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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