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Community => Science and Technology => Topic started by: Feral Dog on June 05, 2013, 11:52:15 pm

Title: Judge rules in favor of lung transplant
Post by: Feral Dog on June 05, 2013, 11:52:15 pm
And despite the way it sounds, it's not good. The ruling undermines the organ transplant waiting list system (it's based on things like survivability, and sadly a small child is even less likely to survive a lung transplant than other patients).

http://xfinity.comcast.net/articles/news-national/20130605/US-Lung-Transplant-Pennsylvania/ (http://xfinity.comcast.net/articles/news-national/20130605/US-Lung-Transplant-Pennsylvania/)
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on June 06, 2013, 01:47:33 am
I feel for this child and her parents, but there are plenty of reasons why a child should only be given pediatric lungs. This is going to cause a clusterfuck.
Title: Re: Judge rules in favor of s isnt'transplant
Post by: MadCatTLX on June 06, 2013, 01:56:35 am
I think this thread should be moved to Politics & Government due to it's importance to medical ethics and authority of doctors vs. a judge when deciding a medical decision. This isn't so much about science and medicine as it is about the politics surrounding it.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on June 06, 2013, 06:55:44 am
I read an article about this awhile ago and her doctors insisted that she'd be able to survive with an adult lung. But I don't know if I agree with the judge.
Title: Re: Judge rules in favor of lung transplant
Post by: Shane for Wax on June 06, 2013, 07:07:18 am
This sets a dangerous precedent. There are thousands of people waiting for new organs, including children. Every child is a heartwrenching story simply because it's a child going thru something so severe. I am unsure about this decision.

My heart says yes, my mind says no. And we can't make decisions like this on our hearts. The system is there for a very good reason.
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on June 06, 2013, 12:58:00 pm
I dislike the hell out of how this story has been played up in the press. It could lead to some really bad, harmful, derpy political actions that end up killing more people, including kids, than the current disbursement scheme for donated organs. Too many right wing fire starters are bullying up on Secretary Sebellius, for one, claiming she can just use her magic pen to sign off for all the kids on the juvenile list to get access to adult organs, just like this judge did for that little girl. Sebellius is potentially a presidential race candidate for the democratic party, so yeah, GOP gobs are flinging poo at every opportunity, as early as possible.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on June 06, 2013, 06:07:55 pm
In general, I'd really hate it if children who are less likely to survive could receive organs before adults who are more likely to survive. You can't side with the child just because of your emotions, you have to look at the freaking numbers. I hate automatic prioritization of kids over adults.
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on June 06, 2013, 07:02:45 pm
The chances that a child will get adult lungs and die on the operating table or from complications afterwards are very high. In that case, those lungs, which could have been successfully transplanted into an adult, go to waste. This could mean two needless deaths, versus one tragedy. It would be far better for a campaign to be started by this news publicity for parents to donate the organs of their deceased kids. Plenty of kids die in accidents and of conditions that still leave some of their organs donate-able, but the extreme grief from losing that child seems to over-ride everything, and those organs mostly go to waste. A really well thought out and compassionate movement to encourage more child organ donations is desperately needed.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on June 13, 2013, 11:24:24 pm
The child has received a pair of adult lungs and survived the surgery. I feel like an ass, but it would have been better if she had passed. You can't tell me, with 40 other people in her area already on the list, she didn't get some sort of preferential treatment because of the media attention. Now every person who doesn't get an organ is going to be running to court.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on June 14, 2013, 06:40:24 am
Yep, the court already made an exception for another girl. This is a dangerous path, and medical experts agree. The way they have the system set up (children 12 and under on the waiting list for children's lungs) has vastly decreased the number of deaths, and I really hope this isn't going to change that. You can't afford to make decisions like this based on emotions.
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on June 14, 2013, 10:04:10 am
I hope this spurs action from HHS, lawyers, legislators and higher level judges to ally with the medical community and come up with some legal mechanism that blocks terrible court orders like this immediately. This could otherwise double, triple, etc. the mortality rate of lung transplant patients and the number of people who die while on the waiting list.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on June 14, 2013, 02:01:59 pm
Oh goody, I'm reading an op-ed from someone named Walter Williams who is arguing this case proves people should be able to buy organs.
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on June 14, 2013, 02:29:34 pm
Oh yeah awesome, cuz then we can just harvest organs from prisoners and shit. Think of the jobs created! Just like the black market in asia...and it'll save us tax dollars, too  :D

