The Organ Donor Opt-Out System Disrepects the Living & the Dead


Two years ago, I wrote a piece making the ethical/property rights argument against the opt-out organ donation which was to be introduced in Wales. There’s now talk of the same system being introduced in England, so I want to discuss the issue from another angle. Human decency.

Firstly, let’s briefly recap the argument from principle against the opt-out system. The ethical problem with the organ donor opt-out system is that it logically implies medical professionals acting on behalf of the state have the right to do things with your body unless you explicitly tell them not to.

But that’s not how ownership in society works. If I own something, then that means you must FIRST obtain my consent BEFORE you do anything to it or with it (regardless of your reasons for doing so).

The order of these actions is crucial. You can’t reverse the order without nullifying the very purpose of ownership, which is to give the owner exclusive control over the property. The more exceptions to our self-ownership and property rights will allow, the more we endanger peace, prosperity and progress.

Let’s now consider the emotional effects the opt-out system will have on wives, husbands or family members where the deceased didn’t previously explicitly consent to be an organ donor.

If your body is whisked away to have its organs removed without hospital staff first asking for your husband, wife or family members’ consent, then that would be upsetting for them. It would be insensitive and disrespectful on the part of the hospital management and staff to do this.

You might believe or hope medical professionals wouldn’t behave this way, but people tend to do whatever a well-intentioned law permits them to and to disregard the harm done to someone in the process. Remember how appallingly medical professionals behaved towards the parents of Charlie Gard? They felt justified in doing so, I suspect mostly because the law was on their side.

If the opt-out system starts in England or Scotland, then it will make people like me, who don’t object to being an organ donor but who don’t want his wife to be treated disrespectfully in the wake of my death, to explicitly retract my consent. Just so my wife’s rights will be respected and to give her back the authority that shouldn’t have been taken from her in the first.

The argument against the opt-out system boils down to arguing for treating the living – husbands, wives and family members who have just lost someone dear to them – with respect and with compassion. Respect for the bond they had with the deceased and with compassion as grieving people.

This is how human beings should treat each other. With recognition of and respect for the strength of the bonds we form with others. We shouldn’t be treating the suffering of widows and surviving family members like it doesn’t matter. We shouldn’t be acting as if the only thing that matters is the suffering of others. Medical professionals in particular, who take an oath to do no harm, shouldn’t be acting this way.

If we just recognise each other’s rights and treat each other with respect, then we can do as much good with organ donorship as we can do without treating each other like shit in the process.

The argument against the opt-out system is as much about respect for the living as it is about respect for the dead. Some may argue that the distress caused to grieving loved ones is outweighed by the good done to people who receive organ transplants, but this ‘greater good’ argument misses the point.

Only you or the person to whom you delegate ownership of your body after your death should decide whether your organs are donated or not. Not managers of state hospitals or government ‘experts’, but you or your next of kin. It’s that simple. The truth often is.

Things get complicated when, in the pursuit of some alleged greater good, some try to evade the logical truths of self-ownership and property rights and conjure up all manner of exceptions to our rights. Worse still, they create unintended consequences and perverse incentives which can often lead to undesirable outcomes.

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