One Death Into Many Lives

24 March 2005

By Stentor Danielson

If you want to get a sense of the moral condition of the United States, consider this: about half of families refuse to allow their deceased relatives' organs to be donated. Having just experienced the pain of a loved one's death, half of Americans choose death for as many as 50 other terminally ill patients.

With current medical technology, a single donor in good condition can save as many as eight lives through organ donation and up to 50 by donating tissue. The risks of donating in vain are small, as organ donation is a well-tested practice with success rates as high as 97% for kidneys, the most commonly donated organ. Despite all this, an average of 17 people die every day because not enough organs are available.

Organ donation imposes no costs on the donor or his or her family. The procedure is paid for by the recipient's insurance. Removal of organs is done discreetly so that an open-casket funeral is not hindered. And the deceased does not need the organs anymore. Organ donation is easily the most efficient way that a single individual can make the world a better place.

A pernicious urban legend claims that doctors will take less care in saving an organ donor, so as to be able to harvest their organs sooner. There is simply no evidence of this ever happening, and the teams of doctors that save patients and those that collect organs are kept completely separate as a safeguard. If doctors are immoral enough to let organ donors die, it seems unwise to entrust them with any of your health care.

Religious objections are also typically non-starters. Nearly every organized religion, including all Christian and Jewish denominations, either leaves donation up to the individual or actively encourages it. Even Jehovah's Witnesses, who stridently oppose giving blood, support organ donation so long as all blood is drained from the organ before transplantation. The remaining few anti-donation religions are simply wrong. Given how common it is for religions to support immoral practices, the near consensus on organ donation is striking.

Yet it misses the mark to focus solely on refuting arguments against organ donation. The main cause of this country's appallingly low donation rate is simple laziness. People don't bother to sign up for donation or to explain their wishes to their family. They default to non-donation.

Luckily there is a simple and powerful fix here: change the donation system from opt-in to opt-out. We should presume that a person wants to donate his or her organs, and place the burden of proof on the would-be donor to leave the system.

Naturally, in a pluralist society we would have to have a smooth and efficient process for opting out for those who do have serious immoral objections. Nevertheless, a strong cultural presumption in favor of organ donation would accompany an official opt-out system. People need to begin seeing organ donation as a taken-for-granted part of life, like paying taxes and driving on the right side of the road. Organ donation is not, and should not be seen as, a special act of charity, but rather a requirement for a decent human life. Much of Europe has shifted toward opt-out systems, and seen large increases in donation rates.

Organ donation offers a beautiful chance to turn one death into many lives. How could anyone be so selfish as to refuse that?

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