Tuesday, January 15, 2008

Harvesting organs and presumed consent

Like Jamie K I find it difficult to form a rational argument against the idea that people should have to actively opt-out of donating their organs but after reading this post from Justin Keating I feel the need to try and find a form of words for something I'm instinctively opposed to.

Maybe it's partly for the rather irrational reason why I've adopted a number of other positions in the past; you find the attitude and arguments made by those for the issue so deeply unpleasant that you feel the opposing case must have some merits. I certainly had this feeling after reading Justin's post.

For example, I really don't think the caricature that anyone opposing this idea is an anti-state rightwing libertarian anti-abortionist should be taken very seriously:

"'It strikes at our relationship with the state,' they say. Well get this: You can't have a relationship with the state when you're dead. You can't assert ownership over your own corpse. Why? Because. You. Are. Dead. What other freedoms would you like to exercise after you've shuffled off?"

It is customary to respect the wishes of people even after they've died with regards, for example, as to how the funeral should be arranged, whether the body should be cremated or buried and so on. I'd immediately accept that not donating your organs has obvious implications that funeral arrangements don't but the point about respecting the wishes of the deceased and their families still links the two. In relation to this there's something quite disturbing about Justin's arguments here. It's not the insistence that this is irrational that is the problem; it is this idea that we can be otherwise, that the feeling of desecration can be entirely dispensed with. For this is a human universal - not, as he ludicrously suggests, something 'weird' that is peculiar to this country, generated by sentimental movies.

And you don't have to be a crazed gun-toting rightwing libertarian to feel queasy about the idea of the state 'presuming consent' and the extension of its power that this implies. It is a notion that has sinister historical precedents and I don't think Justin has considered the implications of what he is accepting here. For if the wishes of the deceased and their families are to be of no account why should the state have to show it requires the organs for the reason of saving lives? Why can't they do whatever they want with our bodies for whatever reason? Because there is, for him, no utilitarian scale to balance because the corpse is useless and any feeling about what happens to it pure sentimentality.

Any student of social history that has looked at the budgets of working-class families in the 19th century will have been struck by the relatively high proportion of their incomes customarily set aside for funeral payments. Given the strictures of the average household income in these days, this felt need for decorum after death was certainly irrational. Irrational but all too human - and the failure to even try and understand this is at the core of the problem with Justin's argument. Because while it is ostensibly concerned with liberty and welfare, it is nevertheless utterly lacking in humanity.

Update:See also Norm and Chris Dillow, not in the same vein but on the same subject.

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