There are some ethicists who believe all organ donations must be mandatory and the option to opt out of the program should only be granted in limited conditions concerning religious beliefs or impaired mental state of the donor at the time of death.
The assumption upon death should be the organs of the deceased belong to the corpus of humanity and — as a matter of believing in each other — those organs must be recycled to keep the ill alive. 


The healthy do not need healing, but it is always the healthy majority that decides the fate of the infirm minority.
The idea of mandatory organ donation has been kicked around since 1987 in an attempt to save 2,000 lives a year in the United States that die waiting on the organ transplant list:

Dr. Nelson cited research by the United Network for Organ
Sharing that said 2,077 people died in 1990 while waiting for a
transplant. Studies also show that 3,000 people are awaiting heart and
liver transplants and an estimated 30 percent of them will die waiting,
he said. In addition, 19,000 people are candidates for renal
transplants, and 30,000 people currently receiving dialysis also could
benefit from a new kidney, he said.
Dr. Nelson said a 1978 Georgia law could serve as a model. It provides
that, upon a request from an eye bank, an eye or a corneal tissue may
be removed from a newly-dead person as long as the person had raised no
advance objection and none is raised by relatives.

If we truly belong to each other
— and without each other we would perish — why should that covenant
not be continued in the event of a death that provides harvestable
organs?

Forensic pathologist H.E. Emson contends that since our
bodies are “on loan to the individual from the biomass” and constitute
“a unique and invaluable resource”, control over cadavers should be
vested in the government as a trustee for potential organ recipients.

The Israeli Organ Donor Network and The Halachic Organ Donation Society both suggest it is fine for Jews to donate organs to others who need transplants to live:

The HOD Society disseminates information regarding Halachic
issues and Rabbinic opinions concerning organ donation and offers card
carrying membership in a society that allows people to donate organs in
accordance with their particular Halachic belief.

We have mandatory vaccine policies. We have mandatory ages set for
driving and for the purchase of alcohol. We have mandatory quarantines
for certain illnesses. All those mandates were created to serve the
greater good beyond selfish individual interests.
Why not have mandatory organ donations as the default interaction
between the living and the dead for the greater goodness in all of us?

30 Comments

  1. I’m in favor of mandatory organ donation, as long as there are safeguards to prevent trafficking and executions to obtain organs. Maybe we could make it a “default” with provisions to opt-out for religious or other reasons.
    The concern that trafficking and executions could occur to obtain organs is not a remote fear. It’s happening in China, according to reports.
    From the U.S. State Department:

    As you know, reports of Chinese authorities removing organs from executed prisoners in China, without the consent of the prisoners or their families, are not new. The Hong Kong and London press carried the numerous reports as early as the mid-1980s, when the introduction of the drug Cyclosoporine-A made transplants a newly viable option for patients.
    Our concern about such practices is also not new. We repeatedly raised this issue with high-level Chinese officials throughout the 1990s, pressing for changes in Chinese policy and practice, and urging changes in China’s legal and medical systems to ensure the protection of individual rights and the guarantee of due process. We have also covered the issue of organ harvesting in our annual human rights report on China to put the spotlight of international attention on this issue. We consider organ harvesting from executed prisoners, without permission from family members, to be an egregious human rights abuse that violates not only international human rights law, but also international medical ethical standards.

  2. Hi Chris!
    I agree with you on the protections that would need to be set in place to prevent organs trafficking.
    I’ve always found it interesting in the United States that it is illegal to sell your organs or to purchase organs — but the hospitals and doctors can profit from the installation and exchange of those very same organs.
    The donor gets nothing but a good feeling, the recipient gets a new life and the medical establishment reaps the profits. Organ donation should be federally subsidized in all aspects to guarantee there is no financial gain to be had from any decision made along the donation pathway.
    I also understand some feel there needs to be a new tax invoked in a mandatory organ donation program where the recipient would need to pay a tax for receiving the donated organ “gift” because that gift has value. The donor would get a tax deduction based on the value of the donated organ (or, in the case of the deceased, the family could claim the tax benefit). That tax money would then be reinvested back into a universal organ transplant program to make mandatory organ donation self-sustaining by generating its own revenue stream.

  3. The taxation idea to make the program self-sufficient is interesting. The one problem might be that the organ receipient might not be able to pay a tax because of the financial hardship associated with expensive organ transplants.
    I don’t necessarily like universal health care, but since medical care is so expensive we might need to start thinking about ways to subsidize medicine for all people. We’d have to be careful that the system didn’t become bureaucratic and inefficient like many other government services. We’d also have to maintain incentives to continue innovations in medical care — the fear being that the easiest way to cut costs is to cut expensive new treatments and clinical trials.

