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The state’s skewed line on moral issues makes me worried about giving it automatic ownership of our bodies after death

Under presumed consent I am not confident the state would feel a duty to treat a corpse with reverence after death or use it solely to help others live

By on Monday, 8 October 2012

The NHS is floating the idea of 'presumed consent' for organ donation (Photo: PA)

The NHS is floating the idea of 'presumed consent' for organ donation (Photo: PA)

Tom Bailey in the online magazine Spiked draws attention to the future possibility of “presumed consent” where transplant organs are concerned. It seems that the NHS is floating this idea as a change from the current rules governing transplants. At present, as Bailey points out, consent for organs to be taken for transplantation must have been given either prior to death or by the deceased’s family members after death. Changing to “presumed consent” would be that, unless you actively opt out, you will be “presumed” to have “consented” to having your organs used for medical purposes.

Bailey is opposed to this, arguing that it would mean an end to organ donation – based on motives of generosity or altruism; it would mean a kind of organ “conscription”. He quotes Professor John Fabre of King’s College, London, as saying that this idea “would degrade the ethical framework of our society… into one of the state taking back what it thinks is its, while intruding on one of the most personal and delicate moments of a family’s life”.

Bailey argues that such “presumed consent” would make our bodies properties of the state; “no longer would we be free autonomous individuals, but rather we would become nationalised property that the state reclaims after our death”. Although I slightly demur at the use of the word “autonomous” here, with its implicit sense that we exist outside a relationship with our fellow men, I agree with Bailey. Christians believe that we are bound in kinship to our fellows; that we are part of a brotherhood under the fatherhood of God. This means we have a certain obligation to our fellows as part of our common humanity – but it should not mean being forced by the state to surrender to it our earthly bodies after our death for their own purposes, unless we clearly set out our conscientious objection.

I write “for their own purposes” rather than Bailey’s “medical purposes” because I also have no reason to believe that “the state” would feel a moral duty to treat a corpse with reverence after death or use it solely to help others live, if it had automatic ownership of it. There are too many cases in the newspapers of disquieting and unethical scientific experiments for me to feel confident of the state’s moral rigour in this area. Looking at all the shifts in the supposed moral perspective of the Human Embryo and Fertilisation Authority makes one think that if so much is now permitted at the start of life, the state’s treatment of the end of life would be no different.

I was reflecting on all this when I read the headlines from LifeSiteNews: “One in five ‘brain dead’ patients still alive, claims lawsuit.” The article suggests that “coercion and abuse are becoming increasingly common in the highly lucrative transplant business”. A lawsuit against a major organ donation group, the New York Organ Donor Network, has been brought by nurse practitioner Patrick MacMahon who says the Network is putting pressure on relatives to accept a patient is dead when they are alive and could recover.

This is a large claim – but given the way markets generally operate, it is believable. MacMahon says that the market for viable organs is sales-driven: “You’re there to get organs. It’s all about sales… Counsellors are required to get a 30 per cent consent rate from families.” The top “counsellors” get a Christmas bonus, he says. His suit cites one alleged case in which a 19-year-old car crash victim was struggling to breathe and showing signs of brain activity, but doctors signed off on the “donation”. A former employee of the New York Organ Donor Network, MacMahon was sacked after raising his concerns with the president of the network. He describes some gruesome scenes that he has witnessed, where patients were, he claims, killed for their organs. (A spokesman for the network told the New York Post that the claims of a quota system were “ridiculous”.)

In his 2008 address to the Pontifical Academy for Life’s conference on organ transplantation, Pope Benedict warned: “Informed consent is the precondition of freedom, so that the transplant has the condition of a gift and cannot be interpreted as an act of coercion or exploitation.” Exploitation occurs because of the demand for organs and because doctors themselves are divided on the meaning of “brain death”. Indeed, an article in 2008 by Dr Robert Trugg of Harvard Medical School in the New England Journal of Medicine, cited by LifeSiteNews, suggests it is a sham, unsupported by the scientific literature: “Although it may be ethical to remove vital organs from [brain dead or cardiac dead] patients, we believe that the reason it is ethical cannot convincingly be that the donors are dead,” he writes. Some doctors even think that the criteria should be changed to “dying” or “severely injured” patients.

I have always worried about the concept of “brain death”, knowing that for organs to be transplanted when they are viable ie fresh or healthy, the patient has to be kept in a kind of suspended animation. For this reason I haven’t (yet) signed a donor card, even though some years ago a person I slightly knew was asking for people to do just this as her own daughter, who had cystic fibrosis, needed a heart-lung transplant. My decision not to do so made me uneasy then and it does now. What is the answer?

  • Benedict Carter

    I pity the person who gets my organs. Particularly my lungs. 

    Surely one can cary a card refusing to give permission for the doctors to steal your innards? 

  • nytor

    “future possibility of “presumed consent””

    Not just a future possibility, if you live in Wales.

