That’s because this thread isn’t about valid reasons to refuse to donate. It’s about what we are prepared to let governments and other authorities assume on our behalf.
I think an organ-donation system should be opt-in, and the family should have no say whatsoever. By opting-in, the potential donor has made very clear her feelings on the issue, and her family should have no right to override it. In an opt-out system, it’s very easy for a family to say that the potential donor didn’t opt out due to apathy or ignorance–the potential donor’s wishes would not be known to a certainty, like they would in an opt-in system.
I have opted-in. I would be very unhappy with my husband should he chose to override that decision (if, of course, I could be around to be unhappy about it). Opting-in is a way to make an active positive declaration; opting-out is more subject to ambiguity.
They can have my cold, dead hands when they…
Let me think about this for a bit.
<golf clap>
As Mangetout said, I don’t feel obliged to offer one. I think if people don’t want to donate, even if there is no reason, that’s their choice. I am okay with people being allowed to make stupid and selfish choices, as I think it beats the alternative.
I agree that it’s stupid.
I don’t bother Her and she doesn’t bother Me. 
I think it’s unfortunate that you’re impuging my motives, and perhaps my intelligence, when I’ve given you no reason to do so. I’m not impressed by this kind of righteousness.
My point is, that’s not for you to decide.
In that case, again, why even give people the choice to do the wrong thing? We all know what the right thing is, after all, because we’ve got Lightnin’ to tell us what it is, so why even bother with the opt out? After all, there is no good reason not to donate.
But is that principle worth c.1000 lives per year?
IMO, it doesn’t have to be. The exising opt-in scheme is vastly underpromoted - and I personally think it should be upgraded to an opt-in-hard scheme, non-overridable by relatives.
That would dramaticallly increase the amount of donors, but I don’t believe it would match the opt-out scheme. Getting people to make any kind of change is actually enormously difficult - more so one that involves filling out forms. For example, look at the sheer number (and cost) of adverts by banks wanting us to change current account. Churn in accounts is apparently only 4%, and declining. Even if we realise we’d be marginally better off for it, we don’t bother. And these organisations are spending a fortune on adverts (those Halifax all-singing, all-dancing efforts, for example). Realistically, how much could even a major campaign by the NHS achieve?
The bottom line is, opt-out will create more donors than opt-in. If you’re against it, you’re putting principle ahead of practical outcomes - and significant outcomes at that. That’s never necessarily wrong, but you have to be very sure about a) the value of the principle and b)the need to apply it in this particular case
Hear! Hear!
Yes, but while we’re talking about 1000 lives, it’s worth considering just how that compares to the population that we’re talking about affecting. Per the CIA World Fact Book the UK has a population of 60,776,238. (Per July 2007 estimate) So, we’re not talking about large fractions of the population that are going to benefit. My back of the envelope calculations tell me that we’re talking about saving the lives of 1.6 thousandths of a percent of the population of the UK.
The odds of this increase in availability of organs directly affecting someone aren’t exactly good, IOW. Better than the lottery, of course, but almost anything is.
If you want to save that number of lives, there are other things you should be considering, too. First and foremost, why don’t you ban smoking? At the moment smoking causes, per the DH, over 100,000 preventable deaths every year in the UK. Besides, if those people keep smoking, they’re ruining those lungs which might otherwise be suitable to save other people!
It’s no surprise that the vast, vast majority of UK citizens who do not currently - nor will ever - need an organ transplant will be unaffected the availability of organs for transplant. In the same way, providing free school meals for children from poor households does nothing - nothing I say - to feed the over 65s. Per the article I cited earlier, there are c.5,000 patients who die needing a transplant- so the chances you’ll be affected by opt-out if you would ever need an organ are 20%.
In July last year, England & Wales instituted a ban on smoking in public places, following the lead of Scotland, which started in May 2006 (IIRC). The reason for this ban was of course public health - not of the smokers, but of the others who despite choosing not to smoke, were inhaling cigarrette fumes (obviously, a known cause of serious illness/death). So, here we have the UK government:
a) restricting citizens’ freedom and
b) doing so for the sake of the health of others.
As such, current policy seems to be more in line with opt-out than not.
