What if....? Would you save a life?

[Holdfast]

This is developing into quite an interesting and fun set of debating points. I'll play along for a while:

Would you take another person's blood or marrow if you were the one injured or sick?

Of course I would, and this is a complete non-sequitur of a question, confusing as it does two totally unrelated and non-reciprocal ethical questions.

Even if you create the stipulation that one should only feel morally sound about accepting a transfusion if contributing something in return (which, incidentally, is a stipulation I do not agree with), your equalling the act of donation with the act of receiving a transfusion is still completely flawed. I can explain why by highlighting its flaw:

The only way to fix your argument would be to insist on an extra restriction that one can only benefit from a concept if you directly contribute to it in exactly the same way. It seems bizarre to suggest this, since our entire way of life is built upon transactions mediated via an arbitrary third party (fiat money).

If you accept the concept of money, you automatically accept that like does not need to given in order to receive like. You can trade goods according to an arbitrary scale. Similarly moral authority is interchangeable and can be traded similarly. So if one were to contribute to "the greater good" in another way other than donation of blood, you would still gain the moral authority to receive blood, even if you did not donate blood yourself.

Of course, since there is no external arbiter of moral worth who can operate on a fine enough scale to judge relative worth in this way, a "fair market" can't actually operate in practice, and the only deteriminant becomes one's own conscience. ie. back to square one!

Now if you have to take time off work, I think it would be nice if you could be compensated for that by the government so that you aren't out of pocket.

Nice? Sure. It would also be nice if the government didn't take so much money from me in the first place, if turning on the kitchen tap resulted in a cascade of Chateau d'Yquem, and if Anne Hathaway was busy whispering sweet nothings in my ear.

None of these nice things are likely to happen however and at least my choices have the added benefit of making my day better, which going to donate blood or whatever most certainly would not.

So really all that you should suffer is a little physical pain. To me that seems to be a very small price to pay to save a life.

This comes back to the "where do you draw the line" issue I raised earlier in another post. To me, it's not even the physical pain that's at stake (as you say, that is largely trivial), but rather the fact I have less than zero motivation to go donate to a stranger at all. Why should I?

Others will doubtless say I am being selfish on this issue. I would agree with them. I would also say that I see no moral problem with this given that there are many other areas where I consider myself most unselfish (referring back to the argument about arbitrary moral trading above).

Again, we all choose where we exercise our selfishness and where we are generous, as none of us are as saintly as we sometimes like to pretend we are. I am selfish by not donating blood; every person on this board will be selfish in a different way. We operate in a morality largely run according to rules we ourselves have created. I don't see anything wrong with that. The ultimate determinant of these issues as I see it is whether we are comfortable in our own consciences, not in someone else's.

Most of us use this sort of "fuzzy moral calculus" all the time without realising. But that doesn't mean it's not happening under the surface. I personally feel that understanding and accepting our essential moral fuzziness is actually enlightening for mankind in the long term.

 

[Miss Chicken]

I can see your point about But I think in an ideal world all people who are capable of donating blood would. My greatest concern isn't how much each individual actually donates rather than a worry over shortages. For example, there shouldn't be quite the amount shortages of organs for transpants that there now is. I cannot see why any person would not want to donate their organs after death. It just doesn't make any sense to me whatsoever.

Neither can I understand why people would throw something out if they knew someone was in need of it.

Though I do not get overly concerned about how much people give to society I get a little annoyed at people who give none at all but expects everyone to give to them. I know one woman who is like this - she refuses to give to charity (because she says she is too poor), has never done volunteer work, has been unemployed for years and receiving benefits all that time. She is also the first to complain loudly if she can't get everything for free. Recently she complained because she had to pay $27 to get a tooth filled by the government dentist. She thinks it should be totally free for her. She thinks it is OK for me to have to pay because my disability pension is higher than her unemployment benefit.

