.
Really shows how incredibly dangerous our automobile oriented transportation system is, and how effective removing cars from the road can be.
This was somewhat predictable.
I will be really interested in another piece of data.
When we re-open fully (whatever that means) and people get back on the roads perhaps even more than they used to will it reset the waiting times because of excess collisions and more fatalities?
For some reason I keep reading this as "the number of people who move to Oregon is decreasing", and my brain can't draw any connection between that and traffic collisions. Maybe it's the HN bubble around news focused in tech hubs on the West coast.
Electrocutions, banana-slipping, fork-stabbing and ladder-falling down as forced self-imprisonment into madhouse soft-rooms reduces stupid domestic accidents.
Meanwhile in Russia, approx. 3000 people are reported to die of corona in 5 months. In 2019, 16'900 died in road accidents. That gives approx. 7000 in 5 months. Which is twice as many, but I can't remember anyone locking down the roads, scanning QR codes in order to unlock the car or zealously repeating the NEW NORMAL, THE WORLD HAVE CHANGED mantra out of every hole. Heck, neither can I remember anyone constructing concrete barriers instead of purely nominal double center lines between adjacent opposite lanes where possible!
But are traffic accidents contagious? We're at 10% infection now. What will 50% look like?
Its cute to deliberately conflate dissimilar things. Corona is different among mortality statistics in that, everybody can be at risk if we're not careful.
A relative of mine works at the central hospital in my city. She's been seeing with her very eyes that the department of infections is empty since the circus began. People with infections other than corona are sent home to cope or die, because empty beds are reserved for corona. Explain, please. And also explain by what magic the U07.2 in death certificates is transmuting into U07.1 for the news and statistics. If you don't know what that means, lookup the WHO's disease IDs.
"U07.2 COVID-19, virus not identified" changes to "U07.1 COVID-19, virus identified" presumably when the test results come back. Probable cases versus confirmed cases.
But do you subscribe for an accident or a non-contagious disease at some kind of Public Terminal of Fate? 3000 dying of tuberculosis every day, did they subscribe for such a death?
Well if nobody subscribes for death, why are people still mortal?
Everyone can be at risk of dying from cv? no, for a young healthy person the risk is similar to shark attack or lightning strike. However everyone is at risk of dying in traffic accidents, even if they never get in a car.
First: I have no reason to trust Russia's reporting on their COVID statistics. Nevertheless, Russia probably should enact more road safety measures had they the resources to enforce them because Russia's road fatality rate is among the worst of developed nations in the world.
All that aside: road accident deaths aren't contagious. They happen and they are done. There is no possibility of [exponential] community spread, I don't have to worry about infecting my grandmother, your grandmother via you, or the immuno-compromised children my wife cares for in the hospital.
Of your deceased relatives, may them rest in peace, did anyone consciously choose the way to die? If not, why did they die? Because they wanted to? Because they didn't resort to drastic counter-measures?
My grandfather died of electrocution in 1996. Would he be still alive today, given that he was born in 1927, if he would meticulously scrutinize every millimeter of electric cords he ever touched for potential cracks?
Bad faith arguments all around. There's a clear difference between isolated events and those that possess the ability for exponential community spread. I'm not inclined to debate it further.
I'm not debating with you. I'm writing this for the occasional sane people coming across this thread who rely on facts and not on the fear of possibilities. For those, a question: if, as they say, the exponential growth is kept at bay by the drastic lock-downs, why haven't Sweden and Belarus die out completely yet? Or Russia, where, I can tell you for sure, most people recognize that this is a staged event to make the wealthy wealthier and the poor poorer and to impose modern slavery and technofascism? Where is that deadly exponential growth being bleated about so hard since January?
You are creating a straw man argument. You have inferred too much about my beliefs based on my incredulous responses to your bad faith comments. You are debating with me, but I'm not debating with you.
>Meanwhile in Russia, approx. 3000 people are reported to die of corona in 5 months.
Yesterday I got a great deal with a loan shark. He gave me $10 at 540×10¹⁴% annual interest. Everyone is acting like this is a big mistake, but today I only owe him $11. Why all the fuss?
