Presumed Consent to Organ Harvesting

Wales is now the first country in the United Kingdom to enforce a system of presumed consent to use of a person’s organs for transplant. The introduction of this legislation has set a dangerous precedent for the UK. Interestingly it was assisted by supine ‘faith leaders’ whose nauseating appeasement of oppressive and reckless practices meant that they agitated only for ‘soft’ presumed consent legislation instead of opposing the practice altogether.

The system has long been pressed by the international transplant lobby, body parts industry and utilitarian philosophers (invariably under the sway of big Pharm) with a penchant for “end-justifies-the-means” thinking and a persistent failure to understand the nature of human ignorance and vice.

One obstacle to proper understanding here is that the associated terminology has been comprehensively hijacked by a powerful transplant lobby and human body part trade to propagate the idea that what is proposed here is some small and technical change of direction. After all, who could oppose so minor a move as that from “opt-in” to “opt-out” status? All that is sought, it is suggested, is a mere presumption that everyone in the country will agree to the state appropriating their very innards when they are lying vulnerable on surgeon’s table. Here then, ladies and gentlemen, is a mere technical alteration. The United Kingdom (now barring Wales) currently operates an ‘opt-in’ consent system. That is to say, informed consent is actually necessary. Individuals who want to donate organs and tissue from their bodies after death must be on the Organ Donor Register (ODR), or make their wishes known to their family. Committing oneself to this course of action, by the way, has become almost impossible not to do given that when one applies for a driver’s licence, one can opt in but one cannot opt out of the organ harvesting industry.

On 2nd of July 2013 the Welsh parliament approved legislation authorising doctors to remove organs from any patient declared dead, unless the deceased had formally registered their objection.

Let us be clear. ‘Presumed consent’ is not consent. It is not donation. It is not voluntary. And it is not informed. In short it undermines every aspect of the Nuremberg Code and much other international law that so clearly outlined its concerns for the vulnerable after the war.

All sorts of claims have been made for the new system of state ownership of the human body. Any examination of how presumed consent operates in jurisdictions that enforce it demonstrate that the effects for organ donation are modest given the threat to the defenceless posed by the system. In other words, the patients end up dead – almost certainly before their time – yet there is little increase in the number of successful transplants in these supposedly progressive countries.

Donation rates in countries with ‘presumed consent’ laws do not actually differ from countries requiring explicit (‘opt-in’) consent. In fact, some countries operating presumption systems have lower rates of organ donation.

Differences vary with numbers of potential donors, provision of intensive care facilities, end of life care, use of transplant coordinators, trust in the donation system and trust in the medical profession (particularly those treating dying patients).

After the war, humanity was treated to new insights into how important consent was before medics were permitted to perform invasive and often life threatening procedures on the patient. It was all too clear then that medics, far from being determined to do the best for their patients would gladly maximise their research, academic profile, grant funding and bureaucratically imposed success rates than defend the lives and well-being of their patients. It became obvious  that consent to organ donation should always be voluntary (uncoerced), informed and autonomous. Powerful agencies like the state or the medical profession and industries representing parties with an interest should not be privileged over the vulnerable unless that vulnerable dying patient has given proper, rational, autonomous and informed consent.

A Bogus Argument Addressed

Those that seek to promote the state or corporate harvesting of body parts invariably dredge out what they think is a knock-down argument. I call this the Terrified Mother Argument. It goes something like this. “Imagine you have a son you love. Imagine he needs an organ to survive. You would want organs for transplant, would you not, and you wouldn’t care how you got them?” It is assumed that an answer in the affirmative proves the questioner’s case.

My answer to this alleged knock-down argument is in the affirmative yet I deny the questioner’s conclusion. Yes, I probably would want a murder victim’s organs for my son. I might well dream of hacking them out of some unsuspecting party’s body to save my  son. But that desire of mine, that vice, that preparedness to countenance murder or manslaughter, ought not to be accommodated by legislation. It is precisely because of man’s propensity for vice that we need laws to prevent the homicidal industry in body-part harvesting.

The very idea that people will be informed about the reality of organ retrieval is misguided. Those least likely to understand the implications of the new Welsh law include the young, the uneducated, those with a fixation on celebrities, football, shopping, movie-going and other social distractions (in short most people who aren’t scouring the Lancet for the latest news) and a number of other ill-informed souls. In the words of Alex Schadenberg, Director of the Euthanasia Prevention Coalition “Silence in many of these cases would and should not amount to consent to donation under an opt-out system.”

Organ harvesting is not the right of the state, the transplant lobby, the body-part industry or desperate patients and their families. Organ donation, properly understood, is an express donation (in the true sense of the word) from a properly informed, autonomous and fully rational agent – nothing less.