# Pros and cons of "presumed consent" organ donating **URL:** \ **Category:** Great Debates\ **Created:** [May 12, 2010, 8:45pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218 "2010-05-12T20:45:38Z")\ **Posts on this page:** 20\ **Page:** 5
**Author:** ![Gedd](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gedd/32/4938_2.png) [@Gedd](https://boards.straightdope.com/u/Gedd)\ **Post date:** [May 13, 2010, 8:04pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/81 "2010-05-13T20:04:02Z")
Maybe the simple solution is to make the question a “yes or no” one, and you have to check a box before they accept whatever form you are filling out. Any objections? ---
**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:** [May 13, 2010, 8:26pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/82 "2010-05-13T20:26:02Z")
> [@begbert2](#): > > No, I wouldn’t withdraw my objection, because robbing the graves of 1 in 5 people is still pretty bad. Especially since I think that it would be trivial to accumulate _actual individual data_ about this, which is always better than guessing. Well, 20% - those who opted out. Opting in means that 80% - those who did opt in are not getting their wishes followed. Are those few who object to donating but not enough to opt out worth 4 ot 5 times as much as those who want to donate but never got around to opting in? > [@](#): > > And I think the only reason people argue for opt-out over a forced-opt added onto some existing process (like drivers’ liscences or social security or whatever) is because people _specifically_ want to take organs against people’s will. Which is to say, they prefer to steal the things than ask permission, when they can get away with it, and allowing people to opt out at all is a mere sop to try to shut up the worst of the ‘whiners’ while deterring opt-out as much as they can get away with. No one wants to take anything against people’s will. No one objects to making the opt-out procedure as easy as possible. > [@](#): > > Yeah, yeah. And the real reason to sieze 100% of income after the first $50,000 is to greatly bolster social programs and handouts to the poor. I can support social programs and handouts and even saving lives without deciding that it’s a blanket justification for anything you can think up. Last I checked, I’m around to enjoy the money I make \> $50K. The person donating organs is not around to enjoy them. > [@](#): > > Pretty big caveat, there, eh? The whole point of opt-out, _particularly_ as proposed by the OP where the relatives are barred from having any say, is to get as many people as possible _never to choose_. That is **explicitly** the goal. Which makes this whole “you can reverse it - until you die” as disingenuous as hell and about as disgustingly morally bankrupt an argument as I can imagine. People upset about the large non-opt out rate are free to advertise ways of opting out. And how do you propose people changing their minds after they die? I doubt very much my last thoughts on Earth will have anything to do with keeping my organs with me. If I had not opted in, I’d much more likely regret not doing so. If a terminal patient changes his mind and tells the doctor, with others listening, I doubt very much he’d be a donor, no matter what the paperwork says. > [@](#): > > Putting aside the disingenous garbage that any significant percentage of people are seriously going to think about the issue before it’s too late, which is both the necessary foundation of your argument and clearly disproven by evidence, I’ve been saying exactly the opposite - the evidence shows that most people don’t think about it, or don’t care enough to do something, even if they lean towards donating. > [@](#): > > I would agree that the 401K default mandate is _also_ apparently flawed. I would say that, were we interested in justice (to the detriment of simplicity), we would allow an opt-out period for up to say six months after the first statement is delivered, up to which the person can bail, and get precisely the money that was put in on their behalf, back, with the government collecting any profit an eating any loss. (Possibly with a year ban from 401K contribution if you do this, do deter gaming of it - but serious discussion of such a plan is rahter off-topic, so I’ll stop here.) Fair enough - if enough people got caught by this and wanted to opt out, it would be worth passing a law to allow it. But the main point remains - lots of people choose the default, even when the default involves them turning down free money. Setting a default one way or another does not diminish freedom, no more than a person not reading a paper diminishes freedom of the press. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [May 13, 2010, 8:51pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/83 "2010-05-13T20:51:57Z")
Quoth **Blaster Master** : > [@](#): > > Anyway, at least in Virginia, it’s a simple check box when getting/renewing your Driver’s License. In fact, I specifically left it blank (along with a few other questions, but that’s another discussion) when I last updated my license and the clerk required that I answer the question in order to process the form. Wait, so the clerk (an agent of the government) forced you to do something you didn’t want to do, and you think this is the proper Libertarian state of affairs? ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 13, 2010, 9:06pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/84 "2010-05-13T21:06:57Z")
> [@Gedd](#): > > Maybe the simple solution is to make the question a “yes or no” one, and you have to check a box before they accept whatever form you are filling out. > > Any objections? While that would probably be the ideal approach, in practice there are definite drawbacks to not having a default option at all. For one thing, there will be people (like **Blaster Master** ) who will deliberately try to leave the box blank and may get away with it if the clerk doesn’t spot it. For another, if we splatter organ-donor-choice checkboxes over all different types of government forms simultaneously, there will probably be people who check different boxes on different forms without actually intending a change in their choice, either out of simple forgetfulness or sheer cussedness. In short, for various reason we’re almost certain to end up with some subset of decedents whose organ-donor-choice status is unclear, and we’ll have to decide what to do with them, so we’ll need to have SOME kind of default choice in any case. It is probably simplest and most efficient to put that default choice in effect for everybody, and let individuals accept or reject the default as they prefer. ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 13, 2010, 9:10pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/85 "2010-05-13T21:10:09Z")
