Ruthann West
Mandatory Organ Donation
English 1010
Mandatory Organ Donation
Ruthann West
English 1010
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Ruthann West
Mandatory Organ Donation
English 1010
Organ Donation
(This information and discussion is given under the assumption that any donors are
legally, verifiably deceased)
What do most people think when they hear the term “mandatory organ donation”? Many
jump to religion- or lack thereof- as their decider. Some factor in their personal views on
altruism or politics. Most people have a mix of any of these factors and more when making a
decision for or against “mandatory” organ donation. The idea of mandatory organ donation is a
concern for many; countries around the world have tried to instill this or something like it into
their systems. However, the misconception about mandatory organ donation, is that it really
doesn’t exist right now. What most consider a mandatory legislation is actually a “presumed
consent” program. Even this is a concern for many. The presumed consent system and the
prospect of mandatory organ donation are complex issues that tie together, with mainly two
viewpoints: for, or against.
Part of the push for a more mandated organ donation system comes from the shortage of
eligible transplant organs the medical field sees. The waitlist in America is much longer than the
number of those who sign up to donate each year. The number of those who are signed up to
donate is larger than the number of those who are eligible to give when the time comes. Thus, a
shortage is created. Every ten or so minutes, another person is added to the “waitlist”. Every day,
it is estimated that seventy nine people receive a transplant, but twenty one more die because
they did not receive one when they needed one (US Department of Health and Human Services,
“Need is Real”).
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Ruthann West
Mandatory Organ Donation
English 1010
The argument has been made before that the survival rate of an organ transplant is not
one hundred percent. According to the US Department of Health and Human Services, this is a
valid point. However, the argument could also be made that there is a survival rate at all. The
statistics are shown:






