Friday, April 28, 2006

Dead Organs

It seems to me that we don't make good enough use of corpses. Many people fail to register as organ donors, and so fewer lives are saved than could be. This is a terrible waste. It would be an obvious improvement to shift from our 'opt in' system to an 'opt out' one. At the very least, we should favour organ-donation as the default position. The more interesting question is whether we should let individuals opt out at all.

I think it would be immoral to opt out. Donating your corpse's organs does you no harm, and it benefits others. You don't get many surer chances to improve the world than that. One might feel a bit squeamish at the idea, but that's simply irrational. In any case, surely one's discomfort is not more important than another person's life. To opt out of organ-donation would thus be an act of extraordinary selfishness.

Despite this, we might think that individuals should have the (legal) right to dispose of their body as they please. For example, it could be argued that to grant the state such powers of bodily violation would set too dangerous a precedent. But there seems a clear enough line between living and dead bodies to avoid any "slippery slope" here.

Alternatively, one might point out that the policy is disrespectful of irrational minority beliefs, e.g. religious nutters who believe that they'll need their organs intact for the afterlife. While I personally think that saving lives is more important than respecting nutty beliefs, I admit that it's best for the liberal state to be as accommodating as possible. Promotes a greater sense of legitimacy and all that. (And I suppose it's always possible that some individuals would find the whole idea so incredibly traumatic that the psychological harm to them would actually outweigh the benefits to others, and hence be problematic even on direct utilitarian grounds.)

A tempting solution would be to offer an inconvenient opt-out option. It should be enough to deter those who are only mildly opposed to saving another's life. But the option is there and attainable (after some inconvenience) for those who feel very strongly about the issue.

A more principled liberal option would be to promote individual choice (rather than the common good) by ensuring that everyone can easily opt out if they so prefer. Thinking that it's not the government's role to place hurdles down the road of vice, we might instead rely on social norms to discourage people from making the wrong decision. People tend to go along with what's expected of them anyway. If organ-donation was widely accepted as the norm, squeamishness or opposition to the idea might disappear almost entirely.

So: which would be best? (Or are there other options that I've missed?)


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4 comments:

  1. I agree that donating should be the default position, and people should have to constantly carry "Do Not Donate Organs" cards if they really want to be buried or cremated intact. I'm thinking of cases also in which medical authorities can't find a card on the deseased, and have to search for a family member to get consent before operating. By this time, it might be too late to use any organs. They should be able to take anything unless they find something on the person that states explicitly otherwise.

    Furthermore, it always seems odd to me that it tends to be religious folks who want to die intact. If I believed in a dualist notion that my body is just a container for my mind, and that a special substance (of non-substance) will leave my body to live eternally in another dimension or whatever, then why would I need my body in one piece? If at the moment of death, the important stuff all floats up to heaven, then it makes more sense for me to say, "Do what you will with the corporeal bits; they all mean nothing to me now."

    However, I do think keeping organs should be an option as some people find the ritual of kissing the dead good-bye at the funeral really helpful to the grieving process. It's a decision more for those being left behind than for the actual deceased. Let's not slam them for their practices too much.

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  2. I'm in complete agreement that donating should be the default. I'm not sure about the practicality of Sage's suggestion to have "Do Not Donate Organs" cards, but I recognise that there has to be some method in place for respecting peoples choices, however unreasonable we may think them to be.

    I also think that the power of vito of next-of-kin should be removed. In Australia and New Zealand at least, even if the deceased person has given their consent to organ donation after their death, the next-of-kin can still decide not to let it happen.

    Now, surely leaving a dead body intact is for the benefit of the family/loved ones of the dead person, to assist grieving as Sage said. But if someone's decided that they want to donate their organs after their death their family and friends must respect that.

    So I think their both important things to consider, since of people who have registered to be donors less than 40% end up donating due to next-of-kin vitoing the decision

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  3. A non utilitarian might ask the question where do you stop?
    If I can take your organs against your will or presume they are available what else should htey be able to do and assume you agree?
    What is the system that prevents that becoming a nightmare scenario?

    Anyway it all depends on how we feel about the situation for example where an immigrant comes to NZ and is not told all the complex things that they might want to opt out of and in an accident suddenly find their families bodies are being used in a way contrary to their religion.
    I expect that in a democracy this is likely to "trump" the alternative - a lack of organs - because of it's nature.

    In a place like China it doesn't - by the way was the Chinese use of criminals organs what make you think along these lines?

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  4. Would it be immoral to use corpses as seat fillers for Cincinatti Reds games or is it immoral to have the Cincinatti Reds play at all?

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