> [@Boyo\_Jim](#): > > The law? You clearly don’t care what the law is, because the law IS that your corpse is NOT property. You do not own it. Your family does NOT own it after you die. These are facts. Your mext of kin has limited rights to bury your corpse, and note I say limited. If there is an autopsy, your family does not have the right to recover any organs that the coroner removes, for example. Your family does not have the right to sell your organs to the highest bidder. You do not have the right to sell a spare kidney to a rich guy while you are still alive. > > Property rights are determined by state law. Unless there is something in a state’s constitution that specifically protects the dead (and I’m not aware of any), there is no legal barrier to changing the state laws to include an opt-out provision for organ donations. > > The reason many state laws haven’t changed are due to people like you making bullshit strawman arguments. How many times do I have to point out that we’re discussing what the law **should** be, which obviously means that what the law currently **is** is not a hardline determiner of the discussion? > [@Kimstu](#): > > I love how according to you, the people who don’t opt out are “for whatever reasons not jump[ing] through extra hoops”, while the people who don’t opt in are simply “too lazy”. Little bias showing there. > > In any case, ISTM that the purpose of opt-out is to claim by default not just the organs of people who would **want** to opt out but are just too lazy to do so (oops, excuse me, I meant to say “for whatever reasons do not jump through extra hoops to do so”), but also the organs of people who just don’t care enough one way or another to have indicated a preference, as well as those who want to opt in but are just too lazy (lemme check; yes, those are the people I’m allowed to call lazy). The bias I was showing was yours, reversed. The choice of terms was deliberate to enhance to you that the expectation that a failure to opt out is an opt in is absurd, because it’s _not_ fair to call one group or the other lazy for not doing it. It is simply a fact that some people don’t opt one way or the other - doubly so if we don’t _require_ them to do so. So, thank you for proving the point by missing it. And as I have said repeatedly repeatedly repeatedly repeatedly repeatedly, if the purpose was to collect those who would opt in if it was trivial to required to do so, then you would be trying to make it trivial and required to do so. The only group targeted by presumed consent that is **not** targeted by mandatory opting are the people who do not wish to donate. So yes, the only reason to _prefer_ opt-out _over_ mandatory-opt is if you want to take people’s organs against their will. That’s it. Period. > [@Kimstu](#): > > Another advantage that I see in the opt-out system is that it reinforces the idea of organ donation as a social positive. If we as a society support organ transplants to save lives, then I think it’s consistent and reasonable for us to assume that individuals by default are willing to contribute their post-mortem garbage to assist that cause, unless they explicitly specify that for some reason they choose not to. Well, at least this isn’t a retread of something I disproved previously. Thing is, though, I think this opt-out _doesn’t_ reinforces the idea of organ donation as a social positive. I think it _explitly_ doesn’t reinforce any opinion about organ donation at all, since once you have presumed consent, why should you keep discussing the matter? There are only two places to go from there: **Forced** consent, where opt-outs are not allowed, or away from opt-out which will most likely lead to fewer organs collected. The only people with reason to keep raising the issue are those who _object_ to presumed consent, which will tend to cause the discussions to be framed in terms of how _bad_ the presumed consent system is, from the perspective of those who don’t like it, to the minimal degree it’s discussed at all. If you actually wanted to reinforce the idea of organ donation as a social positive, you would stick with opt-in and start advertising heavily. > [@Miller](#): > > You say “disingenuous bullshit.” I say, “rational and humanitarian.” Potato, potahto, I guess. More like nonsensical non-sequiter. Do you realize that you just said that “people who don’t want to donate will opt out” = “rational and humanitarian”? Okay, we actually know this is just argument by ad-hominem, but it’s a really **stupid** ad-hominem, so I like pointing that out. > [@Miller](#): > > Sure, let’s do that too. But you have yet to present a rational reason why, in the absence of any information to the contrary, we shouldn’t use these organs to save people’s lives. To avoid encouraging people like you from NOT collecting information to the contrary. Seriously. Mandatory opting is a good plan - especially if all of the claims that 60 or80 percent or whatever of people wish to donate aren’t bullshit. But it’s not going to be _as_ good as default consent (if we assume that more organs is always better). So if in the absence of evidence it’s consent there will be an incentive for well-meaning (but morally defunt) people to ‘misplace’ data, or ‘forget’ to collect it, or whatever. Yeah yeah, I know, there’s no corruption in the universe, right. :rolleyes: > [@Miller](#): > > Well, yes, if you’re the sort of person who values ideology over human lives, I suppose that I haven’t. More argument by ad-hominem. I could equally accurately point out that you think that by your ideology you think theft is moral. _Unnecessary_\* theft, even, since I suspect that mandatory opting could probably get you all the organs you need. > [@Miller](#): > > And you think it’s better to let a human being die, rather than inconvenience someone _who’s already dead_. So, really, how much is your opinion worth? Blah blah blah. There are _three_ primary plans here, not two: 1. opt-in 2. mandatory opt 3. opt-out Plan 1 doesn’t give us near enough organs. Plan 3 would, but requires us to throw out our morals with the bathwater. Plan 2 - do we have stats for plan 2? How effective is it? Because I suspect it would be pretty good, and not require moral compromises. And as a bonus we wouldn’t need bullshit arguments to support it (since you clearly don’t feel that the arguments of ease and results is sufficient). > [@theR](#): > > A pity you had to waste so many words in response to something that is free of content. One would think it would be much simpler to craft a response. No, see, in an argument you have to _disprove_ that a post has valid content, by demonstrating via argument that the points in it are flawed, before you can disregard it. > [@Voyager](#): > > Well, 20% - those who opted out. Opting in means that 80% - those who did opt in are not getting their wishes followed. Are those few who object to donating but not enough to opt out worth 4 ot 5 times as much as those who want to donate but never got around to opting in? Yes, because it’s better to neglect to remind somebody to donate than to assume they wanted to and pilfer. > [@Voyager](#): > > No one wants to take anything against people’s will. No one objects to making the opt-out procedure as easy as possible. Then keep it opt-in, and make **that** as easy as possible. If you’re fine with pretending that you can make it easy enough that everyone who might opt out will actually do so, then you should be satisfied that you can get everyone who might opt _in_ to do so, right? > [@Voyager](#): > > Last I checked, I’m around to enjoy the money I make \> $50K. The person donating organs is not around to enjoy them. I’m not interested in your irrelevent personal opinion that people shouldn’t care about what happens to their corpses - or the corpses of their loved ones. > [@Voyager](#): > > People upset about the large non-opt out rate are free to advertise ways of opting out. And how do you propose people changing their minds after they die? I doubt very much my last thoughts on Earth will have anything to do with keeping my organs with me. **If I had not opted in, I’d much more likely regret not doing so.