# Opt out organ donation and relatives' wishes **URL:** \ **Category:** Great Debates\ **Created:** [July 2, 2013, 5:33pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463 "2013-07-02T17:33:03Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [July 3, 2013, 10:33pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/101 "2013-07-03T22:33:41Z")
> [@Roderick\_Femm](#): > > And like anything else that belongs to me and for which I am responsible in life, I should have first say in what is done to it when I am dead\*. You do have first say. You can opt out for any reason. This only comes an issue if you don’t express a preference. And you can say other people don’t have the right to be saved, but you also don’t have the right to not have to check a box. ---
**Author:** ![Bozuit](https://avatars.discourse-cdn.com/v4/letter/b/edb3f5/32.png) [@Bozuit](https://boards.straightdope.com/u/Bozuit)\ **Post date:** [July 3, 2013, 10:46pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/102 "2013-07-03T22:46:17Z")
> [@Roderick\_Femm](#): > > Here is my reason for being in general against opt-out systems. > > First, as background, I have opted in for organ donation in my state. Second, I am an atheist and I don’t believe in any soul-like thing that will remain in existence after my physical life-processes have stopped. Even if there were such a thing, by definition it would be divorced from my physical corpse. And I am not interested in how my surviving loved ones, if any, would feel about my decision. > > However, my body does belong to me while I am alive, it is recognized in law that, assuming I am competent, I am the one who has final say as to what is done to it while I am alive. And like anything else that belongs to me and for which I am responsible in life, I should have first say in what is done to it when I am dead\*. > > The big argument in favor of opt-out schemes is that it will save the lives of more people who need organs than an opt-in system. There is no doubt about that. However, those people do not have a right to be saved. > > Yes, you read correctly, those people do not have a right to be saved. They have the right to spend their money to get the best treatment they can afford (or their insurance is willing to pay for). They do not have the right to insist or expect for other people to donate organs to them, any more than they have the right to insist or expect that other people will contribute money to their care, because “they need it”. It should always be by the choice of the donors. > > Note that I don’t think it would be the end of the world if opt-out systems are adopted. On the other hand, I don’t think it would be the end of the world if fewer people who need organs are saved if those systems weren’t adopted. > > \*Interesting legal parallel that perhaps argues against my own point. The estates of people who die without wills are disposed of by the government, based on laws. I suppose you could draw a parallel between dying without a will and dying without opting out of organ donation. Stubbornness and ignorance probably account for most of those who die without wills. Just a thought. From my point of view, you’re getting too far into the realm of “principle” and rights or laws as if they’re fundamental things. You say people should get to decide what do with their own bodies after death with no reasoning other than your assumption that that right is as certain as the laws of gravity. Rights have to be agreed upon by humans and are not rules beyond us we can appeal to, as a Christian might consider the Ten Commandments to be. It’s a little like gun advocates insisting they should have guns because of the Second Amendment, with no regard for the possibility that the rule might not be an appropriate one. I don’t wish to debate gun laws in the US, but that kind of reasoning is really just circular logic. “It should be this way because it’s my right. It’s my right because it should be this way.” I know this might seem extreme to some, but I’m somewhat inclined to agree that people do indeed have a right to decide what happens to their body after they die… as long as they don’t make a disgustingly selfish decision, and then that right is gone. ---
**Author:** ![Bozuit](https://avatars.discourse-cdn.com/v4/letter/b/edb3f5/32.png) [@Bozuit](https://boards.straightdope.com/u/Bozuit)\ **Post date:** [July 3, 2013, 10:49pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/103 "2013-07-03T22:49:32Z")
> [@Tequila\_Party](#): > > Absolutely incredible. I wonder if the need for this to become a reality someday, will make lawmakers include a caveat that the only people who may receive a transplant are those who opt-in. I bet then that those that are so concerned about their bodies will have a completely different take on things. I considered that, but it would become too complicated when you started to hear of 35 year old parents who made a selfish decision at 18 and are now dying of kidney failure or something. ---
