Nurse: One of the panelists, Kieran Healy from Duke, makes what amounts to a ridiculous argument that this law will rekindle fears that surgeons are standing over sick people with hack saws, waiting to harvest their organs, and that they might just take them even if you’re not truly gone. Um. . . won’t those people just sign the opt-out if they are truly so concerned? As Arthur Caplan from Penn (woot woot) points out, most people do want to be donors. Healy also makes no suggestions. Maybe he’s against organ donation all together?

Lawyer: And what’s the source of the idea that doctors have more interest in one patient than in another? What interest does the doctor personally have in harvesting organs, unless the patient is his own kid? I agree. Opt out if that’s your nightmare.

I am not against organ donation. Feel free to read any of what I’ve written on this topic. And my argument is not ridiculous. What I said was, look at the data. Presumed consent does not mean what people in the U.S. think it means. Comparative research shows that, in practice, presumed-consent countries (a) do not perform all that much better than informed-consent countries; and (b) with literally one or two exceptions in the OECD (Austria, and to a lesser degree Belgium), presumed consent laws do not in practice remove the next-of-kin’s ability to veto donation. That means the slightly higher rates of donation seen in presumed consent countries cannot be due to the exclusion of the next-of-kin, because they aren’t excluded. As best we can tell they are the result of more investment and better training within the procurement system.

That leaves us with the question of what a strong presumed-consent law would accomplish in the United States. If such a law really, truly removed the next-of-kin from the process, it is not unreasonable to think that you’d get a very strong backlash against donation. This is so for two reasons. First, it’s a historical fact that, in assembling a viable transplant system in the ’70s and ’80s, transplant advocates had to do a lot of work to allay public fears that transplantation would lead to some kind of ghoulish body-snatching. These worries were addressed by putting together a common public understanding of donation as a sacred kind of gift — that is, as something that had to be given, not something that could simply be taken. That’s the American public’s understanding of donation now. Given that, legally asserting the presumption of consent out of the blue is likely to make a lot of people very worried or very angry. You can see this directly in many of the nearly 200 comments on the Times’ blog. If the goal is to maximize the donation rate, it’s not enough to say that these people are mistaken. Fears don’t have to be well-founded to make the donation rate go down, they just have to be widespread.

Second, it’s not enough to say “Um. . . won’t those people just sign the opt-out if they are truly so concerned?” or “Opt-out if that’s your nightmare”. Why? Because the point at issue is that, when a person dies, the family or next-of-kin assert a very strong moral (and perhaps legal) right to the body. (This is why, to reiterate, most presumed consent countries allow a kin veto.) The people to worry about are not those who opt-out in advance. The problem is with the living next-of-kin of potential donors when the deceased did not opt-out in advance. Those families will feel as a matter of right that they should decide what happens to the body of their parent, spouse, or child. Under strong presumed consent a procurement coordinator can say to them, “Sorry, the law says we can take the organs regardless of what you think”. What do you think is going to happen then?

You might believe that, as a matter of ethics, law, public policy, or medical need, that the next of kin really should not have a say. That’s fine. You might believe these people are deluded or misguided in their beliefs about the treatment of bodies after death. Maybe so. You might think that, in the long run, people will eventually come around to the view that everyone should just be a donor. Perhaps they will. What I’m saying is that you cannot just wish away the social facts as they stand, and those include the fears that people have about donation and the moral rights families claim to the body. The upshot is that introducing a strong presumed-consent law in the United States is just asking for trouble. This isn’t Austria. We’re in a country where there is a great deal of suspicion of government intervention in private matters, where there are great structural inequities in health care provision, and where there is already a comparatively high-performing donation system grounded in hard-won public acceptance of the idea that organ donation is a unique “gift of life”, not a resource to be harvested. In that kind of context, it is not a “ridiculous argument” to say that the blowback on a strong presumed consent law could be enormously negative.

I’d almost be happier if this turned out to be some kind of fake. But in the meantime, while you may think of it as a badly flawed and unfair pie chart, I prefer to see it as actually just an extreme version of a genuine pie chart.

Thus far, I think Robert Harris is winning with “I am shocked that any man of 76, whether distinguished or not, should have been treated in such a fashion” and “One of the reasons I’m absolutely shocked and stunned by his arrest is that we have worked together extensively in Switzerland, where he has a home … “. (And he dresses so well! And The Pianist is such an affecting film!) Close behind is French Minister of Culture Frederic Mitterrand, who “strongly regrets that a new ordeal is being inflicted on someone who has already experienced so many of them”. Like Neddy at EOAW I don’t believe there’s anything more to these defenses than “He’s one of us”. But it’s early days yet. For instance, coming up fast now on the outside is Anne Applebaum of the Washington Post, who says the arrest is “outrageous” in part because,

Polanski, who panicked and fled the U.S. during that trial, has been pursued by this case for 30 years, during which time he has never returned to America, has never returned to the United Kingdom, has avoided many other countries and has never been convicted of anything else. He did commit a crime, but he has paid for the crime in many, many ways: In notoriety, in lawyers’ fees, in professional stigma. He could not return to Los Angeles to receive his recent Oscar. He cannot visit Hollywood to direct or cast a film.

See, you or I might think that not going back to the U.S. or U.K. is an action Polanski took in order to make sure that, having raped a minor and fled the country, he would not be rearrested. But you or I would be wrong. In fact these are punishments that Polanski has suffered. But tiens, it was a long time ago. Puritanical Americans simply do not have the enlightened attitude toward wine at the dinner table, quaaludes, and child rape that the Europeans do. In Ireland, for instance, there are quite a number of seventy-odd year old men (and even older) who spent their youth ministering to children and raping them — some of their victims have been able to forgive them, and many want never to speak of those events again, so why all the legal fuss? Perhaps that’s a bad example. Ireland isn’t really a European country.