** If a terminal patient changes his mind and tells the doctor, with others listening, I doubt very much he’d be a donor, no matter what the paperwork says. Bolding mine - like most of the pro-presumed-consent position, you are projecting your opinion onto everyone else. Rewrite your paragraph with “If I had not opted ot, I’d regret not doing so”, and what happens? The argument reverses itself, and opt-out becomes a bad thing. You do not have the moral right to make this decision for others. Or at least, that’s my opinion. A person **could** argue that the need for organs justifies telling people “Look, I know you don’t want to donate your organs, but we’re taking them anyway because we need them.” I wouldn’t agree with this position, but it could be held and argued without bullshit and ad-hominems and misrepresentations and sophistry. Of course, this doesn’t lead to opt-out; opt-out inherently presumes that people’s opinions about their corpses _do_ matter, because you’re letting them opt out. Of course it’s only admitting that so it’s not obvious to all how totatlitarian and ideologically blinded that perspective is. > [@Voyager](#): > > I’ve been saying exactly the opposite - the evidence shows that most people don’t think about it, or don’t care enough to do something, even if they lean towards donating. If NO people who didn’t bother to opt in/out wished not to donate, then you might have a point. But you can’t show that (since it’s not true), so your argument doesn’t hold up. > [@Voyager](#): > > Fair enough - if enough people got caught by this and wanted to opt out, it would be worth passing a law to allow it. But the main point remains - lots of people choose the default, even when the default involves them turning down free money. Setting a default one way or another does not diminish freedom, no more than a person not reading a paper diminishes freedom of the press. Then the main point is critically flawed, because it presumes that both positions are equal. When one is “people are assumed not to be donating, but may” and the other is “We’re gonna take their stuff unless they say no fast enough,” then the way the default is matters. ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 13, 2010, 9:16pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/86 "2010-05-13T21:16:42Z")
> [@Kimstu](#): > > While that would probably be the ideal approach, in practice there are definite drawbacks to not having a default option at all. For one thing, there will be people (like **Blaster Master** ) who will deliberately try to leave the box blank and may get away with it if the clerk doesn’t spot it. How big a problem do you think this would be? > [@Kimstu](#): > > For another, if we splatter organ-donor-choice checkboxes over all different types of government forms simultaneously, there will probably be people who check different boxes on different forms without actually intending a change in their choice, either out of simple forgetfulness or sheer cussedness. It’s unlikely they will be on _all_ different forms, but even if they were, virtually all government forms are dated. It would be trivial to just let the last statement of intent stand. You know, like we do with pretty much everything else. And if somebody is playing around with the checkbox due to cussedness, they’re asking for what they get. (Forgetfullness? How do you forget what you want?) > [@Kimstu](#): > > In short, for various reason we’re almost certain to end up with some subset of decedents whose organ-donor-choice status is unclear, and we’ll have to decide what to do with them, so we’ll need to have SOME kind of default choice in any case. It is probably simplest and most efficient to put that default choice in effect for everybody, and let individuals accept or reject the default as they prefer. I rapidly and instantly concede that opt-in and opt-out are tied for second place in simplicity and efficiency. First place, of course, is given to presuming the default and ignoring people’s desires entirely. But I think there are other concerns here besides simplicity and efficiency - or even ensuring that as many organs as humanly possible are available. Fortunately slapping checkboxes on government forms is relatively cheap. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [May 14, 2010, 12:39am UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/87 "2010-05-14T00:39:08Z")
> [@begbert2](#): > > The bias I was showing was yours, reversed. The choice of terms was deliberate 😃 Uh-huh. > [@begbert2](#): > > Well, at least this isn’t a retread of something I disproved previously. Well, you haven’t actually disproved anything so far: you’ve just vehemently contradicted positions you don’t like without supplying any data to indicate that your positions are better in any objective way. > [@begbert2](#): > > I think this opt-out doesn’t reinforces the idea of organ donation as a social positive. I think it explitly doesn’t reinforce any opinion about organ donation at all, since once you have presumed consent, why should you keep discussing the matter? There are only two places to go from there: Forced consent, where opt-outs are not allowed, or away from opt-out which will most likely lead to fewer organs collected. The only people with reason to keep raising the issue are those who object to presumed consent, which will tend to cause the discussions to be framed in terms of how bad the presumed consent system is, from the perspective of those who don’t like it, to the minimal degree it’s discussed at all. Why should we equate social reinforcement with “discussing the matter”? An opt-out system, where people are aware that their organs will be collected unless they specify otherwise (which is easy and convenient to do), by its very nature reinforces the idea that organ donation is a good thing and socially approved. People can still discuss it all they want to, positively or negatively as they feel inclined, but that’s not the measure of how strongly the idea is being reinforced. > [@begbert2](#): > > There are three primary plans here, not two: > > 1. opt-in > 2. mandatory opt > 3. opt-out > > Plan 1 doesn’t give us near enough organs. Plan 3 would, but requires us to throw out our morals with the bathwater. Plan 2 - do we have stats for plan 2? How effective is it? Because I suspect it would be pretty good, and not require moral compromises. I don’t see why anybody should accept your unsupported suspicions about the alleged convenience and effectiveness of mandatory opt in the absence of any actual data, any more than we’re obligated to accept your rather peculiar hyper-libertarian opinions about morality if we don’t happen to agree with them. You happen to personally believe that a mandatory opt system would be not significantly harder or less effective to implement than some kind of default-opt system. You’ve shown nothing to back that up except your own vehement opinions and some vague generalizations about its being cheap to put checkboxes on government forms. You also happen to personally believe that a default opt-out system is immoral. Almost nobody else here agrees with you about that, your arguments haven’t convinced anyone who didn’t already agree with you, and your arrogant and insulting tone has made your position even more unappealing. Good work, comrade—oops, I mean, how dare you be such a big old meanie. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [May 14, 2010, 1:08am UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/88 "2010-05-14T01:08:03Z")
