I see it the other way around. Worf satisfied discipline by making it clear that he would follow orders, but he knew that Federation and Starfleet morality would not permit Picard to give such an order. See also “Ethics,” where Picard respects Worf’s decision to commit suicide, and declines to order him otherwise.
I’m largely on board with Chronos’ approach here.
Federation officers are regularly called upon to make much greater sacrifices for much lesser causes. If it’s for the greater good, the Federation is quite willing to send its people on suicide missions. I don’t see a compelling reason why protecting this sort of bodily integrity is so fundamentally different. Now, if it were a much more invasive procedure, like maybe Worf needs to donate a chunk of his brain which will leave him with permanent mental damage, then that might be a line I’m not willing to cross.
It’s pretty much moot without the Romulan’s consent, though. If someone of sound mind outside of my authority outright refuses my help then I would respect that decision.
Not an issue. The Romulan is an intelligent adult, and has the legal right to refuse the donation. Since he has declined I have no right to force him. No transfusion will occur, even if Worf is willing.
But only works 50% of the time.
I’d order the medical officer to use the highly advanced medical technology that a civilization which has FTL and matter transmission WOULD have in any logical setting to save the damn Romulan. Because nothing about Trek biotechnology makes any sense at all.
So, the Captain can order a crewman to their death to save the ship (like in Troi’s test), but can’t order a (harmless to the donor) tissue donation?
Yes.
The current military is the same way. You can be ordered to storm the beach in which there is 99% certainty you’ll die, but you can’t be ordered to donate blood.
Makes sense to me. it’s a question of personal liberty. And I wouldn’t order Worf, even if the Romulan wanted it. Even if the Romulan High Command personally demanded it. The line is drawn HERE.
“Mr. Worf, do it and stop bothering me with your talk of honor. I have more important things to concern me than your honor.”
No, I would never give that order. I can order a crew member to sacrifice themselves to save the ship, but ordering Woof to do this crosses the line. What’s next, scrapping Data so we have a chance to make more?
Exactly. You sign up with the idea that your life may be put on the line. You’ve effectively already agreed with that.
Though, in the future, I would not be surprised if Picard could have ordered it. Captains seem to have a lot of leeway. They violate what is supposedly the prime rule all the time. It seems that Starfleet depends heavily on the morality of its participants. It seems that all they have to do is justify it.
Saving a Romulan’s life to avoid an interstellar incident seems like it would fit.
Without addressing the first half of the dilemna (whether Worf donates), the latter half (whether the Romulan accepts the donation) sounds like the episode of MASH (or MASH if you prefer) where a racist soldier about to receive a blood transfusion says he doesn’t want it if it contains black blood. Dr. Pierce not only gives the transfusion – racist preferences be damned – he paints the racist brown with iodine as he sleeps as a prank/lesson. Which raises the question of how a Romulan would look with temporary Klingon forehead ridges? 
I would sit down and talk it through with Worf and try to persuade him that it would be in keeping with the highest ideals of the Federation for him to voluntarily donate, but at the end of the day I would probably order him if it made a difference between the Romulan prisoner dying or not. As noted above, the needs of the many yada yada yada.
Can’t quote exactly, but I recall that after Worf informed the captain of his objections, but stated that he would do so if ordered, Picard stood up sharply saying “Mr. Worf”. Worf snapped to attention, and it seemed as if Picard was going to order him to save the Romulan, but instead he simply says “Dismissed”. He then contacts Dr. Crusher to tell her to make no further attempts to persuade Worf to undergo the procedure, and she at that point tells him the Romulan has died, rendering the whole point moot.
Also, I am surprised to see that I appear to be in the minority when I say that I would have respected the rights and wishes of my crew member.
Depends on how long the pattern is stored in the buffer, doesn’t it? Scotty and the other officer had been in theirs for, what, 75 years? Only logical that at least one of them wouldn’t have survived.
The first time this procedure was mentioned, BTW, was in TOS’s “Day of the Dove”: Chekov wanted to leave Kang and his crew in the transporter, rather than have them rematerialized on board the Enterprise. He referred to it as “nonexistence.”
From the way Chekov was talking, and given the rest of the events of the episode, I’m pretty sure he was talking about killing Kang & Co. in the most expedient fashion. Pavel was the first of the Enterprise officers to succumb to the hate-thing’s influence.
Given that I doubt he intended to materialize them anytime in the near-to-distant future, I’d have to agree with you there. 
I’d like to see the technological safeguard disaster that occured between now and TOS that had them say “EFF safety protocols and permissions”
Hyposprays ALONE should be locked up tight. The armory just opens for anyone apparently! But Engineering can be locked up by one drunk Navigator!
And really…an overload setting for phasers? Those things look like they’d make terrible grenades.
Get your priorities straight Starfleet!
I like to imagine how this episode would have gone down if Worf had refused to donate to some black guy, or woman, or gay guy for “insert Klingon reasoning here”.
On the other hand, they had an emergency-disposal chute not far from the Captain’s quarters that led all the way outside the hull. How often does that come in handy?