# Should organ donation be mandatory? **URL:** \ **Category:** Great Debates\ **Created:** [November 20, 2016, 9:42pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597 "2016-11-20T21:42:21Z")\ **Posts on this page:** 15\ **Page:** 6
**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\ **Post date:** [December 2, 2016, 9:13am UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/101 "2016-12-02T09:13:06Z")
> [@Smapti](#): > > And in that circumstance, whether or not the recipient would have been willing to donate an organ when they were young and healthy is _irrelevant_ to the good that that organ do them today. Between a donor and a non-donor, the donor isn’t going to live longer because they put a little pink sticker on their driver’s license. But there is feedback into the next generation of potential donors of the implications of their decision. And this could save many more lives. ---
**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:** [December 2, 2016, 9:22am UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/102 "2016-12-02T09:22:33Z")
> [@Riemann](#): > > ? But my point is, when you have an absolutely limited resource, and you have to choose who should get that benefit, that’s a qualitatively different situation from just asking whether we should (say) spend extra money on caring for someone who doesn’t look after themselves. > > When there are two people you could save with an available organ, I can see a reasonable argument for always prioritizing a willing donor over a non-donor. Which could mean that non-donors pretty much never receive an organ. > > I know you don’t agree, but it _is_ a qualitatively different situation from the broader notion that in general we should give people the care that they need, not what they have earnt. I really doubt it would be all that common to find that there is an available organ, and two patients who are so precisely matched in need and suitability, that we need an additional non-medical factor to decide the coin-toss - and even if there were, IMO, point of delivery of healthcare is simply not the appropriate place for any social engineering to take place. ---
**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:** [December 2, 2016, 9:28am UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/103 "2016-12-02T09:28:35Z")
> [@Riemann](#): > > But there is feedback into the next generation of potential donors of the implications of their decision. And this could save many more lives. And that has nothing to do with triage or ethical medical practice - it’s just using the threat of withholding medical care as a cudgel to punish people for not “volunteering” to be donors. We don’t withhold medical care to obese people, or alcoholics, or drug users, or unwed mothers, or gays, or STD patients, or people who choose to stay in abusive relationships, in the hope that doing so will convince future generations to “do the right thing” and save more lives in the long run, nor should we. ---
**Author:** ![CairoCarol](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cairocarol/32/3825_2.png) [@CairoCarol](https://boards.straightdope.com/u/CairoCarol)\ **Post date:** [December 2, 2016, 10:29am UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/104 "2016-12-02T10:29:42Z")
> [@Smapti](#): > > How often does the circumstance arise that a who person _needs_ an organ is still capable of _giving_ one? Most of the illnesses that require a transplant happen at an older age where the organs are suboptimal at best, or are of such a nature that disqualifies that person from donating. When my 78-year-old mother passed away, one of HER organs was donated: her skin. In fact, when the representative called me to get my permission, she told me that skin from older donors is actually preferred, as it is more malleable than collagen-rich skin from younger donors. Anyway, [there is no cut-off age for being an organ donor. Old people can donate too.](http://www.livescience.com/36240-donate-organs.html) ---
**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:** [December 2, 2016, 10:36am UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/105 "2016-12-02T10:36:58Z")
For anyone arguing with **Smapti** in this thread, it’s worth noting that at least part of his position comes from an actual fear he has of having his organs harvested while he’s alive. Just… might wanna keep that in mind when discussing this with him. > [@Flyer](#): > > I am against mandatory organ donation partly because the government has wormed its tentacles into enough parts of our lives as it is. We don’t need any more paternalistic laws. Well, in this case, it costs next to nothing and saves many lives, and the _only_ reason people aren’t doing it already is because they’re too stupid or lazy to get their donor cards. So why, exactly, is a “paternalistic” law out of line in this case? Why shouldn’t we legally encourage people to do what is unquestionably the right thing? > [@](#): > > I’m also against it because of this stupifyingly wide-spread myth that it “saves” lives. There is no such thing as “saving” lives, under any circumstances whatsoever. It is often possible to **prolong** lives, but that’s **all** that’s possible. When you “save” somebody’s life, you’re not saving it at all – the ONLY thing that you’re doing is making sure that they will die at some other time, probably in some other fashion. What an utterly bizarre sentiment. I suppose it wouldn’t matter to you at all if, after a stabbing, you got medical attention or not. After all, it’s not like it would “save your life”, you’re just going to die of something else. Sure, you might live another 10-20-30 years, but what does it matter? You’re just going to die eventually! Why should you prolong it any longer? It doesn’t matter. Life is worthless. How does one hold this bizarre opinion and not deem suicide the most logical course of action? Seriously, I don’t get it. > [@](#): > > If your concern is the number of people whose lives could be prolonged by an organ transplant, the only efficient thing, and the only thing that will actually solve the situation, is to repeal the idiotic laws that prohibit payment for organ donations. You do realize the reason we have those laws in place is to ensure that the currently absurd situation **Smapti** is worried about doesn’t become reality, right? No, there’s a good reason we don’t allow people to sell their organs. It leads to perverse incentive systems that are potentially more damaging than the shortage of organs in the first place. > [@Broomstick](#): > > Not everyone recognizes those definitions of death as valid. Especially when the body is brain dead and the heart is still beating - there’s more than one culture and nation where such a person is still considered alive. > > But hey, who cares if the Japanese regard a body with a heart beat as still alive and ripping organs out of it is murder, right? They’re viewpoint doesn’t count, it’s more important for people who want mandatory organ donation to get their way and screw anyone who thinks they’re killing people to make them into spare parts. > > There are also cultures that believe death is when someone stops breathing - would you condone them declaring dead anyone who stops breathing even if their heart was still beating and their brain still showing activity? Forget CPR or even mouth-to-mouth, they stopped breathing, they’re dead, get the saws out! This is cultural relativism driven to an extreme. The Japanese are, at least at the moment, _wrong_. Medically, scientifically wrong. Their belief that a body with a heartbeat is still alive is simply not tenable - if you’re braindead, you’re _dead_. Barring technical advances that may or may not _ever_ come, you’re not coming back. The difference here shouldn’t be cultural. It should be _scientific_ - our best understanding of when someone is or is not dead. That culture in your last paragraph? They’re wrong. Really, _really_ wrong. That shouldn’t mean we can’t do the right thing. > [@Broomstick](#): > > Or shortages exist because there’s just not enough of something in existence to meet demand. > > Even countries with opt-out still don’t have enough organs for everyone who needs them. First, the deceased person’s organs have to be undamaged. Then they have to be matched to a potential recipient because organs aren’t really randomly interchangeable - you to match both for immune factors and size because even if the immune markers are compatible you can’t put the heart of a two year old toddler into a thirty year old adult or vice versa. > > Making organ donation compulsory is NOT going to solve this shortage because it’s not due to price controls, it’s due to a lack of resource, that is, usable donor organs. Unless you propose we start killing one person to save another that’s not going to change. Or that we can somehow clone organs in a short time frame to use instead of naturally grown ones. > > It will make donor organs more available, and that’s arguably a good thing, but let’s not have an illusion that this is really going to “solve” this problem. “We don’t have enough food for everyone.” “Here’s a way to get more food. It’s not as much as we wanted, but it’s still better, and we’ll be able to serve more people.” “Nah, we still won’t have enough food for everyone. Better not do it.” I mean, I’ve heard of the nirvana fallacy, but this? This is just silly. We have a problem. We have a way to make this problem less of a problem. And because we can’t _completely eliminate_ the problem… What? It’s not part of a solution? > [@DLuxN8R-13](#): > > Wow. I think this is the first time I’ve ever agreed with **Smapti** about something. > > No, no, no, and NO. The state does not own me, my body, or any piece thereof. Neither does society or humankind in general. While I live, my body is my own to do with as I will; while I live, all of me is mine, mine mine. When I don’t live anymore, well, it’s obviously not mine because there’s no me left to own anything – but it still doesn’t belong to the state, either. It doesn’t matter that I’m not there