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What amuses, annoys, concerns or otherwise interests me – Noodlemaz

Opt-Out Organs

9 Comments

I’ve never really felt the need to write about organ donation as an issue because what the right thing to do seems very obvious to me; make the system opt-out so that, by default, organs fit for donation are harvested and distributed to patients on waiting lists.

Unless you don’t want that to happen; if, for some reason, you actually care what happens to your body after you die. I don’t really get this POV – when you’re dead, you have no consciousness, no future, no considerations – you are no longer. You are an ex-person.

What’s the problem?Organ transplant box

Some people do seem to have objections. Often religious ones; apparently it’s important when you transition to a non-corporeal afterlife that your corpus (for some reason) remains intact, such as it is. Embalming, coffins, all of that – try to preserve your physical form, even though you no longer need it. Very strange, really. But people do it.

Perhaps you care what your family thinks after you’ve gone. Maybe you want to spare them the apparent trauma of doctors distributing your parts to others who could make use of them. Again I don’t really understand that – what better gift to give in your death than that of more life for others? Life for parents, for children, for friends and family and lovers. Why would you want to withhold that?

People are selfish, that’s why. You and yours matter more than anyone else and theirs. There’s reason to that, to an extent, but I think the world might be a nicer place if people were more concerned about others in both life and death, managing to lay aside what we want for ourselves when others could potentially benefit, at little or no cost to us.

Until research and technology allow us to grow whole, fully-functional organs in the lab, unfortunately we are reliant on organs people have grown in their own bodies for transplants. I also wonder what people who have objections to donation would do if they found themselves or one of their loved ones on a waiting list for an organ? Well, given that aforementioned selfishness, presumably hope that other families are more selfless.

It seems a similar kind of thinking pattern to that of anti-vaccination. We don’t want to take the (tiny) risks, I’ll do what I want despite the evidence, I’ll reap the benefits of a society that doesn’t share my views and shelters me and mine from my stupidity. Too harsh?

Another perspective

I posted about this recently when the opt-out plans enacted in Wales were in the news and someone made a point I had never considered before.

People have funny ideas about death; it’s one of those largely incomprehensible, stressful, emotional yet utterly everyday concepts we really struggle with as human beings. As a result, we sometimes do odd things in life.

One of those odd things is to be superstitious. Avoiding certain things lest we tempt fate and upset the supernatural forces that may or may not govern our destinies. That superstition could well include completely avoiding the idea that we may die unexpectedly, and thinking about what would happen after that event.

So, if someone is squeamish about the idea of death, and their own in particular, maybe they don’t really want to carry around a card that tells the world they’re happy for other people to make use of their organs after that collision with a bus/overzealous motorbike excursion/tragic fall/accidental overdose.

Some people might feel that signing those forms and receiving that card makes that death-reality come closer. They might be as rational as you like and know how ridiculous it is, but just that feeling, that discomfort, could deter them from participating in the opt-in system. They’d have no problem if it were all up to the people dealing with them after their death – they wouldn’t ever have to actively think about it.

I wonder, how many potential donors have we lost because of this emotional quirk? How many could we gain with the opt-out system?

Opt out if you have to

If you care so very much what happens to your no-longer-living flesh, surely at some point in your life you can find the time to sign the form that tells everyone else about it. The change would be publicised, the population educated.

Lives will be saved by that simple action; even if you don’t want to actively participate in donation, you minimise the impact your non-participation has by agreeing to the system change. Maybe that can satisfy you.

If it doesn’t, what exactly is the problem?

I really don’t understand. Religious beliefs are allowed, but surely where there are negative consequences, you should seek to contain those. Personal objections are also allowed, but again, if you care so much, what’s so hard about making sure you tell people?

Is it that it’s embarrassing? Perhaps, then, time to re-examine the position.

Like so many things, it seems to be a problem with failing to empathise, failing to seriously consider the future. A lot of people are really bad at that.

But, thankfully, I do think the majority want to help others when they can, and would welcome the change. It is of course a lot more complicated than the above, but those are my current thoughts.

For now, don’t forget to join the register if you haven’t already – it’s really easy. And I’m proud to have that card in my wallet.

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Author: noodlemaz

I prefer to think of myself as a realist rather than a pessimist, but perhaps that's just optimistic. Honest, atheist, scientist, feminist.

