Deny Organ Transplants from People Not Registered as Donors
Should only those on the organ donors register be eligible to receive organs in a transplant operation?
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This policy will save lives. Under the status quo, people who are willing to donate their organs in...
This policy will save lives. Under the status quo, people who are willing to donate their organs in principle do not register as donors because they cannot be bothered to. As a consequence of their indifference, people die waiting for organs, while perfectly good ones are buried or cremated with the corpses of their owners. The problem is that people face no incentive to register as donors, because there is no penalty for not registering and no reward for signing up. This policy would provide them with a very strong incentive to register – the possibility of dying because they have not registered as a donor. That would raise the number of donors, thus raising the number of transplants, and saving more lives.
The policy requires condemning non-donors to death when there are more palatable alternatives. Nearly as many lives could be saved by closing the organ shortfall with incentive schemes or an opt-out system. The fact that so many people do not become organ donors simply because they do not bother to sign up indicates why an opt-out system would be so successful – those who have strong objections to being organ donors can elect not to, while the majority who do not object become eligible donors. If the gap between supply and demand could be closed without this policy, even more lives would be saved (since everyone requiring a transplant, including non-donors, would survive). In addition, in some countries even if the deceased had signed the donor register, the permission of their nearest relatives is required before organs can be removed. This is a further restriction (relatives may have religious views the deceased did not share) that could be removed to ensure a greater supply of organs.
If people expect to receive organs from others, they should be willing to donate theirs. This comes...
If people expect to receive organs from others, they should be willing to donate theirs. This comes from the concept of moral reciprocity – in other words, that living morally involves acting towards others in a way that you would be happy for them to act towards you. To expect other people to be willing to donate their organs to you when they die, and yet to not believe that you have an equal duty to donate your organs to others, is to deny that your moral actions have to be reciprocal – that you should treat other people as you wish to be treated. Moreover, it cannot be the case that you would see your actions as universalizable if you do not become a donor – you would not accept it as a law of nature that people behave as you do. If everyone acted as you did, there would be no organs available from donors, and everybody requiring transplants would die. It is plausible to believe that acting morally involves ‘doing your bit’ for society – not free riding on the good will of others. Therefore, people can have no moral claim over organs for transplants if they have not declared themselves willing to donate too.
Moral reciprocity does not necessitate performing identical acts. I can consistently believe that I have a moral duty to treat people as I would want to be treated without doing the same things for others as they do for me. The reciprocity is in terms of more basic ideals, such as equal concern for others and respect for the moral obligations I have towards others. In this example, a person with strong religious objections to being an organ donor could ‘do his bit’ for society by contributing in other ways – by donating large sums of money to charity for example. This should not mean that he becomes ‘morally ineligible’ to receive an organ in a transplant because, all things considered, he has carried out his duty towards other people (just in a different way to the organ donor). To draw on another analogy: we do not all expect to have moral obligations to save fire-fighters when they are trapped, since we are not able to do so (other fire-fighters will help them). Rather, we fulfil our duty towards fire-fighters by helping them in other ways that we are able to.
Everyone has a moral obligation to become organ donors anyway. Not signing up for the organ donors ...
Everyone has a moral obligation to become organ donors anyway. Not signing up for the organ donors register condemns other people to death for almost no benefit to you – this is different from murder in all but name. Suppose you walk past a child drowning in a pond. You can swim, and are able to save that child. If you do not jump in to save the child because you don’t want to get your jacket wet, we may legitimately see you as some kind of moral monster – you have behaved monstrously in allowing the child to drown. Those who do not sign up for the organ donors register simply because they cannot be bothered are behaving in a similar way to the man who lets the child drown – they refuse to make even the smallest of sacrifices when others stand to gain a huge amount. We should not, as a society, tolerate such behaviour, and are perfectly justified in punishing transgressors in the way the policy sets out.