 

[Mallory]

Having needed a transplant a couple of years ago, I find this discussion fascinating. I can now see why it's so difficult to not only get a match, but to get a match that's willing to donate.

Personally, I'd donate. But having been on the receiving end probably biases my decision.

 

[thestrangequark]

I can't even comprehend the level of selfishness one would have to possess to say no.

Really? You ever met any human beings? This is really easy to understand, if you at least observe other people.

I thought my sentiment was quite clear, but I suppose I'll have to elaborate: I am perfectly well aware of what people are capable of, I just can't comprehend myself possessing such selfishness as to forgo such a minor procedure that would save another person. I'm sorry if it makes me sound snobbish or holier than thou, but considering the specific situation proposed in the OP, I think one would have to be despicably cold-hearted to say no.

 

[Zulu Romeo]

I'm going to give a more serious response to all this (seeing as everyone else is too).

I think that anything I can give, I would. Sure, there are those ungrateful ones who would take all they can and give little to nothing in return (not to me, that would be besides the point: I mean using their new lease of life for ill means) but what about those who aren't so ungrateful, and who would benefit greatly? Hoping that there is that chance of my bodily fluids doing some good might be reason enough to do it.

I've given blood before (not so sure if I still can nowadays) but I've never really thought about what good those units of blood have done. Perhaps they would have been wasted on an alcoholic bleeding to death from oesophageal varices. Perhaps they might have given a patient with inoperable bowel cancer the chance to see the next Christmas Day. Perhaps it might have helped enable a woman to survive a complicated delivery and let her live to see her firstborn child.

Regardless of those hypothetical outcomes, I would still give something that I wouldn't really make use of in a hurry, which someone else less fortunate might make better use of than I ever could. It would only really be sitting around, to be honest...

 

[Holdfast]

I am perfectly well aware of what people are capable of, I just can't comprehend myself possessing such selfishness as to forgo such a minor procedure that would save another person.

Don't you do exactly this though?

Day in, day out, if you buy yourself a coffee instead of drinking water? Or eat a nice meal, instead of rice and lentils? Or buy a hat instead of making do with the ones you already have?

Everything you do for yourself carries with it an opportunity cost. An opportunity cost of not helping (indeed, quite possibly saving) someone else instead.

Why should blood or marrow donation carry a special status in your mind, compared to all these other acts?

Only because of the directness of the transaction involved. But logically, it's actually no different to any other action you take that deprives someone else of the possibility of survival or a better existence. The directness of this particular exchange doesn't really add any extra moral dimension.

I appreciate I'm being very coldly logical about this, to the point of ruthlessness (or rather, amorality). There is a Devil's Advocate aspect to this, as it generally amuses me to test concepts and conventions to the point of destruction. In a real life situation, if I'm directly asked for the donation, things may (or may not!) be different. But if I think it through, I believe the argument I've laid out in this and previous posts does rings true, as unpalatable as it may be to many people (partly, I suspect, though I may be wrong, because the opportunity cost argument is not conducive to the feelings of moral absolution and conscience salving that the blood donation argument offers).

 

[trampledamage]

But the point of the scenario put forward by Yeoman Randi is that it is a direct transaction - you know someone needs the bone marrow.

If I was going into a cafe with five dollars thinking of having tea and cake and there was a Salvation Army collection outside collecting money for the shelters in the city, then they would get my five dollars and I wouldn't buy the tea and cake.

Direct transactions always have a different result to more generalised "Should I give to charity" or "Should I donate blood" ideas.



Having said all that, the one thing I'm not sure I could do is give mouth-to-mouth resucitation to a stranger. I quail at the idea of it.

 

[thestrangequark]

^That's why they have resuscitation masks!

It most certainly is the directness of the action, and I understand the irrationality inherent in that statement, but the truth is that it does make a difference. Moral Objectivism is certainly logical in theory, but like so many things, it simply does not work in actuality. Well, except for assholes. And I don't want to be an asshole.

