Opt-out Organ Donation

I agree with the OP. People who feel strongly enough can opt out when they become legal adults, their parents can opt out when they’re minors. Otherwise the default should be donor.

My dad had a kidney transplant in November 2014. He only waited 6 months and got a 100% cadaver match, just 4 days before the surgery was scheduled for my stepsister to donate hers. It’s unheard of, and he damn well knows how stinking lucky he is.

not even a sticker in most states- you just check a yes box when applying for your license and it automatically registers you forevermore. It would be pretty easy to reverse it and require objectors to check a no box while everyone else gets automatically flagged as yes.

Asserts facts not in evidence.

If it’s just a sticker, how do they know if they don’t have your physical ID card?

Full disclosure, so as to preempt any possible accusations of hypocrisy: I’m personally a registered organ and tissue donor (regardless of familial consent, i.e my organs/tissues will be donated if possible whether my parents/partner/children object or not) in an opt-in system, as well as a registered O-neg blood, bone marrow, and platelet donor.

It deeply bothers me that opt-out systems are not more common. I know with certainty that a large part of my peers (i.e, young people in their early-mid 20s) have absolutely no objection to organ donation, and yet as far as I’m aware I’m the only registered donor in my relatively wide circle of friends which includes more than a fair few medical students.

At the very least for an opt-in system to work, I think it’s strictly necessary that one’s general practitioner have license to bring up the question of organ donation at annual physicals. Requiring people to go out of their way to hunt down an obscure pamphlet of their own accord, fill out forms, etc results in an abject waste of perfectly good organs that would otherwise be willingly donated - to the point where I consider not switching to an opt-out system little better than participating in involuntary manslaughter on a societal scale.

I really, truly have yet to hear a rationally grounded objection to an opt-out system.

Again - where do you live that “hunting down an obscure pamphlet” is part of the process? I’ve never lived anywhere where it wasn’t a yes-or-no question on a driver’s license form. If you live in such a place, perhaps fixing that should be your priority rather than going after the organs of those who have given no indication that they wish to donate them.

The decision of what to do with one’s body after death is a deeply personal one that should be decided by that person and only that person. If they want to donate their organs, there’s nothing stopping them from making that preference known.

It should not be assumed that the state has power of eminent domain over our bodies and that harvesting us for parts should be the default.

An opt-out system leaves every bit as much room for the individual to decide that they do not wish to donate their organs as an opt-in system does. The issue is purely one of which attitude towards organ donation is considered default.

Now, this may not be the case where you are, but where I live, opponents of organ donation are by far the minority, and yet we still do not employ an opt-out system. Because organ donation is only facilitated by filling out a so-called “Organ Donor Card” which preferably has to be carried on your person at all times, this means a large part of the population dies, and while they do not actually object to the idea of donating their organs, they never bothered to fill out an ODC and as such their organs go to waste.

I’m every bit as much a proponent of bodily autonomy as you, Smapti, but the fact of that matter is that opt-in systems lead to large-scale waste of organs that would otherwise have been willingly donated. The way I see it, in this case, the onus must be on the minority to opt out. Even if it can be interpreted as to some extent an infringement on their rights to have to do so, it is by a wide margin the lesser evil.

On a tangentially related note I also think opting out of organ donation should by law dictate that one is also disallowed from receiving organ donations. I do not see how not wanting to donate organs but being willing to receive them is a coherent position.

I can agree to that sentiment. However the problem here is that most people are very reluctant to deal with the eventuality of their own demise. Thus instead of opting out or in most simply do nothing. I believe the state should find a viable way of forcing the issue, i.e. obtain a clear statement from each citizen on whether they are willing to be donors or not. Asking the question when issuing a drivers license seems a reasonable thing (but it is definitely not done everywhere). However of course that only works for those of us who do have a driver’s license.

In every state I’ve lived in they ask the same question of people getting an official state ID card, which is pretty much identical to a driver’s license (the de facto identity card in the US) except for now granting driving privileges.

And really, that is a decent solution - instead of requiring a separate donor card simply make it part of the official ID used for any other official business.

I live in Germany. The system here is based on an organ donor card (“Organspendeausweis”). A small document that you are encouraged to fill out, sign and carry around in your wallet. If medical staff find such a card on your person, they know to what extent you have agreed to organ donation. The card is easy to obtain. Pharmacies, doctors and hospitals have it. Your health insurance company will send it to you. Or you can download it from the internet and print it. Whatever you do, your decision is not centrally registered. It is considered a private matter and as long as you do not die nobody needs to know.

The system has the usual drawback: People need to *do *something before they can become donors, and many who say they have no objection to becoming donors still do not have the card. (If you happen to live in Germany, get the card here. Today. Takes less than 5 minutes of your time.)

I am a registered organ donor & a blood donor but I am not in favour of an opt out system

However I can get completely behind this sentiment

And while we’re at it, if you’ve never donated blood, the paramedics should let you bleed out.

