by Theresa Spranger, Bioethics Program Alumna (MSBioethics 2012)
Organ donation is the gift of life. By donating organs after we die we can literally bring someone back from the brink. Pretty awesome right?
So awesome in fact, that it could be argued, and has been, that everyone should want to donate their organs when they die, and consent for donation should be presumed.
What would this mean? Presumed consent for organ donation means that viable organs would be harvested from anyone who dies and consent from the patient or family would be unnecessary. Every person would need to opt-out of the donation program rather than the current “opt-in” plan we have now.
As with everything in life there are pros and cons with an opt-out plan. Let’s start with an obvious pro: with more available organs, more sick patients can get the transplant they need. This is a definite good, but is it worth the cost.
One of the arguments I have heard for mandatory organ donation is: you don’t own your body once you die. The assumption is that once I have died neither I, nor those who love me, have a vested interest in my body and until it is released to my family for funeral arrangements it in essence belongs to the government and my organs can be taken for donation without any ethical issue.
I adamantly disagree with the idea that I have no vested interest in my body once I have died. My interest extends from the values I have lived during my life. Furthermore, ownership and all decisions therein, should belong to my next of kin. This ownership is crucial for many families. For me, the final act I can perform for my loved one is ensuring the safe passage of their remains. It is vital for me to have ownership of this task as part of my grieving process. To remove personhood and its intrinsic value because life has left the body is illogical and disrespectful to the person as well as the loved ones they leave behind.
Another issue with presumed consent is that it expects an educated populous. At this point in our society we need to recognize that this cannot be expected. The vast majority of Americans live very uninformed lives for a variety of reasons. If you don’t believe me watch some of Jimmy Kimmel’s Lie Witness News, they will make you cringe.
Finally, I think that making organ donation mandatory changes the psychology of the act. Right now to donate you organs is altruistic and selfless. If it becomes mandatory it changes the dynamic, instead of an altruistic giving of your organs, you become a renter of those organs until your death. This may sound like a small thing, but changing this changes the way we view donors entirely.
In the end, organ donation saves lives, which is an important and wonderful thing. However, making donation mandatory comes at a cost. Are the lives saved worth possibly violating a person’s body? Or upsetting their family?
Treating everyone with respect and dignity is the most important thing we can do. We should not place one patient at a higher priority while neglecting the other patient or their family.
As you have likely gathered I am strongly against mandatory organ donation. That being said, organ donation is crucial and we should educate all citizens on the great gift they can give at the end of their life. This will be an uphill battle, but if you agree with organ donation tell a friend and tell them to tell a friend. With passionate advocates making the case to individuals we can raise the number of willing organ donors without compromising the donation process.
[This blog entry was originally posted in a slightly edited form on Ms. Spranger’s blog on May 15, 2014. Its contents are solely the responsibility of the author alone and do not represent the views of the Bioethics Program or Union Graduate College.]
The Bioethics Program 
I think there is a confusion here between the idea of mandatory donation (everyone must give – no opt out) and the presumed consent method.
Agreed; there is nothing “outrageous” or “unethical” about moving from our relatively ineffective opt-in system to a more sensible opt-out system. The presumption should be that most are decent enough to wish to save lives with their organs once they no longer need them, and the onus should be on the rarer individual who doesn’t wish to donate to opt-out. Surveys routinely show that the majority of American citizens believe in organ donation, but between an insufficient system that requires donors to actively register and keep a sticker on his/her driver’s license, and the ability of surviving relatives to nullify a donor’s donation request, far fewer organs than are intended end up available to needy recipients. This system would keep everyone’s rights intact, but result in far more frequent and effective organ donation, which we desperately need.
What do you do if someone opted out only to have their organ used anyway? Do you politely tell the person that you’ll need that liver back?
That is the one indisputable advantage of the opt-in method; it puts the burden of proof on the people who want to use the organs and makes errors like that much less likely.
i think organ donation should be of choice instead of making it compulsory. it sounds a bit awkward to say that the government owns our body even after death .
but it is made compulsory it should be made with due care and respect as such without violating the process and make it as human traffiking as far as possible
I am an organ donor in…which I personally made a conscious and sound decision.. also discussed with my family so they knew what i wish to happen with my body…..but to make it Mandatory to me takes away that right of a person as to what happens to it after passing… you also have the ethical & Moral rights of those who have Mental Health issues, or Cultural differences or unaware of what is going to happen to them or who are sometimes unable to make a decision due to a Mental or Physical condition… even with the opt out option… Not everyone can do it for what ever reason…. where as for the gift of giving your organ… you would find a way of making sure you have given your consent. Mandatory to me sounds like …we will just take it from you with no consideration of yours or your family feelings..
As for presumed consent is just another word for ” To take ”
You didn’t fill out the forms so we will TAKE!!