Should Organ Donation be Mandatory?

[Boyish-Tigerlilly]

Since your argument is basically on utilitarian grounds (benefit to more) rather than deontological principles (sanctity of property or body), how would you like it if the government puts $10000 in your pocket as "compensation" then rips off one of your eyes, one of your kidneys, half your liver, one of your ears, one of anything else you have a double of and half of anything that you only "need" half of.

You are still more or less functional and $10000 richer. The half-liver and kidney went to two people, your eye went to make one totally blind guy see again, and so on. Mathematically it is valid utilitarian math.

Do you really think that's a "Utilitarian" solution to be adopted to society?

WHen you are talking about living people, they are preferences. Those people can feel, can think, and can experience. There really are no qualifiers above, so I assume anyone could be the target of this. This would not only affect the people you are taking from directly, it would also have indirect long term consequences. Yes, you are functional with one eye. To an extent. The same can be said of other organs you only really "need" one of, but what sacrifice of the individual is worth another's?

Forcibly taking organs from the unwilling living is very different from taking the organs of dead people. The dead have no preferences at all and you can't objectively hurt them or violate any of their preference. They can't suffer at all, and no one really need suffer or worry about themselves indirectly, since you are only dealing with dead people anyway. A living person down the road has no need to fear for his life and or suffer in fear of being hacked to pieces if you take the dead. The same cannot be said of the living "donors."

The above proposal could actually, on the macro level, cause less Utility to society and backfire horribly. You have to ask: "Is this the MOST necessary means to achieve the goal, and what are the long and short term consequences of it." Sometimes, Act Utilitarianism can lead to many problems on the macroscale if the particular action were to set a dangerous precedent (when applied consistently as a moral maxim). What you are suggesting is very similar to the "hospital" scenario anti-utilitarians come up with. That scenario claims that, mathematically, you could potentially save many lives by hacking up one healthy guy who comes into the hospital (yet leaving him technically functional). THere is also a version where you kill him and harvest his organs. However, it does not take long-term macro-problems into calculation. Sure, directly, it might have that potential to improve the lives of many people from the cost of fewer individuals, but at what cost to society/family and associates? Is it applicable? What cost is it to the individual as well? You would also have to measure what preferences the hosts would lose compared to those their recipients would gain.


I'm pretty sure people in society, if this is made a moral maxim of general conduct, are't going to be fine with you going around to live people and disassembling them for spare parts. From a Rule-perspective, this would not work on Utilitarian grounds. The paranoia and fear that would likely erupt due to the government seizing random people who are still alive and ripping off their body parts would be something which you couldn't reasonable deal with and keep society free, stable, and happy.
Anyone can be a target, so it will likely create mass fear to live in a society that can take anyone, any time, and hack them up for part (but leave them functional).

It would also probably not be the only means to achieve a similar goal. Sometimes, Utility is a lot more than a simple numbers game. Even if we assume it is a morally 'fair trade" on the individual level and in the Act Utilitarian framework, the macro consequences can nix it if society can't function well after it's consistent application. I can't see society working while everyone is worrying when the goverment will come and hack them into pieces for others.

[His Divine Shadow]

I'm hoping that organ donation will become an obsolete practice in a decade or so anyway.

[The Kernel]

By that standard, the government has the right to throw you in jail for nebulous mutterings concerning national security. Sure, it'd be a huge blow on rights, but if one's right to bodily sanctity is easily violable...

It's not bodily sanctity after death genius. You are no longer a person after you die, and your body does not have rights once it is nothing more than a pile of decomposing parts.

If you legalize the sales, why would they be "grey"? There might be a gray or black market, but I doubt there really isn't a black market for drugs somewhere.

Because there will always be people willing to pay top dollar to get their hands on something with strict supplies. Preference based on wealth goes against the idea of equitable medical treatment regardless of wealth.

Since your argument is basically on utilitarian grounds (benefit to more) rather than deontological principles (sanctity of property or body), how would you like it if the government puts $10000 in your pocket as "compensation" then rips off one of your eyes, one of your kidneys, half your liver, one of your ears, one of anything else you have a double of and half of anything that you only "need" half of.

You are still more or less functional and $10000 richer. The half-liver and kidney went to two people, your eye went to make one totally blind guy see again, and so on. Mathematically it is valid utilitarian math.