 

[Holdfast]

Interesting. I would actually suggest that my position is one of moral relativism rather than objectivism. I'm certainly not postulating that donation is either absolutely good or absolutely bad, independent of opinion.

On the contrary, one can easily construct an argument that you are far closer to taking an objectivist position than I am, given that towards one end of the spectrum you are taking the position that it would always be the right thing to do.

My position is that at whatever point of the decision-making spectrum you find yourself, you have to make a choice as to whether it is a morally correct thing to do or not. That is a far more relativist position to take.

Since I do not see a logical difference between whether it is a stranger in the abstract indefinite future, or a stranger in the here and now, my personal moral calculus doesn't make me feel more obliged to donate blood than to donate money or to donate time or to not donate anything at all.

I would see a logical difference between whether it is a stranger and a friend or family member. In that sense, in that really far extreme end of the spectrum of situations, I become objectivist. The limit of my relativism tends to zero at that far extreme but operates across a much wider range of solutions throughout the rest of the range, if you like.

 

[iguana_tonante]

There's a lot of self-righteous holier-than-thou-ness in this thread.

Those of you suggesting you would do "everything to save a life; any life" (I paraphrase, but only slightly, so as not to single anyone out), ask yourself if you donate all of your income beyond what is required to survive at a subsistence level. If not, you are most certainly not doing "everything to save a life".

I won't deny that. But the difference (and it's a big one in my opinion), is that the original sentiment was not "everything to save a life", but "something to save any life", to counter arguments based on the perceived "worthiness" of the receiver, not to suggest that there are should be no limits to generosity. So, while I understand the Devil's Advocate point, I think that your aim was a bit off this time.

On the other hand, I really can't see how you can equate giving money to charities with direct, live-saving intervention to save someone from a life-and-death situation. Refusal to give five quids could mean that someone will skip a meal: uncomfortable, but survivable. Refusal to donate bone marrow (something that your body will recreate in a short time, I should add), will mean that someone will be dead in six weeks. Quite different, in my opinion.

Why should blood or marrow donation carry a special status in your mind, compared to all these other acts?

Only because of the directness of the transaction involved. But logically, it's actually no different to any other action you take that deprives someone else of the possibility of survival or a better existence. The directness of this particular exchange doesn't really add any extra moral dimension.

It most certainly is the directness of the action, and I understand the irrationality inherent in that statement, but the truth is that it does make a difference. Moral Objectivism is certainly logical in theory, but like so many things, it simply does not work in actuality. Well, except for assholes. And I don't want to be an asshole.

What tsq said.

 

[bluedana]

If I could donate, I would. Without hesitation, without strings, anonymously.

 

[Holdfast]

There's a lot of self-righteous holier-than-thou-ness in this thread.

Those of you suggesting you would do "everything to save a life; any life" (I paraphrase, but only slightly, so as not to single anyone out), ask yourself if you donate all of your income beyond what is required to survive at a subsistence level. If not, you are most certainly not doing "everything to save a life".

I won't deny that. But the difference (and it's a big one in my opinion), is that the original sentiment was not "everything to save a life", but "something to save any life"

Firstly, there were others in the thread more directly saying what I quoted.

Secondly, even in the modified form you propose, I'm not sure I perceive the difference, to be honest. You might need to explain it to me further. To me, they are logically rather similar and the difference is only one of degree rather than nature.

What I mean is this: you can ALWAYS do SOMETHING to save any life, UP TO the point of doing EVERYTHING to save a life. So where's the difference, really?

On the other hand, I really can't see how you can equate giving money to charities with direct, live-saving intervention to save someone from a life-and-death situation. Refusal to give five quids could mean that someone will skip a meal: uncomfortable, but survivable. Refusal to donate bone marrow (something that your body will recreate in a short time, I should add), will mean that someone will be dead in six weeks. Quite different, in my opinion.

Five pounds could very well save not just one but several people's lives quite immediately. There are plenty of life-saving low-cost interventions that can be implemented at that price point or less, esp. in the 3rd World. It is very directly comparable, in my opinion.