**Author:** ![Roderick\_Femm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/roderick_femm/32/14875_2.png) [@Roderick\_Femm](https://boards.straightdope.com/u/Roderick_Femm)\ **Post date:** [July 3, 2013, 10:55pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/104 "2013-07-03T22:55:24Z")
> [@Bozuit](#): > > From my point of view, you’re getting too far into the realm of “principle” and rights or laws as if they’re fundamental things. You say people should get to decide what do with their own bodies after death with no reasoning other than your assumption that that right is as certain as the laws of gravity. Rights have to be agreed upon by humans and are not rules beyond us we can appeal to, as a Christian might consider the Ten Commandments to be. It’s a little like gun advocates insisting they should have guns because of the Second Amendment, with no regard for the possibility that the rule might not be an appropriate one. I don’t wish to debate gun laws in the US, but that kind of reasoning is really just circular logic. “It should be this way because it’s my right. It’s my right because it should be this way.” > > I know this might seem extreme to some, but I’m somewhat inclined to agree that people do indeed have a right to decide what happens to their body after they die… as long as they don’t make a disgustingly selfish decision, and then that right is gone. Then there really is no choice. Either I decide the way you think I should, or else I am disgustingly selfish. I disagree with your view about rights. I am among those who think that there are very few rights that humans possess, but that the possession of those rights can be argued from basic principles. Note that possession of rights, and recognition of rights, are two different things. People possess rights independent of their society and government; however, that society or government may not recognize those rights. This distinction is often the basis of revolutions. Litigation of apparently-conflicting rights is one of the most urgent functions of governments (and one which they often perform worst at). And **Tequila Party** , maybe your comment wasn’t directed at me, but did you miss the part where I said that I have opted-in? The issue here is not whether people ought to opt in, but whether they should be forced to opt out to avoid something they don’t want. Roddy ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [July 3, 2013, 10:55pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/105 "2013-07-03T22:55:57Z")
> [@Damuri\_Ajashi](#): > > I support it because I think a lot of people, deep down inside are squeemish, selfish or don’t want to contemplate their own mortality. Sure they like organ donations in theory and would like an organ transplant if they needed it but aren’t really so excited about their body being used for spare parts after they die. I did mention that in passing in one post. I think it’s OK to put it under the same heading: people who put off a decision because they don’t want to think about it are being lazy. They’re more or less assuming the situation will magically work itself out if they don’t do anything. > [@](#): > > Your reading of the polls is probably incorrect. Please explain how. I do think it looks like more people claimed to be registered donors than really signed up. > [@](#): > > And you can’t really say that its paranoia. There have been instances of doctors being pressured to declare patients brain dead so that the organ tranplant teams could harvest organs while they were still fresh. **Smpati** is the one who called it paranoid. But if I had to, yes, I could. People really get murdered by deranged serial killers, but if you don’t go outside because you’re afraid of those, you’re being paranoid. Rare and crazy stuff does really happen, but the rarity needs to be taken into account. > [@](#): > > I think the answer to these pressures to harvest organs is to have a lot more organ donors, flood the market so to speak. Right. I suggested the same thing earlier. ---
**Author:** ![Roderick\_Femm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/roderick_femm/32/14875_2.png) [@Roderick\_Femm](https://boards.straightdope.com/u/Roderick_Femm)\ **Post date:** [July 3, 2013, 11:03pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/106 "2013-07-03T23:03:02Z")
> [@Marley23](#): > > You do have first say. You can opt out for any reason. This only comes an issue if you don’t express a preference. And you can say other people don’t have the right to be saved, but you also **don’t have the right to not have to check a box**. (bolding mine) On what do you base this claim about what my rights are? The issue here is not the level of effort required. If you say that I have to make a specific provision in my will or else 20% of my estate will go towards helping sick people, that doesn’t make that right either. It doesn’t matter how easy it is to comply. Roddy ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [July 3, 2013, 11:03pm UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/107 "2013-07-03T23:03:37Z")
> [@Roderick\_Femm](#): > > (bolding mine) On what do you base this claim about what my rights are? On what do you base your claim? ---