  4. Hey Chris —
    I agree taxing the ill for a life-saving transplant could be unfortunate and might very well force only those unable to pay the tax out of the program. That would be unfair.
    I think universal healthcare is a necessity — but I don’t see it happening in America any time soon. There are too many vested interests in the process right now who would sabotage any inkling of change and to disassociate their monetary ties would be extremely difficult.
    We need medical innovation and if there were a way to guarantee a universal healthcare system that would not prejudge or unfairly bind those in need and unable to defend their healthy interests then I’m all in for making it happen.

  5. Too bad we don’t have universal health care and higher education.
    Both have inflation rates that price many out of those markets, or place those who utilize them into back breaking debt.
    Even with insurance coverage, often co-pays and non-covered items create a finanical burden.
    High medical costs aren’t necessarily good for the providers, either. The only hospital in Gary, Indiana might be closing because it’s losing $2 million a month.

  6. Hi Chris!
    I would love universal MANDATORY higher education as well!
    😀
    Something needs to be done. Costs are rising and the poor become poorer with every passing day. We are heading into an even worse stratification of the well-to-do and the poor in America and that can lead to great civil distress and psychic unrest.
    “Back-breaking debt” is right! It should not be that way in America.
    Let’s hope we’ll see some change soon. I loved it when Hillary headed up universal healthcare effort — but the tease of the broken promises in the end were too hard to take.

  7. It’s hard for the middle class as well.
    One might make a relatively nice salary, but when it comes time to pay the student loans, mortgage, utilities, car payment, insurance, etc., there isn’t much left over to save for the future. (And, this isn’t paying for top notch items — I can’t see how people afford to buy their McMansions and Escalades).
    Working more (or at a job that might pay more but require longer hours) is always an option, but there are familial costs to be paid by being away from the family more.
    Working in the city is always an option, but there are increased expenses that often offset the increased pay in the city.
    I’d be able to save a little if I didn’t have to pay for insurance and my student loans.
    Too bad I can’t sell an organ to the highest bidder to pay off my student loans! (Just kidding).

  8. Chris —
    You are absolutely right we have a “Working Poor Middle Class” in America and many families earning $100,000.00 USD a year and living in a nice house with a nice car and kids in private school are living paycheck to paycheck. If a paycheck were missed — due to layoffs or even simple bank error, the entire House of Cards they’ve been living in would come tumbling down around them as their entire lives suddenly become overdue.
    That despair in the Middle Class leads to great debt and, specifically, credit card debt because it is so easy to get and nearly impossible to ever rid of by paying off the balance due.
    I have friends with excellent jobs who have credit cards with at 30% Vig because they are financially over-extended in other areas of their lives that they cannot immediately cure or reduce. They must have the credit card – at any interest rate — for convenience or emergencies or just because they can’t really buy anything online without that kind of purchase verification.
    The temptation to sell organs for profit is certainly tempting for many — and you know it happens a lot in America. The surgeries are done elsewhere but the exchange of cash is all American.

  9. I’m glad we have a plan, Dave!
    Oh, and we could make this even better by making our donors soldiers in the military.
    When they finish their donation career at age 18 — and before we retire them on a federal salary with full benefits — we’d ship them over to the latest war we’re starting and have them hold the front line. You only need one eye and one arm to shoot a rifle, right?
    The whole world knows “These Colors Never Run” so only having one leg isn’t that big a deal since only hopping forward would be required because retreat is never an option.

  10. I don’t think any religion prevents organ donation but I don’t know about transplantation of animal body parts though. There is no religious law in Hinduism that stops someone to donate an organ but there are numerous superstitions, customs and beliefs those keep a person away from committing to this. I 200% agree with you, education is the only eye opener.
    I am donor here and that concept perturbed one of my friends, she asked me – ‘’what if something happens to you here, your parents won’t get to see your body for the last time?’’ I replied – ‘’that won’t bring me back but some of my organs might bring back someone’s life – that is more important,’’ and I believe it.

