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back to article Steve Jobs and governator tout transplant reform

The über-private and über-reclusive Apple CEO Steve Jobs made a rare non-keynote public appearance on Friday, joining California governor and action-film hero Arnold Schwarzenegger to promote organ-donation legislation. The San José, California Mercury News reports that the tech world's most famous transplant recipient joined …

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So how come he was chosen?

Not that I claim he should have gracefully let somebody go in front of him. I certainly would spend quite a bit of money in order to survive. Not very moral, but certainly normal...

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Not a linear queue

He was presumably chosen because he was the best tissue match to the donor. That's usually how such things are decided, give it to the person who stands the least chance of rejecting it. There might have been some element of "if you can get here quick enough", which would apply more in a country the size of the US compared the the UK.

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Right type?

I'm not a doc but I do know that tissue compatibility is a major issue. Jobs was probably the only person that the available liver would actually match up to. In which case he was bloody lucky and and cash or importance had nothing to do with it. In fact it is more than likely Jobs could have died waiting for a compatible organ to come available, this is a fact of life (or death) for anyone waiting for any kind of organ transplant.

It is also worth pointing out that the liver is the only organ that can regenerate itself. Quite often part of the donor liver will be transplanted into one patient and the other part to a different patient, it is possible that this has happened here so Jobs may not have been the only beneficery of this liver.

The only way to improve on this situation for everybody is for us all to carry a donor's card or get onto the donor's register - or adopt Larry Niven's suggestion in the "Known Space" stories and execute criminals for spare parts...

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Transplants

Here in the US at least, when you called for a transplant you have to be able to make it to the hospital within 4 hours. This is at least in part because organs have a limited lifespan outside a functioning body, for most organs this is measured in hours.

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could have died'

do you really believe that ? All that money he could just snatch a person off the street, Instant donor .

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My liver may not be much...

but its mine. Ain't nobody else got a "right" to it, regardless of my current state of conciousness.

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Jobs Halo

Say what?

I don't know if you're implying that Steve Jobs and and/or the Gubinator are planning to steal people's organs, but that is not the case. All the proposed law would do is help streamline the process of registering as an organ donor, for people who wish to do so.

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There is no menton of the law

So I think the asumption was that it was the same as the laws some people want in the UK

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FAIL

Not a "right"

No one has a "right" to your liver at all, unless you GIVE them that right by voluntarily becoming a doner. There no cost to do so, and no penalty if you choose not to be one. Much to the disdain of lots of other doners, even not being a doner you can still get donated organs (many of us think if you're not in the system, you should not be able to partake).

If you're not a doner, and you're dying or dead, even if you have what could be considderd the perfect organ for the perfect person on a waiting list, they simply can not take your organs, not with any amount of court effort, unless you are already a donor, or unless your Will leaves the door open as well, or unless someone has legal rights over you (because you're under 18, mentally disabled, etc).

If you don't want to be a doner, you're organs will hapily go to the grave with you...

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Jobs Horns

shifty

I'd like to know how long he was on the waiting list. Also how many people were pushed off because they couldn't make the 4 hour window what with not having a jet and all.

Still organ donation publicity is good even if it comes from St Shifty himself.

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See my comment above!

as I said...

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Terminator

The title is required, and must contain letters and/or digits.

" how many people were pushed off because they couldn't make the 4 hour window"

That is exactly why people work hard and make an uber amount of money, so that in the event that they need to be in a specified place by a specified time they can be there....

and on another point regarding transplant of organs.

Everyone has the right to life, but maybe some have more right than others.

lets say for instance, mr big wig executive, keeps fit, works hard, does plenty of charity work family man etc. For some unknown reason his liver fails and is placed on the transplant list

there is also a young, lad, spent most of his life in and out of jail, drink abuse, drugs abuse, never worked a day in his life. claiming benifits and all the rest of it.... due to alcahol abuse his liver fails... for 6 months he has been clear of drink and drugs and has started to attend colage

If it was my liver i know who i would want it to go to....

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Who Knows

There is not a single queue for donor organs since they are given to the people who have the best tissue match. So he may also just have been lucky.

Being able to get there in time is surely going to be a bonus though. They are not going to chuck an organ in the bin, just because a "more deserving mother of 8 kids" has been on the list longer, but just happened to be on holiday in Mexico and couldn't get there in time.

Which brings up the rather macabre image of people racing to the hospital for the first come first served medical treatment.

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Not a queue, more a lottery

"Also how many people were pushed off because they couldn't make the 4 hour window what with not having a jet and all."

I think you've answered your own question here. If they can't make it to the hospital in 4 hours then the liver would be ruined, so they weren't 'pushed off' the list, they were simply too far away to be a viable recipient.