Kidney (from a deceased donor): 83.4%
Kidney (from a living donor): 92%
Heart: 76.8%
Liver (deceased donor): 74.3%
Liver (living donor): 81.3%
Lung: 55.2%
(US Department of Health and Human Services staff, “Need is Real”)
Presumed consent was introduced primarily to lower wait times for transplants. Austria
and Australia use this system, to name just a couple. “Presumed consent” is an opt-out system,
versus an “opt-in” system. For example, America is an opt-in system. A person is considered to
be a non-donor if they are found without identification, or if they have not marked “Y” on their
driver’s licenses. In an opt-out system, a person is considered an organ donor if they are found
without identification, or if they have not specifically opted OUT of donating on whatever
identification is available to them (McGraw-Hill Dictionary). The idea of presumed consent is to
lower wait list times and save extra lives that wouldn’t have been salvaged otherwise.
Switzerland has a very low post-mortem donation rate compared with other European
countries, which is potentially because of the lack of presumed consent law (Weiss, 1-7).
Surveys done have shown no more negative feedback about donation, compared to other
countries with higher rates. However, the opt-out system may not be responsible for a higher
donation rate, either. Studies done that have shown an increase in donation after presumed
consent legislation was introduced, cannot conclude that the increase was due to the legislation
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Ruthann West
Mandatory Organ Donation
English 1010
alone. These countries generally focus even more on patient/population education as well
(Rithalia, 338).
Possibly the most complicated aspect of this issue is religion. Religion is the main cause
of the controversy surrounding mandatory organ donation, understandably. All religions
discussed here tend to focus on the ethical question of verifiable death, but again, this discussion
itself is focusing on post-mortem donation, without the added complication of how to define it.
Religion can make one’s decision about whether or not to donate in an opt-in system, and it is
believed that some religions are against organ donation at all, mandatory or otherwise.
Catholicism and those with the same basic doctrines (Lutherans, Episcopalians, etc),
believe in organ donation, but under certain circumstances. All of these circumstances preclude
completely a system involving mandatory organ donation. Informed consent is a main concern
for this religion, but the term “ashes to ashes” is used frequently among members of the church
(Lay Witness Staff, Lay Witness).
Judaism is widely believed to condemn organ donation, but actually, the Jewish religion
believes that saving another life overrides any small danger to the individual (which is the
concern, they are to avoid danger to themselves in reverence of life and its value). There is
controversy just within this religion, however, as not all organs harvested from a body are always
used to directly save a life. This takes mandatory organ donation completely out of the question.
Having a rabbi consult before organs are removed is encouraged here (Moss, 5775).
The Church of Jesus Christ of Latter Day Saints, or the LDS religion, preaches
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Ruthann West
Mandatory Organ Donation
English 1010
“the donation of organs and tissues is a selfless act that often results in great benefit
...The decision to will or donate one’s own body organs or tissue for medical purposes, or
the decision to authorize… is made by the individual or the deceased member’s family
(HRSA Staff, “Religious Views on Donation”).”
This by definition condones organ donation as a whole, but condemns the idea of
mandatory organ donation.
Atheists have varied views, as they’re not dictated at all by the guidelines of religion.
This is more based upon individual views.
These are but a few examples of how religion can influence the decision to be for or
against mandatory organ donation, or presumed consent. Most religions either encourage organ
donation, or leave it up to the individual to decide. They rely on informed consent and freedom
of choice- even more “strict” religions, such as Islam or Jehovah’s Witness.
The medical field, when a patient is verifiably dead (this means there is no question as to
brain death vs activity; no question to whether or not the patient’s body is alive- that is a
discussion for another time), is a little less complicated right now. Most of those who work in the
medical field are absolutely for organ donation, and completely against making it mandatory. A
survey of the professionals working for Utah’s local Intermountain Healthcare system showed an
overwhelming majority against mandatory donation. The reasons are varied; a few stated they
wanted to keep the altruism involving donating. Altruism is a major component of organ
donation as a whole. Those who donate feel good about making the choice to donate, to help
others. Introducing a mandatory system to organ donation would take that from those who do
choose to help, making the idea even less popular (Spranger, Bioethics Program).
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Ruthann West
Mandatory Organ Donation
English 1010
Some were against due to the trauma it could cause the already grieving family. Most
were against it because of the “slippery slope” making anything involving an individual’s body
mandated by the government could create. In a survey of fifty-six individuals, forty-seven were
against mandatory donation, and nine were for mandatory organ donation.
The few that were for, felt that way because of the lives that could be saved- or even just
bettered- by one person’s death. Three specifically mentioned the presumed consent system and
how it would be a good compromise in America.
Money is another part of this issue. The rich are privileged in many ways; healthcare is
no exception.
“Rich people can pay, poor people can’t. ‘There’s a huge triage involved in getting in,’
Arthur Caplan, chair of the department of medical ethics at the University of
Pennsylvania, told CNN. ‘If you’re a homeless alcoholic sleeping on the streets of L.A.,
and you’re going toe to toe with Steve Jobs, you’re going to lose.’(Rall, p.10)”
It is believed that introducing a mandatory organ donation system would take away the
“wait-list cutting” that the rich are able to ensure; thus making the system itself fair, equal, and
more efficient.
A “slippery slope” was mentioned previously, and this refers to the question: if a
government is given total control over one aspect of an individual’s life, what is to stop it from
assuming complete control and domination? “Opening the flood gates” could be used to describe
the same concern. Making organ donation mandatory is considered a slippery slope by manywhat is to stop them (the government) from then making decisions on who an individual is to
marry, or procreate with (Spranger, Bioethics Program)?
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Ruthann West
Mandatory Organ Donation
English 1010
It’s rare to find an individual who just doesn’t care one way or another, once the subject
has been explained. Mandatory organ donation doesn’t exist yet, and the idea of presumed
consent is still rather new and very controversial. The subject as a whole is complex, not because
of multiple sides of the controversy, but because of the multitude of issues it presents. Religion,
politics, individualism and altruism, money, and universal ethics are all factors here; these are
only the ones this paper has covered. When other things, like brain-death and the morals
surrounding organ harvesting while the body still lives come into play, a brand new facet of the
problem opens up. Each corner turned has a new issue revolving around organ donationmandatory organ donation could clear this up, or cloud it further. As of now, the subject remains
extremely clouded.
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Ruthann West
Mandatory Organ Donation
English 1010
Works Cited:

Lay Witness Staff, “Play It Again Organ Donation”. Article, Lay Witness,
Catholic United for the Faith, INC. 2001. Web.
URL: http://www.catholiceducation.org/en/science/ethical-issues/play-it-againorgan-donation.html
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McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGrawHill Companies, Inc. Web.
URL: http://medical-dictionary.thefreedictionary.com/Presumed+Consent

Moss, Aron. “Organ Donation”. Article, Nissan 22. 5775. April 11, 2015. Web.
URL: http://www.chabad.org/library/article_cdo/aid/635401/jewish/OrganDonation.htm

Rithalia, McDaid, Suekarran, et. Al, “Impact of Presumed Consent for Organ
Donation on Donation Rates: A Systematic Review”. BMJ 2009; 338. 15 January
2009. Web.
URL: http://www.bmj.com/content/338/bmj.a3162.long

Spranger, Theresa. “Mandatory Organ Donation: Ethical or Outrageous?”
Bioethics Program Blog for Alumni, 2014. Web.
URL: https://thebioethicsprogram.wordpress.com/2014/05/16/358/

US Department of Health and Human Services Staff. “Religious Views on Organ
Donation”, Health Resources and Services Administration. Web.
URL: http://www.organdonor.gov/about/religiousviews.html
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Ruthann West
Mandatory Organ Donation
English 1010
US Department of Health and Human Services Staff. “The Need is Real: Data”, Health
Resources and Services Administration. Web.
URL: http://www.organdonor.gov/about/data.html
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