  11. Hi Katha —
    There are some Jews who believe organ donation is a “mutilation of the body” and refuse to participate, but more and more Jewish leaders are encouraging organ donation as the “ultimate mitzvah” of all mitzvahs:
    http://www.myjewishlearning.com/lifecycle/Death/Issues_in_Death.htm
    Here’s an interesting link on pig valves planted in Jewish hearts:
    http://judaism.about.com/library/3_askrabbi_c/bl_pigs.htm
    I am glad to know you are a donor, Katha! My New Jersey Driver License says “Organ Donor” right on the front.

  12. My Indiana Driver’s License has a heart imprinted on the card right under the “Donor” label — they ask you what you want to donate and they record it in the computer, if I remember correctly.
    I told them “any needed organs,” so I assume the heart is the symbol for anyone who is a donor.
    It would be cool if you could have an eye, liver, or whatever particular part you’d like to donate on the card to designate what you want to give. 😉
    I saw in the news that someone had a “reverse transplant” in England. Doctors removed a transplanted heart when the original equipment started working correctly.

  13. I type faster than I think sometimes.
    Right after “when,” in the last paragraph, I should have written: “when receipient’s body rejected the transplanted heart. The original equipment started working correctly.”

  14. Dave —
    A sticker is interesting!
    I think you can fill out an “Organ Donor Card” and carry it around in your wallet if you don’t have a license.
    I understand the point you’re making about organ donation being a private decision like donating blood. I’m just opening the spigots for discussion…

  15. Chris —
    I love it how you correct your own record!
    😀
    Thanks for telling us how it works in Indiana! The heart icon is pretty cool and it would be fun to see a whole list of goodies we’re willing to give up!
    The “reverse transplant” is wild!

  16. Hi David!
    I haven’t been on the computer since passover began – hence why my article is running a little late – but i thought I’d chime in here.
    Someone gave a talk about organ donation in a class I took a few years ago – and one of the things brought up was the HODS – thanks for reminding me of that. I just signed up for it after reading this. I hope this article brings about many volunteers. 🙂

  17. you truly believe that the an individual should give up their rights and freedom to their own body because the government believes they have a right to and know what’s best for the person’s organs more than the person who is forced to give them?

  18. Hi matt —
    Welcome to Urban Semiotic and thanks for the interesting question!
    If the people are too selfish to volunteer their organs after their deaths, then isn’t it the government’s vested responsibility to step in and do the right thing in the best interests of the people?

  19. About 60% of the organs transplanted in America go to people who haven’t agreed to donate their own organs when they die. As long as we let people who refuse to register as organ donors jump to the front of the waiting list if they need a transplant we’ll always have an organ shortage.
    There is a simple way to put a big dent in the organ shortage — give organs first to people who have agreed to donate their own organs when they die.
    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren’t willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.
    Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. They do this through a form of directed donation that is legal in all 50 states and under federal law. Anyone can join for free at http://www.lifesharers.org or by calling 1-888-ORGAN88. No one is excluded due to any pre-existing medical condition. LifeSharers has 6,525 members, including over 600 minor children enrolled by their parents.
    David J. Undis
    Executive Director
    LifeSharers
    http://www.lifesharers.org

  20. David:
    Thanks for welcome.
    If you think the LifeSharers strategy makes a lot of sense, please enroll as a member. By doing so, you’ll increase your chances of getting a transplant if you ever need one. You’ll also make the transplant system fairer and help create an incentive for non-donors to become donors.
    It only takes a minute to join at http://www.lifesharers.org. It’s free, and it could save your life.
    Thanks,
    Dave Undis
    p.s. — if you think this subject is worthy, I’d be happy to submit an article for posting.

  21. David:
    I’m sending an article to the email address I found on your web site. It’s original and unpublished and I won’t send it anywhere else. Please let me know if it’s acceptable. I have others if you’d like something different.
    Thanks,
    Dave

  22. I agree with this, save someones life by taking organs of the dead. Dead people dont need them. This should be maditory under any circumstances. What are the organs going to do in a lifeless body? People who have something against it have not obviously understand the circumstances of this proceedure and what it could do.

  23. Hi,
    Im doing “Why Organ Donation must be mandatory” for my school speech. And i am with it. Many families will think that after they have the organs out of the body, that the body will he dis-figured. that is not true, That it one of the main reasons why families do not go with this. People die every day. In America 30,000 people are on the National Transplant list. Most of them die before they even get their organ/organs. Millions more are waiting to be put on the list. Every 20 minutes somebody gets replaced on that list, 70% of the time its because they have died, 20% of the time is because they have gotten their organ/organs. These are just a FEW facts on why Organ Donation must be mandatory.
    Thank you,
    Niall