I've seen this a lot online and I can understand the appeal, but it's also misguided. (I'm not all doom and gloom, I believe there's no need for total lockdown until a vaccine.) Simply we don't know exactly how many people have died of coronavirus right now because it's hard to separate out sometimes what the cause of death is. We DO know, however, how many more people are dying than generally die this time of year. It's a lot more. In England and Wales, it's 52% more while in Belgium 60% more.
In the USA there are usually around 35-40k traffic fatalities per year. COVID19 even with the lockdowns has killed around 95k. With the release of restrictions, soon there will be more.
At the current count of a minimum of 354,000 deaths, we would have to mitigate 26% of traffic deaths world wide for the entire year before it would make up for the fatalities caused by COVID19. So far it appears that traffic fatalities haven't decreased that much during the lockdown. In California, where we have good figures for this sort of thing, there has only been an 8% decrease in fatal accidents for the first 3 months of 2020 despite an 18.6% drop in number of miles driven.
Unfortunately it doesn't seem that the decrease in traffic fatalities will offset more than a fraction of the deaths due to COVID19. Especially considering that the death toll is projected to easily exceed 1 million worldwide.
you are right in a certain sense. The point of lockdown was to avoid triage deaths, ie deaths from a lack of hospital capacity. We have not had an issue with running out of capacity so it looks like we could have kept triage deaths to zero even with basic preventative measures like masks. On the other hand we are actually saving lives due to reduced traffic, because of lockdown.
You are making a lot of unfounded assumptions in tht statement. As far as we can tell, 'self-driving' cars are no safer in real-world conditions any more than a trained driver is.
I think the biggest safety increse from transportation autonomy, whatever its form, we are already seeing with Uber et al. Those who would rather not drive, don't have to.
I am not an organ donor. The reason is simple: Everyone in a transplant chain (Organ Procurement Orgs, Hospitals, Transplant Surgeons) makes money off a transplant except the guy giving up his organs. The rules for me are clear: I have a simple price on each of my organs should I be brain dead. Pay the price to me, and it will go to my beneficiaries in my notarized will, and you can hollow me out if I'm brain dead. Don't and I take them with me.
Haha, many people react in that fashion because I haven't yet met anyone who has also formed this opinion, but it isn't for me, it's for the family.
Other things that also act to make 'me' money after death: my wealth, my copyrighted property, my land. No one expects me to give that away for free even though many would benefit. So no, I won't be giving away my body either.
The transplant list works on a point based system. What if those who previously agreed to be organ donors get a bonus point on the list to reduce wait times?
What makes it worse? So far, you said that the things that make it bad are 1) it's removing a choice and 2) causing citizens to get "equivalently" murdered.
It's worse because it causes a significant net increase in suffering and death relative to allowing people to do what they want on their own.
I didn't actually say that removing a choice is inherently bad, although often it is. I was explaining why I was holding the government responsible for that action.
> motor vehicle fatalities per miles driven increased by 14% compared to the March 2019 rate
> "When we see the combination of both a dramatic decrease in number of total deaths coupled with a dramatic increase in the fatality rate on our roads that was very surprising," Kolosh said.
It sounds like both articles agree that the number of total deaths over a period of time is lower, despite the increase in deaths per miles driven.
To give a sense of wait time, it varies from region to region. The bay area region is pretty long wait. I think UCSF is 10+ years of wait for a type O blood recipient. In Sacramento area its a 5+ year wait. If you are type AB blood the wait is almost half the time. Some parts of the country the wait times is as short at 1 year.
Although I am somewhat eager for kidney transplant, I also know its not a cure. They might last 10-15 years before you get rejection and have to get another transplant or go back on dialysis. But the anti-rejection medications have slowly improved. Mainly been trying to stay as healthy and stable as possible.
The stay-at-home rules has also been a blessing though because I do home dialysis and that takes a lot of time so not having to travel to work means extra time is available. I even have more time for exercise. My current job has generally been flexible before but I hope more companies will offer remote work after this. Even an extra half hour lost on commute hampers my treatment schedule.