We have a long waiting list for recipients, and we don't have an excess of donors to be picky with.
Why are you assuming Scott was not "able to see" the explanation you laid out, when in all likelyhood that thought has crossed his mind (he's thought about this far more than you, a commenter who speculated that in 5 minutes)?
Perhaps he thought of it, and decided saying it would be even meaner to the hospital... which frankly, I think that framing is far crueler to the hospital. Like, if they rejected him from bureaucratic incompetence as they tried to filter out people who can't consent to surgery? Fine, incompetence is bad, but fine.
If they rejected him because they could give someone with kidney failure 10 more years of good life, they thought he had a healthy kidney and could consent, but they had a personal grudge or moral judgement... That's a much more repugnant way to operate a hospital than simple incompetence. Reducing the quality of life of a potential kidney recipient for any of those reasons intentionally is far crueler than mere incompetence.
I also suspect saying anything other than the hospital's purported reason would be grounds for libel.
> Like, if they rejected him from bureaucratic incompetence as they tried to filter out people who can't consent to surgery? Fine, incompetence is bad, but fine.
I'd be even more charitable to them: it's not incompetency, but waste inherent in a bureaucratic process, which is a consequence of scale. Sure, it would be better if Scott was interviewed with someone dedicated and empowered, who could hear and verify the full story, understand the context. But there are only so many people able to do this and willing to accept responsibility for making a bad call - and healthcare system can't afford them anyway. The bureaucratic process focused on effectively minimizing false positives will introduce a lot of false negatives - but it's also much more streamlined and cheaper to run at scale. And sure, it sucks to be the one rejected by an effectively automated process[0], but it's better for everyone than not having any process at all.
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[0] - I maintain that bureaucracy is software running on a distributed system made of meat instead of networked silicon. It has the same dumb failure modes because it's the same thing.
> And sure, it sucks to be the one rejected by an effectively automated process[0], but it's better for everyone than not having any process at all.
You could have a much lighter weight process, that leaves more of the decision making powers with individuals and families. That would be cheaper and overall suck less.
Placing the responsibility with families results in compelled donations (“you love your Dad, don’t you?”). Our medical system is (imperfectly) built around consent; that consent needs to be in evidence.
Yeah. When my dad had a kidney failure I had a lot of fun proving to the doctors that I did not in fact love my dad, and that's why I was giving him a kidney.
Really though, the definition of "compelled" is fuzzy, and mostly for medical stuff we take "consent" to mean "sound of mind" and "not overtly coerced, i.e. by threats of violence or such".
Is someone able to "consent" if they're only donating blood or a kidney because their religion tells them to do good? That sounds like a cult, huh. What about because they love someone? What about because the local blood drive literally gives you 10 bucks and a candy for donating blood?
Like, you can argue around enough and say everyone is always compelled at all times by "society" or "their upbringing", but that's an obviously useless definition.
What we have now, you getting a private meeting with a nurse or such who asks "are you really sure? Is anyone making you do this?"... that, plus doing basic mental health checks of "does not have dementia or mental retardation", that seems like it should be enough for any real situation.
Trying to say "No, someone who's famous might be doing this to write a blog post about it, that's not okay" is an interpretation of consent that simply is too far gone to be useful.
> Trying to say "No, someone who's famous might be doing this to write a blog post about it, that's not okay" is an interpretation of consent that simply is too far gone to be useful.
Nobody has said this, as far as I can tell. My claim was that there were other things about his situation that might suggest to the bureaucrats in question that he was a risky donor. I don’t think Scott gave a kidney so that he could write a blog post about it.
There are two people in surgery and two families involved in this transaction. The recipient side is relying on the healthcare system to make the transplant work out well, and it's the medical staff that will be blamed and held responsible if the recipient suffers or dies due to an avoidable mistake. Because of that, there's only so much decision making powers that can be granted to the donating side.
> We have a long waiting list for recipients, and we don't have an excess of donors to be picky with.
That’s not how this works. Organ donation is inherently picky and fallible: without that pickiness, you get coerced organ donation and people undergoing mental crises seeking a form of salvation.
I don’t understand where the moral judgement or grudge determination came from: everything I’ve said is a prima facie plausible reason to reject a donation candidate on basic medical ethics grounds.
That international organ trade still operates as a black market. So it's hard to compare that with being less picky about organ donors.
The very pdf you linked to even mentions 'Reducing U.S. Demand for Trafficked Organs' as one of the policy avenues to pursue to help combat trafficking of organs. Being less picky about donors in the US seems exactly like what you'd need to do to reduce that kind of demand.
You might also want to look into the situation in Iran, where financial compensation for organ donors is legal.
Why are you assuming Scott was not "able to see" the explanation you laid out, when in all likelyhood that thought has crossed his mind (he's thought about this far more than you, a commenter who speculated that in 5 minutes)?
Perhaps he thought of it, and decided saying it would be even meaner to the hospital... which frankly, I think that framing is far crueler to the hospital. Like, if they rejected him from bureaucratic incompetence as they tried to filter out people who can't consent to surgery? Fine, incompetence is bad, but fine.
If they rejected him because they could give someone with kidney failure 10 more years of good life, they thought he had a healthy kidney and could consent, but they had a personal grudge or moral judgement... That's a much more repugnant way to operate a hospital than simple incompetence. Reducing the quality of life of a potential kidney recipient for any of those reasons intentionally is far crueler than mere incompetence.
I also suspect saying anything other than the hospital's purported reason would be grounds for libel.