Surely it's better for the organ to be used than go to waste just because you may think a person hasn't been on the list 'long enough' or it's unfair that they have a form of transport that gets them there quicker than other people.

It's a lottery not a strict queue. If a donor happens to die that is a tissue match to you and you are in the vicinity, then you get the organ. Unfortunately many people die waiting for this to happen while others find a donor within a relatively short period of time.

I carry a donor card and personally believe that the donor register should be an opt-out scheme not opt-in.

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Not simply a match list...

...there are caveats, and some who are otherwise equal matches are weighed vs others. This is done by a small comittee.

First of all, certain drug use, or certain abuses may automatically disqualify you from organ donation if it's occured at all within say 5-10 years recent histroy. A history of it in the deep past (say you were reckless in your 20s and 30s, but now you're 50 and need an organ) usually has no impact. Some other factors may also disqualify you in some cases.

Age and "quality of life" and life expectancy usually weigh heavily on the decision when there are multiple matches. The primary concern is not simply who will the organ survive in, but will they a) survivie the surgery itself, b) will they remain crippled afterwards (or are they already), c) how many years do they expect to get off that organ, etc. This is generally the first set of cuts for who doea and does not get an organ, before anything else is considdered.

Distance and time are other big factors. They have to be able to contact you at a moments notice, and you have to be able to get to a transplant facility typically within hours unless they're lucky enough to be able to sustain a braindead body (which is not as frequent as you think).

Celebrities typically gas a small boost in the list because: a) they have access to funds necessary to travel great distances on short demand in short times, greatly expanding the search radius for an organ as well as their ability to get to one (they're not limited to having the transplant dome in just one part of the country, or even the world), b) they are emminently connected 24x7 and generally not only easy to get a hold of, but readily able to drop everything and travel, c) back-end financial issues. Many who might get an organ can't afford the lengthy loss of work, and don't have proper coverage for the extended recovery, and that places organs at risk in many cases, most celebrities don't have that issue.

money never plays into the decision. In fact, when an organ is geven to any celebrity, wealthy person, politicial, and a few other categories of person, an audit over the decision process is AUTOMATIC.

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Unhappy

Donor cards

I signed mine when I turned 18. Which was an unspecified period of time ago.

Once you're dead, what use have you for the organs? Who could possibly be so selfish that just because they are dead they would deny someone else the chance to live?

*sigh*

I’ll never understand some folks.

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Joke

but think!

Think, if we had an opt out system, people could wake up addicted to crack, or worse still! HAVE A HIPPY HEART!!!

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Selfish

Right, how many people who wouldn't donate would also turn down an organ if they should need it? I'm guessing none, selfish bastards.

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Heart

I DO have a Hippy heart

Still have the hair too.

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Anonymous Coward

re Donor Card

I think its about it being a personal decision to donate, rather than the state making assumptions about what it can and can't do with you when you're not around to say no.

My wife made the decision to register when she read the bit of paper than came with her passport renewal. I'm of the mind that they can take what they want when I'm gone but I can't bring myself to actually write that down - too much 40-ish angst.

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Me

I find the idea obnoxious in the extreme. No, I'm not in any way religious, just squeamish.

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Unhappy

I am paranoid. Aren't You?

Don't know about You - but I have read more than once (newspapers, not books!) about rings of people who traffic organs. Yes, it's creepy and real.

No, I am not saying that your country/city/family/whatever does it. But I am DO saying that I don't have the confidence of not being "decesead" in order to have my organs harvested.

And THAT'S why I put a big "no" on my driving license. A shame, really. I would love to have more confidence on this state of affairs.

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Fatal flaw (no pun intended)

And you think someone trafficking in organs is going to care whether you opted in or not?

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Coat

...shame on me

"zhis brave compüter pïoneer could have bein terminated"

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WTF?

"I could have died"

Says billionaire able to afford any medical care I wanted.

No doubt with the sub text that it's your own silly fault if you work for a company with no (or poor) health insurance. Or if you can't afford it in the first place.

People *say* America has the finest health care system in the world. They neglect to add "if you can afford it."

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@John Smith 19

> People *say* America has the finest health care system

> in the world. They neglect to add "if you can afford it."

I don't know what part of the world you come from, but I can't think of anyone but US citizens to say "America" has the finest health system in the world.

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UK organ donor

Some drunk tales from "interns" a good few years ago in a northern teaching hospital put me off ever being a donor.

It seems if you are a known donor and your chance of survival is slim they may decide to "call time" and get your organs than go that last mile and try and save you. Note that because organs have to be removed before they can remove life support and there is always the possiblity that you could still be alive (not technically brain dead) when the remove your organs.

OK junior docs and nurses are known for thier sick humor and pranks but this is beyond sick.