> [@begbert2](#): > > More like nonsensical non-sequiter. Do you realize that you just said that “people who don’t want to donate will opt out” = “rational and humanitarian”? Yes, that’s right. The opt out system is rational and humanitarian. Which makes two different axes where it is the opposite of your position. > [@](#): > > Okay, we actually know this is just argument by ad-hominem, but it’s a really **stupid** ad-hominem, so I like pointing that out. And “slimy and disingenuous” is not an ad hominem? > [@](#): > > To avoid encouraging people like you from NOT collecting information to the contrary. > > Seriously. Mandatory opting is a good plan - especially if all of the claims that 60 or80 percent or whatever of people wish to donate aren’t bullshit. But it’s not going to be _as_ good as default consent (if we assume that more organs is always better). So if in the absence of evidence it’s consent there will be an incentive for well-meaning (but morally defunt) people to ‘misplace’ data, or ‘forget’ to collect it, or whatever. > > Yeah yeah, I know, there’s no corruption in the universe, right. :rolleyes: What’s the corruption motive in this situation? How exactly does someone profit from taking organs from someone against their express wishes? The organs themselves aren’t worth money: no one’s getting charged an arm and a leg so they can get a kidney. The transplant procedure costs money, but someone who needs a donor organ is going to need extensive (and expensive) medical procedures whether they get the organ or not. So what’s the motivation for deliberately losing or altering paperwork and taking an organ away from someone who didn’t want to donate? > [@](#): > > More argument by ad-hominem. I could equally accurately point out that you think that by your ideology you think theft is moral. _Unnecessary_\* theft, even, since I suspect that mandatory opting could probably get you all the organs you need. I doubt that even using 100% mandatory donation, with no option to refuse, would get us enough donor organs to meet needs, so I reject the idea that it’s unnecessary. And calling it “theft” merits as much attention as calling taxes “theft” does: which is, of course, none at all. > [@](#): > > Blah blah blah. > > There are _three_ primary plans here, not two: > > 1. opt-in > 2. mandatory opt > 3. opt-out > > Plan 1 doesn’t give us near enough organs. Plan 3 would, but requires us to throw out our morals with the bathwater. Plan 2 - do we have stats for plan 2? How effective is it? Because I suspect it would be pretty good, and not require moral compromises. And as a bonus we wouldn’t need bullshit arguments to support it (since you clearly don’t feel that the arguments of ease and results is sufficient). There is nothing - nothing at all - immoral about an opt out system. Not one damned thing. We’ve been going at this for two pages now, and you’ve yet to present a coherent moral argument against an opt-out system. Can we expect one to arrive soon, or are we safe in assuming that no such argument exists? ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [May 14, 2010, 1:22am UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/89 "2010-05-14T01:22:39Z")
> [@Gedd](#): > > So what are the cons? It used to be the rule in France…in theory… In practice, doctors would never go against the wishes of the family. Registering willing donors seems more effective even though I don’t think they would transplant organs without the agreement of the relatives even in the case of a registered donator. But at least, it’s an argument when the family seems to hesitate. ---
**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:** [May 14, 2010, 6:18am UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/90 "2010-05-14T06:18:15Z")
> [@begbert2](#): > > If NO people who didn’t bother to opt in/out wished not to donate, then you might have a point. But you can’t show that (since it’s not true), so your argument doesn’t hold up. > > Then the main point is critically flawed, because it presumes that both positions are equal. When one is “people are assumed not to be donating, but may” and the other is “We’re gonna take their stuff unless they say no fast enough,” then the way the default is matters. Of course it is likely that some people who’d rather not donate won’t bother to opt-out. However, by definition it can’t be critical to their lives, or else they would bother. Opting in, on the other hand, is never critical to one’s life - just something nice to do, and thus something more likely to be skipped. The only argument I could see for forcing opt-in would be if some deity or other wanted us whole - but I think we’re on the same page on that subject, and if this were true, donations would be made illegal anyway. And you ignore the upside. As for saying no fast enough, fast enough is probably measured in decades. BTW, there are occasional campaigns to get people to opt in. However, of all the things that might be put off, this is top of the list, since it is of no benefit to us, except in making us feel good, and we aren’t expecting to die anytime soon. So it is not surprising that opt-in leads to low participation, over many countries. ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 14, 2010, 8:57pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/91 "2010-05-14T20:57:31Z")
> [@Kimstu](#): > > 😃 Uh-huh. Just because you fell for the bait like a ton of brick, you don’t think it can have been intentional? > [@Kimstu](#): > > Well, you haven’t actually disproved anything so far: you’ve just vehemently contradicted positions you don’t like without supplying any data to indicate that your positions are better in any objective way. Oh, like you’ve done anything to support _your_ baseless statements. And at least mine don’t require me to blow off, dismiss, and ignore the existence of other perspectives - or simple rationality. Seriously, the arguments you’re employing against me are _absurd_. Allow me to demonstrate: > [@Kimstu](#): > > Why should we equate social reinforcement with “discussing the matter”? An opt-out system, where people are aware that their organs will be collected unless they specify otherwise (which is easy and convenient to do), by its very nature reinforces the idea that organ donation is a good thing and socially approved. People can still discuss it all they want to, positively or negatively as they feel inclined, but that’s not the measure of how strongly the idea is being reinforced. How the heck to you plan to reinforce something socially if nobody is aware of it and never thinks of it? This is absurd - the whole claimed _point_ of opt-out is that despite the fact that near-everyone _wants_ to donate organs, they don’t because they _never think about it_, and so the point of opt-out is to allow them to donate without _having to_ think about it. With is the exact opposite and directly contradictory to your claim that it “by it’s very nature” reinforces the idea. (Thor only knows what part of opt-out’s “nature” you think causes this reinforcement. The magic fairy powder, perhaps?) Seriously - this is absurd. I really have no idea why you’re bothering to try to make this argument - it _clearly_ doesn’t work and is self-defeating. Isn’t “it gets more organs!” a good enough argument that you don’t have to resort to pathetic efforts like this? > [@Kimstu](#): > > I don’t see why anybody should accept your unsupported suspicions about the alleged convenience and effectiveness of mandatory opt in the absence of any actual data, any more than we’re obligated to accept your rather peculiar hyper-libertarian opinions about morality if we don’t happen to agree with them. > > You happen to personally believe that a mandatory opt system would be not significantly harder or less effective to implement than some kind of default-opt system. You’ve shown nothing to back that up except your own vehement opinions and some vague generalizations about its being cheap to put checkboxes on government forms. It’s hard to believe you’re serious with this. You’re claiming that it’s hard for the government to add checkboxes to forms. Forms that they’re already printing. This is absurd. Though this time, I _do_ know why you’re arguing it: 1. You know-but-won’t-admit that opt-out deliberately disregards the wishes of a segment of the population. It of course does this to get more organs. 