to claim my body or innards, those innards are NOT THEIR PROPERTY, period. And I would really rather keep it that way. > > Those who prefer to pass their re-usable components to their fellow folk and the future should surely be thanked, commended, and handsomely compensated for their, ermmm, vital contribution to society. We all have the right to give of ourselves to others as we would and as much as we can; the right to do as one will with one’s own body extends to the parceling out of one’s parts _post mortem_. When the option to be harvested is an individual’s conscious choice, then getting a donor card or whatever becomes an honor - a recognition of that person’s generosity and a sort of thank-you note. I would compare this to a child whining about having one of their toys taken away, but the child has a point - they’re losing something that could very well matter to them. When you’re dead, _you’re dead_. Organs aren’t like normal property. Barring very specific circumstances, you can’t pass a liver on to your kid. You can’t use it to make their lives better. It’s either you donate it to save lives, or it goes into the ground, rots, and does _nothing_. There’s no point. It’s an utterly senseless waste of resources that serves _no purpose_. > [@gigi](#): > > > [@DrDeth](#): > > > > and just _why_ do you want your organs to rot and feed worms rather than being put to good use? > > Because they’re mine and just because organ donation is an option doesn’t mean it has to happen, and not with my parts. And I don’t want the angels to have to look all over the place to find my particles. 🙂 > > That said, I do donate blood. Like I said: _childish_. “Why won’t you do this incredibly useful, life-saving thing that costs you nothing?” “I don’t wanna, and you can’t make me!” ---
**Author:** ![Riemann](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/riemann/32/3133_2.png) [@Riemann](https://boards.straightdope.com/u/Riemann)\ **Post date:** [December 2, 2016, 10:58am UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/106 "2016-12-02T10:58:15Z")
> [@Budget\_Player\_Cadet](#): > > Like I said: _childish_. “Why won’t you do this incredibly useful, life-saving thing that costs you nothing?” “I don’t wanna, and you can’t make me!” Why do you hate Freedom? ---
**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:** [December 2, 2016, 12:32pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/107 "2016-12-02T12:32:41Z")
> [@Budget\_Player\_Cadet](#): > > For anyone arguing with **Smapti** in this thread, it’s worth noting that at least part of his position comes from an actual fear he has of having his organs harvested while he’s alive. Just… might wanna keep that in mind when discussing this with him. That’s correct, and it’s an entirely rational fear for a person to have, especially in a climate (like this one) where people are assuming that an individual’s organs are state property by default. > [@](#): > > I would compare this to a child whining about having one of their toys taken away, but the child has a point - they’re losing something that could very well matter to them. When you’re dead, _you’re dead_. Organs aren’t like normal property. Barring very specific circumstances, you can’t pass a liver on to your kid. You can’t use it to make their lives better. It’s either you donate it to save lives, or it goes into the ground, rots, and does _nothing_. There’s no point. It’s an utterly senseless waste of resources that serves _no purpose_. My organs cannot be harvested when I’m _dead_-dead. To paraphrase _The Princess Bride_, they have to be taken when I’m only _mostly_ dead; the heart still beats, the lungs still draw in air, but the brain has ceased to function. It is my concern that a doctor will declare me to be mostly dead when in fact my brain is still functioning, and that the probability of him/her doing so increases when it is known to them that I’m a willing donor. ---
**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:** [December 2, 2016, 12:34pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/108 "2016-12-02T12:34:43Z")
> [@CairoCarol](#): > > When my 78-year-old mother passed away, one of HER organs was donated: her skin. In fact, when the representative called me to get my permission, she told me that skin from older donors is actually preferred, as it is more malleable than collagen-rich skin from younger donors. > > Anyway, [there is no cut-off age for being an organ donor. Old people can donate too.](http://www.livescience.com/36240-donate-organs.html) Had she herself ever received an organ donation? Because I’m struggling to imagine a scenario in which a person who needs a donor organ to live is still fit to donate an organ themselves. ---