In any case, it seems odd to suggest that we have to chose only one health policy to enact - why can’t we have opt-out and (e.g.) screen for bowel cancer? They’re not mutually exclusive.
What about people who already have a medical condition that makes them ineligible to donate? Should they be left out entirely?
Even with opt-out you won’t have nearly enough transplantable organs for everyone who needs one. It might make things a little better but it’s a long, long way from solving the organ shortage.
I agree. They are complementary. It is simply my assertion that if you’re going to redefine what is and is not a personal choice vs. a public health choice, citing the number of lives that will be saved by such a measure as your rationale, I’d think that a simple governmental policy that could reduce a practice that is costing 100 times the deaths that opt-in is costing, would have priority.
ETA: You’re the one who seems to be asserting that saving 1000 lives is worth granting the government increased control over individuals. So, why not expand that control further for 100000 lives?
There’s not much point having principles if you’re prepared to discard them just like that - as I keep being reminded every time I ask if we can’t just force Fred Phelps to shut the fuck up.
In the US, federal law mandates that before accepting your still-warm carcass as a potential donor, it must be tested for HIV (although the standard test used may not pick up very recent infection - see here). It will almost certainly be screened for a panel of other transmissible diseases, such as hepatitis C. I am not familiar with UK practices regarding organ donation, but I would be surprised if they do not have a similar policy.
Just to throw more fat on the fire, what if your clearly expressed wish regarding donation and you family’s opinions are discordant? That is, you wanted your squishy parts to serve the greater good but your family insists that your corpse remain intact, or vice versa? Who takes precedence?
JRB
Two very similar points being made here, I feel, so I’m going to try to address them as one.
There’s a touch of absolutism creeping in here. I get the feeling (and I could be wrong) that to suggest that there might sometimes be a need for a higher level of state control in a particular and clearly defined set of circumstances is being taken as saying that I am always in favour of increasing state control, in any and all circumstances. Similarly, recognising that blind adherence to principle might not always give the best out come is not the same as abandoning the principle.
Again, it’s important to ask why we follow the principle of lower levels of state control. Is it because we found it written down somewhere, or because we’ve found that generally following it generally results in good outcomes? If the latter, what should we do if following it seems to lead to bad outcomes? It seems to me that “stick with it, because it’s generally a good principle” is a bad answer. The goodness of principle derives from the fact that it gives good results - it’s not an innate property. Alternatively, arguing that we should apply the principle *here *because it makes it easier to defend there seems to be me to be weak - the principle should be able to stand for itself, wherever it does good.
So to answer the two separate points:
I don’t want an outright ban on smoking because the level of policing/government control required for that - basically, CCTV cameras in the home - strikes me as brutally excessive, even for the higher benefit in lives saved.
Even Fred Phelps does not have the freedom to say certain things - “God commands you to bring me the head of Elton John” for example. This doesn’t reflect an abandonment of the principle of free speech.
Both of these positions are based on weighing up different principles and percieved good outcomes, and making a judgement on where to draw the line. People will disagree on where the line is, but we all draw one.
There’s an outright ban on the use of Heroin, cocaine etc, yet I haven’t yet found a CCTV camera in my house.
Thanks for your calm and well-reasoned reply, amrussell - I think, then, it is that I draw the line differently - and short of being comfortable with this scale and type of coercion.
I don’t quite see it as a simple comparison of lives saved vs intrusion into personal volition. People die for all kinds of reasons that could be reduced if we were prepared to accept other changes, and there are plenty of other kinds of human suffering that we could also be mandated to improve, at little personal inconvenience.
For the record, I have signed up to the NHS organ donation register (my card will arrive in the post sometime) and I have discussed the matter with my family (they agree with the decision and will respect my wishes), but I still would not approve of the opt-in scheme.
“The majority” doesn’t own my body ,any more than anyone besides myself does, therefore has no right to just take the useful chunks of it, even if it’s their collective will.
It doesn’t, though. Just because there’s no intrinsic value for them to the decedent, that doesn’t make the decedent or any part of him/her the rightful property of the government to be taken and used as outside entities see fit. This is all about one’;s body and existence not being owned by anyone but oneself; any argument that undermines personal autonomy here is invalid…