For as long as I can remember, I've wanted to be an organ donor, and - as with my plans to emigrate - I've no real reason as to why I've always wanted to be such, I just have. I've always felt that it was right: that when I no longer need my organs, someone else should benefit, and perhaps extend their life, for however short a period. Obviously, as with my characteristic idealism, I can fairly happily ignore all of the ethical implications my wanton myopia suggests; it is not until I get down to the nitty-gritty that I realise there is fair debates on either side. This is unlikely to ever sway me, because emotion will always oust logic, even when the latter is so patently obvious. This, however, alludes to the main issue which arises when debating the ethics of organ donation: separation of emotion and rationalisation. The two are, evidently, inextricably linked, but the two also are not compatible in terms of logical and profitable discourse. It is up to the individual to decide which path they would like to take: the epistemological rationalist who views the act of donation as supererogatory, and thus inherently decent, but not morally obligatory; or the emotionalist who would either deem it a duty - axiomatically disparate from supererogation in the fact that not doing it would be morally wrong - or would feel duty-bound to not donate.
As you can see, it's an absolute minefield of horrible language, and ludicrously complex concepts -- but that's ethics for you. For the uninitiated, or the uninterested, it boils down to whether you think with your heart, or with your head. The head can lead you two ways: what is good, and what is right; and the heart can lead you two ways: what is dutiful to your own autonomy, and what is dutiful to a super-being.
As with pro-choice/pro-life arguments around abortion, the idea of autonomy is a crucial one: the idea revolving around the idea that anything you want to do with your body is your decision, and your decision alone. The question in relation to state intervention needs slight tweaking: do ideas of autonomous individualism supersede state ideals? As a blanket idea of course autonomy trumps state intervention, but when applied directly to the question of organ donation you can see wherein the difficulty lies. One underpinning principle of democratic governance is that the state will do all in its power to ensure the health and ongoing security of the population en masse, and this would self-evidently lead on to assuming an 'opt-out' programme was for the greater good. The counter, naturally, is that the main sanctifier of one's security and safety is the preservation of one's autonomy: a more laissez-faire attitude to ideology, which imbibes all crucial decisions to the individual. So what do you think? Does autonomy trump the need for the maintaining of population and the health of the populace as a whole? Or does 'machine' obligation necessitate the opting-in to the programme? Are we individiuals working within a state, or groups working as individuals? As you will know, I am a firm believer in individualism, and thus it follows that I should be a devout and blind propagator of autonomy. I believe that one's ultimate control supersedes the rights of the newborn child, for instance, and that's why I am pro-choice.
The problem here comes because intervention does not necessarily automatically displace autonomy of self: an 'opt-out' programme intervenes with the mechanisms of the process, but does not demand a different opinion, ideology, or action. The idea is fallacy that one should opt-in if they believe it is right, but that to opt-out if they believe it is wrong would be an indiscretion. It seems discordant as the ideas are fairly interchangeable: impetus is still solely on the individual, it is just role-reversal. Obviously, because A equals B, does not necessarily mean that B equals A, but in this instance I think we can assume the similarity between the two systems. No, the objection lies because they see state intervention as the first-step to a utilitarian government; one based around autocracy of a select group of democratically elected people. At least, this is what I think the objection revolves around. It was hard to disentangle the why from the what, because when you throw emotion in, the two become intertwined and hard to extricate. The counter to this idea of utilitarianism could be called egoism (the idea that the self is of greatest importance), but perhaps should focus more crucially around the locus of slippery-slope fallacy. This dictates that one action that may lead to an end result is not necessarily going to lead there; in this circumstance: that just because the government would be taking a greater control of individualistic rights, does not mean you will end up with unilateral forms of government where groups are always put before individuals. This is the main recourse for the rationally uninitiated, the emotion surges through you, and you assume that "Oh, once we let them do this, soon we'll be under complete government control. Having to pay homage to them as their propaganda spews out of sound-systems." Yes, well, it's not 1984; and there are ways and means with which you could prevent this fallout. Not that you'd need to, because the idea that this intervention necessitates total governmental autonomy is frankly ludicrous.
