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Grim Harvest: In Vermont, a Push for Organ Conscription

Wesley J. Smith

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A bill has been filed in Vermont for presumed consent to organ donation, and it would grant an explicit ownership interest in the organs of all dead Vermonters to the organ transplant system. From H.57:

All Vermont residents 18 years of age or older shall be presumed to consent to making an anatomical gift of some or all of their organs, eyes, tissues, or a combination thereof upon their death for the purpose of transplantation, therapy, research, or education. 

If someone doesn’t want to be an organ "donor" — they have to take affirmative action to say no, rather than — as is the law now in every U.S. state — opt in by saying yes:

(a) A Vermont resident may refuse to make an anatomical gift of the individual’s body part or parts by:

(1) including a specific refusal in an advance directive… 

(2) creating a written record indicating that the individual is unwilling to make an anatomical gift…

(3) including a specific provision in the individual’s will…

(4) completion of an anatomical gift refusal form…or, 

(5) any form of communication made by the individual during the individual’s terminal illness or injury addressed to at least two adults, at least one of whom is a disinterested witness…

That isn’t "donation." It is conscription.

Presumed consent apparently works well in Spain and some other more communitarian-oriented countries, but it would be a disaster here:

1. Presumed consent would sow greater distrust in the already profoundly distrusted health care system. If you think people are worried about death panels now, wait until people perceive that their deaths could be considered to have greater value than their lives if profoundly disabled or terminally ill.

2 Presumed consent could impact how medical professionals viewed the moral value of the most seriously ill or disabled patients. Such a system would amplify the already existing moral crisis in medicine caused by the "quality of life" ethic and utilitarianism.

3. Imagine the impact of coupling presumed consent with futile care theory, in which doctors and hospital bioethics committees are empowered to withdraw wanted life-extended care based on "quality of life" and financial considerations

4. Presumed consent would lead to contentious litigation by grieving (or greedy) family members. 

5. Presumed consent would couple assisted suicide and organ harvesting without consent. Vermont has legal assisted suicide. Would such dead people then be subject to organ harvesting? Belgium and Netherlands already harvest bodies made dead by euthanasia (with consent). This bill would allow a coupling of killing and harvesting without consent.

The government and/or medical bureaucracies should have no ownership claims to our remains. Presumed consent is the wrong prescription for the organ shortage, and indeed, could push people to opt-out of the organ donation program who might otherwise have opted-in.

Image: Vermont State House, by GearedBull at en.wikipedia [GFDL, CC-BY-SA-3.0 or CC BY 2.5], from Wikimedia Commons.

Cross-posted at Human Exceptionalism.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.

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