<goes outside to pressure wash between ears>
Title: Re: Judge rules in favor of lung transplant
Post by: TheReasonator on June 14, 2013, 06:05:42 pm
Sometimes under the current system organs go to waste!

Why can't they instead of either putting the child on the list or not at all why can't there be a secondary list so if there are no adults who could use the lung within the applicable area/location then the child gets the lung?

Why are organ donation lists all or nothing? It would make all the sense in the world to have secondary lists maybe even tertiary lists. More lives could be saved.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on June 14, 2013, 06:45:48 pm
I think the problem, as this case has shown, is that children will always be put first because of emotions. 40 adults in her area needing those lungs, and a pair magically showed up within weeks that only could be matched to her?
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on June 14, 2013, 08:22:24 pm
Sometimes under the current system organs go to waste!

Why can't they instead of either putting the child on the list or not at all why can't there be a secondary list so if there are no adults who could use the lung within the applicable area/location then the child gets the lung?
Why are organ donation lists all or nothing? It would make all the sense in the world to have secondary lists maybe even tertiary lists. More lives could be saved.

That's roughly how the current/"new" allotment system works. But we can kiss it goodbye with this court order and all the "me too!' shit to follow.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 02, 2013, 01:30:13 pm
You know, I do legitimately see nothing wrong with harvesting dead prisoners for organs, and I don't think opting out of donation should even be possible. "No, no, I'm not using them, but you're gonna die anyways because I won't donate!"
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on July 02, 2013, 05:46:41 pm
I love how the girl got a second set of lungs because her body rejected the first ones. Good job, assholes, now someone is dead because of you. This is what happens when you let judges make medical decisions.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on July 02, 2013, 05:49:14 pm
Wait, wut? They gave her a second set? Exactly how are they justifying this blatant favoritism?
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 02, 2013, 05:59:19 pm
Wait, wut? They gave her a second set? Exactly how are they justifying this blatant favoritism?
She's a child. Any judge who rules against her will literally face a lynch mob. I don't like it, but I admit, I'd do the same.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on July 02, 2013, 06:03:04 pm
Wait, wut? They gave her a second set? Exactly how are they justifying this blatant favoritism?
She's a child. Any judge who rules against her will literally face a lynch mob. I don't like it, but I admit, I'd do the same.

The problem is that children are less viable candidates for organ transplants. This girl cost a life, as Sleepy pointed out, who could have used that first set. This outcome was predicted.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 02, 2013, 06:26:50 pm
Wait, wut? They gave her a second set? Exactly how are they justifying this blatant favoritism?
She's a child. Any judge who rules against her will literally face a lynch mob. I don't like it, but I admit, I'd do the same.

The problem is that children are less viable candidates for organ transplants. This girl cost a life, as Sleepy pointed out, who could have used that first set. This outcome was predicted.
I know. I never said it was right. If the courts were robot-controlled like I wish they were, this wouldn't happen. But, humans have emotions, and in the end, they will factor in. I think it was wrong. I still would do the same.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on July 02, 2013, 06:30:10 pm
Wait, wut? They gave her a second set? Exactly how are they justifying this blatant favoritism?
She's a child. Any judge who rules against her will literally face a lynch mob. I don't like it, but I admit, I'd do the same.

The problem is that children are less viable candidates for organ transplants. This girl cost a life, as Sleepy pointed out, who could have used that first set. This outcome was predicted.
I know. I never said it was right. If the courts were robot-controlled like I wish they were, this wouldn't happen. But, humans have emotions, and in the end, they will factor in. I think it was wrong. I still would do the same.

