There are interesting pieces on the organ donation row by Libby Purves and Polly Toynbee today. Polly seethes that “rightwing commentators are sharpening their pencils for what they see as an excellent ideological dividing line…here we have an important battle of ideas – and the Conservatives have just instinctively plonked themselves on the wrong side.”
What is certainly true is that this issue does test one’s fundamental attitude to the relationship between the individual and the state. Locke’s notion of “self-ownership” is not absolute: we do not accept that you can sell yourself into slavery, or (for that matter) sell your organs while you are alive. But the idea that we should have control over our bodies is deeply entrenched and was, let us not forget, at the heart of the feminist case for the legalisation of abortion. The cultural assumption is that, after death, that control passes to our families.
Interestingly, the debate in the US about transplantation revolves around “commodification”: how far the market should operate in organ donation, and whether, for instance, bereaved families should be recompensed.
In this country, the philosophical fissure relates to the power of government. Polly argues from a utilitarian perspective. “At least a thousand lives could be saved [a year] with the release of more viable organs,” she says. Dead bodies could be used to help live bodies stay alive. So what’s the problem?
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”?
My pencil remains sharpened, Polly.
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