**Author:** ![Bozuit](https://avatars.discourse-cdn.com/v4/letter/b/edb3f5/32.png) [@Bozuit](https://boards.straightdope.com/u/Bozuit)\ **Post date:** [July 4, 2013, 12:21am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/108 "2013-07-04T00:21:53Z")
> [@Roderick\_Femm](#): > > Then there really is no choice. Either I decide the way you think I should, or else I am disgustingly selfish. I wasn’t intending to call you disgustingly selfish. I would call actively refusing to donate organs disgustingly selfish. And I understand it’s a false choice that I mentioned, and not a useful position to actually take. Certainly not one I’m proud of. It’s really that, while I don’t disagree that a person has (or should have) the right to have some say in what happens to them after death, using that right to deny someone else life seems such a poor use of it that I wouldn’t feel inclined to place much value on the wishes of such a person. In reality, of course, we would have to (and probably should) accept someone’s decision on the matter, but relatives should never be able to override that. I’d be horrified to learn (and of course I never could) that some relative had denied me the opportunity to donate. Perhaps awareness of the significance of such decisions is just lacking in a lot of people. I read a story today, while doing a bit of research, about a woman whose first baby died and she refused to donate the organs. That’s an entirely understandable position. I doubt I could say yes, if ever put in that position, without taking some time to build up some courage. Sadly, her third baby also died, this time while waiting for a heart transplant. The whole thing just seems unnecessarily tragic to me, when I consider that rights that really only matter in principle are put above lives. To use the gun analogy again, I can just about understand how someone could see the right to own a gun as more important than the lives lost because of it. Many things we do have a cost in human lives, and it seems we have no choice but to accept it when those things are valuable to us. But what value does this right to decide how your corpse is treated have over the value of someone’s life? And let’s not forget many of these people who need donations will be leading shitty enough lives as it is with their organs not working properly. Often it might not be just saving a life but giving one back to someone. I can’t imagine a more comforting thought before death than the hope that it might be so positive for someone else. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 4, 2013, 12:26am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/109 "2013-07-04T00:26:02Z")
> [@Roderick\_Femm](#): > > (bolding mine) On what do you base this claim about what my rights are? The issue here is not the level of effort required. If you say that I have to make a specific provision in my will or else 20% of my estate will go towards helping sick people, that doesn’t make that right either. It doesn’t matter how easy it is to comply. > Roddy If anyone thought that people had a right to organs, then there would be a call for mandatory donation. There is no such call. The only thing up for discussion here is how to decide when the deceased has made no choice. Period. There are many religions that oppose having the deceased cut up. No matter how silly I may find that, I support members of that religion being able to opt out. There will be plenty of donors if we have an opt out system. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [July 4, 2013, 12:33am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/110 "2013-07-04T00:33:27Z")
This whole discussion is an example of the default effect. When my daughter teaches behavioral economics, she uses the chart displayed in this [blog post by Dan Ariely](http://danariely.com/2008/05/05/3-main-lessons-of-psychology/) and asks her class to explain the difference in donation rates. The classes try to explain it culturally, but it is of course due to the opt-in or opt-out policy, in other words default. One of the reasons for default behavior is the cue from what the default is. As a less loaded example, it has been observed by Thaler and others that making 401K participation the default on employment significantly increases participation rates. This is hardly from laziness, since the form is right there. An odd thing that they discovered is that if you make the minimum contribution the default (so as to not stress the finances of the new employee) money contributed decreases since the cue is not to choose the minimum, not to maximize employer contributions… This is a real effect - we can use it to save lives, or we can use to to ensure people die through the lack of organs. It is our choice. ---
