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Organ donation and consent

The Government plans to introduce an opt-out system for organ donation. (irishtimes.com/politics/2022/1)

This is a system whereby organs will be removed from patients’ bodies upon death, for transplant, if they have not expressly forbidden it. Otherwise, consent will be presumed.

The opt-out regime is based on the assumption that when inevitable death is approaching, the State or the hospitals own our bodies and can dispose of their parts, unless we or our family explicitly object.

This principle is not acceptable, even if it is motivated by the noble intent of addressing the problem of shortage of organs for transplant in Ireland.

Donation should arise from an informed and deliberate decision.

An opt-out system does not properly respect the principle of informed consent.

If the current opt-in regime is not adequate to satisfy the need for donors, it could be improved so that every patient, when visiting their GP or a hospital, should be explicitly asked to express their option on the matter.

An opt-out system is detrimental not only for those who are not aware of the details of the legislation, probably the majority of people, but particularly for vulnerable groups in society such as those who do not have adequate language skills, or cannot fully consent.

Donation must remain a choice freely made and taking without asking is not giving. Our organs are not at the State’s disposal.

@angelobottone
This is a position I've never understood. I agree that the decision to donate whatever needs to be made freely as whatever you donate is being sacrified by yourself in favor to others. But this holds true as long as a persons alive since 1) you don't really sacrifice anything when your dead as you certainly have no use of any organs in this state and 2) consent isn't possible anymore.
As long as your relatives don't plan to put your organs on shelf, they probably don't need it either, so I can't see no valid reason for an op-in system in this case which would hurt society in the long run.

@bloc We respect people wills even when they are dead, with regard to their bodies, their funerals, their belonging, etc. Somehow, we survive our own death, and leave a material and spiritual legacy. The disposal of what is left of us is a delicate matter, heavily regulated by cultural and legal norms.

@angelobottone
The legal norms is just whats at discussion here. Cultural norms seem to be a pretty bad advisor in terms of life and death, as even within a single country there are almost infinitely many different of them.
Funerals and belongings are of direct value to the relatives of a dead, spiritually and materially, respectively. Organs provide for none of these to anyone not in direct need of one.
Overall, holding to an opt-in to organ donation for some nebulous reasons we can apparently not even lay out concretely while on the other hand lifes are at stake seems pretty selfish to me. This is just my personal point of view.

@bloc I appreciate your point of view. I don't think the wishes of the deceased are of direct value to the relatives only. Sometimes are detrimental to the interests of the relatives, and sometimes there are no relatives but we still honour the wishes. We do because we value the deceased, including their dead bodies, intrinsically, for what they are, rather than instrumentally, for what they could be used for. We don't force people to donate their organs when alive, even if that could save lives, and so we don't it when they are dead. Respect for the body is linked to the dignity of every person, which doesn't end with death.

@angelobottone
While I can see your point, I still consider the needs of the living, especially in an urgent and potentially life-saving case like organ donation, to be more important than some rather metaphysical needs of the dead.
It's true we don't force the living to donate organs even if it could save lifes, as this would mean a serious decrease of life quality. This does not hold true for the dead, I wouldn't even speak about "forcing" in this context.
I also value the respect for the dead as everyone else, however to me the body's physical integrity is not necessarily a requirement for this respect. We can still mourn for a person and celebrate his or her life without the need of a intact body as physical representation.
TL;DR I see this from a point where a dead body has nothing to loose anymore, therefore the need for a life-saving donation should come first.

On a side note, I highly appreciate the discussion.

@angelobottone Is this also an argument why abortion should be permitted without restriction at any time, because no one has the right to demand use of your organs without your consent, even if they need them to survive?

@Adrasteianix No, The foetus cannot demand and so the relationship with the mother cannot be understood in the same terms.

@angelobottone Interesting. It is not the recipient who is usually demanding use of the organs, it is often, including in your missive, the 'state' who, in the interest of preserving life, that is intervening on behalf of the person who needs use of the organs.

Why would it make a tangible difference who needs your organs to survive? Isn't the question the same? Can the state compel the use of your organs without your consent to save someone's life?

@Adrasteianix Comparing pregnancy to organ donation is a poor analogy, as I explain earlier. But if you really want to argue in those terms, the conclusion is the opposite of what you suggest.
The state can't compel anyone to donate a organ or anyone to get pregnant. Once the donation has happened, or someone is pregnant, the action cannot be reversed otherwise you kill the recipient, or the baby. But I still believe it is a bad analogy comparing something that could last nine months and happens naturally to an artificial procedure that is much shorter. The equivalent of an abortion would be interrupting the donation of the organ in the middle of the transplant procedure, causing the death of the patient. Again, bad analogy but still morally wrong.

@angelobottone It may not be as much of stretch as you think, especially when we are discussing informed consent, which was the original topic. Pregnant people are routinely required to have compulsory surgery for someone else's benefit. Most of the time, pressure is enough to get them to acquiesce, but at least in my country, there are examples of court-ordered surgery.

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