You just have to think about whether or not an action for the self is always the right action, or whether an action for the group is always the right action. A balance can be struck, but in this situation, the two are inseparable. As the boring, infantile argument against happiness goes: "If everyone just lived for themselves, the world would be selfish, and would end." Well, no, because evidently one's happiness is most often sought in the happiness of others: you make yourself happy by being in a loving relationship and making the other person happy. So profligate individualism can work, in theory, but it depends on however zealously it is applied. As far as I am concerned, ideas of the self are normally the most important, and ideas that the 'group' is a separate concept are incorrect. By opting-in, by trying to help someone else, I am made happy: it is my own decision, for my own happiness; it is a latently selfish action, masked wonderfully by its supposed altruism, but it is one which benefits the group. You cannot take a 'group' stance which benefits the individual in this way, but you can take the reverse.
Let's take a short break, and have a recap:
1. Rationalisation vs. emotion. Ideas that we are duty bound to opt-in, or opt-out, of this mechanism.
2. Autonomy of self vs. governmental utilitarianism. Ideas that the greater good supersedes the self.
3. Utilitarianism starts a process which ends with utilitarianism. Debunked by the ideas of 'slippery-slope' fallacy. One does not always beget the other.
I don't want to force my stupid opinion on anyone who might be reading this, so hopefully you can see past the... fairly low levels of subjectivity (I did my best) and make your own decisions as to whether or not one's autonomy is the most or least important thing at work here. Now we've covered ideas of opt-in and opt-out, I will move on to ideas of priority, and how logic dictates emotionless decisions.
The Israeli government has introduced a policy which encourages people to become organ donors by giving them priority - and a legal right - over those who aren't registered on the organ donation list. This is also known as 'preferred status'. It is, however, important to contextualise this decision, before we just discount it as ignorant of individuals' needs. In the UK one-in-four people are registered as organ donors, in Israel the number remains alarmingly low, at one-in-ten. It would seem that something needed to be done in order to meet the demands of a country so desperately in need of it. Just quickly before reviewing whether or not I agree with this idea, I will outline the three other choices that places have:
1. Mandated Choice. This basically just involves directly asking people whether or not they want to be an organ donor (when they register a driving license, for instance). This differs from what the UK has, for example, where the question is never asked, and the impetus is solely on the individual to seek out how to register. You could call this Optional Choice I suppose, though that would seem tautological. This apparently increases the amount of numbers, and would seem logical as I can imagine quite a lot of the windfall is from two factors: i) that people forget to become one, and ii) that people are unaware how to become one. Seems only logical.
2. Presumed Consent. This is the idea that you have to opt-out instead of opting-in to the organ donation list. If you do not opt-out, it is taken as a given that you are happy for your organs to be posthumously removed for other people. Differs from preferred status because this does not guarantee a priority if the need arises.
3. Required Request. This is at work in quite a few places, as far as I am aware. This basically just involves the medical professional obtaining permission for organ removal from the deceased's family.
I) Issues arise with 'mandated choice' because numbers are not actually increased as highly as they should be. One question box with no information isn't enough to give people enough impetus to check it.
II) Seems the most viable, because countries which have adopted it have seen "adequate numbers" of donations to need (thanks to socialissues.wiseto.com). It would be fallacy to assume that this is infallible, though, because evidently numbers fluctuate: smaller populations may have a greater need, or a lesser, and so on and so forth.
III) The main issue that arises here is that familial relationships do not necessarily denote identical ideologies. A lot of times children are the products of their parentage, but it is not always. This can be applied to all relationships here: parent/child, child/parent, wife/husband, uncle/brother, etc.. What the 'alive' party wants may not be the same as the deceased: although obviously the deceased should make known what it is that they want done, this is not always going to be the case.