Which is why the judge was an idiot. The old system removed the human element. Toss it back in and we may well hear that this child is on set three.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 02, 2013, 06:42:13 pm
Wait, wut? They gave her a second set? Exactly how are they justifying this blatant favoritism?
She's a child. Any judge who rules against her will literally face a lynch mob. I don't like it, but I admit, I'd do the same.

The problem is that children are less viable candidates for organ transplants. This girl cost a life, as Sleepy pointed out, who could have used that first set. This outcome was predicted.
I know. I never said it was right. If the courts were robot-controlled like I wish they were, this wouldn't happen. But, humans have emotions, and in the end, they will factor in. I think it was wrong. I still would do the same.

Which is why the judge was an idiot. The old system removed the human element. Toss it back in and we may well hear that this child is on set three.
I agree, and wish the old system would stay, but if I were in the judge's position, I would do the same thing he did.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on July 02, 2013, 08:00:20 pm
Why would you do the same thing?
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 02, 2013, 08:07:51 pm
Why would you do the same thing?
Because I'd be unable to go "Sorry, but your kid has to die because of our system".
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on July 02, 2013, 08:13:06 pm
You can't afford to operate on emotions when you're in that position. Those lungs had a greater chance of saving an adult, and therefore you need to make a ruling based on that probability.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 02, 2013, 08:31:08 pm
You can't afford to operate on emotions when you're in that position. Those lungs had a greater chance of saving an adult, and therefore you need to make a ruling based on that probability.
I never claimed to be a good judge. Just, honest about how I'd act.
Title: Re: Judge rules in favor of lung transplant
Post by: dpareja on July 02, 2013, 11:29:53 pm
You can't afford to operate on emotions when you're in that position. Those lungs had a greater chance of saving an adult, and therefore you need to make a ruling based on that probability.

The judge does, yes, but the judge also needs to take into account the fact that, as noted above, ruling against the kid would immediately get him vilified beyond all redemption (as "that judge who killed that kid"). People usually don't have the patience for logical arguments when something as visceral as "a kid might die" is in play.
Title: Re: Judge rules in favor of lung transplant
Post by: Witchyjoshy on July 03, 2013, 03:18:09 am
Basically, this is a lose/lose situation for the judge, a lose/lose situation for the system, and a win/lose situation for the girl.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on July 03, 2013, 07:06:27 am
You can't afford to operate on emotions when you're in that position. Those lungs had a greater chance of saving an adult, and therefore you need to make a ruling based on that probability.

The judge does, yes, but the judge also needs to take into account the fact that, as noted above, ruling against the kid would immediately get him vilified beyond all redemption (as "that judge who killed that kid"). People usually don't have the patience for logical arguments when something as visceral as "a kid might die" is in play.

And this is why people piss me off. God forbid we attempt to save the maximum number of lives.
Title: Re: Judge rules in favor of lung transplant
Post by: Shane for Wax on July 03, 2013, 08:15:39 am
The sad thing is we can't expect people to be completely emotionless. Not even professionals like judges.

We demand them to be, though. And they try to be. And that's the best we can do until we decide to trust computers to come to a court decision.

With that said, I am in agreement with Sleepy on this. Throughout the evolution of modern man, our emotions when it comes to children is part of why the species has survived. There is the rare person who doesn't care about human life, children or otherwise so they could be impartial in this kind of decision. But would we want them to?
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 03, 2013, 10:24:32 am
The sad thing is we can't expect people to be completely emotionless. Not even professionals like judges.

We demand them to be, though. And they try to be. And that's the best we can do until we decide to trust computers to come to a court decision.