2. You know that forced-opt doesn’t have this moral problem - but it’s almost certainly going to get less organs, because it doesn’t tap the market of people who don’t want to donate but are too lazy, stupid, lazy, and stupid to bother to opt out. 3. You know that the presence of a more-moral plan that gets more organs than straight opt-in undermines the argument for opt-out, since the argument for opt-out is strongly dependent on the alternatives delivering insufficient organs. 4. So, you must discredit forced-opt in any way possible, fallacious or not. I can see the reasoning, but of course your argument against forced-opt is clearly absurd, which is a bit of a problem for your position. The _proper_ way to argue against forced-opt would be to find statistics about its collection rates and show that forced-opt is ineffective at collecting sufficient organs. (Such statistics might very well might exist, since posters above have described encountering forced-opt in practice. However they might not exist, since there’s an obvious lag and I don’t know how long the forced-opt programs have been in effect.) Of course, for you having such statististics might be risky, because if they showed the forced-opt _did_ collect enough organs it would firmly relegate opt-out to the “bad idea” category, since it would not have the “no other plan will get us enough organs” moral justification it requires to counterbalance the “opt-out takes some people’s organs against their will” problem. And since you’re more interested in being **right** than supporting the best plan, this would be a problem for you. > [@Kimstu](#): > > You also happen to personally believe that a default opt-out system is immoral. Almost nobody else here agrees with you about that, your arguments haven’t convinced anyone who didn’t already agree with you, and your arrogant and insulting tone has made your position even more unappealing. Good work, comrade—oops, I mean, how dare you be such a big old meanie. Yeah yeah, I hurt your widdle feelings when I wasn’t polite back when you were rude first. Poor little pot, the kettle’s being mean. And you fail to comprehend my position in this thread. This thread is about the pros and cons of opt-out. The pros are obvious and readily provable. My point is not that the cons necessarily outweight the pros - my point is that the cons _exist_. Opt-out _does_ disregard a chunk of the population’s wishes. Obviously. Explicitly. Regardless of the increasingly hysterical and absurd baseless assertions otherwise. I would consider my time well spent if you charming idealogues would realize that _you don’t have to pretend that there are no downsides_. Opt-out could be compellingly argued by simply saying “sure some people will end up donating who might not want to, but the results are worth it”. This would be compelling not because the arguments against are nonexistent, but rather because the opt-out is demonstrably **so much better** at collecting organs than opt-in currently is. (Putting aside forced-opt for a moment.) “The ends justify the means” is a compelling argument for many people, and you can _certainly_ muster political will with it; politics when it works is all about compromise, and opt-out is all about compromise too. But _nooooo_, you need opt-out not only to win, but to be _completely_ flawless, so you break your back and destroy your arguments and your credibility twisting around and making absurd and obviously invalid arguments to try to argue that the car is not only the fastese, it uses no gasoline **at all**. Which honestly is pathetic, and with the degree it forces you folks into about denying that other people’s opinions matter, is kind of appalling as well. > [@Miller](#): > > Yes, that’s right. The opt out system is rational and humanitarian. Which makes two different axes where it is the opposite of your position. In what way is forced-opt irrational and unhumanitarain? This I gotta hear. > [@Miller](#): > > And “slimy and disingenuous” is not an ad hominem? Aside from being true, sure, it’s an ad-hominem. However it’s not an ircoherent and **stupid** ad-hominem, so it has that going for it. [quote=“Miller, post:88, topic:539218”] What’s the corruption motive in this situation? How exactly does someone profit from taking organs from someone against their express wishes? The organs themselves aren’t worth money: no one’s getting charged an arm and a leg so they can get a kidney. The transplant procedure costs money, but someone who needs a donor organ is going to need extensive (and expensive) medical procedures whether they get the organ or not. So what’s the motivation for deliberately losing or altering paperwork and taking an organ away from someone who didn’t want to donate?[?QUOTE]You’re now arguing that nobody wants the organs after all. Seriously. You’re arguing that they’re valueless and expensive and difficult and gosh we never wanted those organs anyway. Which certainly is _one_ way to argue that nobody will bother stealing them, but a better example of throwing out the baby with the bathwater I have _never_ seen. Good lord people. I get that you feel the need to refute everything I say because I don’t unquestioningly agree with your the only option you’re considering the merits of, but could you do yourself the courtesy of expending a _little_ effort to make your position consitent and coherent? Please? > [@Miller](#): > > I doubt that even using 100% mandatory donation, with no option to refuse, would get us enough donor organs to meet needs, so I reject the idea that it’s unnecessary. And calling it “theft” merits as much attention as calling taxes “theft” does: which is, of course, none at all. So argue for mandatory donation, no opt-outs allowed, then. Stop bothering with opt-out at all, and _certainly_ stop making such pathetically craptacular arguments in defense it. > [@Miller](#): > > There is nothing - nothing at all - immoral about an opt out system. Not one damned thing. We’ve been going at this for two pages now, and you’ve yet to present a coherent moral argument against an opt-out system. Can we expect one to arrive soon, or are we safe in assuming that no such argument exists? There’s also nothing immoral about stealing all your family photographs, or seizing all of assets of anyone who dies (including the photographs. Who do you think you’re fooling? I’ve presented a fine coherent moral argument against the opt-out system and you know it. Sure it might arguably not be as strong the moral argument that lives need to be saved so damn people’s desires about their corpses - but it’s a cound argument nonetheless. That’s why you’re so desperate to refute it that you’re willing to throw out everything from rationailty to dignity to do so. > [@Voyager](#): > > Of course it is likely that some people who’d rather not donate won’t bother to opt-out. However, by definition it can’t be critical to their lives, or else they would bother. Opting in, on the other hand, is never critical to one’s life - just something nice to do, and thus something more likely to be skipped. > The only argument I could see for forcing opt-in would be if some deity or other wanted us whole - but I think we’re on the same page on that subject, and