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Risk Management—Common Sense, Regulation, and Insurance—Organ and Tissue Donation

Posted By Thom Young, April 7, 2015

Risk Management in the Modern Era

There’s an email that circulates among the older folk that observes it’s amazing we all have lived so long. We had none of the currently omnipresent restrictions on our play activity. Common sense was the process that guided us into to doing the right thing. Those without common sense often suffered the fate of Darwinism—their failure to survive the challenges of our youth and their inability to contribute to the gene pool made our species stronger. That was the theory then, anyway. I think of this principle when I travel to third-world countries where things seem to work their way through without all the intrusions. Ultimately, some fail to use common sense and suffer the expected consequences.

In an old story about an American lady who fell into a hole in a sidewalk on a downtown Mexico City street, the statement of claim contained all the usual boiler plates—the city and its contractors were negligent in allowing this terribly dangerous obstacle to exist and should have taken many steps to protect the public from injury. The defense of the case was simple—the city produced seven days of video monitoring the hole in the sidewalk exactly as it was when the plaintiff fell in it. By the city’s account, over 3700 people passed by the hole (which had a pylon on both sides of it) and no one fell in it. Case dismissed? Well, not entirely. The city had to pay a small amount and cover the legal costs of the plaintiff, but the award was abnormal by Canadian standards. The plaintiff was found 90% responsible for her own damages because she failed to watch where she was going. The contractor was fined for failing to follow the city regulations that require holes to be covered and proper barriers in place to prevent the public from injury.

Often people lose sight of the reason for regulations concerning individual behaviour. As a motorcyclist who spends a lot of time in the U.S., I’m often asked why I wear a helmet all the time when I ride. The reason is simple: it protects me. The law really isn’t my motivator. When my second child was born, the law still did not provide any incentive to wear a seat belt in an automobile, but we decided to purchase a car seat for our new baby. From the day the car seat was installed, everyone wore a seatbelt in my car to ensure that one of us would survive to look after the guy in the car seat. Funny thought, but a true story. The adjustment period was difficult for the older child who had become accustomed to bouncing around the car and sitting in her (unseat-belted) mother’s lap or sleeping in a bassinette set down on the back the seat. It’s amazing we survived. The aforementioned car seat was likely the cause of many injuries as it was banned from use about ten years after I bought it.

A lot of the risk management procedures that have become regulations initially developed in our industry as attempts to limit the costs of poor individual and business practices. Intense analysis of the causes, consequences, and costs of losses informs the highly competitive selection process in our industry, and we have become very good at it. Our activities eventually prompted the public authority to enact regulations to limit the damage from those individuals who fail to follow the risk-management discipline developed by our industry. Often we hear about the zealous regulator creating obstacles that are both expensive and unnecessary, but these regulations come about not as a result of altruistic attempts to protect people so much as through the reality that limiting personal injury or property damage through regulations reduces the cost to the state in dealing with them. Those who fail to follow the discipline needed to manage their own risks properly offload the costs of this behaviour onto the state which, as the ultimate insurer of the people, receives adverse risks with no selection or mitigation other than by regulation. An actuary might call this the ultimate adverse selection process.

How To Make a Difference in Someone Else’s Life

If you’re around a registry office in our province this month, you’ll see a number of initiatives being made to encourage people to sign the authorization to become a tissue donor when processing an Alberta Health card change. National Organ and Tissue Donation Awareness Week (NOTDAW) is from April 19th until April 25th, 2015. Registry agents will be asking about organ donation and providing informational material in support of giving permission for organ donation. Registry agents will be wearing green lanyards showing their support for this cause.

I find it difficult to understand the need to have a discussion about such a simple thing as allowing your earthly remains to be put to some good use helping another before they are discarded in a ritual of remembrance of what a person gave to the world. No matter how much money you amass and leave to help others, nothing could equal the difference you could make in other people’s lives by simply agreeing to donate tissue and organs. This gift of health and recovery is simple, painless, and important.

Did you know that over 4500 people in Canada are on waiting lists to receive organ transplants and thousands more are waiting for tissue donations? That’s 4500 people in pain and suffering whose lives are diminished by a need that is so simple to fill. Over 700 Albertans are on that waiting list for organ transplants.

So here’s what you need to do. Stop what you’re doing right now. Get out your Alberta Health Card, flip it over, and read what the back says. Discuss it with your family, sign it, and have one of your family members witness it—painless and productive work here, ladies and gentlemen, work that will make a difference in the lives of others sooner than you think!

If you haven’t got an Alberta Health card, or the one you have is old and ratty, get on down to the nearest Registry Office and order one. This is one of the few government services that is still provided for free. After you sign it you can laminate it too!

While much information is available on organ and tissue donation, the Alberta Health website posts some handy FAQs.

While on this topic, I have long said that the premise of organ and tissue donation should be an implied consent and not a formal one. That is, if you don’t have a stated and recorded objection to it, then agreement to donate should be assumed. A consent form should not be required in the normal process. Those who object should have a place to record their wishes and have them honoured, but, otherwise, donation should be a mere formality of notice to family members when organs and tissues are harvested to help others. This debate needs to continue, and I offer this opinion in closing to stimulate that discussion.

In Closing

March has come and gone in its usual chaotic manner. I can’t say it came in like a lion or went out like a lamb as our winter was only a brief inconvenience in Western Canada anyway. Spring, for what it is, has begun in Alberta, and the promise of the new year begins with the cycle of tilling and planting. Economic prospects are not as bad as predicted, nor as good as they could be. We will soon be before the polls once again, asked to choose which brand of conservative principles we wish to govern our prosperous and successful piece of Canada. This is a cynical observation my friends, no need to challenge me on it.

Sheldon Casavant, illusionistWe are very quickly coming up on the annual IBAA convention, which this year will be held in beautiful Lake Louise. I am as always looking forward to meandering around that venue in my highland garb and will of course be very happy to see in person many of you who have taken the time over the past year to dress me up or down on my commentary here.

Looking forward to it!

The opinions expressed in this blog are not necessarily those of IBAA.
Comment on this post below or email Thom Young privately. Thom also encourages suggestions for topics.

Tags:  common sense risk management  insurance risk management  organ and tissue donation  regulation risk management  risk management 

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