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Anonymous Coward

Exactly

Some years ago there was a campaign for organ donation, featuring (as I recall - brain not up to transplant standards) a person setting up a lottery for his/her organs. Turned out to be fake. I immediately registered opt-out on everything. If they're willing to lie to get to my organs, I'm willing to rot in the ground instead of helping someone out. Trust has to be absolute in this matter, and it isn't any more.

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Re: UK organ donor

"It seems if you are a known donor and your chance of survival is slim they may decide to "call time" and get your organs than go that last mile and try and save you."

IF that is true, that'd be fine by me. I'd rather end my life giving up organs to a worthy kid than betting on a slim chance of surviving to become a living vegetable.

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Pirate

@AC, too true

If I'm at Death's Door, kick it down and pillage my human form for whatever organs are needed (eyes are the exception), I certainly have no need for them as me and the Grim Reaper walk off into the light (or hot sauna like environment).

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Hypocrites?

If any of you needed an organ and had a private jet at your disposal you wouldn't use that to widen your search area and so increase your own chances? Seriously? I'd have that thing permanently fueled up with a crew on standby just in case. I certainly wouldn't sit dying insisting everyone else goes first.

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alternatively...

all the more reason to pour money into that organ growing technology we occasionally hear being trotted out as the future. They're upto making kidneys last I heard. More complex organs are proving to be a bit tricky for now.

Why wait for a matching transplant when they could take some of your cells and grow a new one that is 100% matched to you?

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Silver badge

Register, and tell your loved ones.

It's probably the easiest thing you can do to save a life. It requires no work, no pain, no inconvenience, and is genuinely and easily the most chance you'll ever have to save the life of a stranger. Or if you're prepared for the smallest of inconveniences, give blood too, and you'll be a f*cking hero. Money can't make blood, money can't make organs, so make sure you give.

DO tell your relatives and next-of-kin though - tell them in no uncertain terms that you really want to do this. It's a way they can remember you as a hero, a lifesaver if they feel squeamish about it. They need to know as there is such a short window after death when your organs are usable, and they'll be in a total state having lost a loved one, and barely able to make any kind of decision or take in the news. Brief them well beforehand, make sure they know, make sure it's not news for them on the most stressful of days, and you make everyones life easier - and potentially save several lives as well.

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Anonymous Coward

Missed opportunities...

"Last year, 400 other Californians died waiting. I could have died."

Just imagine how much poorer the world would be if he had. Just imagine.

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Anonymous Coward

30 seconds...

http://www.organdonation.nhs.uk/ukt/default.jsp <--UK Organ Donation Register

Name, address, DoB, gender, ethnicity - it takes just 30 seconds to register. Just 30 seconds. You already spent longer than that reading The Reg.

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Future transplants

So how long before stem cell research, now back on the agenda thanks to Obama, nano technology and a few other breakthroughs mean we can grow new organs, instead of having to wait for some unfortunate to die.

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Jobs Halo

Donor cards

Yes, I agree on that fully. More people could be saved that way.

I am not surprised Jobs got a liver when he needed one and I cannot blame him for that, nor do I think some poor guy lost his life because of him.

The thing that surprises me is that I cannot remember any discussion or information about the "reason" he lost his liver.

Normally, I suppose, one would think of alcohol but that, of course, cannot be the reason, even if it might explain some of his behaviour during later years.

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Anonymous Coward

re: Donor cards

"The thing that surprises me is that I cannot remember any discussion or information about the "reason" he lost his liver.

Normally, I suppose, one would think of alcohol but that, of course, cannot be the reason, even if it might explain some of his behaviour during later years."

There was PLENTY of discussion - hard facts are more difficult to come by. Jobs made a rare act of speaking publicly about the liver transplant but merely said that his "health issues" were "more serious" than first thought. Seeing as he was recovering from pancreatic cancer, it’s not out of the realms of possibility that these two events are connected… cancer does spread.

As for “some of his behaviour during later years” and alcohol remark, this illustrates less about Jobs and more about your own ignorance. Jobs has mellowed out considerably in recent years – you just need to look at the way he acted when he was first at Apple to see this, and it would also show that he’s also been a bloody-minded sort.

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Anonymous Coward

Simple summary?

American 'healthcare' system - very expensive

Transplant operations - very expensive

Transplant organs - very rare

Conclusion make laws to plunder organs of the poor for the benefit of the rich.

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How dead is dead?

This is the point that a lot of people miss when discussing this.

Imagine a doctor knows that in an adjacent ward there is a lively little girl who will die without a donor. A badly smashed up drunk driver of around 60 get's brought in, who co-incidentally appears to have no living relatives. His chances of survival look slim even with the very best possible treatment, and if he isn't treated like right now he will die in the next few minutes.