if this were true, donations would be made illegal anyway. And you ignore the upside. > As for saying no fast enough, fast enough is probably measured in decades. I’m getting tired of people pretending I haven’t made arguments, or that I haven’t made the arguments I’ve made. The argument for ‘forcing’ opt-in (did you mean ‘choosing opt in as the social program to implement’?) is that you don’t wish to extract donations from people who don’t wish to donate. It’s pretty miuch that simple. Of course, straight opt-in without embellishments has the problem that you don’t get anywhere near enough organs donated. Opt-in is an approach that seeks to recrify that by partially discarding the concerns about unwilling donors. (Mandatory donation is an approach that _completely_ discards such concerns.) If one doesn’t _want_ discard such concerns, and is unwilling to dishonestly pretend that opt-out doesn’t do so, then the obvious alternate approach would be mandatory opting. Would that provide enough organs? Hard to say, but it won’t provide as many as opt-out or mandatory donation, which is a downside to it. Wether that’s a worse downside than taking organs from unwilling donors depends on a number of factors, including how many unwilling donors there actually are, and whether you believe that unwilling donors don’t deserve rights and should all just die or something. > [@Voyager](#): > > BTW, there are occasional campaigns to get people to opt in. However, of all the things that might be put off, this is top of the list, since it is of no benefit to us, except in making us feel good, and we aren’t expecting to die anytime soon. So it is not surprising that opt-in leads to low participation, over many countries. Right, so you’d also want a mandatory opt program of some kind to ‘encourage’ people to express their desires one way or the other. We all know that left to their own devices most people don’t bother to say one way or the other. ---
**Author:** ![FinnAgain](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/finnagain/32/12500_2.png) [@FinnAgain](https://boards.straightdope.com/u/FinnAgain)\ **Post date:** [May 14, 2010, 9:22pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/92 "2010-05-14T21:22:09Z")
I think what all of us are wondering is… so, begbert, can we have your liver then? ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 14, 2010, 9:49pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/93 "2010-05-14T21:49:25Z")
> [@FinnAgain](#): > > I think what all of us are wondering is… so, begbert, can we have your liver then? I’ll answer this seriously, actually. First things first - not until I’m dead. None of that bathtub full of ice stuff for me. Second - I’m too lazy to so much as _find out_ how to opt in or out. So under opt in, my liver would rot with me. Under opt out, it would be taken without asking. Third - if somebody _did_ ask me, as in under a forced-opt scheme where it’s on a drivers’ liscence re-up or whatever, I would check “yes”. You can have my liver. After I die. Not until then. No bathtubs of ice allowed. I’m serious. Fourth - I may _already have_ done the forced-opt thing on some form or another. I honestly don’t recall. If so, my liver is yours. Now, of course, the shocked masses would ask me how I can _possibly_ argue against opt-out, as one who would choose to donate if it was that easy? My answer is that, I might (and have) give five bucks to a panhandler on the street, but I would **not** be happy to have that panhandler picking my pocket to get those same five bucks. I value _affirmations_ of consent when the alternative is the presumption that I have no rights and my posessions (and organs!) are not mine to control. If I do not actively make the choice to donate, that means I haven’t donated, and I want that to be respected. Which means that I want you to **ask** me for my stuff. Despite the fact that just taking without asking is both easier for you and will get you more loot. ---
**Author:** ![FinnAgain](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/finnagain/32/12500_2.png) [@FinnAgain](https://boards.straightdope.com/u/FinnAgain)\ **Post date:** [May 14, 2010, 9:54pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/94 "2010-05-14T21:54:35Z")
> [@begbert2](#): > > not until I’m dead. No one who has ever had their liver taken out by us has survived. ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 14, 2010, 9:58pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/95 "2010-05-14T21:58:58Z")
> [@FinnAgain](#): > > No one who has ever had their liver taken out by us has survived. Well, yeah, which is a main reason for you to wait until _after_ I’m dead - at that point the low survival rate of the procedure is fairly likely to bother me a bit less. ---
**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:** [May 14, 2010, 10:23pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/96 "2010-05-14T22:23:19Z")
> [@begbert2](#): > > I’m getting tired of people pretending I haven’t made arguments, or that I haven’t made the arguments I’ve made. This may be because no one can figure out the logic of the arguments you are making. > [@](#): > > The argument for ‘forcing’ opt-in (did you mean ‘choosing opt in as the social program to implement’?) is that you don’t wish to extract donations from people who don’t wish to donate. It’s pretty miuch that simple. Ooh, scary word “forced.” No body is forcing anything on anybody. We’re just talking about a default chosen when a person has made no wishes known - which means that for any particular person, we don’t know if we are violating their unexpressed wishes or not. Statistically, I’m sure there are going to be some people who donate who might have wished they hadn’t. But, guess what? They are never going to know. They are flippin’ dead when it happens, and if they express an opinion to the doctor before they die, their opinion will be and should be followed. Your unexpressed premise here seems to be that it is worse for one person who wishes not to donate (but who has never made his wishes known) to donate than for any number of people who do wish to donate (and also never made their wishes known) to not donate. And also that the one person who donates against his unexpressed wishes outweighs living people who would benefit from the donation. Did I get that right? > [@](#): > > Of course, straight opt-in without embellishments has the problem that you don’t get anywhere near enough organs donated. Opt-in is an approach that seeks to recrify that by partially discarding the concerns about unwilling donors. (Mandatory donation is an approach that _completely_ discards such concerns.) If one doesn’t _want_ discard such concerns, and is unwilling to dishonestly pretend that opt-out doesn’t do so, then the obvious alternate approach would be mandatory opting. Would that provide enough organs? Hard to say, but it won’t provide as many as opt-out or mandatory donation, which is a downside to it. Wether that’s a worse downside than taking organs from unwilling donors depends on a number of factors, including how many unwilling donors there actually are, and whether you believe that unwilling donors don’t deserve rights and should all just die or something. No mandatory system will ever reach 100%, so the problem of defaults by those who managed not to participate remains. And what about people who never thought about it when forced to make a split second decision? Does a sign at the DMV saying “Be a mensch, agree to be an organ donor” unduly influence them? What about if they change their mind years later, and never get around to changing their selection in the database? Are their rights still violated? However, I’m all for mechanisms that will encourage people to make an explicit choice, since a written desire to donate could override objections by relatives. ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 14, 2010, 11:14pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/97 "2010-05-14T23:14:46Z")