**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:** [December 2, 2016, 1:31pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/109 "2016-12-02T13:31:38Z")
> [@Smapti](#): > > We don’t withhold medical care to obese people, or alcoholics, or drug users, or unwed mothers, or gays, or STD patients, or people who choose to stay in abusive relationships, in the hope that doing so will convince future generations to “do the right thing” and save more lives in the long run, nor should we. I’m with you on this. Medical care should just focus on delivering treatment to try to achieve the best possible outcome for the patient. We do, however, tolerate the state applying pressure or obligation in other areas of our lives (that is, not by withholding care) to notionally effect better behaviours, better society, better personal safety etc - taxes on tobacco, requirements to wear seat belts or have driver insurance and so on. I see the opt-out system of organ donation as being something in that category - I think that the category breakdown of non-donors is probably: Minority: Non-donor because they don’t want to Majority: Non-donor because they don’t care enough one way or the other Changing the default (opt-out) would do the following: [ul] [li]People who are non-donors by choice could continue to be non-donors by choice[/li][li]A minor portion of the ‘don’t care’ category would make up their minds also to become non-donors by choice[/li][li]The remaining majority of the ‘don’t care’ category would continue not to care, and would be donors by default (but that’s fine isn’t it? - _they don’t care_)[/li][/ul] ---
**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:** [December 2, 2016, 1:38pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/110 "2016-12-02T13:38:07Z")
> [@Smapti](#): > > My organs cannot be harvested when I’m _dead_-dead. To paraphrase _The Princess Bride_, they have to be taken when I’m only _mostly_ dead; the heart still beats, the lungs still draw in air, but the brain has ceased to function. It is my concern that a doctor will declare me to be mostly dead when in fact my brain is still functioning, and that the probability of him/her doing so increases when it is known to them that I’m a willing donor. I can understand why you might have that concern, but I don’t think it’s a valid concern - and I think it’s a bit insulting to the medical profession to imagine that they would do such an unethical thing, that also has no comprehensible incentive for it - why would a doctor be in haste to push through a slipshod declaration of your death in order to benefit the patient of some other doctor somewhere else? Potential donor and potential recipient being in adjacent beds under the care of the same doctor happens on TV, not so much in real life. ---
**Author:** ![gigi](https://avatars.discourse-cdn.com/v4/letter/g/a587f6/32.png) [@gigi](https://boards.straightdope.com/u/gigi)\ **Post date:** [December 2, 2016, 2:36pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/111 "2016-12-02T14:36:29Z")
> [@Budget\_Player\_Cadet](#): > > Like I said: _childish_. “Why won’t you do this incredibly useful, life-saving thing that costs you nothing?” “I don’t wanna, and you can’t make me!” It does cost me something. It costs me the peace of mind while I’m alive that my body will be buried as is and not cut up and distributed out. And I don’t expect to receive an organ either. I just don’t believe in doing everything that is available and then having to be on anti-rejection meds forever. I hope to accept my diagnosis, make the most of it and die a natural death with my body left intact afterwards. I don’t fault folks who want to pursue these options, but it’s not for me. ---
**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:** [December 2, 2016, 2:48pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/112 "2016-12-02T14:48:58Z")
> [@gigi](#): > > It does cost me something. It costs me the peace of mind while I’m alive that my body will be buried as is and not cut up and distributed out. > > And I don’t expect to receive an organ either. I just don’t believe in doing everything that is available and then having to be on anti-rejection meds forever. I hope to accept my diagnosis, make the most of it and die a natural death with my body left intact afterwards. > > I don’t fault folks who want to pursue these options, but it’s not for me. See, I’m arguing for opt-out, but I support your right to choose not to donate - and it’s none of my business how sensible or otherwise (to me) are your reasons for that choice. You made a choice. I have absolutely no interest in forcing you to choose otherwise. It’s the people who don’t care enough to make a choice that are in scope here. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [December 2, 2016, 10:41pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/113 "2016-12-02T22:41:57Z")
