Monday, 17 November 2008

Organ Donation: Opt In or Opt Out?

I wonder how you feel about the current transplant debate? Gordon Brown supports a change in the law to give the State the right to remove and reuse organs from deceased individuals, unless they have specifically opted out.

There are, of course, good arguments in favour of increasing the number of organs available for transplant. If availability of an organ might save my life or that of someone dear to me, I imagine that I might feel the gift of life outweighed any personal sensibilities.

But I find the idea of the State awarding itself ownership of our bodies altogether too reminiscent of 'Brave New World' and 'The Handmaid's Tale'. The conscious choice of an individual to gift his remains so as to give a chance of life or health to another is generous and altruistic, but I am not sure the 'right' to life is such that the State should be empowered to seize cadavers for dissection and the removal of body parts under the noses of grieving children, parents and partners.

I can see other difficulties too. Not so much the fear that hospitals, keen to get their hands on organs in best useable condition, would 'give up' on patients earlier than might otherwise be the case - although there would always be that risk. What I suspect would be inevitable though, would be strong institutional pressure against death at home, so that organs could be 'harvested' in the freshest possible condition - just as for years hospitals made it very difficult for mothers to choose a home birth. The prospect of a duty to report deaths of loved ones immediately to the local hospital, so that 'organ snatch squads' could tear up one's stairs to the master bedroom, scalpels twinkling, is equally unthinkable.

Deemed consent would inevitably bring a shift in attitudes. From the present position in which a donor's family are welcomed as benefactors by the medical establishment and organ recipients - bringing them pride and solace - there would be the sense that organs were taken by right, and perhaps vexation with the relatives of anyone who'd opted out. In any case the chances are that, with the burden of proof on next of kin, by the time they had discovered and were able to demonstrate that their loved one had opted out, any organs would have been long gone.

So I come down emphatically on the side of sticking with an 'opt in' approach, albeit with better publicity and encouragement.


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  2. I am with you completely on this Brother T. To donate, or not to donate, has to be a private decision and not something the state can dictate.

    I would be very uncomfortable with presumed consent; while I have not registered, my family know I have no objection and would be able to consent. However, if the government legislated on this I would opt out as a matter of principle because I object to being dictated to.

  3. I too would opt out as a matter of principle if the government legislated on this. I think you have made some excellent points about the disadvantages of such a scheme. Shudders! Scary thought!

  4. The idea of freedom is closely related to - even dependent upon - the ability to have a choice. If Gordon Brown had got his way we'd have lost the ability to choose what to do with our own bodies and the whole shame idea of true freedom that keeps us all sane would have been stripped away forever. Anarchy would have ensued. I'm beginning to wonder if GB is the antichrist. But seriously... I think you argue the point well. Choice is everything - people should be encouraged to opt-in not forced to opt-out if they happen to disagree with the Government.

  5. Yup, I reckon I'd opt out on principle too. That Monty Python skit springs to know the one where the person isn't actually dead but they take him anyway....
    Over here you are able to opt in or not on your driver's licence and you renew that every so many years so you can change your mind. It also would pay to have your instructions/wishes documented with your lawyer or own GP.

  6. Yes, I would opt out too - I loathe being told what to do.

    I do understand how difficult it must be for those who are awaiting transplants (or who have relatives who are) to feel that there are wasted organs out there. so yes, I think there does need to be better publicity and more people should be encouraged to talk about their wishes with those close to them so they are aware what they are.

  7. Goid BT that's a tricky one, isn't it - I'm with RB, people need better educating about the needs of transplant patients. I always carry a donor card (although my lungs would be of no use to anyone and I doubt the rest of my organs are much better) but wouldn't be happy with presumed consent - maybe a national mailshot of donor cards with explanatory booklets? And also details of blood donation?

  8. This is disturbing, and for all the reasons you list. While on the one hand, oh, yes, we should all donate our organs, barring religious or personal preferences; but the idea of the State (and we've entered into "capital letter" territory here) seizing your body after death like so much farmland is distasteful and intrusive. I can't put my finger on it, but this one's going to bug me; I can tell!

  9. Wholeheartedly (!!) agree with you here, Brother. "Harvested" has made my wrists go limp.

  10. I agree with your analysis and final opinion. Wishing you well from Waikiki. aloha-

  11. See the J. S. Mill Quote on my thursday blog post. Society intrudes where it has no business; making our deeply personal & holy places into some committee's slave.

  12. Comment Deleted - If you want to advertise industrial fans, do your homework and choose an appropriate site.

    Completely - Funny, I also thought that if they did this I'd opt out. Suggests it might be counter-productive, although of course the next step would be for the government to remove the right to opt out except on religious grounds.

    Justme - Likewise. It is scary, isn't it?

    Steve - I share your feelings about freedoms entirely. Sometimes their erosion is for small, ostensibly unimportant things, but the principles matter all the same.

    Amanda - An opt in/opt out on the driving licence sounds fair.

    RB - We bloggers are a cussed lot, aren't we? I'm sure persuasion is a nutcracker and compulsion a hammer, if you see what I mean.

    Lucy - I agree. (I will tell the tale of my earliest adventures as a blood donor one day!)

    Pearl - That aspiration does seem to push the 'State' from a benign convenience into a controlling monolith, doesn't it.

    Daisy - Good on you! The 'H' word was a bit loaded (but justifiably).

    Cloudia - Whoopee - we all feel the same about it. This either means bloggers are an atypical subset of the population, or that our Prime Minister is a misguided control freak. I like the quote.

  13. I am too selfish to donate my organs, and I hope wouldn't want anyone else's if in that position.

    I wish they'd hurry up in the mastering of growing one's own regenerated organs (no risk of rejection)from cells as that would be the best solution all-round rather than desecrating the dead/even keeping them alive to harvest organs.

    Never a lender or borrower be as they say. However I do feel terribly sorry for those whose organs fail as a result of no fault of their own (unlike the binge drinker/smoker/druggie who has ruined their own organs) What a waste it was to give George Best a new liver rather than someone who would have actually valued and looked after it!