> [@Voyager](#): > > This may be because no one can figure out the logic of the arguments you are making. Then maybe ‘everyone’ should try reading for comprehension, _without_ extrapolating wildly. > [@Voyager](#): > > Ooh, scary word “forced.” No body is forcing anything on anybody. We’re just talking about a default chosen when a person has made no wishes known - which means that for any particular person, we don’t know if we are violating their unexpressed wishes or not. Statistically, I’m sure there are going to be some people who donate who might have wished they hadn’t. But, guess what? They are never going to know. They are flippin’ dead when it happens, and if they express an opinion to the doctor before they die, their opinion will be and should be followed. > > Your unexpressed premise here seems to be that it is worse for one person who wishes not to donate (but who has never made his wishes known) to donate than for any number of people who do wish to donate (and also never made their wishes known) to not donate. And also that the one person who donates against his unexpressed wishes outweighs living people who would benefit from the donation. Did I get that right? I didn’t question the word “forced” because it was scary or whatever crazy thing you’re imagining; heck, I use it _myself_ in the term ‘forced-opt’, which I enthusiastically _support_. That aside, **no** , your strawman isn’t right. My _point_, if I wish to pretend you’re not going to ignore it, is that it is **bad** for one person who wishes not to donate (but who has never made his wishes known) to be made to donate anyway. It is **also** bad for one person who _does_ wish to donate (and also never made their wishes known) to _not_ donate. _Both_ outcomes are bad. Any instances of me placing a single individual of the first on a scale against an _infinite_ number of the other and found the latter wanting have only taken place in your imagination. I _will_ go on record as saying that when comparing one person to one person, I think that it’s worse to take against their will then to allow a person to fail to get around to donating, because there is a qualitative difference between not saying yes and not saying no in stuff like this. (You disagree? Then rape law disagrees with _you_.) I’d go so far as to say it’s easily ten times worse, and very easily an order of magnitude worse than that. Which of course not the same as saying that one man on one side outweighs uncountable billions of the other, as you have attributed to me. As for your comparison of the wish not to donate with the wish of the dying patient to have the organ, I wonder if you’re even aware that that’s a completely separate argument. Specifically, _that_ argument is the “we need the organs, so screw the wishes of the dead and their families; the end justifies the means so lets rob graves with impunity”. And if one has been paying attention, I have been consistently maintaining that _that_ is a position that can be argued consistently, though in that case the ultimate goal would be forced donation, with opt-out being grudgingly accepted only as a political necessity. The thing about this argument, is that it can be presented _without_ the rest of the bullshit the opt-out side has been shoveling. It’s very simple - one simply declares that the state has the right to take corpses and do whatever they like with them. You don’t have to pretend that it’s not a violation of people’s preferences or rights or anything; you just declare that the end justifies the means, it’s a tax, and you don’t have to like it, too bad for you, nobody cares. It would be nice to see an end of the shoveling of the bullshit. Even if neither side ended up convincing the other, at least the discussion and points of disagreement would be clear and above the table. > [@Voyager](#): > > No mandatory system will ever reach 100%, so the problem of defaults by those who managed not to participate remains. And what about people who never thought about it when forced to make a split second decision? Does a sign at the DMV saying “Be a mensch, agree to be an organ donor” unduly influence them? What about if they change their mind years later, and never get around to changing their selection in the database? Are their rights still violated? > However, I’m all for mechanisms that will encourage people to make an explicit choice, since a written desire to donate could override objections by relatives. Point-by-pointing: - the problem of defaults remains, but if we got explicit opting up to, say, 95% or even upwards of 99.9% (both of which seem extremely plausible to me), then how big of a problem would it actually be? The _actual_ problem is a shortage of organs. Once we got to the point where we’re dealing with a small minority of people we might be missing, how big a gain in real terms would we be looking at by presuming consent for the undocumented remainder? - People who never thought about it are still able to make a decision. And there’s always the chance to change their decision on a later re-registration, or even going in and explicitly changing their opt, if they feel bad enough about their snap decision. - I have no problem with pro-organ donation advertising; in fact I strongly encourage it in general. It’s not like we have an amendment saying the government isn’t allowed to take a stance on organ donation, after all. So long as it’s clear that you can still opt not to donate without suffering any penalties, feel free to slap giant posters everywhere. - If they change their mind years later, odds are they are still re-upping their drivers’ liscence, paying taxes, signing up for social security, or some other such thing, where we could get current opinions. I wouldn’t want to have to answer the checkbox _every day_, but having it on a few key forms should be sufficient to keep it reasonably up to date, I’d think. - the violation of rights comes from taking without asking. I have a lot of sympathy for the guy who’s pocket is picked. I have a lot less for the guy who you asked for money, who told you you could dip into the change jar at will, and then who changed his mind but forgot to tell you. - We agree about forced-opt! Yay! Now to debate violently to the death about that remaining 0.1 percent… ---
**Author:** ![YogSothoth](https://avatars.discourse-cdn.com/v4/letter/y/8edcca/32.png) [@YogSothoth](https://boards.straightdope.com/u/YogSothoth)\ **Post date:** [May 14, 2010, 11:30pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/98 "2010-05-14T23:30:50Z")
I would go further. Every dead person has their organs harvested if the government needs them. No exceptions should be made over anyone’s objections You can’t sell organs, you can’t eat them, you can’t enjoy them after you’re dead. They become worthless commodities. They only have value donated to other people. Any family member who objects out of some misplaced desire to respect the wishes of the dead, or religious reasons, should be forced to look a dying patient in then eye and tell him their dead relative’s wishes and the nebulous beliefs of some religious is more important that the real life and suffering of that patient ---