> [@Budget\_Player\_Cadet](#): > > > [@Broomstick](#): > > > > Not everyone recognizes those definitions of death as valid. Especially when the body is brain dead and the heart is still beating - there’s more than one culture and nation where such a person is still considered alive. > > > > But hey, who cares if the Japanese regard a body with a heart beat as still alive and ripping organs out of it is murder, right? They’re viewpoint doesn’t count, it’s more important for people who want mandatory organ donation to get their way and screw anyone who thinks they’re killing people to make them into spare parts. > > > > There are also cultures that believe death is when someone stops breathing - would you condone them declaring dead anyone who stops breathing even if their heart was still beating and their brain still showing activity? Forget CPR or even mouth-to-mouth, they stopped breathing, they’re dead, get the saws out! > > This is cultural relativism driven to an extreme. The Japanese are, at least at the moment, _wrong_. Medically, scientifically wrong. Their belief that a body with a heartbeat is still alive is simply not tenable - if you’re braindead, you’re _dead_. Barring technical advances that may or may not _ever_ come, you’re not coming back. The difference here shouldn’t be cultural. It should be _scientific_ - our best understanding of when someone is or is not dead. That culture in your last paragraph? They’re wrong. Really, _really_ wrong. That shouldn’t mean we can’t do the right thing. And how would you feel if some other country barged in and started demanding changes to YOUR culture? People are not Vulcans and do not make emotionally charged decisions based on logic and facts. The _only_ reason brain death is a legal criteria in the US is due to court cases where doctors performing organ transplants were brought up on murder charges. Its been a generation or so since the US fought these cases in the court system so a lot of people have either forgotten them, or simply are unaware of the history. > [@Budget\_Player\_Cadet](#): > > > [@Broomstick](#): > > > > Or shortages exist because there’s just not enough of something in existence to meet demand. > > > > Even countries with opt-out still don’t have enough organs for everyone who needs them. First, the deceased person’s organs have to be undamaged. Then they have to be matched to a potential recipient because organs aren’t really randomly interchangeable - you to match both for immune factors and size because even if the immune markers are compatible you can’t put the heart of a two year old toddler into a thirty year old adult or vice versa. > > > > Making organ donation compulsory is NOT going to solve this shortage because it’s not due to price controls, it’s due to a lack of resource, that is, usable donor organs. Unless you propose we start killing one person to save another that’s not going to change. Or that we can somehow clone organs in a short time frame to use instead of naturally grown ones. > > > > It will make donor organs more available, and that’s arguably a good thing, but let’s not have an illusion that this is really going to “solve” this problem. > > “We don’t have enough food for everyone.” > “Here’s a way to get more food. It’s not as much as we wanted, but it’s still better, and we’ll be able to serve more people.” > “Nah, we still won’t have enough food for everyone. Better not do it.” > > I mean, I’ve heard of the nirvana fallacy, but this? This is just silly. We have a problem. We have a way to make this problem less of a problem. And because we can’t _completely eliminate_ the problem… What? It’s not part of a solution? Did you even see the part where I said **It will make donor organs more available, and that’s arguably a good thing, but let’s not have an illusion that this is really going to “solve” this problem.**? I NOT arguing we shouldn’t do opt-out, what I am saying is that claiming such a change will “solve” the organ shortage is false and not a valid argument for opt-out systems. So, sure, make the claim it will increase the organ supply, but DON’T claim it will result in enough organs for everyone who needs new ones. It won’t. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [December 2, 2016, 10:43pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/114 "2016-12-02T22:43:12Z")
> [@Mangetout](#): > > I can understand why you might have that concern, but I don’t think it’s a valid concern - and I think it’s a bit insulting to the medical profession to imagine that they would do such an unethical thing, that also has no comprehensible incentive for it - why would a doctor be in haste to push through a slipshod declaration of your death in order to benefit the patient of some other doctor somewhere else? Beat me, but apparently [it’s an issue even under our current system](http://nypost.com/2012/09/26/organs-taken-from-patients-that-doctors-were-pressured-to-declare-brain-dead-suit/) So while I agree such an event is unlikely it is NOT an entirely baseless fear. ---
**Author:** ![ThisIsTheEnd](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thisistheend/32/4713_2.png) [@ThisIsTheEnd](https://boards.straightdope.com/u/ThisIsTheEnd)\ **Post date:** [December 4, 2016, 4:08pm UTC](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597/115 "2016-12-04T16:08:13Z")
Mandatory? Are you kidding? Where are you going to put all that shit? [Previous page](https://boards.straightdope.com/t/should-organ-donation-be-mandatory/772597.md?page=5)