“These successes depend on acts of altruism.”

In the Sunday Times, Liam Clarke has a considered article on the recent [ongoing?] campaign by BBC NI’s Stephen Nolan to affect a clinical decision in the case of a 19 year old with alcohol related liver failure. From the Sunday Times article

One of the most compelling moments on the Nolan show came when a caller asked Stephen Nolan if he carried a donor card himself. “No, I don’t,” the presenter replied. Asked if that made him a hypocrite, Nolan argued: “I have never said someone should become an organ donor. I have never said that, nor am I saying that Gareth should get an organ.”

Yet over three hours of broadcasting Nolan had lambasted politicians for failing to intervene and grilled medical teams. They were unable to disclose the full background to the Anderson case due to considerations of confidentiality, but it is considerably more complex than the inflexible application of a six-month rule.

Liam mentions the solution favoured by some – automatic donation of organs unless an opt-out is specified.

All the world’s main religions support organ donation, but people tend to be squeamish. Although doctors often recommend making organ donation automatic unless an individual opts out, there has never been the political consensus necessary to legislate for this. Assuming consent unless the person carries a card stating the contrary would make life-and-death decisions such as the one hovering over the Anderson family largely irrelevant. There would be enough organs to go around.

Instead, we have collectively opted for a voluntary system, and that alone gives the howls of outrage surrounding cases such as Gary Anderson’s a hollow ring. Most people don’t volunteer. Following Best’s death, the number of donors in Northern Ireland fell, probably because, despite the public outpouring of grief at his funeral, he was seen as an “unworthy” recipient. People weren’t willing to give the gift of life to someone who might die in a few years through alcohol abuse.

I say some favour the automatic donation route because although superficially attractive as a solution to the problem, which it probably would be, my view is that implementing such a scheme, even with an available opt-out, would, at the very least, call into question who owns your body – you or the state. Currently you have the choice of what you want to do with your organs, or your next of kin can decide on your behalf, while you are still alive. An automatic donation scheme gives that right directly to the state. In this example, that might seem to be for the greater good, but it risks altering the relationship between citizen and state in a fundamental way.

But, as Liam says at the end, there is an alternative

I hope Gareth pulls through and that his case serves to bring about a change of attitudes. We must, as a society, take our heavy alcohol consumption, particularly by the young, more seriously. Drink kills 30 times more people than drug abuse, but this is not reflected in the efforts to enforce licensing regulations or the sale of drink to the young.

There is also a challenge to every citizen to show practical concern for cases such as Gareth Anderson’s by carrying an organ-donor card. My new one is in the post. I hope to hear Nolan, arguably Northern Ireland’s most influential broadcaster, giving an example to his listeners by saying the same when I tune into his show tomorrow morning. There is a link on his own website where he can register online.

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  • michael

    ‘who owns your body – you or the state?’

    I seem to recall a student of the law once telling me that I didn’t own my body.

    The conversation was at least three years ago, and i suspect made more hazy by a strong pair of beer goggles. But maybe someone here can clarify.

  • Pete Baker

    Well, michael, you could start the ball rolling by giving your opinion.

    Perhaps I should have said further call into question?

  • dunreavynomore

    Who owns your body? I’ve never thought about that before but imagine in the case of some plague or other we might find that the state would decide what to do with corpses regardless of the individuals wishes.

  • Local Government Officer

    We already have, Dunreavy. We already have.

  • Pete Baker

    dunreavy

    Except that we’re not talking about corpses per se.

    Once deprived of oxygen human tissue deteriorates rapidly making organs unsuitable for transplant.

    The decision has to be made while the donor is alive – if brain dead. That still leaves the question of whether the state has the right of ownership of your body [and your organs].

    And it’s an international problem.

  • USA

    With regard to the issue of who owns your body, for me the example of the draft comes to mind. It was used here in the US during Vietnam, the ‘state’ could decide that your body was off to war and there was nothing much you could do about it.

    As it happens I am a card carrying organ donor.

  • Dread Cthulhu

    USA: “With regard to the issue of who owns your body, for me the example of the draft comes to mind. It was used here in the US during Vietnam, the ‘state’ could decide that your body was off to war and there was nothing much you could do about it.”

    Feh — there was plenty a body could do about it, ranging from going to college, seek a job in a “necessary” industry, etc. I seem to recall relied upon the simple expedient of lying to his draft board about his ROTC status… went on to bigger things after that, iirc…

    The draft was not ownership, it was a lease program wed to a backwards lottery, with loophole I could drive a M-113 through…

  • Comrade Stalin

    Feh—there was plenty a body could do about it, ranging from going to college, seek a job in a “necessary” industry, etc.

    It would have been shorter to type “middle and upper class white people”.

  • Guys

    As a matter of law, no-one owns your body – not you, not anyone else, because there is “no property in the human body” – there are no property rights to own.

    Indeed, this was one of the great legal hurdles to live organ donation in the recent past.

    Your next of kin do have certain rights in the case of your remains, but they are not property rights.

    As for Nolan, I would love to say something fittingly eloquent but really, what else is there to say but “SHUT UP YOU MUPPET!”. (Man playing in the extreme I know, and I apologize, but hey it’s not as if Stephen follows any rule sin HIS ‘debates!).

    Pete

    I’ve been known to criticize your style, and question your biases in the past, but I would like to say that this was an excellent post, the level of which was so far in advance of the nonsense on Radio Ulster as to be unreal.

    Chapeau !

  • bollix

    agree with spectator on the law. people aren’t capable of constituting ‘property’ (for various understandable public policy reasons, not least making it impossible to ‘buy’ people).

    media populism isn’t a good way to make tough ethical decisions over scarce resources. everyone wants the young lad to get a liver, but so do they also want the other people in the queue to get the liver. i don’t even have to listen to nolan to know that he will deal with it in his usual hectoring way full of faux outrage.

  • only asking

    It would have been shorter to type “middle and upper class white people”.

    Racist crap.

  • kensei

    The solution if you do not favour opt-in (and I’m not sure, that providing there is easy routes for your or family to opt out that it affects all that much. Why is the opt-out assumptions necessarily the right one, here?), then the solution is forced choice.

    If you haven’t registered a preference, then any time you visit your GP, the hospital, the dentist, whatever, you should be forced to indicate a preference.

    You’ll get a big boost from now. Problem solved.