**Author:** ![Mangetout](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mangetout/32/19_2.png) [@Mangetout](https://boards.straightdope.com/u/Mangetout)\ **Post date:** [July 4, 2013, 1:15am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/111 "2013-07-04T01:15:26Z")
If the opt-out process was somehow difficult, expensive or made one a social outcast, then this would be a problem, but it’s not. The default doesn’t actually matter if it’s so trivial to change - I get that there’s a _principle_ involved, but really. The government already has significant control of the disposal of my remains - I can’t, once dead, be used as a store mannequin, or buried just any old where. My surviving relatives can’t decide to hang on to me in the freezer, or have me made into soap. I did not always feel this way - I used to be against it, but people need organs - I won’t. There is a public need to be served, and I won’t any longer be a member of that public at such time as my organs become available - principle be damned - least harm is what’s really important here. When I changed my mind, I also made sure I went on the donor register, so it’s sort of moot for me personally. ---
**Author:** ![Rachellelogram](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/rachellelogram/32/8689_2.png) [@Rachellelogram](https://boards.straightdope.com/u/Rachellelogram)\ **Post date:** [July 4, 2013, 1:46am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/112 "2013-07-04T01:46:38Z")
> [@Anaamika](#): > > I have opted in. I opted in many years ago. I am quite willing to put my money where my mouth is. No one has come to chop me up or mutiliate me. And I have no fear that they will. I am still using my body. When I’m done with it, the State can have it and maybe save someone else’s life, or eyesight, or some such. > > I’m not sure why this is even a deal. When you go to apply for your license or State Id, the form will have a place: > > CHECK THIS BOX IF YOU WISH TO OPT OUT FOR ORGAN DONATION > > That’s it. That’s all it will take, and all of those people who don’t care but are too lazy to change it, or who don’t think about it, will be included. And we’ll have more organs for sick children and sick people. > > Easy peasy. I’m on the registry too. But plenty of people don’t have a license or ID and never will–like disabled folks, or those who are too unskilled to drive a car. Or people living in urban centers who will never HAVE a car. An opt-out organ donation policy stinks of thoughtless classism. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [July 4, 2013, 1:51am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/113 "2013-07-04T01:51:06Z")
> [@Rachellelogram](#): > > An opt-out organ donation policy stinks of thoughtless classism. I think you mean basing it on drivers’ licenses stinks of thoughtless classism, except **Really Not All That Bright** proposed that if you don’t have a license that counts the same as opting out. Or on the other hand you could use any other form of official ID in place of the license. Oh, and nobody gets deprived of anything. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [July 4, 2013, 1:59am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/114 "2013-07-04T01:59:34Z")
> [@Marley23](#): > > I think you mean basing it on drivers’ licenses stinks of thoughtless classism, except **Really Not All That Bright** proposed that if you don’t have a license that counts the same as opting out. Or on the other hand you could use any other form of official ID in place of the license. Oh, and nobody gets deprived of anything. Or a free ID bracelet. Or an online registry. Any number of things that show you have opted out. But I would have penalties for those that Opt out. They can’t receive an organ from the pool, either then. If you want that heart from the Pool, better show you have not opted out in the last year. ---
**Author:** ![Smapti](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/smapti/32/17938_2.png) [@Smapti](https://boards.straightdope.com/u/Smapti)\ **Post date:** [July 4, 2013, 4:13am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/115 "2013-07-04T04:13:28Z")
> [@DrDeth](#): > > Or a free ID bracelet. Or an online registry. Any number of things that show you have opted out. > > But I would have penalties for those that Opt out. They can’t receive an organ from the pool, either then. If you want that heart from the Pool, better show you have not opted out in the last year. Once you’re forcing people to consent to organ donation under pain of death, it kind of stops being a “donation”, now doesn’t it? ---
**Author:** ![Budget\_Player\_Cadet](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/budget_player_cadet/32/205_2.png) [@Budget\_Player\_Cadet](https://boards.straightdope.com/u/Budget_Player_Cadet)\ **Post date:** [July 4, 2013, 4:44am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/116 "2013-07-04T04:44:12Z")
> [@Roderick\_Femm](#): > > Please note the courtesy that I quoted you accurately and did not call your comments “stuff”. > > Yes, I do have a comment. I think that your feeling (or way of thinking, if I am going to be generous) is misguided. What you have on one side is “I need someone’s organ in order to live.” What you have on the other side is me and my body and my decision as to what to do with it. Corpse. You and your _corpse_ and your _dead_ decision