With that said, I am in agreement with Sleepy on this. Throughout the evolution of modern man, our emotions when it comes to children is part of why the species has survived. There is the rare person who doesn't care about human life, children or otherwise so they could be impartial in this kind of decision. But would we want them to?
In the grand scheme of things, yes, we do want them to be. Emotionally, we don't, and that side of us supports this ruling. But, the logical side of us, the side that keeps stuff working even when emotionally we would tear it down, we want this.
Title: Re: Judge rules in favor of lung transplant
Post by: Sigmaleph on July 03, 2013, 05:04:10 pm
The sad thing is we can't expect people to be completely emotionless. Not even professionals like judges.

We demand them to be, though. And they try to be. And that's the best we can do until we decide to trust computers to come to a court decision.

With that said, I am in agreement with Sleepy on this. Throughout the evolution of modern man, our emotions when it comes to children is part of why the species has survived. There is the rare person who doesn't care about human life, children or otherwise so they could be impartial in this kind of decision. But would we want them to?

The thing here is, we don't want "emotionless". Emotion is a necessary part of moral judgement*, and a judge without emotion would probably be more trouble than they are worth. What we need is reason informed by emotion. We want the judge to care about the child who might die if the ruling is one way, but also care about the adults who might die if the ruling is the other way, figure out how to balance those things, and act on it.


*Not intrinsically, perhaps, but it is as of now, and it will remain so until we have a universal theory of ethics we can use to derive moral judgements without having to human-check every result.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 03, 2013, 05:47:49 pm
The sad thing is we can't expect people to be completely emotionless. Not even professionals like judges.

We demand them to be, though. And they try to be. And that's the best we can do until we decide to trust computers to come to a court decision.

With that said, I am in agreement with Sleepy on this. Throughout the evolution of modern man, our emotions when it comes to children is part of why the species has survived. There is the rare person who doesn't care about human life, children or otherwise so they could be impartial in this kind of decision. But would we want them to?
I disagree with this. An emotional-lacking judge would let the punishment fit the crime, not either overreact or pity the defendant. A judge without emotions would be much more fair, and would logically analyze a case.

The thing here is, we don't want "emotionless". Emotion is a necessary part of moral judgement*, and a judge without emotion would probably be more trouble than they are worth. What we need is reason informed by emotion. We want the judge to care about the child who might die if the ruling is one way, but also care about the adults who might die if the ruling is the other way, figure out how to balance those things, and act on it.


*Not intrinsically, perhaps, but it is as of now, and it will remain so until we have a universal theory of ethics we can use to derive moral judgements without having to human-check every result.
Title: Re: Judge rules in favor of lung transplant
Post by: Sigmaleph on July 03, 2013, 09:00:20 pm

The thing here is, we don't want "emotionless". Emotion is a necessary part of moral judgement*, and a judge without emotion would probably be more trouble than they are worth. What we need is reason informed by emotion. We want the judge to care about the child who might die if the ruling is one way, but also care about the adults who might die if the ruling is the other way, figure out how to balance those things, and act on it.


*Not intrinsically, perhaps, but it is as of now, and it will remain so until we have a universal theory of ethics we can use to derive moral judgements without having to human-check every result.
I disagree with this. An emotional-lacking judge would let the punishment fit the crime, not either overreact or pity the defendant. A judge without emotions would be much more fair, and would logically analyze a case.

An emotion-lacking judge cannot make the punishment match the crime, because there's no objective parameter for such a thing. Without human emotional reactions, how exactly do you tell the difference between murder being right or wrong, or what an appropriate punishment for that would be? What aspect of the world can you look at to determine if a theft should be punished with cutting off a hand, ten years in prison, a fine for the value of the item, or the death penalty, that isn't at some level based on human emotional reactions?

Sure, one can observe human emotions indirectly in other people, but that doesn't fully capture the experience. For subtle ethical judgements, where the average person is not sure what is right, this would be useless.

An emotionless judge would have the advantage of not being swayed by irrelevant appeals to emotion, and that's not negligible, but it's also not the greatest problem facing the judicial system.


