"‘It strikes at our relationship with the state,’ they say. Well get this: You can’t have a relationship with the state when you’re dead. You can’t assert ownership over your own corpse. Why? Because. You. Are. Dead. What other freedoms would you like to exercise after you’ve shuffled off? I take it you’ll be putting your favourite songs on your iPod to take with you as well? It’ll be as much use to you as your liver."
You clearly can and do have a relationship with the state when you are dead. It doesn't take very long to think of some examples:
- There is both a criminal penalty (I assume) and a massive social sanction to necrophilia.
- People frequently refight criminal trials after the person convicted has died in order to establish their innocence.
- A will has legal force.
- Even under Brown's proposed reforms we will legally respect explicit opt-outs.
We clearly believe that people are entitled to maintain some kind of dignity after they have gone. This requires that we respect their wishes. Assuming that they would be okay with us removing their organs, rather than leaving them be if we don't know, is a fairly major change in how the state treats the dead. If you assume some kind of continuity between a dead person's identity and a live person's - which you should if you support the use of wills - then it most certainly does strike at our relationship with the state.
Balancing the dignity of the dead against the interests of the living is the philosophical question at the heart of any reasoned consideration of this problem. Plenty of people get very angry at the idea that their autonomy over the final fate of their bodies is being limited. Justin's rant isn't going to win them over. It isn't designed to. Those who die for lack of organs are never really used as anything but a rhetorical stick with which to beat assorted enemies.
Such a debate would look at alternatives like reforming how the health services treats grieving families. The Department of Health reckon they could increase organ donations by 50 per cent by better managing that process. That isn't enough but throw in some inventive new ways to get people to consent before death and I think you'd be fine. Beyond that, there's always commoditisation. Wat Tyler has more on the various alternatives to Brown's initiative.
I find the idea of an opt-out system for organ donation alarming for the same reason I found the idea - floated a while ago - that the HMRC should be able to take money straight out of our bank accounts alarming. It will mean that when inevitable screw-ups take place it will be far more likely that someone will wind up having their organs removed against their wishes. Bureaucratic procedure tends to err on the side of the default position; it seems almost certain that scandals thanks to overlooked opt-outs would become commonplace very quickly.
I don't actually feel outraged myself - I'm blessed with a rather moderate temperament - but I absolutely understand those who just feel very affronted at the idea anyone would presume consent to take their organs. As Justin says, even many of those who will quite happily take a donor card are angry at the presumption. Just the way plenty of people will give to charity but wouldn't like to find the RNLI lifting their wallet. Our bodies are our own, even after our death our wishes over how our corpses should be disposed of are quite rightly respected, and having them stolen grates even if it is for a good cause.