In fact, something like Oral Rehydration Therapy (ORT) for cholera sufferers would have a MUCH higher cost-effectiveness ratio than bone marrow transplants have.

I think part of the broader issue at stake here (if you'll forgive me expanding a thread a little further) is just how "tradeable" and "measurable" you consider human life. Most people instinctively say all human life is equally valuable. But very few people actually practice that in day to day life. If you sit down and ask people a battery of questions to try to understand how they prioritise other people's value, it reveals that most people end up (implicitly) assigning different values to different people's lives. This is the whole basis of QALY theory in healthcare (google it, if you're interested; the topic is too big to broach fully in this thread).

A lot of people's "gut instinct" when they hear about it, is that it is an unfair calculus... despite them doing it all the time themselves, without realising it. This is why one tends to assign greater importance to saving someone through a transfusion than to a carton of ORT fluid. And humans don't just use QALY theory in healthcare situations, they actively (if implicitly) use this sort of moral calculus in all their life interactions. We're very calculating creatures.

Understanding, appreciating and coming to terms with how we prioritise each other's existence is crucial to our individual and collectiveness happiness in my opinion. I actually think my position makes me happier (or, at least, closer to the understanding part of the equation), since it eliminates a conflict between theory and practice, reducing overall cognitive dissonance at a deep level. I don't believe something I do not put into practice. Or at least, and perhaps more honestly, I do it a little less than some others do.

Anyway, enough pinhead-dancing and semantic-gaming for one evening. I'll try to remember to look into the thread tomorrow to read any replies. It's an interesting discussion, for sure.

 

[iguana_tonante]

But the difference (and it's a big one in my opinion), is that the original sentiment was not "everything to save a life", but "something to save any life"

Firstly, there were others in the thread more directly saying what I quoted.

Secondly, even in the modified form you propose, I'm not sure I perceive the difference, to be honest. You might need to explain it to me further. To me, they are logically rather similar and the difference is only one of degree rather than nature.

As I said, the difference is emphasis: my point (I can't talk for any other, but I have the impression that they would say the same) was about people that would donate depending on how much they would like the receiver. That's just cold. My point would doubly apply for refusing post-mortem organ donation, since you won't even be bothered or inconvenience, since you would be dead. That is, pardon the pun, just cold.

As for the other parts, you actually made me think about something I previously didn't, i.e. how mind-boggling cheap are some medical treatments in the Third World that are literally life-saving.

So in that regard you are right, my five quids could theoretically be exactly as life-saving as a bone marrow transplant, if not more. However, there are some problems with a mere numerical assessment of the situation (which I'm sure was your point, too).

The reasoning is two-fold. The first issue is that of reasonable assurance. Sure, my five pounds could theoretically save a life from cholera in Angola. The question is: they would? Or they will be stolen, or wasted, or spent on something else entirely? Problem is, I will never know. Direct donation of bodily fluids, on the other hand, will come with a directly observable results. Selfish? Maybe. But I don't think it's sensible to expect anything different from human beings.

Then, there is the issue of personal liability. My five pounds could save a life, but anybody's else money would work just as fine. I strongly believe in the collective responsibility to take care of the less fortunate: economic resources work best when pooled. In case of marrow donation, on the other hand, me and only me could save that person. If I refuse, they will die, period. It will be, unquestionably, my decision and my responsibility. Cowardly? Maybe. But letting a person die due to my direct, personal unwillingness to lend aid is something I just could not do.

Now, are those reasons logical? Probably not. But there are some few instances where I think being logical is beside the point: good things done for selfish reasons are still good.

So, I agree your points about quality-adjusted life years and implicit moral assessments were definitively spot on, and I thank you for pointing that out to me. However, it don't change my feeling that most people who said they would willfully refuse life-saving treatment won't do it due to some kind of academical sense of theoretical equality, but only because they enjoy being a dick.