All this, with the caveat that this is now. There's no theoretical reason that I know of that says we cannot at some point in the future build an emotionless machine that fully captures all human intuitions on morality and rules accordingly. However, we don't have a way of building that at this point.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 03, 2013, 09:25:33 pm

The thing here is, we don't want "emotionless". Emotion is a necessary part of moral judgement*, and a judge without emotion would probably be more trouble than they are worth. What we need is reason informed by emotion. We want the judge to care about the child who might die if the ruling is one way, but also care about the adults who might die if the ruling is the other way, figure out how to balance those things, and act on it.


*Not intrinsically, perhaps, but it is as of now, and it will remain so until we have a universal theory of ethics we can use to derive moral judgements without having to human-check every result.
I disagree with this. An emotional-lacking judge would let the punishment fit the crime, not either overreact or pity the defendant. A judge without emotions would be much more fair, and would logically analyze a case.

An emotion-lacking judge cannot make the punishment match the crime, because there's no objective parameter for such a thing. Without human emotional reactions, how exactly do you tell the difference between murder being right or wrong, or what an appropriate punishment for that would be? What aspect of the world can you look at to determine if a theft should be punished with cutting off a hand, ten years in prison, a fine for the value of the item, or the death penalty, that isn't at some level based on human emotional reactions?

Sure, one can observe human emotions indirectly in other people, but that doesn't fully capture the experience. For subtle ethical judgements, where the average person is not sure what is right, this would be useless.

An emotionless judge would have the advantage of not being swayed by irrelevant appeals to emotion, and that's not negligible, but it's also not the greatest problem facing the judicial system.


All this, with the caveat that this is now. There's no theoretical reason that I know of that says we cannot at some point in the future build an emotionless machine that fully captures all human intuitions on morality and rules accordingly. However, we don't have a way of building that at this point.
Enter various factors with an assigned weight on a pre-determined scale created by a panel of at least 15 years practicing psychologists of various (but equal) races, genders, sexualities, religions and political beliefs (they can overlap) on a range of -100 to 100, with -100 meaning purely immoral, and 100 being purely moral. For example, a greed-based murder would be a pure -100, as there is no redeeming factors there. However, a pre-planned revenge murder over the harming of an innocent party would be lower, and something like, say, shooting someone who was in the middle of raping another would be a high number. Rape would also be a -100. Factors beside the crime that would be weighed would include mental illness so long as it has an effect on emotions (for example, OCD would not be included, even if someone screwed with their stuff, but depression would be), prior criminal record, amount of times this specific crime has been committed, motive (for example, an armed robber trying to feed his kids would be weighed differently than an armed robber stealing for himself), and recent events in the criminal's life (for example, if parents died recently, it would be determined to have much the same effect as depression). Not easy, not a quick fix, but a better method.
Title: Re: Judge rules in favor of lung transplant
Post by: Sigmaleph on July 03, 2013, 10:14:02 pm
Enter various factors with an assigned weight on a pre-determined scale created by a panel of at least 15 years practicing psychologists of various (but equal) races, genders, sexualities, religions and political beliefs (they can overlap) on a range of -100 to 100, with -100 meaning purely immoral, and 100 being purely moral. For example, a greed-based murder would be a pure -100, as there is no redeeming factors there. However, a pre-planned revenge murder over the harming of an innocent party would be lower, and something like, say, shooting someone who was in the middle of raping another would be a high number. Rape would also be a -100. Factors beside the crime that would be weighed would include mental illness so long as it has an effect on emotions (for example, OCD would not be included, even if someone screwed with their stuff, but depression would be), prior criminal record, amount of times this specific crime has been committed, motive (for example, an armed robber trying to feed his kids would be weighed differently than an armed robber stealing for himself), and recent events in the criminal's life (for example, if parents died recently, it would be determined to have much the same effect as depression). Not easy, not a quick fix, but a better method.

Human ethical reasoning as it is right now, I would not trust any panel of experts to successfully capture everything that could possibly come up. At the very least, you would need an extensive trial phase, and even then I'd be worried of just implementing it and going with whatever it says without checking it before with a human-emotional oversight. Humanity is complicated, and it is in constant change (try ruling on cyber-crimes using legislation written before the internet). I don't think there's any reason to assume we've already reached the peak of complexity in ethical dilemmas and everything that comes up from now on will be easily dealt with using principles that came up before.