as to what to do with it. > [@](#): > > Your argument (being generous again) seems to be that, once I am dead, it is fair and right of the government to assume control of my remains unless I have expressly forbidden it. The rationale for this seems to be that there are a lot of people who need organs. Hell, I’d go so far as to say it is fair and right of the government to assume control of your corpse regardless of whether you want it or not, because at that point you’re dead. You don’t need it any more, and there is nobody whom that corpse will benefit more. It’s not like other parts of your estate - your home and income go to benefiting your next of kin and effectively are transferred to them as you die. > [@](#): > > My position is two-fold: the need of those people for organs does not constitute a right to receive them, and that not granting that right is not at their “expense”; and I am talking about rights because we are talking about a government-run program for the harvesting of organs from dead people. Idealistically, they don’t have a right. However, I’ve been talking about practicality from the start, and the fact is that rights or not, the ability to provide donor organs is a gigantic boon to society and there is no harm in violating the rights of a corpse. > [@](#): > > There you are, more stuff for you to read. Let’s not get pissy about truncation. ---
**Author:** ![Roderick\_Femm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/roderick_femm/32/14875_2.png) [@Roderick\_Femm](https://boards.straightdope.com/u/Roderick_Femm)\ **Post date:** [July 4, 2013, 4:46am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/117 "2013-07-04T04:46:23Z")
> [@Mangetout](#): > > If the opt-out process was somehow difficult, expensive or made one a social outcast, then this would be a problem, but it’s not. The default doesn’t actually matter if it’s so trivial to change - **I get that there’s a _principle_ involved, but really**. > > The government already has significant control of the disposal of my remains - I can’t, once dead, be used as a store mannequin, or buried just any old where. My surviving relatives can’t decide to hang on to me in the freezer, or have me made into soap. > > I did not always feel this way - I used to be against it, but people need organs - I won’t. There is a public need to be served, and I won’t any longer be a member of that public at such time as my organs become available -\*\* principle be damned\*\* - least harm is what’s really important here. > When I changed my mind, I also made sure I went on the donor register, so it’s sort of moot for me personally. Bolding mine. There is a principle involved, thank you for acknowledging that. I think that principles are important, and if we shove a principle aside for one issue, it won’t be there later when we want it for something else. **Voyager** is also right, that what is important is the default setting. But what is important about the default setting is not the effort required to change it, nor the results of one setting or the other, but the principle that is recognized by the default setting. The opt-in setting says that the individual’s rights are foremost. The opt-out setting says that the individual’s rights are secondary. Roddy ---
**Author:** ![YogSothoth](https://avatars.discourse-cdn.com/v4/letter/y/8edcca/32.png) [@YogSothoth](https://boards.straightdope.com/u/YogSothoth)\ **Post date:** [July 4, 2013, 4:58am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/118 "2013-07-04T04:58:07Z")
> [@Rachellelogram](#): > > What about people who were never informed about the policy in the first place? Due to having no television, or uninformed parents, or whatever. Honestly? Fuck them. What they don’t know when they die won’t hurt them. And will save another person’s life. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [July 4, 2013, 5:50am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/119 "2013-07-04T05:50:06Z")
> [@Smapti](#): > > Once you’re forcing people to consent to organ donation under pain of death, it kind of stops being a “donation”, now doesn’t it? Too bad. Just like you don’t pay your taxes and you don’t get to participate in society. And of course the idiots will think they will never get sick and want an organ anyway. ---
**Author:** ![Budget\_Player\_Cadet](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/budget_player_cadet/32/205_2.png) [@Budget\_Player\_Cadet](https://boards.straightdope.com/u/Budget_Player_Cadet)\ **Post date:** [July 4, 2013, 6:02am UTC](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463/120 "2013-07-04T06:02:08Z")
> [@Smapti](#): > > Once you’re forcing people to consent to organ donation under pain of death, it kind of stops being a “donation”, now doesn’t it? You aren’t getting any cognitive dissonance by asserting that refusing an organ donation is “under pain of death”? Any at all? [Previous page](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463.md?page=5) [Next page](https://boards.straightdope.com/t/opt-out-organ-donation-and-relatives-wishes/662463.md?page=7)