  • scary goat

    I used to carry a donor card.  I stopped when they put ovaries on the list.  I know you could cross it off, but I didn’t feel comfortable.  I don’t mind giving something that would help someone else to have a chance after I’m gone, kidneys etc. but not ovaries….that’s different.  So if they bring in “presumed consent” do we get cards where we can state specifically what we don’t consent to?

  • Jonathan West

    I see. So our bodies are our own, even after death, but a proportion of our money (according to the german bishops) belongs to the church, and can be taken by the state to pass on, even though we are still alive.

    It seems that different people have different ideas about the extent to which the state is trustworthy.

  • Timt-robertson

    I agree, the state cannot be trusted to treat our bodies with due respect, or even to keep us alive while in hospital. According to a report in this week’s Sunday Telegraph, 43 hospital patients starved to death last year and 111 died of thirst while being treated on wards. 

  • JabbaPapa

    Catholicism teaches exactly nothing about this question.

  • JByrne24

    There is no answer. We must try to do what we consider to be our best in each situation.

    Within the NHS (in the UK) the risk of being “signed off” prematurely as a donor, because of the profit motive, would be small.

    It is surely a fact that many people needing transplants are presently dying because so many never get-around-to-it (i.e. the signing of a donor card) – and keep putting off the matter.

    But these questions should never be left to people with bachelors degrees in medicine. 

  • JByrne24

    It is possible to opt-out of this amazing ecclesiastical relic, and to be then kicked-out of the Church. Applies to Catholics too. 
    It certainly saves the trouble of agonising about whether you should choose to go, or to stay.

  • teigitur

    What have you chosen Mr Byrne?

  • theroadmaster

    Once life becomes degraded and cheapened at both ends of the spectrum of life i.e conception and old age, then it would only be a matter of time before human bodies were regarded as being of less value than the sum o their parts and internal organs.  The prospect of the harvesting of human organs under the guise of “presumed consent” is like a scenario that one would encounter in Aldous Huxley’s “Brave New World”(1932) which foresaw state control over the destiny of people in a future utopia, which in reality would be a dystopia.  The violation of the dignity of human beings in life and in death is completely at odds with biblical revelation concerning the status of mankind in God’s Creation.  Catholic voices need to be heard to defend the innate worth of each person and in clear opposition to any ideology which undermines this.

  • Papa Sisto

    At the moment, it is very simple.  When you registered with a medical practice (i.e, a GP), you should have filled out a form, which gives the option of allowing the state to take some or all of your organs.  Similar forms are included on applications for driving licenses etc.  If you don’t know your status, check next time you go to your GP or just call them direct.  If informed consent comes in, they you will have to contact your GP or your local hospital to get them to put you on the “not giving” register.  

    Personally speaking, I am quite happy for the NHS to use any bit of me they would like.  I won’t need it wherever I go, after all.  JabbaPapa says that Catholicism teaches nothing about this question (not being a Catholic myself, I defer to him), but I would assume that one’s immortal soul is more important than one’s mortal body, surely?  

  • Benedict Carter

    I am not necessarily against in principle. I DO object though, and strongly, at the State’s over-mighty power over anyone, whether in tax, education or on any other issue. 

  • scary goat

     I DO object in principle……not to giving…..they are welcome to take any part of ME they want to help others, but I don’t think the state has the right to take anyone’s body parts without consent. Included in the list of donatable body parts are ovaries.  This has implications way beyond simply taking organs.

  • scary goat

     These are completely different issues and in different countries.  A lot of people are objecting to the German Church tax situation.  I am not keen on the Church tax….but having said that, I think the intention is more to do with “sorting sheep from goats” than anything else.  The Pope is German and probably understands the mentality of his own people.  It might seem odd to us, but we aren’t German, and don’t have the same historical context.

    This body parts thing is here in our own country, and Catholics are at odds with some of the medical practices of this country.  Personally I don’t object to donating my body parts, but I would object very strongly to the state potentially taking my ovaries. That’s the problem with presumed consent…..they can help themselves to anything if you happen to die without making your wishes known.

  • Benedict Carter

    Yes, I agree with your stance Scary. You expressed it much better.

  • Kevin

    The answer is that there is no shame in being terrified of the evil secular regime we live under.

  • scary goat

    I just had another really bad thought on this one actually.  “Presumed consent” has got to be a very bad precedent to set, because if we have the notion of presumed consent, what else can that be applied to? Euthanasia comes to mind.  I’m no expert on this, but I’m guessing there is some sort of presumed consent to give medical treatment if a patient is unable to give consent, but that’s a positive, a giving.  This is about taking. It may be that the intention is good….to provide organ transplants…but there has got to be another way to go about it which doesn’t involve setting a dangerous precedent.  A big advertising campaign…..then send out donor cards to everyone, through employers maybe, and in every social security letter? I think I’m going to be prepared for this….I’m going to get a donor card and state clearly what they can and can’t take.

  • JabbaPapa

    Apostasy is what he’s chosen.