Should We Go To Organ Opt-Out?

There was an interesting piece on the CNN website today.  Written by a young woman whose health condition required her to receive a heart transplant, it argues that the United States should change its approach to organ donations, and go from a voluntary donation system to an opt-out system.

organ-donation-transplantationThat is, the United States would presume that all of its citizens have agreed to become organ donors unless and until they have “opted out.”  Some European countries, most recently Wales, have gone to an “opt-out” system, and the argument is that the system will allow the U.S. to avoid the many deaths — according to the writer of the CNN piece, 22 each day —  of Americans who are waiting for a life-saving organ transplant that simply doesn’t arrive in time.

I’m one of the 40 percent of Americans who have voluntarily become organ donors.  I figure that when I’m dead I won’t need my eyes, or organs, or anything else, and if somebody can get some additional use out of them, that would be great.  (Of course, I’m hoping that I’ll have gotten a lifetime’s worth of production out of them before that inescapable eventuality happens.)

Still, there’s something about an opt-out system that troubles me, ethically.  The CNN writer argues that such a program will heighten awareness of organ needs, and better match public opinion — where polls indicate that 95 percent of Americans favor organ donation — with the number of actual organ donors.  And, she contends that an opt-out approach is still voluntary, only the choice is to opt out, rather than opt in.

I disagree with that.  Unlike some, I don’t think an opt-out approach would turn doctors into ghouls who would fail to provide appropriate care in order to expedite harvesting valuable organs.  Instead, I think the issue boils down to one of very basic, essential choices.  If the United States went to an opt-out system, the government would presume to be deciding what to do with your organs, and the burden would be on you to take action to reverse the government’s decision.  I think deciding whether to contribute organs upon your death is about the most personal choice a human being can make.  The fact that the government thinks the greater good might support one choice rather than another doesn’t make the choice any less personal, or one that should be taken away from the individual, even if it is only until they state their intention to the contrary.

I hope that everyone decides to contribute their organs upon their death, so people like the young CNN contributor can live a long and healthy life — but I also think it is a decision that everyone has to make for himself.

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Redefining “Success”

John Kirby, a spokesman for the United States Department of State, has published a “year in review” piece on the Department’s official blog.  He notes that while “the year was not without challenges,” the “United States has helped to change the world for the better” and adds:  “Our diplomats have been busy, and they have met with significant success across a range of issues.”  He then gives his “take” on them using “a great hashtag — #2015in5Words — which was recently trending on Twitter.”

One of the #2015in5Words items Kirby lists is “Bringing Peace, Security to Syria.”

syrian-refugees-opener-6151Huh?  Syria?  The Syria where a bloody civil war between the terrorist forces of ISIS and the repressive regime of Bashar al-Assad has provoked a huge refugee crisis?  The Syria where significant parts of the control are under the control of a deadly terrorist group and where fighting is going on, even now?  The Syria where every big power is flexing its muscle and where, thanks to the support of Russia and Iran, it looks like the murderous Assad might conceivably stay in power?

How does Kirby explain that the U.S. was involved in “Bringing Peace, Security to Syria”?  He doesn’t, really.  He says only that the U.S. has “stepped up to aid the Syrian people during their time of need” and that “the UN Security Council passed a U.S.-sponsored resolution that puts forward a roadmap that will facilitate a transition within Syria to a credible, inclusive, nonsectarian government that is responsive to the needs of the Syrian people.”  Americans should be proud of their traditional generosity to others, of course, but neither increased aid or the passage of a preliminary United Nations Security Council resolution can reasonably be characterized as “Bringing Peace, Security to Syria” in the face of intense ongoing fighting.

Oh, and another “success” included by Kirby is “Winning Fight Against Violent Extremists.”  It touts the “Summit on Countering Violent Terrorism” hosted by the White House in February 2015 and says “this monumental summit launched an ongoing global CVE effort now underway that reaches throughout the world and across countless nations” that ultimately will lead to the defeat of ISIS.  Seriously?  We’re supposed to count a summit meeting that barely hit the news as a success?  Only a flack could say, in the wake of the events in Paris, San Bernardino, and other locations of horrific terrorist actions in 2015, that we are “winning fight against violent extremists.”

Diplomats are supposed to have credibility, but when you’re searching for “success” and trying to present your case in 5-word hashtags that were recently trending on social media, this is what you get.  Maybe there’s a reason the Department of State’s official blog is called “Dipnote.”