Note of interest: to my surprise, I discovered that, as for 2004 computation, Italy has the second best DALY in the world after Japan. Weird.

 

[Yoda]

But the point of the scenario put forward by Yeoman Randi is that it is a direct transaction - you know someone needs the bone marrow.

If I was going into a cafe with five dollars thinking of having tea and cake and there was a Salvation Army collection outside collecting money for the shelters in the city, then they would get my five dollars and I wouldn't buy the tea and cake.

Do you have the attention span of a goldfish or something? If the Savlation Army setup permanent positions strategically outside of every Starbucks, would you just never drink coffee again?

The Salvation Army guy never gets money out of me. If I feel compelled to donate, I'll send em a check. I'm far less likely to donate on account of who is hounding me the most.

As for the marrow thing, I guess I would donate if it's relatively simple, say on the level of donating plasma... I wouldn't need to know who it was going to, but if I did happen to know, and didn't like them, I wouldn't feel too bad about keeping good marrow to myself. Bernie Madoff wouldn't get my goop, Osama wouldn't, etc... I don't have a problem with playing God to some extent, to paraphrase the plant from Little Shop of Horrors, a lot of folks DESERVE to die!

If I could profit from it in some way, whether legal or not, I would have no problems in doing so. If Bill Gates needs marrow and for some reason I'm the only person who's compatible, I'm sure he could find an extra $100 million he's not using in his couch cushion. If Megan Fox needed my marrow, we could probably come to some sort of arrangement that wouldn't even have to be financial! I'm a perfectly reasonable guy!

 

[RJDiogenes]

Those of you suggesting you would do "everything to save a life; any life" (I paraphrase, but only slightly, so as not to single anyone out), ask yourself if you donate all of your income beyond what is required to survive at a subsistence level. If not, you are most certainly not doing "everything to save a life".

Not too long ago, I cut my income in half, pretty much to the subsistence level, by resigning from my previous job because they were covering up the abuse of women. I think if somebody's life were at stake, I'd be willing to make a greater sacrifice.

 

[JAG]

I would do it. I am in the registry. My brother did it 9 years ago for a complete stranger, she survived for 6 years and watched her children grow. After 2 years a letter was sent to my brother from her and they corresponded back and forth.
She died, and the family invited him to her funeral and thanked him for allowing her to have extra time with them. Yeah, I would do it.

 

[Yeoman Randi]

This scenario that i brought up was more than just another round of "what if?" with my friend. This really happened to me about 10 years ago.

A child in the next town over needed a life-saving bone marrow transplant. The family was asking for people to come and donate blood and allow themselves to be put on the bone marrow registry.

I went, donated a pint of blood and checked the box to allow my blood to be tested and for my name to be put on the registry. Went home and never heard anything back so i assumed i couldn't help that child. Eventually i completely forgot about it.

A few months later while i was at work i got a phone call from the National Bone Marrow Donor Program telling me it was discovered that i was a match for someone who needed a marrow transplant. I wasn't told any other details. They couldn't tell me anything about the person, but I was very excited!

I was told there was a procedure to the process, the first being that i had to have more blood drawn, about 10 tubes worth. We set that appt up for the next day.

Hung up the phone and told my boss. He was very upset with me. Not because i was going to have to take the morning off for the blood draw. But because i was going to "put myself at risk" for someone i didn't know. I was shocked! His words, "This is very selfish of you. You have a family that depends on you. How can you put yourself at risk like this?"

I was shocked. I started to think maybe i made a mistake by allowing my name to be put on the list. What did he see that i didn't?

I call and tell the husband. He really doesn't say much about it. That night I talk to my parents and they become upset with me. My inlaws are upset with me. I'm like, am i seeing this in a completely different light than everyone else? The mother-in-law finds an article about some woman who donated marrow and ended up in a wheelchair. That there is real pain in store for me and that things could go terribly wrong. (Remember, this was 10 years ago.)

