The Corner

Adopt ‘Opt-Out’ Organ Donation & Destroy Trust in Medicine

Well meaning people and utilitarian bioethicists continue to push an “opt-out” system of organ donation that would automatically make each of us “donors” unless we signed a form saying “no” in advance.

The latest example of the advocacy comes over at CNN from a heart transplant recipient. From, “Time to Fix America’s Organ Donor System:”

All this might sound simple, but there are some people who consider an opt-out policy to be unethical, believing that it is a violation of the right to choose what happens to our bodies. Others worry that defaulting to opt-out will affect the quality of medical care — that doctors might be more interested in harvesting a patient’s organs than saving a patient’s life.

Yet presumed consent is not taking away anyone’s choice. Quite the opposite — an opt-out policy raises awareness and forces people to make tough decisions. If 9-in-10 people support organ donation, an opt-out policy is surely the most efficient way to ensure that Americans are having their wish granted when they can no longer speak for themselves.

No. Opt-out would really amount to an organ conscription program.

I don’t think the American people would stand for it. They were solemnly promised that organ donation would only be allowed with specific consent. Changing the consent rules would amount to a serious case of public policy promise breaking.

The organ system requires trust of donors and their families, already weak. Even now, families of a registered organ donor are asked for their consent regardless of the dead person’s stated desires.  If they refuse, often the organs are not taken. An opt-out system would worsen that frailty.

Moreover, an opt-out system would exacerbate existing controversies. For example, the concept of brain death is opposed by many. Imagine a family told their loved one is brain dead and has thus been sent to the organ retrieval surgical suite. Lawsuits would proliferate.

Opt-out would also impact medicine generally. For example, bioethicists are continually promoting death panel medicine, pushing futile care protocols that allow doctors/hospital committees to refuse wanted life-sustaining treatment. Couple that idea with opt-out and you’d have a real firestorm.

Then there is the prospect of non voluntary harvesting conjoined with healthcare rationing. Rationing already exists in Oregon for Medicaid recipients, and if Obamacarians get their way, it will one day go national based on bureaucratically imposed invidious distinctions and/or cost-benefit “guidelines.”

Imagine the screaming if a patient who dies after being refused treatment, who then has her organs harvested because she hadn’t opted out. Zowie!

And consider how utilitarian considerations have entered medicine, with some bioethicists pushing a “quality of life” ethic that values some patients over others. In such a milieu, suspicion and paranoia would definitely strike a beat!

No, as well-meaning as its proponents are, at least in the USA, opt-out “presumed consent” to donate would be a disaster, sowing distrust in organ transplant medicine specifically, and creating a suspicion that at least some doctors would see the most catastrophically ill, seriously disabled, and grievously and injured patients as so many organ farms.

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