There is a relevant moral difference between killing someone and being a bystander to their death. If there wasn’t, then all kinds of bizarre moral burdens would arise: for example, it would become obligatory to donate all disposable income to charity, in order to save those starving in the developing world (with the consequence that nobody could pursue any personal projects or engage in personal spending beyond that required for survival). The drowning child analogy is misleading, since in that case you are the only person able to save the child – it would be quite different if the pond was surrounded by lots of people, all able to save the child (especially if some of the other people were better placed than you to intervene, a lifeguard for example). However, even if we accept that people who do not donate their organs are immoral, is death an appropriate punishment for this transgression? Because, of course, death is the potential punishment this policy recommends.
The biggest objection to becoming an organ donor – religious objection – is overcome by an in-built ...
The biggest objection to becoming an organ donor – religious objection – is overcome by an in-built sincerity test. If a person’s religion prohibits organ donation, then it must equally be the case that the religion would not permit organ transplants. This would be the case for religions that require bodies to be buried ‘whole’ – a body is broken up in a transplant operation just as much as it would be from removing a organ from a copse for donation. Religious objections to this policy must, therefore, be hypocritical. Furthermore, the religious objection is possibly overstated. Most religions have requirements to do all that is possible to save lives. Judaism is often cited as a religion that opposes organ donation, even though in fact Jews are obliged to donate organs if it can save a life. Jehovah’s Witnesses, who refuse blood transfusions, also permit organ transplants (so long as the organs are drained of blood).
Some religious cultures could prohibit donation while not prohibiting transplants for their members. Non-universalistic religions, such as the Shinto, and some Gypsy cultures disfavour organ donation, but do not necessarily believe it inappropriate for non-members to donate organs, and for their members to receive such organs in a transplant. It is also not the case that, just because the religious objection is overstated, that the objection does not exist. As mentioned above, there are religions and cultures that prohibit organ donation; there are others where donation falls into a grey area. The main controversy for Jews and certain Christians is their definition of dead, which is restrictive and rules out many cases where people’s organs are taken (e.g. when organs are taken from the brain-dead whose hearts are still beating). In these cases, the state should permit people to practise religion according to their interpretation, and not hand out de facto death penalties for holding a particular religious view.
Bodily autonomy cannot hold for the dead. An objection to policy based on individuals’ rights to se...
Bodily autonomy cannot hold for the dead. An objection to policy based on individuals’ rights to self-ownership cannot hold in this case, since the relevant bodies are those of the dead. It is built in to the concept of right that it is held by an interested party – but the dead, being dead, have no interests and consequently cannot be considered as rights-bearing agents. If a corpse cannot have a right to bodily autonomy, it must follow that no autonomy is violated when we remove organs from the dead. Moreover, the state does not deny people self-ownership with this policy, since not donating is still permitted. The state is not making organ donation compulsory, simply making people face up to the costs of their decisions for others.
The relevant consideration for bodily autonomy applies to the living, and their right to know what will happen to their bodies once they die. It is a part of your ownership of your body that you have control over what will happen to it – hence our respect for people’s wishes to be disposed of in certain ritualistic ways, or, indeed, our respect for wills. The proposition also denies people other kinds of autonomy, namely their freedom to practise religion in a certain way, or choose for themselves a lifestyle that, for some reason, involves not becoming an organ donor. There is also an autonomy issue for the non-donors the state is willing to kill (noting that the proposition wish to claim that allowing to die is morally equivalent to killing in their point 3). Surely these people should not be denied their right to life because of a moral decision they made?
It is unfair to prioritise people in such a way. The only way people should be prioritised is where there is a desperate need for an organ that is more desperate than someone else’s. Most people on the list are there because the transplant will be life saving.
On the contrary, it is double standards for those not willing to donate their organs to thereafter ask to be placed at the front of the queue for someone elses.
All those who enter into organ donorship should receive some benefit for doing so, and fairness would suggest that should be being placed at the front of the queue if needing an organ themself.
What Would Happen To Public Perception Of Organ Donation?
The consideration for an ‘opt-out’ system of organ donation received heavy criticism from the public, especially when it came to human rights aspects of that decision. Organ donation is a sensitive subject and if the public thought that there was favouritism present, it may have a detrimental effect on the NHS and the public perception of organ donation.
What do you think?