Can we say false analogy? There is a difference between removing organs from a dead person, who has no inherent rights or needs whatsoever, and removing them from a living one.

[The Kernel]

The government is only allowed to seize select things with select reasons with fair compensation. Just because something has no value doesn't mean its ok for someone to take away its still theft.

Except that since organs are not transferable, they would not be transferable upon death and could default to the state. See how easy that is?

I would disagree on them having no monetary value. You could probably argue that since the doctors make money on the organ transplant there is a monetary value.

Wrong, doctors make money on the service of installing those organs, not on providing them. The organ donation service is free of charge to all.

Also you could say that since there are people willing to pay for said organs there is a value

No there isn't since it is not a legal market. Just because there is a percieved value for cocaine doesn't mean someone can claim that value in a civil action.

But I would say more importantly you can place monetary value on things that commonly have no value. Such as awarding money for emotional distress. There really is no monetary value for emotions but courts still award money for emotional distress in supeonas.

Sorry, but too fucking bad for the people that want the bodies "whole". They have no rational need for the organs whatsoever while society benefits from them highly. There is literally zero reason for anyone to keep such a thing other than nonsense reasons related to religion and culture.

Mine may be a utilitarian argument, but they don't get any better than this as far as such arguments go since there is no rational loss involved.

[Broomstick]

We have artificial blood which does reasonable job for now

Actually, there continue to be problems with the artifical blood.

The biggest problem with the "mandatory donation at death" idea is that it won't cure the organ shortage. MOST organs are not suitable for donation - not only does the person have to be healthy, but they have to die in a certain manner so the organs remain viable. Even if every viable organ were harvested, though, there would still be a waiting list and there would still be people dying on that waiting list. Nor is it just a matter of pulling a liver off a shelf and installing it - donated organs have to be at least a partial immunological match, and frequently size factors into the matter, too. A heart that's a perfect match but too large or too small is useless.

So -- would the societal disruption caused by making this change (and it would be disruptive) really be a net benefit? It's all very well to discuss the rationality of recycling usable bits of fellow citizens, but we're not Vulcans. People are not rational, and even more so around issues involving death. You can call it "silly superstition" but people are willing to kill and die over it.

[The Kernel]

The biggest problem with the "mandatory donation at death" idea is that it won't cure the organ shortage. MOST organs are not suitable for donation - not only does the person have to be healthy, but they have to die in a certain manner so the organs remain viable. Even if every viable organ were harvested, though, there would still be a waiting list and there would still be people dying on that waiting list. Nor is it just a matter of pulling a liver off a shelf and installing it - donated organs have to be at least a partial immunological match, and frequently size factors into the matter, too. A heart that's a perfect match but too large or too small is useless.

So -- would the societal disruption caused by making this change (and it would be disruptive) really be a net benefit? It's all very well to discuss the rationality of recycling usable bits of fellow citizens, but we're not Vulcans. People are not rational, and even more so around issues involving death. You can call it "silly superstition" but people are willing to kill and die over it.

Actually, thousands of viable organs are lost each year because of an inability to verify donor status (with the default assumption being a non-donor) in time to harvest the organs. A national medical database would obviously help this issue, but if the default assumption was a "yes", or even better a mandatory thing, then these organs wouldn't be lost.

I don't think anyone is suggesting it will cure the organ shortage, especially given the amount of alcoholics in the US. But it's safe to say that it could help alleviate the problem to the point where children don't need to stay on dialysis for years waiting for a transplant.

[PainRack]

Many people who actively do not want to donate organs (unlike me who lost the $#%# sticker saying I wanted to be one) do it for strongly personal or even religious reasons. Punishing someone for their beliefs is rather cruel.

If people actively opt out of the donation system at the giving end isn't it only fair that they should also be opted out of the recieving end aswell? Why should they be able to take from the system whilst actively taking steps to avoid ever giving to it?[/quote]
Because it violates from the idea of justice in medicine, where treatment is proved as needed. Not based on how good or bad a person you are?

[Sir Sirius]

Finnish legislation on this says:

Section 9
Consent
Organs and tissues of a deceased person may be removed
unless there is reason to assume that the person would
have objected while still alive, or that a near relative
or other close person would object.

