Not Without My (Rotting) Spleen

British PM Gordon Brown floated the idea on Sunday that Britain should convert to an “implied consent” system of organ donation. If cranky Internet comments are any indication, Brown is taking a lot of flack for the idea- and British papers seem to be in the act too, choosing to represent Brown’s plan with the quaint headline “Organs to be Taken Without Consent“.

For those not familiar with the implied consent system- which is already used successfully in Spain- here’s how things work. In the system currently used in Britain and the United States, the blanket assumption is that people do not want their organs donated. You must explicitly opt in in order to be considered as an organ donor. Here’s the problem: these opt-ins are often ignored or forgotten, even though most people claim to support organ donation, and only a comparatively small portion of the population has religious or other beliefs that lead them to explicitly reject organ donation.

Implied consent turns the assumption around. Everyone is assumed to consent to donating their organs in the event of their death, unless they opt out. You can opt out of the system for any reason: religious beliefs, irrational fears about EMTs smothering you with a pillow so they can gather your precious corneas, selfishness, or elective conformance with ancient Egyptian burial practices. Whatever. If, for any reason, you want your organs to rot in the ground, be burnt, or pickled in formaldehyde, that’s your right. You just have to care enough to fill out a form or sign your driver’s license, click on a link on the Internet, etc.

The net effect of such a plan is that anyone who actually cares enough to take a token action will still not have their organs donated- thus preserving the religious conformance of those whose beliefs dictate a need to keep their organs around after death- whereas people who never cared enough to have an opinion may have their organs used to save lives.

The notion that this will result in organs being taken “without consent” seems like a red herring. Anyone who cares even slightly about retaining their organs can easily make their wishes known through a registry. Everyone retains the exact same rights over the disposal of their corpse that they know have; Brown is just proposing that we change the default option in a way that will benefit many, many people.

If someone has an organ removed from their dead body because of laziness or indifference, it’s little enough tragedy. Not so with someone dying for the same reason.


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