News from the New Party

Organs of the state

Gordon Brown has declared his support in the Sunday Telegraph for a change in the system of organ donation such that consent would be presumed unless an individual has specifically opted-out of the organ donor register.  This is not a new proposal (Sir Liam Donaldson, the Chief Medical Officer, made the same suggestion last year).

The earth-shaking implication of such a move is that it amounts to nationalisation of the human body: your body in its entirety will become the property of the state.  For "presumed consent" means, in fact, no consent at all.  The fact that an individual may have the opportunity to "opt out" of organ donation does not in essence change this.  In practical terms there is no meaningful difference between a communication withholding consent from organ donation and a request to be excused from organ donation.  "Presumption" is the operative concept - a transfer of ownership is what is proposed.

Melanie Phillips comments:

Undoubtedly, the impulse to give people the gift of life after one’s own death is a noble one. But if Mr Brown really imagines that he will win popular acclaim by saying that the state will whip out people’s hearts or kidneys without their consent, his advisers undoubtedly need a brain transplant.

For the implications are truly terrifying. There is no more fundamental human right than control over our own bodies and what is done to them, both in life and death.

The inescapable implication of a donor opt-out is that we no longer possess such control. The presumption instead is that the state controls our bodies and can do what it likes with them after it declares us to be dead.

If the medical profession alone were to suggest this - as its leadership most lamentably is doing - it would be alarmingly coercive. For the Government to be backing it, however, deepens coercion into something even more threatening.

Volunteering to donate your organs is one thing. Making it compulsory unless you opt out transforms an act of altruism into state oppression.

Melanie goes on to suggest the threat of discrimination against patients who withhold consent would bring undue pressure to bear.  Already some supporters of the scheme have suggested that those who withhold consent should not be entitled to receive a transplant under the NHS.  This suggestion at least has the benefit of some logic.  The problem is that it may not end there.  In principle why should this not be extended so that any patient who withholds consent would not be entitled to any NHS treatment? 

Matthew D'Ancona sums up:

The problem is not the ends but the means. If Brown had recommended that a higher portion of the health budget be allocated to persuading people to carry donor cards, I would have been with him all the way. The elected government is richly entitled to engage in persuasion of this sort: touring classrooms, running adverts, using the web. The obstacle for me is the notion of "presumed consent". I object to the principle that I have to take a step, or sign a form, or tick a box to prevent the State from taking ownership of my corpse. If I sign it away to the State, that’s my affair. But the onus should not lie with me to opt out of an otherwise universal transplant scheme, to become, so to speak, a "conscientious objector" from a system of organ conscription.

At the heart of this debate - understandably emotional on both sides - is a basic point of principle. Does everything, including our bodies, belong to the State unless otherwise indicated? Is net income (for instance) simply what the State chooses to let us keep of what we earn? Should the default position in a free society be that the authorities own a corpse unless the dead person has previously indicated he or she would like to "opt out"?

Of course, in a free society no such default position can apply.  If we exist as free individuals, there can be no "presumption of consent".  If this presumption is conceded, we cease to be free and become, in a real sense, organs of the state.