If a person has, while alive, given consent to the
removal of organs and tissues for the purpose referred to
in section 8, paragraph 1, the measure can be performed
despite being forbidden by a near relative or other close
person.

While I belief that the above is a reasonable practice I do have to admit that I would like to see mandatory organ donations upon death to be written in to law, just so I could see the selfish swines who, for what ever inane reason, refuse to donate their organs squirm.

[Kazuaki Shimazaki]

It's not bodily sanctity after death genius. You are no longer a person after you die, and your body does not have rights once it is nothing more than a pile of decomposing parts.

But you had a choice when you were human, and you chose not to give up anything. That power does not go away when you are dead, just as the control of other things, like your property, do not end. That doesn't mean its right. If you have no relatives to inherit your shit, you might as well give it all way to charity after your death.

Because there will always be people willing to pay top dollar to get their hands on something with strict supplies. Preference based on wealth goes against the idea of equitable medical treatment regardless of wealth.

1) Let's face it, real "equitable medical treatment regardless of wealth" is a joke unless you happen to live in a government where there are only public hospitals and nobody pays a single buck beyond taxation for care. The rich can always afford specialized treatments the poor cannot.
2) If you are really concerned, set a few price controls on the system so the livers don't cost $1 million per copy while still providing incentive to donate.

Can we say false analogy? There is a difference between removing organs from a dead person, who has no inherent rights or needs whatsoever, and removing them from a living one.

There is a difference, mathematically. However, since you decided that the Principle of Sanctity of Body can be compromised on utilitarian grounds, you open the door to the idea that at a certain ratio of gain to others vs loss to you, you can be sacrificed.

Sure, Tigerlily is right in pointing out that I played a variant of the standard anti-utilitarian example, and he used a standard counter by expanding it into the macro and talking about the long term consequences - rule consequentialism. Both are enshrined in Wikipedia and no doubt in a million other places.

But it may not work this way. For example, suppose you can be effectively silenced after this somehow - lead or silver deals afterwards (maybe not a bullet, but a long prison sentence, or something dastardly that would discourage you from squawking too loudly), for example, or worse, instead of leaving you half functional, you plain disappear. If they didn't keep doing this too often, they'd still save a lot of people since people who need organs are still a minority of our massive population and your sacrifice will benefit many of them at once, satisfying act consequentialism at least in mathematical theory, while not causing too much damage to society, in principle satisfying rule consequentialism as well.

[Broomstick]

The biggest problem with the "mandatory donation at death" idea is that it won't cure the organ shortage. MOST organs are not suitable for donation - not only does the person have to be healthy, but they have to die in a certain manner so the organs remain viable. Even if every viable organ were harvested, though, there would still be a waiting list and there would still be people dying on that waiting list. Nor is it just a matter of pulling a liver off a shelf and installing it - donated organs have to be at least a partial immunological match, and frequently size factors into the matter, too. A heart that's a perfect match but too large or too small is useless.

So -- would the societal disruption caused by making this change (and it would be disruptive) really be a net benefit? It's all very well to discuss the rationality of recycling usable bits of fellow citizens, but we're not Vulcans. People are not rational, and even more so around issues involving death. You can call it "silly superstition" but people are willing to kill and die over it.

Actually, thousands of viable organs are lost each year because of an inability to verify donor status (with the default assumption being a non-donor) in time to harvest the organs. A national medical database would obviously help this issue, but if the default assumption was a "yes", or even better a mandatory thing, then these organs wouldn't be lost.

It's not just a matter of confirming if someone consented to donation or not - you also have to establish a medical history. Someone who falls off a motorcycle while riding and kills their brain would appear to be an ideal donor, but if they had had cancer 10 years before no, they would not be a suitable donor. Yes, a national medical databse might also elminate that objection, but we don't have one of those yet in the US, and might not for a long time given the political and social realities.

I don't think anyone is suggesting it will cure the organ shortage, especially given the amount of alcoholics in the US. But it's safe to say that it could help alleviate the problem to the point where children don't need to stay on dialysis for years waiting for a transplant.

Nope, it won't cure that problem. For one thing, it's not enough merely to have an organ - it has to be a matching organ. Some people are much harder to match immunologically than others. The flip side of this is that anyone who can't bear to see children on dialysis is welcome to volunteer one of their kidneys to the cause. If you aren't willing to part with one of YOURS, how can you justify taking it from someone else?