And what do we do when the oversight says "hey, something came up that I don't think the system was built to account for"? Do we re-summon the psychologists every time to debate on the new adjustments, thus making the trial take a few extra years? Do we update it once every x amount of time, guaranteeing that some people will be treated unfairly because their cases happened before a relevant adjustment? Do we never update it, making sure it quickly becomes useless? Do we directly give the human oversight the ability to over-rule a judgement, making it so we have more or less the same situation we have now?

I am not against this in specific situations, though. Going back to the subject of the thread, transplants are an obvious example of somewhere where a system with objective criteria that isn't easily overruled works adequately (certainly better than the alternatives). Applying that to criminal cases, though, is an entirely different thing.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 03, 2013, 10:53:59 pm
Enter various factors with an assigned weight on a pre-determined scale created by a panel of at least 15 years practicing psychologists of various (but equal) races, genders, sexualities, religions and political beliefs (they can overlap) on a range of -100 to 100, with -100 meaning purely immoral, and 100 being purely moral. For example, a greed-based murder would be a pure -100, as there is no redeeming factors there. However, a pre-planned revenge murder over the harming of an innocent party would be lower, and something like, say, shooting someone who was in the middle of raping another would be a high number. Rape would also be a -100. Factors beside the crime that would be weighed would include mental illness so long as it has an effect on emotions (for example, OCD would not be included, even if someone screwed with their stuff, but depression would be), prior criminal record, amount of times this specific crime has been committed, motive (for example, an armed robber trying to feed his kids would be weighed differently than an armed robber stealing for himself), and recent events in the criminal's life (for example, if parents died recently, it would be determined to have much the same effect as depression). Not easy, not a quick fix, but a better method.

Human ethical reasoning as it is right now, I would not trust any panel of experts to successfully capture everything that could possibly come up. At the very least, you would need an extensive trial phase, and even then I'd be worried of just implementing it and going with whatever it says without checking it before with a human-emotional oversight. Humanity is complicated, and it is in constant change (try ruling on cyber-crimes using legislation written before the internet). I don't think there's any reason to assume we've already reached the peak of complexity in ethical dilemmas and everything that comes up from now on will be easily dealt with using principles that came up before.

And what do we do when the oversight says "hey, something came up that I don't think the system was built to account for"? Do we re-summon the psychologists every time to debate on the new adjustments, thus making the trial take a few extra years? Do we update it once every x amount of time, guaranteeing that some people will be treated unfairly because their cases happened before a relevant adjustment? Do we never update it, making sure it quickly becomes useless? Do we directly give the human oversight the ability to over-rule a judgement, making it so we have more or less the same situation we have now?

I am not against this in specific situations, though. Going back to the subject of the thread, transplants are an obvious example of somewhere where a system with objective criteria that isn't easily overruled works adequately (certainly better than the alternatives). Applying that to criminal cases, though, is an entirely different thing.
I feel that the best plan is to make it broad enough to include just about everything physically possible, but not too broad to be useless (or, if you're against broadness, account for every situation possible, including every minor variation). Basically, a non-video game version of The Dev Team Thinks Of Everything.
Title: Re: Judge rules in favor of lung transplant
Post by: Sigmaleph on July 04, 2013, 08:23:20 am
I get the idea, I just don't think it's possible to actually think of everything ahead of time.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 04, 2013, 02:52:29 pm
I get the idea, I just don't think it's possible to actually think of everything ahead of time.
I think you can be in at least 99% of the cases.
Title: Re: Judge rules in favor of lung transplant
Post by: Sigmaleph on July 04, 2013, 05:39:28 pm
I get the idea, I just don't think it's possible to actually think of everything ahead of time.
I think you can be in at least 99% of the cases.
Probably, yeah, but you have to handle that 1% of cases (or whatever the number is). You need to have something that steps in and notices that this is the one-in-N case where the system fails and to stop it.