What would you do in that situation?

Now step back. What would you do in that situation if there was also a law stating that dead peoples organs are automatically, and unquestionably available for transplant.

Now move forward a few years. The law has been changed to permit harvesting from unconscious patients with little prospect of survival.

Next move is ' with little prospect of meaningful existence'

Followed by ' a person little of value to the community'

Can you say 'mission creep'?

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Pirate

Liver long and prosper

If I die (and I have my hopes about medical developments), then anyone who needs it is welcome to any bits and bobs they can use.

Jobs needs my liver? Fine.

Gates needs my kidneys? No prob.

Schwarzeneger needs my brain? Only a small improvement, but OK.

But if you start assuming a right to them, then I will opt out immediately. My bits, my decision.

And I don't carry a donor card. Why not? Because here in the UK, and I think also in the USA, they are meaningless; they will not touch my cadaver, whatever I have said, written, or registered with the Government, until they have clearance from my next of kin. There is no point in carrying a card - it will make no difference to what happens on the day.

I believe..... the headbone conected to the neck bone, the neck bone connected to the back bone....

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Now let's talk

Apparently the waiting list is huge and Jobs bypassed the waiting list. The question now is "who died to save Steve Jobs?".

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Jobs Horns

I wonder...

How many fanboiz they will have to turn away after explaining you cannot donate organs then and there when you are alive? (well apart from Kidneys cos you come build with a spare).

Then again, maybe they don't turn them away, the governator could just terminate them... Can't imagine St Jobs would be too happy about that... Maybe he sends the governator round *after* they've ordered their iPad.

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Jobs Horns

Typical rich americans ....

Sorry, but I am from Canada. Do people today really still go to the grave with all their organs intact?

Wow what a messed up world you live in. Oh and I think that the next person on the list should sue because Steve definitely skipped the queue.

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Where is the news?

Okay, I found it, you actually need to watch the video to find what legislation is that they are promoting. Funny how the original article text goes into depth on the Palm stock price and doesn't even mention what the proposed legislation is.

BTW, incase you were wondering, they are proposing that anyone applying for a driving licence must either:

* say whether they want to be an organ donor

* or consent to being asked the question at a later date

There was also talk about a database of willing live kidney donors (not sure if that requires legislation)

Personally, I reckon the would get a greater increase in donors if they made it mandatory before getting a motorcycle licence.

BTW, how long before the iPhone mandatory registration asks if you want to be an organ donor?

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Terminator

Your liver

MAN: Hello. Uhh, can we have your liver?

MR. BROWN: My what?

MAN: Your liver. It's a large, ehh, glandular organ in your abdomen.

ERIC: [sniff]

MAN: You know, it's, uh,-- it's reddish-brown. It's sort of, uhh,--

MR. BROWN: Yeah,-- y-- y-- yeah, I know what it is, but... I'm using it, eh.

ERIC: Come on, sir.

MR. BROWN: Hey! Hey! Stop!

ERIC: Don't muck us about.

MR. BROWN: Stop! Hey! Hey! Stop it. Hey!

MAN: Hallo.

MR. BROWN: Ge-- get off.

MAN: What's this, then? Mmh.

MR. BROWN: A liver donor's card.

MAN: Need we say more?

ERIC: No!

MR. BROWN: Listen! I can't give it to you now. It says, 'in the event of death'. Uh. Oh! Ah. Ah. Eh.

MAN: No one who has ever had their liver taken out by us has survived.

MR. BROWN: Agh.

ERIC: Just lie there, sir. It won't take a minute.

MR. BROWN: [screaming]

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Coat

Was you referring to this?

http://www.youtube.com/watch?v=aclS1pGHp8o

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Boffin

Did he queue jump?

@Ratfox & Thomas 18

There's more to receiving organ donation than being first in the queue. There has to be a level of compatibility between organ and recipient for the transplant to succeed - there's a reason why siblings are asked to donate a kidney to a sick brother or sister.

"Mr Shifty" has more money than the average American and US healthcare costs money. He can afford a private jet. So his catchment area for potential donor organs is going to be much wider than for Joe Bluecollar with no medical insurance. But that's the American dream. Perhaps some kind of universal, federally underwritten health service is required?

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Anyway, good for him

I don't begrudge him his good luck, no matter how much his money may have played a role.

Honestly, I can't even bring myself to claim it is unfair.

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LDS
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In more developer countries...

In more developed countries one does not need to fly its own private jet to get to his new liver. Organs are delivered by state-owned jets (usually military - they should not fly only for fun on taxpayers money, but VIPs jets coud be used as well, if needed) to those in the waiting list in the nearest hospital which can handle a transplant. Otherwise "self-made man" gets a sinister meaning...

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