So there we are: different solutions and their respective problems. So Israel has gone for preferred status - which would seem an almost inevitable decision given their low numbers. This, however, may be suitable for them (although it does greatly increase governmental intervention), but according to lots of British people, it wouldn't be good here. It's not yet known how it is going to fall out in Israel, but I know it would go atrociously in Britain - whatever freedoms and lives it aspires to save. The main argument here seems to be 'rights vs. responsibilities' which I have covered briefly above (duty, etc.). The argument revolving around the fact that a person's responsibilities outweigh their rights. I would agree, suggesting that their rights are only sanctified by the responsibilities of others. The protection of rights is only because of the unerring responsibilities of the community at large. So, you can't really argue against that as far as I am concerned. It all acts analogously to the debate I spoke about earlier, however, and so I don't feel obliged to go into this too deeply.
As I have mentioned, the first issue is that people see it as 'right' or 'responsibility'. Not wanting to stray too far away from these thought processes, but there is an argument to be made that the two are synonymous in this context: that it is your inherent right to have societal responsibilities. It's a complex idea, but works concurrently with the idea that rights are only enabled and maintained by responsibility. Anyway, I won't go down there, because there's not a lot else to say -- you can decide. The second issue, apparently, is that of the 'state intervention': I've covered this at length, and won't go further into it. The third - and perhaps most pertinent - issue is that people against this idea of prioritising say "I am still a human and as such have the same rights as everyone else." Evidently, this has huge implications for all sorts of arguments: the death penalty, euthanasia, etc., and it is important to briefly look at these to see where this viewpoint is flawed. If we are all guaranteed a right to life - and thus in turn a right to autonomy - then evidently the death penalty is inherently wrong, as it goes against innate 'rights' (as dictated by what? Does this view preclude atheism?) This, however, is discordant when applied to the idea of euthanasia: the idea that rights are human, not individual, suggests that euthanasia should remain illegal, as a person does not have total control over what they do with their body; they are rather guided by universal, human obligations. Unfortunately, these two scenarios play out why 'natural' human rights are not guaranteed irrespective of life. Whilst freedoms are guaranteed and enshrined by different bodies, and by innate societal traits, they are repeatedly taken away by the state. You cannot use this argument solely for this idea because you do not apply it to other situations where it is necessary to argue along the same ideological lines. The issues are utterly inseparable, and thus you cannot cherry pick when you use it.
The other counter to this idea is that "it's mine, I'll do what I want, I want the same as everyone else" is a selfish idea. Well, as per definition, it is selfish. It is not necessarily 'selfish' in action, however: it is only natural to want the same rights as everyone else, regardless of their or your actions and behaviours. We cannot brand this view as selfish in practice, simply because it is born from enshrined human ideals -- not objectively ratified truths. People who argue against this view suggest that all people have the right to choose whether or not to donate an organ, but that choosing not to precludes the possibility of ever receiving one. This centres around the idea that because no one has a 'right' to an organ, it is only logical that those willing to donate will receive. Seems sort of fair, bit emotional mind. This is it though: the idea is contentious because horrible decisions have to be made every day. People's lives will be lost, and logic has to work as the main factor in the decision. That is why smokers die, and alcoholics, and fatties. That's how it works, unfortunately.
It is plain silly to suggest this idea of prioritising is "Draconian", because conceptually you are flawed. The arguments against the opt-out prioritising are almost self-defeating both in the language they use, and the ideals they propagate.
I will, just before I finish, lay one issue at the feet of the 'pro-opters'. There is quite often a split when the people harp on about "Oh yes I'm an organ donor" but then go on to say "but no one can have my eyes". It seems foolish to make a commitment, and then utterly undermine it: why bother? You've already precluded theistic ideals of the after-life - as it is a sin to desecrate the body - and so why would you need to retain certain parts of you? Evidently it is a difficult concept to engage with because it's 'horrifying' to think of your corpse without eyes. I never really got it, but ok, go with that half-gesture. It seems self-defeating and self-undermining, but I guess some organ donation is better than none. It's good to do what you can, and to view it as not just your responsibility, but your right.
After all, you can always get cremated.
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