I am not prejudging this case, but I bring it up here because I think it illustrates the loss of trust that a “presumed consent” organ donation scheme would engender in people. (Current law requires us to “opt-in” to be an organ donor–as I have. Presumed consent would require us to each “opt-out.” Otherwise, we would automatically be organ donors, no consent required.)
I worry that a presumed consent regimen would lead catastrophically injured patients to be looked upon more as organ farms than patients. Take a look at the story I quote below–particularly the parts I italicized–and you will see what I mean:
According to family members of 26-year-old Martha Perez, her organs were removed on Friday against their wishes. Fox 4 spoke to the family before the removal and they said the third woman confirmed dead of injuries sustained in an Arlington wreck involving a suspected drunk driver was technically still alive.
The Tarrant County medical examiner says Perez died Wednesday and doctors have declared Perez brain-dead, although the hospital declined to confirm that citing patient privacy. “But she still has heart and lung functions,” said family member Juan Martinez. “They took her off the life support and she was still breathing.”
First, “brain dead” is dead and the organ removal protocols would not require the removal of life support. More, if Perez was indeed breathing on her own, by definition, she wasn’t dead.
Now, see how a presumed consent would breed distrust and anger:
Perez was a registered organ donor and doctors told the family they were prepared to harvest the organs for donations. Perez did not have a will or an advance directive that would have instructed doctors exactly what to do in regards to taking her off of life support.
According to Martinez, the family felt it was too soon. “We don’t want to be pressured. My family feels pressured and it’s just hard for someone to make that kind of decision when this just happened,” Martinez said Friday before her organs were removed.
Legal expert Jessice Dunne said the family has the legal right to keep Perez on life support if her organs are still functioning. If they stop, then it’s up to the hospital what to do. “We know we have to come to a decision but we aren’t going to let no hospital or no state make that decision for us,” Martinez said. That wasn’t the case as the hospital decided to move forward in the process.
Under presumed consent, anytime a hospital stopped life support and removed organs, loved ones could become similarly suspicious, feeling that a rushed decision was made because the organs mattered more than the patient.
(That seems to be the concern here because Perez had opted-in. Even so, permission is requested prior to procurement. This is the first case I have heard of where organs were taken under these circumstances without family permission. That could also sow distrust, but I don’t want to get into that now.)
The distrust would be especially acute in a medical system increasingly obsessed with cost control and in a milieu in which bioethics “experts” increasingly reject the sanctity/equality of human life in fabor of a utilitarian “quality of life” ethic.
I have no idea what happened in this case. But if we adopt an opt-out organ donation system, I will remove myself as an organ donor. I wouldn’t have enough trust to “leave it to the doctors” whether the time had come to harvest my organs.
By Wesley J. Smith, Human Exceptionalism
