Proposal: All New Yorkers Become Organ Donors
Assemblyman Brodsky Earlier Introduced a Bill That Would Have Made Organ Donation the Default Position for Every New Yorker.

You know you are on to a scam when a proposal redefines basic language.   This politician has suggested that who is a donor should be decided by the state.

That’s kind of like the mandatory volunteer corps the US House of Representatives voted on last year.
This shouldn’t come as any surprise, however. Organ donation has never been about informed consent. I doubt if most people who give permission to have their organs removed realize they are authorizing the removal of those organs while they are still alive.

Many people think that if they die in the parking lot of a hospital they can have their vital organs removed and given to someone else. They cannot. It is too late. Most organs (the cornea might be one exception, for example) must be taken from your body while you are still breathing and your heart is still beating.

There were no legal organ donations of vital organs in the U.S. until after the AMA changed their definition of death in 1973 from the previous definitions of irreversible cessation of respiration and circulation (your heart stopped and you stopped breathing, and no one could resuscitate you).   These, of course, are Biblically-based definitions of death.

There were several awful consequences to this new legal phrase: brain death.

First, of course, there was no settled definition of brain death (and there still isn’t!). At last count, there were about 23 definitions of brain death.

Second, only a new definition of death could justify the removal of vital organs. So, “he’s dead now, we can take his organs” could be said legally, if not sincerely. This death was by decree, not by science or rationality. In fact, the legal change of definition that followed the AMA’s change would be in the face of contrary evidence. Before the definition was changed, several “practice” studies were done using the new definition and resulted in calling some patients “dead”. It carried no legal authority so no organs were removed, of course. But shockingly (to those wanting to change the definition), several of those that had been declared “dead” would come back to life.

Third, declaring people dead while they were still breathing and their hearts were still beating would more easily justify the removal of life support mechanisms. Instead of letting someone die (which arguably is justifiable in some cases) you would simply remove machines from people who were “already dead”.

These changes have had one other sorrowful result. The line between death and life has been blurred in the eyes of the public. When Terri Schiavo was dying of thirst, many journalists defended what was done to this poor woman because she was “brain dead” anyway.

Now, some want to take organs from unwilling “donors”.  What was questionably “informed consent”  may soon become “presumed consent.”   Will death panels be even more encouraged to assign people to death, when there is the added “incentive” of finding good organs for harvesting?

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  1. Secondhand Smoke over at First Things has a lot of nightmare inducing bioethics stuff, including this.

    Europe has presumed consent.

  2. Mr. Shedlock, very interesting article. The bioethics of organ donation has always been a subject that was very interesting to me and I have spent some time thinking and researching it. I don’t have the time to get into point by point discussion of your article, maybe some time in the future. But a few things:

    I would say you may be giving the current system of “informed consent” a little too much credit. True informed consent requires much more than a DOT worker asking you “Do you want to be a donor?”. That is not informed consent.

    I haven’t read the the New York bill, but every presumed consent program that I am aware of (a few in Europe) have an opt out system. It reverses the current system where it is presumed no unless you opt in, to presumed yes unless you opt out. So no one is being forced into it. I would advocate a “mandatory decision bill” where at 18 you must either consent or not consent and this would be on your permanent medical record and could be amended at any time, but your wishes would be on file and would not be your families decision when they are already going through a difficult time.

    I am actually an advocate of paying people to be living kidney donors. I have done a lot of thought/research into this and hope to have an extended article about it in the future.

    1. Dustin wrote: “I would say you may be giving the current system of “informed consent” a little too much credit”

      Perhaps I was too subtle. I thought I made clear with my title and the following quote that I don’t see any “informed consent” either.

      I wrote: “Organ donation has never been about informed consent. I doubt if most people who give permission to have their organs removed realize they are authorizing the removal of those organs while they are still alive.”

      I don’t see it is the government’s job to mandate me making a decision. I am even less in favor of a system that requires me to affirm that I don’t want to be killed. I prefer the assumption that people don’t want to have organs taken from them while they are still alive. I am heading the opposite direction you suggest.

      If organ donation is going to be allowed at all it ought to require more knowledge than what you admit is the case today. I would argue that the very practice of killing some people to save others is repugnant to Biblical ethics. Even Christ voluntarily laid down his life. The only organ donations that are acceptable are ones that either allow the donor to continue living (giving one kidney, for example, or bone marrow) or ones that can be given after one is completely dead (and not mostly dead) such as cornea transplants.

      1. It occurs to me that opting into something, with the assumption that you will do the homework yourself, is worlds away from having to opt OUT of doing something, with the assumption that you’ll do the homework yourself.

        Plus, what happens when the paperwork gets lost?

        “Oops.” *shredder sounds*

  3. I am a huge advocate of organ donation since my 25 year old cousin received the heart he needed to live. But donation is the keyword. Since as you state the body cannot be dead to harvest this is something that each family must decide on their own.

Comments are closed.

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