This is guesswork, but I'd say that the current system works adequately for the ninety-something percent of cases, as well, and it doesn't fail catastrophically on most of the remaining ones. I don't have any hard figures on this, obviously, so I could be over- or under-estimating by a lot. Still, my intuition here is that
1) Most cases are unexceptional, and could be handled equally well either way.
2) For every system, there's a small fraction of cases where one would be clearly worse than the other.
3) For each of the above sets, there a small fraction where one system leads to awful (as opposed to just bad) results, and the other doesn't.
4) I don't have a decent estimation for the relative sizes the set of cases where each set fails, but it seems likely that the human-judge system fails catastrophically much less than the alternative.

This is, like I said, intuition. At this point, all I can say is that my (limited) experience in trying to formalise things human care about in an objective way tells me it tends to be harder than it appears at first, that it's easy to mistakenly judge the project complete, and that when it fails, it does so rather horribly. This experience is more relevant to ethics in general than to judicial rulings, which is probably an easier subset to deal with, so I could be overestimating the difficulty of the problem. I cannot think of an easy way to test any of my assumptions. The obvious way of testing it would be to build your system and then check it against judicial rulings in a large set of cases, (and find some way to determine failure and catastrophic failure, which is non-trivial), but that's not practical.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on July 09, 2013, 07:11:51 pm
http://www.cnn.com/2013/07/08/us/pennsylvania-girl-transplant/index.html

So she now has pneumonia in set number two.
Title: Re: Judge rules in favor of lung transplant
Post by: Witchyjoshy on July 09, 2013, 07:23:55 pm
....I feel bad for being angry.

It's not the poor girl's fault.  She's going through a lot of shit right now and she doesn't really have a choice...

It's just that I also feel bad for the adults who are going to die because the state couldn't bring themselves to make a difficult decision.

Situations like this are why people pray for miracles in the first place...
Title: Re: Judge rules in favor of lung transplant
Post by: Shane for Wax on July 09, 2013, 08:25:15 pm
http://www.cnn.com/2013/07/08/us/pennsylvania-girl-transplant/index.html

So she now has pneumonia in set number two.

I feel bad for thinking 'let the poor girl just die'. But... Ah. Humans are so emotional.
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on July 09, 2013, 09:13:00 pm
I also hate to say it, but she will likely die soon. And as tragic as that is, it will underscore why the frickin' organ allocation system should never have been messed with by the courts.  Two adults, with the odds of success statistics in their favor, may die now that 2 sets of lungs have gone to the little girl.

This little girl gets a few more weeks of shitty quality life, where she is in chronic post operative pain (she has not had time to recuperate between emergency transplants), and she will pass away by congestive asphyxiation, and/or pulmonary embolism, which is terrifying and painful. Bravo. Way to hurt the one you love. Then, let's all fervently hope that she does not come down with ARDS, which is a total breakdown of multiple organ systems that begins with acute lung injury, which is what aspirating stomach acid does. ARDS is the post op complication that killed my mom. It took 6 weeks for her to reach the point when they would let me enforce the DNR and take her off all support.

Title: Re: Judge rules in favor of lung transplant
Post by: Sigmaleph on July 09, 2013, 09:48:45 pm
A small part of me thinks her dying would be the best outcome, because at least it will prevent more scenarios like this one. And as horrible as it is to say it, that's the optimistic part of me. The cynical side says nobody will learn anything from this and it will be just a painful and meaningless death.

Fuck.
Title: Re: Judge rules in favor of lung transplant
Post by: wrightway on July 09, 2013, 11:48:10 pm
I feel so much better knowing I wasn't the only one with these reactions. I don't want a child dead; but she is in pain. These complications were predicted. She was shown incredible favoritism; new lungs were found for her in three days. The argument for that being that the lungs had pneumonia and it was a more acceptable risk to give them to her. Congrats, it came back.