[Anguirus]

If you aren't willing to part with one of YOURS, how can you justify taking it from someone else?

Because, as per the OT, the other person is dead and not using it.

[Lord Zentei]

Providing an opt-out is fine, but it shouldn't be as easy as, say, signing up for the Do Not Call list. Make it require a mandtory consultation with a doctor about the benefits of the organ donation program, this would ensure all but the troublemaking fundies would simply deal with it.

An opt-out seems a perfectly reasonable solution. And actually, I doubt that you would need to make it all that hard, even.

ok switching to this thread for everything.

Its part of your person thus making it yours. When you die your body basically becomes the property of your family to bury to cremate according to there wishes(or the wishes of a will)

So? The fact remains that your body parts have zero monetary value. Even if you qualify them as property (which is questionable given the restrictions surrounding remains) the Government does have the right to seize them.

I disagree here: organs have a quite steep value as they can command a hefty price. Of course, I doubt that many families would sell their deceased loved ones for transplantation, but still.

[Admiral Valdemar]

I disagree here: organs have a quite steep value as they can command a hefty price. Of course, I doubt that many families would sell their deceased loved ones for transplantation, but still.

I think The Kernel was getting at the fact that, as raw materials, they are worth barely a buck usually (they are formed from the most abundant elements on Earth anyway). But that's not really a good viewpoint, since there obviously is monetary value, since there is demand and where there's a supply for that demand, there's money. The organs may be worth little as raw material, but the structure they form is priceless since it is far beyond our current technology level. It's the difference between the lead in your pencil and a 24 carat, well cut diamond.

[Mobiboros]

My concern would be the precedent it sets. The reason it's not mandatory is that when you die your body becomes part of your 'estate', and unless specified otherwise it defaults to your next of kin for them to dispose of as they see fit. Signing up for organ donation is basically like specifying in your will what parts of your estate go where. In this case you've said you leave your organs to someone else.

A more equitable way to do it might be like how Selective Service is handled (though in this case everyone would need to, not just males). At 18 you'd have to go down to the post office and fill out forms that say you are a registered organ donor, or you aren't. You can opt out, but if you do it carries the same penalties as not signing up for selective service.

[Darth Raptor]

Yes, hell yes. The dead have absolutely no rights, and the concerns of the berieved are eclipsed by the needs of transplant patients.

Only when our cloning, prosthetics and synthesis technology improves will you have the right to be a fucking scumbag and let your liver rot away uselessly after you die. Until then, fuck the rights of people who don't exist anymore.

[Aeolus]

Make being a registered organ donnar lower your income tax rate by 1 bracket.

You'll have more organs then you need

That would likely backfire. For the same reasons they dont pay you to donate blood.

[Darth Wong]

This thread would be a lot shorter without the idiotic "is/ought" fallacies being employed by the people who invoke current rules in order to argue against the morality of a proposed change in the rules.

[brianeyci]

The dead have rights. The dead dictate where their assets go with their wills. If the dead say that their assets, namely their body parts are to stay with their bodies into the furnace, then I don't see how you can justify taking away their property unless you want to also take away the assets of rich bastards on their deaths and give them to worthy causes.

The question isn't whether the dead have rights, but whether by default (unless the person objects) organs should be donated. Broomstick's already mentioned the problem that organ donation isn't just rip out a heart and stuff it in another person. The other problem is the idea of donating organs by default (unless the person objects) is it just wouldn't work in a society with so many different cultures and religions without appearing to disrespect those cultures and religions. Yes, life is more important that somebody's feelings, but there's no way mandatory organ donation would practically work in let's say Canada.

The doctor can just ask relatives if he wanted his organs donated (the organs being the property of the relatives). AFAIK the relative's wishes are more important than even that little donor card you sign (the donor card is not legally binding), because if they say no the doctors don't go through with it because of liability issues.

Brian

[The Kernel]

But you had a choice when you were human, and you chose not to give up anything. That power does not go away when you are dead, just as the control of other things, like your property, do not end. That doesn't mean its right. If you have no relatives to inherit your shit, you might as well give it all way to charity after your death.

Let's cut to the chase here, I see nothing in the Constitution that prevents the government from assessing ownership rights over the carcasses of people. Do we really need to go further in the legal argument? Even if you prove that human organs are property, the government can still take them away with due process.

