Imagine that tomorrow, through a series of unexpected and unfortunate events involving the collapse of the euro, some desperate eurocrats and a P&O ferry, you end up dying in hospital. You will probably be looking forward to a quiet end as you depart this veil of tears, dignified in death, etc etc. You would be wrong; the NHS watchdog has called for your doctor to be legally required to interrupt your last moments. Your doctor should, according the National Institute for Health and Clinical Excellence, ask whether after you're dead, he can have a rummage around inside to see if there are any organs anyone else might want. This is wrong. He shouldn't have to ask.
Compulsory organ donation may seem somewhat extreme but every year a thousand people die waiting for an organ transplant. That ghastly number, the number of those who die needlessly, is only increasing. They die because others neglect to do the right thing. Negligence is a crime.
As a society we accept that there are a lot of things the state can legitimately ask its citizens to do; they range from the annoying - not littering, to the angering - income tax, to the ultimate sacrifice of being conscripted to go and die for the country. Compared to these, allowing a pound or so of biological matter to be taken from after you're done with it, is trivial. It's not as if you even knew or cared about what they did for you in life; who knows what a spleen does? What sort of narrow boat sails down the renal canal? The point is that your body is no more yours than your house, your car or your iPhone.
There are three main objections to compulsory organ donation; freedom of choice, religious concerns and the ability of the family to say goodbye. I will deal with them all in order.
Firstly to the: "It should be my choice what happens to my body, it's not fair!" argument. Well, if we are going to bang on about "human rights", then the right to life trumps the right to decide how garbage is disposed of every time. The person dying next door has more of a right to life than you do to decide how to get rid of your body. Furthermore, you don't lay claim to the various bits and bobs that will eventually make up your body before you exist, so how can the same bits and bobs be yours after you've finished existing. How can "you" own anything if there is no "you"?
Some people don't like the idea of organ donation at all, never mind compulsory organ donation, because of religion. When we are all swept up in the rapture on judgement day, there could be a great deal of confusion if various people have got various other people's hearts, livers, spleens and so forth. However, it is perfectly acceptable in these religions for the body to rot into worm food or to be burnt to ash. If god is already turning worm and ash back into humans, he should be able to deal with some misplaced organs. At any rate, these religious believers are a minority - all six major religions care not a jot what happens to the body, it's the soul they're after. If we went around doing things because various small religious sects wanted us to, the world would be a very nasty place indeed.
As for the grieving family, the surgeons tend to do a very neat job nowadays. Quick slit down the middle, whack out any useful organs and sew them back up. Put a shirt on the corpse and mum/dad/brother/sister/family dog wouldn't even notice that the body's organs had been used to save a life. The family can hardly be given priority to the body over a dying child next door.
So, given that organ donation saves lives and given that there is no rational objection to it, it should be made compulsory. It is said that a dead man still lives while the effects of his life are still being felt. This way, if you have a particularly resilient liver or heart, you can live forever.
Steve Bawden 2019