Every day people
die and every day people are needing organ transplantations. Hospitals, as well
as people, are relying on a presumed consent policy in which organs are being
taken from the deceased who wanted to keep their organs. However, presumed
consent policy is only in certain European countries. To some, specifically
non- European countries, presumed consent may sound unethical, but some
European countries see it as morally permissible since the deceased were
already dead and their organs would, according to those in favor of presumed
consent, just go to waste. Organs are no longer of use for a deceased person
and can be of viable use for someone else in organ failure. Presumed consent
relies on the presumption that the individual provided consent and without this
assumption viable organs will be going to waste. Presumed consent is a policy of
organ procurement that does more good, than harm, for a person’s autonomy and
allows for accepting the risk of taking a person’s organs, in situations where
they wanted to retain them, to be morally permissible. Presumed consent
minimizes emotional burdens of the family of the deceased and has save
countless lives.

Presumed consent
relies on the premise that a person would consent to organ procurement even
though they haven’t been asked to donate. Since they haven’t explicitly opted
out of organ procurement, doctors feel they may use their organs for organ
procurement because of the assumption their patient silently consented.  In deadly accidents, the next of kin, or
family members of the deceased are sometimes hard to locate. Organs are only
viable for a short period of time or they become unsalvageable. In times of
great pain, one may not be able to make the decision to have their loved one
undergo organ procurement because they are in grieving and just want to hold on
to their loved ones a little bit longer. Presumed consent allows family members
of the deceased not to make such a tough decision regarding organ procurement. Instead,
it allows doctors to make this decision because, presumed consent makes
donations routine for doctors and they don’t have a personal tie to their
patient in which their emotions can cloud medical judgments. This routine of
donation limits family members to state objectifications to organ procurement
and potentially compromise viable organs. Doctors making this decision for
family members releases them of any burdens and responsibilities of deciding
what they feel their loved one would have wanted. This also releases the family
of being interrupted by a doctor asking for their loved one’s organs right
after being told by the same doctor that their loved one died.

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someone’s religious beliefs are one reason when presumed consent does more harm
than good for the person’s autonomy. Veatch and Pitt are philosophers who
compare presume consent to “presumed treatment” in their article “The Myth of
Presumed Consent: Ethical Problems in New Organ Procurement Strategies.” Veatch
and Pitt use the analogy of if a person is brought into the emergency room
unconscious, the hospital assumes they want treatment. Veatch and Pitt further argue
that doctors are only wrong about presumed treatment (presumed consent) if it
turns out that their patient is a “Christian Scientist” who may refuse
treatment altogether or when a Jehovah Witness is transfused blood. Doctors
will get false positives only a small percentage of the time and “by contrast
if we presume consent in the case of organ procurement, we will be wrong at
least 30 percent of the time.”

However, this
objection of disrespecting someone’s religious beliefs does not have
significant influence on the idea that presumed consent is more helpful than
harmful. More often than not, injured people want treatment and practicing doctors
have taken a Hippocratic Oath “to keep them from harm.”  Presumed consent respects the autonomy of the
individual because he/she is free to opt out of organ procurement. No
individual is being forced to give. It is not the fault of the doctors that
they provided treatment to a Christian Scientist, transfused blood to a Jehovah
Witness, or take the organs from a deceased who wanted to keep their organs if
the individual was too lazy, busy, and felt unpleasantness thinking about their
death or treatment. If the individual doesn’t take the necessary steps to
express their preferred method of treatment such as verbally expressing to the
doctor that they do not want their organs harvested, then it is not morally
impermissible for the doctors to take the necessary measures they feel their
patient would have wanted such as taking their organs for donation. By
mandating information in school settings or other appropriate settings about
presumed consent, people will become aware of such a policy.

David Steinberg
favors a “opting in” paradigm that would reward people who agree to donate
their kidneys after they die by putting them on the top of the list if they
would need a kidney when they were alive. I bring up David Steinberg’s opting
in paradigm to show that I do not favor opting in, because Steinberg defends
his policy on the grounds that reciprocal altruism is a good thing. People
should not be expected to return a favor; in this case: giving an organ because
an organ was taken. Therefore, presumed consent is favorable because it relies
on the premise that unless the deceased has expressed a wish in life not to be
an organ donor, then consent will be assumed for partaking in organ

Michael Gill
critiques Veatch and Pitt’s analogy and counters it with Presumed Treatment.
Michael Gill argues that doctors would still provide treatment even if the odds
were that 30% of the unconscious were Christian Scientists or Jehovah
Witnesses. Michael Gill claims that it is better to utilize a presumed consent
policy rather than “opting in” to minimize errors in respecting the wishes of
the deceased. Presumed consent will produce fewer mistakes of disrespecting
someone’s personal autonomy than the current American system of “opting in.”
Polls have suggested that 70% of individuals want to donate their organs, thus
a majority of people prefer to donate their organs. Presumed consent is
favorable because with the current statistic of 70% of people wanting to donate
their organs, one can believe that an individual that does not want to donate
is more likely to “opt out” under this system of presumed consent than an
individual who does want to donate is to “opt in.” Essentially this will cause
fewer overall errors than the current system based on statistics which show
that most people want to donate, but do not take the steps to opt in.

The beneficial
nature of presumed consent is supported by providing examples that show
acceptance of the risk of taking a deceased person’s organs, when they wanted
them, to be morally permissible. Presumed consent is an organ procurement
policy that provides more good than harm to a person’s autonomy. Organ
procurement is just another routine surgery for doctors that eliminates the
burden of families having to choose whether to allow their loved one’s organs
to be harvested for viable organs for donations. Mistakes can happen with respecting
the religious beliefs of a patient and a deceased person’s silent consent to
not harvest their organs. However, these mistakes are morally permissible
because the individuals did not explicitly opt out of organ procurement or
state their religious affiliations. Percentages are high that people want to
donate their organs and without favoring a presumed consent policy a horrendous
amount of deaths would occur. Therefore, the risk should be accepted that a
presumed consent policy might result in organs being taken from the deceased
who wanted to keep their organs.  

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