University of Sussex Students' Newspaper

Is the opt-out organ donation policy ethical?

Rebecca Spencer

ByRebecca Spencer

Feb 18, 2020

The Big Debate is a regular Badgerfeature which brings the spirit of competitive debating to the printed page. Two writers tackle a contentious topic, representing polarised views. They might not agree with what they write – on this page, they represent a viewpoint, not an individual. This week, they discuss if the state should be able to impose organ donation on all those who do not ‘opt-out’?

YES

By Cloe Grampa

From Spring 2020 the law regarding organ donation will be changing, meaning that all adults in England will be considered organ donors unless they opt-out. 

One of the reasons why the state should be able to impose organ donation on all those who do not opt-out, is to save more lives. According to the Organ Donation website run by the NHS, there are 6,185 people waiting for a transplant in the UK, and only 3,300 transplants have been carried out since April 2019. 

According to a BBC report, last year more than 400 people died waiting for a transplant. The government has claimed their new ‘opt-out’ system could potentially save up to 700 lives a year. Once a person has died, it is in the main interest of the state to be able to offer support to those who are still fighting to survive. 

In a sense the state should be allowed to do everything it can to help those who still have a second chance at living, therefore the ‘opt-out’ system is good to serve this purpose. Furthermore, the compulsory donation of organs, unless the person opts-out, increases the chances of families having this very important conversation. According to the new law, families would still be able to withdraw consent if they believe that the deceased person would not have wanted to donate their organs. However, starting with the assumption that a person would donate unless they opted out, increases the chances of families saying yes to the donation. 

In the current ‘opt-in’ system, those who want to donate have to record their decision on the donor list, meaning that all those who could be potential donors but never registered will not be counted as donors. Currently there are many bodies being buried or cremated that contain valuable organs for someone whose life is at stake. The change in the law aims to provide more hope for those who are still waiting for a transplant. 

Furthermore, organ donation can be considered an act of giving to the community. Whether the organs are used for a transplant or for medical research, donating becomes a service to others and to science. If you or a member of your family had a long-term organ disease and was in need of a transplant, you wouldn’t want to wait months or even years to receive the organ needed. As mentioned above, it is in the best interest of the state and the national health service to increase the likelihood of survival of those who still have a chance at life. 

Many people feel like the state should not be able to do so because they are scared that if they are automatically registered as organ donors, hospital staff will not try to save their life as hard as they would if they were not donors. However, this is a myth that needs to be debunked because if a person is found in a life threatening situation, medical staff are going to do all that is possible to save that life without thinking of how their organs are going to save someone else’s life. There is in no way a list of ‘worthiness’ when it comes to life-saving. 

It is also important to notice that the state, when the law is implemented in March, will not be able to go against the will of the family of the person that died. In this sense, the state does not have full power in deciding what to do with someone’s body the moment they die. If a family decides that the person that died should be not be used as an organ and tissue donor, even though they did not opt-out, the state does not have the power to overrule that decision.

Although death is a very delicate moment for grieving families, the state should not have to ask for consent to use the organs to save other people’s life.

If you are wondering how someone’s death and the subsequent donation of their organs can help a grieving family, the best example is the case of Max and Keira. Keira was a 9 year old girl who died in a tragic car accident in July 2017, and following her death her father decided to donate her organs. The donation of her heart ended up saving Max’s life. 

Keira’s dad stated, “Meeting Max and his family bought us some comfort and it was really helpful to see how powerful organ donation is. Keira lives on in Max and the other people she helped and we are super proud of her.” This is a powerful example of someone who has lost their precious child but found solace knowing that the donation of her organs has saved the life of another. 

However traumatic and tragic someone’s death is, their body is going to be either buried or cremated, destroying important organs. It is understandable that the idea of having your loved one cut open and their organs and tissue taken away is upsetting, however, knowing that your dear one is helping someone else to stay alive can even help the grieving process. The opt-out system will both prevent deaths and help us to preserve the legacy of lost loved ones.

NO

By Rosanna Weber

When I go through my wallet, I usually find an endless amount of old receipts and loyalty cards for coffee shops I cannot even remember having been to. Something else you can be sure to find is a laminated pink card with a heart in the middle of it. 

It says, “NHS Organ Donor Card”. I got it about two years ago through the NHS online website. All you needed to do is print out the card and sign it at the back, stating that you are willing to donate your organs, in case of death. 

I decided to become an organ donor for no particular reason, mainly because I do not see any need for my organs to rot six feet under or to be burnt to ash. If they are in good condition and there is even the slightest chance for someone else to receive them, I think this choice is worth-while.

Though I do believe organ donation to be crucial and important, I also believe that the UK’s new law around organ donation to be undemocratic and unethical for several reasons. This new law is to become an ‘opt-out’ system by March 2020.

Organ donation is an emotional topic,  as lives depend on it.  Less than 70 years ago, the first successful kidney transplantation was performed. Nowadays, modern medicine enables thousands of transplants to be performed a year; nothing short of awe-inspiring.

But there are still 6,185 people who are waiting for a transplant in the UK. Because the need for organs has always been higher than the number of donated organs, the opt-out system seems like a great way to solve this problem. 

As a supporter of organ donation myself, this seems like a fair deal: everyone is a donor and with that, the figures of after death organ donation will hopefully be increasing. Everyone can still decide against it and opt out, if they wish to do so.

What is problematic about this new law is the question of autonomy. After all, automatically being a donor by the power of legislation from the age of 18 and onwards is not the same as willingly agreeing to donating organs and signing a pink card, like I did. It is not consent; it is presumed consent. There is a difference. 

The right to decide over your own body in life and after death is a form of freedom that should not be played around with by government legislation. It is an interference with your right to self-determination. Many people have spiritual or religious beliefs, and forced organ donation compromises the sanctity of this. 

Yes, you can opt out at any time. But, the right to autonomy over your own body is a fundamental right because it is something you are born with; you do not have to earn or do anything for it, except to exist. Such legislation can feel invasive of one’s own being and human rights. 

This is taken away from you by making you opt out of something you really should have had to opt in for. Your right to physical integrity should not be given to you by the act of filling out a form saying you want out. 

You should be entitled to it from the very moment you are born.

After all, a donation, which comes from the Latin word donatio, means a voluntary gift. It is not a donation if not done by your own choice and free will. In a system where this is merely a presumption, it is no longer a voluntary gift.

Opt-out culture is a phenomenon that isn’t occurring for the first time. Signing up for Facebook and Google comes with a gift basket filled with an endless amount of privacy concerns. How does Google know I’m planning a trip to Tuscany? Why is there an ad for the exact same pair of shoes I’ve been looking at yesterday? 

Unless you want to receive personalised advertisement for the price of nothing less than your most intimate secrets, you must opt out of a process that you never voluntarily agreed to in the first place. Any kind of trend towards an opt-out culture is another small slice of our autonomy being taken from us and is a further step away from freedom and liberty.

I still carry my Organ Donor card with me, somewhere between the old receipts and loyalty cards I never use. In the end, this is what consent means. An informed choice that you make. Not presumed consent, which is really no consent at all.

Only then can we ensure that these life-saving donations are voluntary and not enforced on us by legislation. We shouldn’t undermine one of the most valued aspects of life in the modern world: the freedom to decide over our own body.

To anyone who has further questions about organ donation:https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/

Image credit: Johanna Kollman

Leave a Reply