**Author:** ![begbert2](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/begbert2/32/3357_2.png) [@begbert2](https://boards.straightdope.com/u/begbert2)\ **Post date:** [May 14, 2010, 11:37pm UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/99 "2010-05-14T23:37:16Z")
> [@YogSosoth](#): > > I would go further. Every dead person has their organs harvested if the government needs them. No exceptions should be made over anyone’s objections > > You can’t sell organs, you can’t eat them, you can’t enjoy them after you’re dead. They become worthless commodities. They only have value donated to other people. Any family member who objects out of some misplaced desire to respect the wishes of the dead, or religious reasons, should be forced to look a dying patient in then eye and tell him their dead relative’s wishes and the nebulous beliefs of some religious is more important that the real life and suffering of that patient See, now, I disagree that you should be able to impose your disbelief-in-the-value-of-corpses opinion upon others\*, but this argument is still simple, self-consistent, and completely logical (once you accept the premises), and in this respect it is a beautiful thing. Seriously - beautiful. - I kinda wish I was personally opposed to donating so I could tell you that you can take my dead body over my dead body, but instead I’ll just have to settle for including the joke in this footnote. 🙂 ---
**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:** [May 15, 2010, 12:09am UTC](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218/100 "2010-05-15T00:09:38Z")
> [@begbert2](#): > > Any instances of me placing a single individual of the first on a scale against an _infinite_ number of the other and found the latter wanting have only taken place in your imagination. > > I _will_ go on record as saying that when comparing one person to one person, I think that it’s worse to take against their will then to allow a person to fail to get around to donating, because there is a qualitative difference between not saying yes and not saying no in stuff like this. (You disagree? Then rape law disagrees with _you_.) I’d go so far as to say it’s easily ten times worse, and very easily an order of magnitude worse than that. Which of course not the same as saying that one man on one side outweighs uncountable billions of the other, as you have attributed to me. I’d love to hear how you think rape laws are relevant here. Sex with a corpse is against the law, but it isn’t rape. The closest I can come is whether someone is asked if they were willing to have sex while they are asleep or unconscious and refuses to answer. As for the rest, it seems you have a fantasy about the effectiveness of forced choice. Are we going to go through the expense and hassle of sending back drivers license applications with nothing checked? Track down non-drivers? > [@](#): > > As for your comparison of the wish not to donate with the wish of the dying patient to have the organ, I wonder if you’re even aware that that’s a completely separate argument. Specifically, _that_ argument is the “we need the organs, so screw the wishes of the dead and their families; the end justifies the means so lets rob graves with impunity”. And if one has been paying attention, I have been consistently maintaining that _that_ is a position that can be argued consistently, though in that case the ultimate goal would be forced donation, with opt-out being grudgingly accepted only as a political necessity. Wishes of the dead says it all. The dead have no wishes. Families are another matter. Should they override an expressed wish, one way or another? In France it appears they do, which is no doubt to avoid lots of trouble. What if there is no family present? No one in this argument has objected to the expressed wishes of the deceased being paramount, so no one is disappointed at not being able to “grave rob”. (I’m surprise you haven’t used ghoul yet - unless I missed it.) The bigger question is how we set defaults. Maximizing social benefit seems to be the best way to me. > [@](#): > > The thing about this argument, is that it can be presented _without_ the rest of the bullshit the opt-out side has been shoveling. It’s very simple - one simply declares that the state has the right to take corpses and do whatever they like with them. Unless we’re talking about a VA hospital here, the state isn’t taking anything. The state is usually not directly involved with the transaction. What the state does is to set rules by which doctors and other interested parties know they are not liable when no wishes have been expressed. The state is even less involved than it is when my bank and I negotiate a mortgage. > [@](#): > > - the problem of defaults remains, but if we got explicit opting up to, say, 95% or even upwards of 99.9% (both of which seem extremely plausible to me), then how big of a problem would it actually be? The _actual_ problem is a shortage of organs. Once we got to the point where we’re dealing with a small minority of people we might be missing, how big a gain in real terms would we be looking at by presuming consent for the undocumented remainder? We could be sure that anyone who objects to donation would be in the 99% or whatever making a decision. Those who don’t care at all - and don’t object - would be heavily represented in the remainder. So why not let them donate? I doubt very much decision rates will get that high in any case. If everyone makes a decision, and the result is that there aren’t enough organs, that’s the way the cookie crumbles. Heeding an expressed choice comes first. > [@](#): > > - People who never thought about it are still able to make a decision. And there’s always the chance to change their decision on a later re-registration, or even going in and explicitly changing their opt, if they feel bad enough about their snap decision. But what if they die before they are forced to make another one? > [@](#): > > - I have no problem with pro-organ donation advertising; in fact I strongly encourage it in general. It’s not like we have an amendment saying the government isn’t allowed to take a stance on organ donation, after all. So long as it’s clear that you can still opt not to donate without suffering any penalties, feel free to slap giant posters everywhere. That’s because you seem to have no objection to donation per se. If you did, you might find these posters as offensive as pro-choicers find the requirement of putting bloody fetus pictures in each birth control clinic. This is a case where the state is actually trying to influence a choice. > [@](#): > > - the violation of rights comes from taking without asking. I have a lot of sympathy for the guy who’s pocket is picked. I have a lot less for the guy who you asked for money, who told you you could dip into the change jar at will, and then who changed his mind but forgot to tell you. Your analogy fails because when the organs are taken there is no one to ask. > [@](#): > > - We agree about forced-opt! Yay! Now to debate violently to the death about that remaining 0.1 percent… I’ve never objected in principle to forced choice, just as a matter of practicality. 10% of people are undecided about whether the sky is blue. I bet you’d find that the position of the Yes/No boxes on the form will make a difference in how people choose. You are basically trying to make the default issue go away, and I think it will always be an issue, no matter how hard we try to force people to decide. [Previous page](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218.md?page=4) [Next page](https://boards.straightdope.com/t/pros-and-cons-of-presumed-consent-organ-donating/539218.md?page=6)