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Organ Donation: The New Presumed Consent Policy


On December 12, 2017, the UK Government Department of Health announced that England is considering reforming the soft “opt-out” organ donation program. The announcement was met with broad cross-party support and the policy reform is currently in the open public consultation phase. The government is taking public feedback for the next ten weeks. This potential policy reform raises the possible notion of a similar overhaul here in the United States.

There are currently over 116,000 individuals on the US national transplant waiting list. In 2016 33,611 transplants were performed. According to the US Department of Health and Human Services, 95 percent of US adults support organ donation but only 54 percent are actually signed up to be donors. Organ donation recipients depend on there being a large group of registered donors because, in actuality, only three deaths in 1,000 happen in a manner conducive to organ donation. Ultimately, it comes down to a numbers game; we can only help as many people as there are viable organ donations.

Currently in the United States, people must expressly opt-in to organ donation, most commonly done by registering at the state Department of Motor Vehicles or by registering with a state’s Organ Donor Registry. But what if we flipped that coin? Under the current opt-in policy, twenty people die each day waiting for a transplant. But what if we had to opt-out of being a donor instead? Meaning, if we didn’t purposely choose not to donate our organs, and our deaths resulted in transplant-viable organs, our organs would be donated to those in need. Obviously an opt-out policy would save many more lives.

The proposed UK policy will not come without safeguards. There is still consensus that family members can make the final call as to whether organ donation is still the last desire of the deceased. Additionally, doctors will not perform the procedure if they know doing so will cause duress to the surviving loved ones of the deceased.

Many humanist chapters in England have expressed support for the opt-out policy reform approach to organ donation. “After campaigning on this issue for many years, we are delighted to see the government is moving forward with a Welsh-style opt-out organ donor register in England,” says Richy Thompson, the director of public affairs and Policy for Humanists UK. “By having the confidence to address this issue head-on and move past people’s taboos, we can create a more rational and more humane model which will save countless lives while protecting individuals’ right to choose.”

Humanism is an evolving off-shoot of Utilitarianism, an ethical system that centers on the principle of doing the greatest good for the greatest number of people. We all should aim to contribute to each other’s health and wellness, especially when science can make that a real possibility. A single donor has the potential to save up to eight lives.

As explained in the Humanist Manifesto III, humanists endeavor to lead ethical lives of personal fulfillment that aspire to the greater good of humanity. As a part of recognizing the inherent worth and dignity of every life, we as humanists can pay homage to the fragility of life by generously agreeing to donate lifesaving organs when we have finished our own course of life.

Still, efforts at organ donation consent policy reform in the US have been fruitless. Colorado, Texas and Pennsylvania legislators, for example, have pushed for presumed consent. Ted Kennedy Jr.’s attempt at introducing an organ donation “opt-out” policy in Connecticut was met with strong backlash just last year. The engrained American value of individual rights superseding that of a menacing government could be the source of this initial pushback, but one would like to believe it could be overcome if the American public was more aware of the current organ shortage gap.

We as members of the humanist movement ought to heed the the call for a new presumed consent policy. This should not be an uphill battle as we already have popular opinion on our side: public opinion polls have shown most Americans actually want to be organ donors. At the very least, we can get the discussion started.

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