And if you don’t make enough to pay income taxes, you shouldn’t be eligible for food stamps.

And if you’ve never been a first responder, they shouldn’t prioritize saving your life in the event of a disaster.

No. I can understand where this is coming from, and I am critical of people who are unwilling to donate. But not to the extent that I would refuse to save someone’s life over it.

These are strawmen, and you know it. There is a significant difference between simply not having done something (i.e not having opted in) and having outright and actively refused participation in something. If there were as critical a shortage of donated blood and opting out rather than opting into blood donation was a reality, I would hold the exact some position on this as I do on organ donation.

Say, hypothetically, that a person lay bleeding out, and you were asked to donate your blood. If you were to actively refuse to do so on no solid grounds (e.g it would kill you because you have a severe bleeding disorder), I do not see how you could object without hypocrisy to similarly being allowed to exsanguinate, or how someone that refused blankly to pay income taxes (if this were legally possible, anyway) could object without hypocrisy to being denied food stamps.

Now, perhaps I can agree with Hiker that in the hypothetical situation where there was an actual surplus of organs (i.e there were no waiting lists at all for organ donation), I would not deny an organ even to someone that had opted out of donating themselves - but in practice this is not the case, there is not a surplus of organs, and someone that opts out of donating their own organs should at the very least be placed at the absolute back of the line. I am not familiar enough with existing opt-out systems to say whether this is already general practice, but if it is not, I cannot consider that anything other than a gross injustice.

I know no such thing.

I have no obligation to provide my blood to anyone. That is in no way inconsistent with being willing to accept blood that is given out of the donor’s free will. There’s a difference between choosing to donate and being strongarmed into it under threat of death.

Deciding whether an innocent person deserves to live or die based on their willingness to make a “donation” is a gross injustice. I wouldn’t want to live in your dystopia where the medical professional I’m paying to help me has to tell me “Sorry, the state doesn’t approve of your moral choices, so I’m obligated to do nothing and watch you die.”

First of all, to clarify, any and all statements I make are with the basic assumption that a system of universal healthcare exists. It is the state of affairs I am used to, and I realize it probably has a non-insignificant impact on my opinion on the matter. Notions such as paying a medical professional to help me are alien and revolting to me on their face. Healthcare is a basic right that should be entirely independent of financial means, as I see it - and where I live, it thankfully is.

Now, here is what I am struggling to reconcile, Smapti: I cannot reasonably see how you can consider organ donation morally reprehensible enough that you are not willing to participate in it even after death (where, quite frankly, your physical body is of very little use to you, and not long for this world anyway) and reconcile that with the willingness to receive an organ. It reeks of special-casing to serve one’s own interests to me, although I will gladly be convinced otherwise by a cogent argument.

Either organ donation is so revolting a concept to you that you are neither willing to receive nor give an organ under any circumstances (a position I can respect, if begrudgingly), or you somehow value your own bodily integrity post-mortem over the lives of others whilst at best indifferent to theirs when your own life is concerned. I do not see how the second position is internally consistent, and I do not see how someone who refuses blankly to donate their organs after death can be entitled equally to an organ as someone who does so willingly.

No, the medical professional says, “You are last on the recipient list due to a variety of factors. These factors include age, overall health and the impact on ability to accept a donation, and your unwillingness to be a donor yourself. Because there are not enough organs to go around, the state has set guidelines for the waiting list.”

Why should you receive a donation you are unwilling to make yourself? Note the key word - unwilling, not unable. That is why your arguments were strawman.

For more information on thoughts, here is a short paper on the subject of donations and opt-in:

It’s like refusing to pay insurance premiums whilst still expecting cover in the event of accident

Because that’s what a donation is - an act of charity given without expectation of benefit to oneself. When you start telling people you’re going to let them die unless they “donate”, it stops being an act of charity and starts being extortion.

I don’t have any objection to people choosing to donate their organs. I object to the idea that anyone is obligated to make their organs available for donation or that people should be rewarded or punished for choosing whether to donate or not.

I refuse to be an organ donor because I don’t trust the medical industry to prioritize protecting my life over cutting corners and declaring me “dead” so they can profit off the sale of my organs. If that’s a gamble other people are willing to take, then I have no objection to them taking it. If I need an organ, and someone wishes to give me one, I will accept it. I have no right to say “I need an organ - you there, give me yours”.

No, it’s like paying insurance premiums, getting sick, and being told that the bean-counters have decided not to cover me because I smoke / drink / am LBGT / ride a motorcycle / engage in any other form of activities that they’ve decided are immoral or make it “my own fault” that I’m sick.

Much as I appreciate the sentiment it won’t make any difference, because the need for an organ is in the future, and fairly unlikely. In the US 401 K participation rates when they were opt-in were low and the need for money when you retire is a lot more sure than the need for organs. The whole point here is that we behave in irrational ways, and opt-in versus opt-out is an example of this. If we are going to “nudge” people let’s do it in a socially useful way.