In any event, I look forward to more detailed explanations of who the Real Victim is here, and more fine-grained elaboration of the criteria — other than “marvelous dinner guest” — for being issued a Get Out of Child Rape Free card.

First and foremost, it is a terrible evil for a wife to sit forlorn at one of her several homes, severed from her husband, always hearing many malignant rumors, and for one messenger after another to come bearing tidings of disaster, each worse than the last, and cry them to the household. Because of such malignant tales as these, many times others have had to loose the high-hung halter from my neck, held in its strong grip. It is for this reason, in fact, that our boy, Timmy, does not stand here beside me, as he should. For he is in the protecting care of well-intentioned taxpayers, who warned me of trouble on two scores—your own peril beneath Ilium’s walls, and then the chance that the people in clamorous revolt might nationalize everything, as it is natural for men to trample all the more upon the fallen. Truly such an excuse supports no guile.

CASSANDRA
Are you sure you should be paying out this money?

CLYTAEMNESTRA
Thanks to a substantial injection of public funds, my heart is freed from its anxiety and the annual bonuses may be paid. [To AIGAMEMNON] So, my dear lord, dismount from your car, but do not set on common earth the foot that has trampled upon global markets. You to whom I have assigned the task to strew with bonuses, salary top-offs and the like, Quick! With something on the order of $160 million let his path be strewn, that Justice may usher him into a new quarter he never should have seen. The rest my unslumbering vigilance shall order duly, for if Geithner can be made to swallow this then, please god, pretty much fucking anything can be subsequently ordained.

AIGAMEMNON
Offspring of Leda, guardian of my house, your speech fits well with my views. Pamper me not as if I were a woman, nor, like some barbarian. For I do not take these gifts out of greed, but rather because my hands are tied with the bonds of contractual obligation. I find it difficult and distasteful to proceed in this fashion. But the gods of Serious Legal Consequences must be appeased and so unhappily I must shoulder the burden of paying out this money to employees who only recently crashed the global financial system.

CASSANDRA
Normally it’s the other way around, but I don’t believe this.

AIGAMEMNON
We honor the market thus; but it is not possible for a mortal to proceed with such barefaced cheek without fear. Thus I tell you it is better to revere me as a god. Only when man’s life comes to its end in taxpayer-funded, wholly unjustified prosperity dare we pronounce him happy; and if I may act in all things as I do now, and roll the Treasury in this quite spectacular fashion, I have good confidence that future creative restructuring solutions will likely eventuate similar outcomes. To have it turn out otherwise would be tantamount to Class Warfare. Besides, we are committed to seeking other ways to repay the taxpayers for supporting the Financial Products Division Retention Payments.

CASSANDRA
Such as what?

AIGAMEMNON
I was thinking maybe placing excrement in the trashcan of every citizen and setting it on fire on their doorstep.

CLYTAEMNESTRA
What do you suppose that Priam would have done, if he had achieved your triumph?

AIGAMEMNON
He would have gone with the flaming poop at the outset, I certainly believe.

CLYTAEMNESTRA
Then do not be be ashamed of mortal reproach.

AIGAMEMNON
And yet a people’s voice is a mighty power.

CASSANDRA
To be honest, I’m beginning to doubt it.

To be honest, watching the anchors and reporters draaaaaaag out the joke and gnaw it to death makes it clear that the real zombies are holding down well-paying jobs presenting local news. I especially liked the vox pop with the caption “Jane Shin / Drove by sign”.

A Long Island doctor is demanding that his estranged wife give him back the kidney he donated to her seven years ago. Dr. Richard Batista’s lawyer Dominic Barbara says his client would also be satisfied with the value of the kidney: $1.5 million. Newsday reports that Batista married wife Dawnell in 1990 and that he donated the kidney in 2001. According to Batista, their marriage was on the rocks then, but “My first priority was to save her life. The second bonus was to turn the marriage around.” Dawnell Batista filed for divorce in 2005. Dr. Batista told WCBS 880, “She had an affair, then would not reconcile, then handed me divorce papers as I was going into surgery trying to save another person’s life.

All in all the very archetype of a wacky organ donation story, right down to the mandatory quote from Arthur Caplan.

Some people familiar with R describe it as a supercharged version of Microsoft’s Excel spreadsheet software that can help illuminate data trends more clearly than is possible by entering information into rows and columns.

On second thoughts, though, I imagine no tea was spilled. It would take rather more than that. There is the required bit of stuffy huffiness from a spokesperson for the SAS Institute, too:

SAS says it has noticed R’s rising popularity at universities, despite educational discounts on its own software, but it dismisses the technology as being of interest to a limited set of people working on very hard tasks. “I think it addresses a niche market for high-end data analysts that want free, readily available code,” said Anne H. Milley, director of technology product marketing at SAS. She adds, “We have customers who build engines for aircraft. I am happy they are not using freeware when I get on a jet.”

R also gets some stick (though not in the article) from the computer science side of things for being fairly slow in comparison to some potential competitors. But it’s an exemplary open-source project and is now the lingua franca of academic statistics, for good reason. In day-to-day use for its designed purpose it’s hard to beat. The commitment of many of the core project contributors is really remarkable. In the social sciences R’s main competitor is Stata, which also has many virtues (including a strong user community) but costs money to own. I like R because it helps keep your data analysis honest, it has very strong graphical capabilities, it’s a gateway to understanding new work in statistics, and it’s free. Just take my advice and be sure to read the Posting Guide before you start asking any questions on r-help.