John Farquhar Munro, a Liberal Democrat Member of the Scottish Parliament (MSP), recently proposed that a system of 'presumed consent' for transplant organ donation be introduced as law in Scotland.
Under such a system, individuals would no longer carry donor cards indicating their willingness for their organs to be used for transplantation in the event of their death; instead, everyone will be presumed to have given their consent to the removal of their organs after death, unless they have explicitly indicated their refusal.
I was very alarmed indeed when I learned of this proposal. I wrote to my MSP, Mrs Margaret Mitchell, setting out the reasons for my opposition to 'presumed consent' and asking her not to support any motion proposing it.
The text of that letter is given below.
Dear Mrs Mitchell
I am concerned that the Scottish Parliament is now taking seriously a proposal to implement 'presumed consent' for organ donation. It is difficult to imagine a more grotesque intrusion by the State into the private sphere, or a more shameful perversion of the words donation and consent. That the State should assume priority in the disposal of our mortal remains, usurping the role of our loved ones, is not only a repugnant idea, but a genuinely disturbing one in an Open Society.
There is no right to health. There is a valid negative right, the right not to have our health adversely affected by the actions of others, but there is no positive right to health. If we did have such a right, we would have a claim against our fellows to ensure our health, and they would have a duty to meet it, regardless of the cost to themselves. Our claim would therefore infringe upon their Liberty, the most fundamental right of all.
The implicit assumption of the 'presumed consent' proposal is that there is such a 'right to health'. It also comes perilously close to regarding human beings as being mere 'means', resources to be exploited and deployed in accordance with Government planning, rather than as ends in themselves. Needless to say, this is in every case wrong.
The argument that individuals will be able to opt-out is disingenuous. Certainly, the state will not be using legal coercion to achieve its ends, but it will be using its prestige to exert coercive power, in the form commonly referred to as ‘emotional blackmail’. One can all too easily imagine that individuals will be made to feel wicked and selfish for withholding that which they might give, when in fact it is the proponents of ‘presumed consent’ who are selfish, for demanding that which they have no right to.
At present, surgeons must approach the relatives of the deceased, even if he carried a donor card, and ask that they be allowed to take organs. This is right and proper. It recognises that the organs must be given as a gift, not demanded as a right. The introduction of ‘presumed consent’ would invert this situation entirely. Now, surgeons would approach the next-of-kin, already suffering the extremes of grief, and challenge her to provide a reason why they should not take her loved ones organs, the unspoken but clear implication of the law being that they (or perhaps ‘society’) have a ‘right’ to them, and that to refuse would be antisocial and immoral. Some surgeons seem to believe that they have a right to organs already, as discoveries at Alder Hey, Bristol Royal Infirmary and elsewhere have shown. The Scottish Parliament must not confirm them in their error.
There is a shortage of transplant organs in Scotland. It is curious that proponents of ‘presumed consent’ should regard this as a ‘problem’ requiring to be ‘solved’ by politicians. The implication is that the decision of all those Scots who have chosen not to complete a donor card was the ‘wrong’ decision, which must now be ‘corrected’ by those who know better. Alas, this sort of contempt for the choices made by private individuals is now all too characteristic of the Scottish political class and its associated nomenklatura of public sector and media professionals, and it must be challenged by those who believe that it is individuals themselves who are best able to make the decisions that affect their lives.
I am a supporter of organ donation, and carry a donor card myself. I carry the card voluntarily; what is proposed is nothing more than a system of conscription, albeit one which allows for conscientious objection (at least for now); it is the reductio ad absurdum of State welfarism, an attempt to nationalise an act of giving that is the deepest expression of private charity, and I suspect that it originates in a loathing for private solutions of any sort.
Of course, the solution is the private one, the very one we currently have. If the State is to have a role in the matter at all, it must be this: to promote the private charity of individuals, to encourage organ donation and demonstrate the transformative effects it has on the lives of recipients.
This is a moral issue, an issue of principal that addresses the limits of state power over the individual, their dignity and physical integrity. The idea of ‘presumed consent’ is offensive to those who believe in the primacy of the individual moral choice. The term itself is an oxymoron; the concept previously upheld only by date rapists.
As you are a Conservative, I hope I am right in presuming that you are an advocate in the cause of reducing State power, and of protecting and extending the liberty of individuals to make free choices. Implementing a system of 'presumed consent' will only serve to further the opposite cause, and I hope therefore that you will oppose the passing of any such law and will encourage your colleagues in the Scottish Parliament to do likewise.
Yours Sincerely
Jamie Young