1) Let's face it, real "equitable medical treatment regardless of wealth" is a joke unless you happen to live in a government where there are only public hospitals and nobody pays a single buck beyond taxation for care. The rich can always afford specialized treatments the poor cannot.

By that logic because the criminal justice system isn't as equitable as it should be, we should open the floodgates and allow the rich to purchase justice openly.

2) If you are really concerned, set a few price controls on the system so the livers don't cost $1 million per copy while still providing incentive to donate.

Why set any controls at all? The current system works fine, aside from a lack of supply. You don't need to go to the hassle of purchasing organs with a mandatory donor registry.

There is a difference, mathematically. However, since you decided that the Principle of Sanctity of Body can be compromised on utilitarian grounds, you open the door to the idea that at a certain ratio of gain to others vs loss to you, you can be sacrificed.

No it doesn't; one has nothing to do with the other. Depriving property rights with due process upon the dead is not even close to the same thing as depriving a healthy person of functioning organs while still alive. Utilitarianism does not demand that every slippery slope be followed despite your simplistic interpretation of it.

[The Kernel]

It's not just a matter of confirming if someone consented to donation or not - you also have to establish a medical history. Someone who falls off a motorcycle while riding and kills their brain would appear to be an ideal donor, but if they had had cancer 10 years before no, they would not be a suitable donor. Yes, a national medical databse might also elminate that objection, but we don't have one of those yet in the US, and might not for a long time given the political and social realities.

The national medical database has secured funding and is under late stage technology development. Does this mean that we can't solve the other end of the equation? An increase in donors is always going to help the situation, so this entire tangent is a red herring.

Nope, it won't cure that problem. For one thing, it's not enough merely to have an organ - it has to be a matching organ. Some people are much harder to match immunologically than others.

I never said it would cure the problem, I said it would help alleviate it, and it will. Just because something does not work aboslutely perfectly does not mean that it should be discounted.

The flip side of this is that anyone who can't bear to see children on dialysis is welcome to volunteer one of their kidneys to the cause. If you aren't willing to part with one of YOURS, how can you justify taking it from someone else?

I don't justify taking it from anyone, I justify taking it from the dead carcasses of people, something I have already agreed to myself. Take your false dillemas elsewhere please.

[The Kernel]

The dead have rights. The dead dictate where their assets go with their wills. If the dead say that their assets, namely their body parts are to stay with their bodies into the furnace, then I don't see how you can justify taking away their property unless you want to also take away the assets of rich bastards on their deaths and give them to worthy causes.

Ever hear of estate taxes? Property is routinely taxed upon death, there is no legal precedent forbidding the seizure of property.

Mike is right, this entire legal argument is stupid given we are advocating a change in the law. Any argument should be on a moral, not legal, grounds since it has already been established that such a law would probably hold up.

[brianeyci]

Clarify what is meant in change of the law. Is it A. You are forced to donate no matter your wishes after death or B. The default is donate, but if the relatives or the will objects you don't donate. I was talking about B which is what I assumed because that is a practical change actually being considered by medical professionals, rather than A which at least in Canada has been said to be unworkable.

Brian

[The Kernel]

Clarify what is meant in change of the law. Is it A. You are forced to donate no matter your wishes after death or B. The default is donate, but if the relatives or the will objects you don't donate. I was talking about B which is what I assumed because that is a practical change actually being considered by medical professionals, rather than A which at least in Canada has been said to be unworkable.

Brian

Both could be done with new legislation without any obvious Constitutional barriers in the US. B would be impratical given the public uproar, but is still a defensable position.

[brianeyci]

Sorry B should be "the default is donate, but if the relatives or will objects the doctors will not harvest."

The argument is then about practicality. Whether or not there are so many religious groups that would object to a default harvesting of organs with B or a forced harvesting of organs with A.

Brian

[CarsonPalmer]

I am in favor of an "opt out system" but there is an interesting, albeit strained and slightly dishononest legal loophole that anti-abortion activists could seize on in their crusade through forced organ donation. Forced organ donation implies that bodily sanctity can be violated for public good. Now, this opens up a whole new front in the anti-abortion debate. Its not logically good, and I'm not using this to argue against forced organ donation or abortion, just saw something interesting.