Why would your organs become less 'fresh' if you are stable but appear to be in a vegetative state? I understand being worried about people taking advantage of disabled (perhaps temporarily) folks - but I don't think there's a ticking clock issue here?

If you're already (physically) dead by the time you arrive at the hospital, the chances of successfully harvesting a working organ are low.

Thus, organ harvesters prefer patients who are physically alive but brain dead. Organ donor status basically gives them permission to harvest your still-beating heart.

Good. I hope it's of use to someone; I won't be needing it any longer at that point, being brain dead and all.

The problem isnt if you are actually brain dead. The problem is if you just appear to be brain dead. Organ harvesting is done without the aid of anaesthetic.

> Organ donor status basically gives them permission to harvest your still-beating heart.

The 'ticking clock' scenario you outlined makes no sense and now you're just spreading scare mongering.

That’s absolute horse shit, you are grossly misinformed about the process of organ donation

> They will not hesitate to pull the plug in an effort to harvest your organs while they're still "fresh"

On the contrary, it seems like they'll keep you on life support after brain death to ensure your organs are still fresh.

> that decision should be made by my family and not the vultures at the hospital.

I mean, sure. In most places it's your next of kin that decide. You do know that the hospital doesn't get paid for organs donated, right? I have no idea what incentives you think they have to kill you.

> You do know that the hospital doesn't get paid for organs donated, right? I have no idea what incentives you think they have to kill you.

Believe it or not, money is not the only motivator of people. Wanting to help someone you have a stronger relationship with (because one patient can communicate, the other cannot) could be incentive enough for some people. And doctors are, in the end, just people.

I am not suggesting that most doctors would do this, or even a sizable percentage, but it would be reassuring that measures would be in place to ensure what the GP is talking about cannot happen. I suspect everyone realises this, and there are actually systems in place to protect organ donors against harvesting whilst still alive.

Edit: this comment suggests the GP's fears are not so far fetched https://news.ycombinator.com/item?id=33300503 EEP!

I believe I almost all cases the doctor removing and the doctor installing are on two different medical teams.

Otherwise you’d be doing two surgeries back to back, using two different skill sets and at two different locations.

Not only are the two teams of doctors likely different, and the hospitals where they are operating different, but in the US a bureaucracy determines who gets the organ based on need. It's not up to any doctor involved. So the odds that the two doctors who are involved will ever know each other, let alone one doctor knowing both patients, seems microscopic.

Does the hospital not make money on transplant surgery?

The hospitals and doctors transplanting the organs in make a lot of money. Those harvesting the organs do not.

At least if it's aboveboard and in the US. Getting Steve Jobs an off the books pancreas would obviously have been exceedingly profitable. And I cannot speak to what happens in other countries.

But in general, the biggest cost is from the hospital stay for the recipient, followed by the surgery transplanting the organ itself. And, usually, the next cost will be transporting the organ, not acquiring it.

Imagine if you needed some organ but the other you decided to hold back only because of the vultures.