9 thoughts on “Opt-Out Organs

  1. I’m all for anything that gets more organs (mine, anyone’s) to do useful things once their original owner isn’t using them. When I worked at Diabetes UK one of my jobs was as project coordinator / liaison person for the Islet Transplant Project (using donated pancreatic tissue to help people with Type 1 diabetes who were no longer able to recognise when their blood glucose levels were dropping – in the wrong circumstances this can be fatal, though more commonly leads to someone ‘just’ collapsing, but still not much fun). Two people died while on the waiting list for this transplant. So yes, more organs please and less squeamishness.

    However I wonder if part of the reason for people’s dislike of being assumed to be a donor is that it *seems* to stop it being a donation or a choice if someone else decides for you. Also many people might be uncomfortable with the state intervening in your organs (that’s not quite correct of course, but people will likely be hearing about this not from the NHS but from newspaper articles reporting Parliamentary decision-making). A lot of people might just want the right to be left alone, and not feel that they’re going to be stripped for parts. I don’t particularly agree with those sentiments but I don’t have a very good argument against someone’s natural distaste for such things.

  2. There are other types of interference with corpses which the law forbids, for example sexual interference. This is because a corpse is not able to give consent. I’m not sure how that would work out if prior consent could be proven. I suspect it would still be forbidden, so I’m not sure how that might advance the argument except to show that the law recognises that a corpse retains some rights.

    • I think (not) consenting to a medical procedure is very different to not consenting to sexual violation post mortem. The purposes of the acts are so vastly different, I’m not sure why they’re at all equatable.

      Assumption that people consent to any procedure? That’s why I mentioned the education bit. If everyone is made aware *this is what happens after you die: if possible, bits of you will be given to other people who need those bits because of disease/accident/hereditary illness* then surely if you don’t want it, you can easily say so?

      I don’t think that’s the same as necrophilia; I don’t think anyone would assume anyone else would want that (even if they’re dead and unaware) – it is, indeed offensive to others, for whom the dead-body-object is still important. It serves no purpose other than sexual gratification for the (living) individual, so again I don’t think they’re comparable. We don’t do sign I-don’t-consent-to-necrophiliacs-having-their-way-with-me forms because a) no one assumes you would in the first place b) society condemns the act c) general lack of benefit to others.

      Legally, ‘rights of a corpse’ is an odd concept to me – again, as you said on Twitter, it is become an object that retains importance to living persons. I think there’s an important subtlety in there, though. As a potential organ source, the corpse has importance to living persons that don’t happen to be related.

      Again, surely, if the system is in place that both informs people of the default position and how to change what happens to them if that’s what they’d want, there’d be a problem. If people have disagreements with their own family… I can see that’s a problem within the family, but for anyone else..?

      • My point was that the corpse retains certain rights of inviolability, albeit with next of kin able to give voice. The living will is the final say if properly drafted. So what lawfully happens to the corpse is predicated on the clearly expressed wishes of the living person that was, regardless of the strong objections of the family. The corpse remains in a sense the property of the person who vacated it. I have no problem with the system you describe, but I think where a default is activated the family should be able to override within a reasonable time period. This is different to requiring the consent to begin with.

  3. Some people are concerned that the definition of “death” allows organs to be removed when there is still some chance of being alive and surviving. Scare stories like this: http://www.naturalnews.com/041152_transplant_patients_organ_harvesting_presumed_consent.html must do great harm to donor schemes.

  4. This is an argument I’ve been making for a few years now. It makes perfect sense in everyway. It would save so many lives, and at the same time wouldn’t force people to donate organs if they didn’t want to. It’s like we have a shit solution and a great one, and we’ve currently got the shit one.

    The strange quirk is really common, not just for donation cards. It’s like some extreme sports performers or even military persons carrying blood type info. Some people would never do it since it’s “just asking for something to happen”. Yep, entirely irrational, but it seems common from the people I’ve talked to about it.

    I carry a donor card, it’s a no-brainer for me.

  5. Agree entirely. I also have no real qualms about me being kept “alive” (if, e.g. Otherwise dead) to enable the organs to keep nice and fresh. A two hour time window can be easily missed for the most banal reasons. Having said that, I’d find it very difficult (I think) to allow my partner/child to be kept in the same state. Relatives rights become more important then I guess.

    In any case, my horn is available to the neediest person:

    http://www.telegraph.co.uk/health/healthnews/10154686/Opt-out-organ-donation-will-treat-bodies-like-clapped-out-cars.html

    “You strip the car of parts for reuse, unless the owner prefers to scrap the whole vehicle. Its outrageous to pretend that people feel no differently about a human heart from a used car horn.”

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