The kindest outcome would be a quick death and for a lesson to be learned by the alleged adults.
Title: Re: Judge rules in favor of lung transplant
Post by: Distind on July 10, 2013, 06:48:28 am
A small part of me thinks her dying would be the best outcome, because at least it will prevent more scenarios like this one. And as horrible as it is to say it, that's the optimistic part of me. The cynical side says nobody will learn anything from this and it will be just a painful and meaningless death.

Fuck.
With any luck the law will look back at this case as a precedent, see the medical results and go off those rather than the legal decision. But outside of that... yeah, no one's gonna learn shit, people will still try.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on July 10, 2013, 07:04:17 am
She shouldn't have even gotten the second pair of lungs. You got lungs the first time around, and they failed. End of story. You don't get unlimited access to them because she's a little girl.

I hope the judge feels really friggin' good about costing people their lives.
Title: Re: Judge rules in favor of lung transplant
Post by: The Right Honourable Mlle Ant├ęchrist on July 10, 2013, 12:35:17 pm
This is all vaguely reminiscent of the Terri Schiavo case, what with people ignoring medical ethics & prognosis in favour of what makes them feel good in the short term.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 10, 2013, 02:23:17 pm
According to the CNN article, pneumonia is pretty common with lung transplants, and isn't likely to kill her. And, it's only in one lung. So, she might be fine.
Title: Re: Judge rules in favor of lung transplant
Post by: Shane for Wax on July 10, 2013, 02:26:26 pm
She's also a child and possibly immunosuppressed depending on what they do for lung transplants. So...
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 10, 2013, 02:28:56 pm
She's also a child and possibly immunosuppressed depending on what they do for lung transplants. So...
No, they mean, with the immunosuppressors (and she is). They still say it's likely she'll live.
Title: Re: Judge rules in favor of lung transplant
Post by: Sleepy on July 10, 2013, 06:07:36 pm
I also kinda want to point out how low her life expectancy is at this point. That needs to be taken into account if they're going to make special exceptions.
Title: Re: Judge rules in favor of lung transplant
Post by: mellenORL on July 10, 2013, 07:34:07 pm
I also kinda want to point out how low her life expectancy is at this point. That needs to be taken into account if they're going to make special exceptions.

Yes, especially since her onset and progression of cystic fibrosis was unusually severe early in life. She may at best live another few years, if everything goes perfectly well with the second set of lungs.

http://www.livescience.com/37367-cystic-fibrosis-lung-transplant.html (http://www.livescience.com/37367-cystic-fibrosis-lung-transplant.html)
Title: Re: Judge rules in favor of lung transplant
Post by: erictheblue on July 15, 2013, 05:59:58 pm
The judge does, yes, but the judge also needs to take into account the fact that, as noted above, ruling against the kid would immediately get him vilified beyond all redemption (as "that judge who killed that kid"). People usually don't have the patience for logical arguments when something as visceral as "a kid might die" is in play.

So? Judges are paid to make rulings based on the law, not on emotion.

When I was interning, one of the local judges made a ruling in a child custody hearing that pissed the community off. So much so that there were protests at the courthouse, and she had a police officer guarding her. But her ruling was the correct one based on the law, which is why she ruled as she did.
Title: Re: Judge rules in favor of lung transplant
Post by: PosthumanHeresy on July 16, 2013, 12:26:17 pm
The judge does, yes, but the judge also needs to take into account the fact that, as noted above, ruling against the kid would immediately get him vilified beyond all redemption (as "that judge who killed that kid"). People usually don't have the patience for logical arguments when something as visceral as "a kid might die" is in play.

So? Judges are paid to make rulings based on the law, not on emotion.

When I was interning, one of the local judges made a ruling in a child custody hearing that pissed the community off. So much so that there were protests at the courthouse, and she had a police officer guarding her. But her ruling was the correct one based on the law, which is why she ruled as she did.
I'm curious as to what the ruling and the controversy were. A lot of custody hearing's main guidelines seem to be "Are you the mother? You get custody".