I think to myself that i can't back out. If I am a match for this person and i back out, this person WILL DIE. I felt like it would be murder. I think I will never be able to live with myself if i don't go through with this. I know that my actions will definitely and directly affect someone else's life.

So i go for the blood draw the next day and it's no biggie. I'm told that if everything comes out ok my next step will be a series of physical exams and tests.

A couple of days pass and i get the call from the registry telling me I am no longer needed. I ask why. They tell me they don't know, but usually when this happens it means the person can no longer go through the donation process. I don't know if that meant I couldn't be the donor or if the person took a turn for the worse.

Anyway....this experience was a real roller coaster ride. On the one hand i was so excited that my life might have real meaning...that i could save another person's life. And yet, everyone i knew was telling me i was crazy to do it.

I asked to be taken off the registry for a while. I needed to think it all through again.

Eventually I did have my name put back on the registry. I don't know that i'll ever be called again. But if I am, i hope the people around me will be a lot more supportive and that I'll do it without any hesitation or fear. I do know that with my name on the list I will never be able to live with myself if i am told i am a match for someone and i back out.... so...part of me hopes i never get that call again. But part of me does want to get the call.

Anyway, thanks to everyone who replied. It has been very interesting listening to all the different thoughts on the subject. I appreciate the time you all took to answer!

 

[Admiral Buzzkill]

I am perfectly well aware of what people are capable of, I just can't comprehend myself possessing such selfishness as to forgo such a minor procedure that would save another person.

Oh, I can.

 

[iguana_tonante]

Thanks for sharing your experience, Randi.

While I understand the worries of your loved ones, I can't help but feel that they were the ones behaving selfishly, trying to guilt you into not doing something that was obviously very important for you.

Sure, bone marrow donation carried a (very small) risk: but so is going out to get groceries, driving on the highway, taking a plane, eating a pretzel. Were they going to prevent you from doing all that because of what might happen?

 

[trampledamage]

But the point of the scenario put forward by Yeoman Randi is that it is a direct transaction - you know someone needs the bone marrow.

If I was going into a cafe with five dollars thinking of having tea and cake and there was a Salvation Army collection outside collecting money for the shelters in the city, then they would get my five dollars and I wouldn't buy the tea and cake.

Do you have the attention span of a goldfish or something? If the Savlation Army setup permanent positions strategically outside of every Starbucks, would you just never drink coffee again?

Repeated comments from me notwithstanding, no I do not only have the attention span of a goldfish - it was an example. If I have a choice of buying a tea and cake or donating to a direct cause (Sally Army being the first that came to mind) then I'll donate. I can make my own tea. Obviously I'm not going to be giving all my money.

Hung up the phone and told my boss. He was very upset with me. Not because i was going to have to take the morning off for the blood draw. But because i was going to "put myself at risk" for someone i didn't know. I was shocked! His words, "This is very selfish of you. You have a family that depends on you. How can you put yourself at risk like this?"

I was shocked. I started to think maybe i made a mistake by allowing my name to be put on the list. What did he see that i didn't?

I call and tell the husband. He really doesn't say much about it. That night I talk to my parents and they become upset with me. My inlaws are upset with me. I'm like, am i seeing this in a completely different light than everyone else? The mother-in-law finds an article about some woman who donated marrow and ended up in a wheelchair. That there is real pain in store for me and that things could go terribly wrong. (Remember, this was 10 years ago.)

A guy who's journal I read on LiveJournal went through something similar in that he volunteered to donate a kidney to someone outside of his own family. (I don't know all the background so I don't know how well he knows the guy) His family were very against it, and making the argument of "well what if someone in your family later needs a donation", which was really freaking him out.

He went ahead with it though, the surgery was in December. He's fine now, and the other guy's doing well too - they had a joint party a month ago to celebrate their recoveries. He's pleased he went ahead with it, but it was difficult in the face of all the anger from his parents.