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Does ‘not saying no’ mean ‘yes’?

Does ‘not saying no’ mean ‘yes’?

Last week the Human Transplantation (Wales) Act 2013 came into effect as a measure intended to address the shortfall between donors and patients in need of organ transplants. This law has evoked mixed reactions, with some welcoming it as a life-saving initiative and others concerned about the implications of introducing deemed consent in organ donation.

Before the change in the system, Wales was the same as the rest of the UK, that is, adults could choose to be on the organ donors’ register. Those who did not want to donate would simply not sign up; however, this also meant that many people who would have liked to donate their organs would not take the time to register, putting the NHS in a position where more people need organs than there are donors to give them.

The new system seeks to ensure that no one dies because someone never managed to sign up, a noble aim in itself. This law will allow doctors to take organs from adults who have lived in Wales for more than a year even if they have never expressed any wish to donate. In short, deemed consent takes ‘not saying no’ as ‘yes’.

The rationale behind the change is that the new law is supposedly clearer. One reason given for the shortage of donors is that many families say no if they did not know the wishes of the deceased. The official website states: ‘The new system will be clearer for everyone. If family members are approached about organ donation, they will know that their loved one could have opted out but chose not to.’ This is a shift from a position where it is considered best not to interfere with a body without explicit consent to one where the state has ownership of our bodies after we die.

It is difficult to know how to react to this. On the one hand, the heroic act of becoming an organ donor has been made easier and lives will be saved, the benefits of this law will be seen in the form of the extra years families will get to spend with loved ones. On the other hand, this change in the law clouds what was once a clear understanding of consent and promotes an assumption that we do not mind what is done to our bodies after we die.

At the heart of the problem with this change in the law is an underlying assumption that the human body is just a body, a shell containing the real us. There is a sense of dualism implicit in the notion that it is acceptable to treat a body as separate from the person, even after death.  This law is a move from the state in the direction of downgrading the importance of the body. A dualist distinction between body and self is especially worrying for Christians as one of the implications of this is a danger of the whole person being downgraded; if our bodies do not matter to the government then neither do we.

From a religious perspective, the human body is seen as important and sacred in many traditions. This contributes to a notion of the body as more than a mere biological entity. To assume that it is permissible to make important decisions about a person’s body after death, without their consent, is a failure to show proper respect for not only their beliefs, but for them as a person.

This adoption of deemed consent does a disservice to one of the most loving things a human can decide to do. To paraphrase Pope John Paul II, transplantation without prior, explicit, free and conscious decision on the part of the donor or a legitimate representative would no longer correspond to an act of donation but would amount to a dispossession or plundering of the body.

To be clear, organ donation is not incompatible with the Christian tradition. For instance, the Catechism of the Catholic Church shows support, but is blunt in condemning it as morally unacceptable if the donor or their proxy has not given explicit consent. Exploitation of a person’s body presents problems from a Christian perspective, even when it is done unintentionally and for good reasons.

In cases where consent has not been given, leaving medical professionals to make this decision for them runs the risk of going against the wishes of the deceased. This could lead to a violation of the innate dignity of their body in a way that instrumentalises and dehumanises a person and tarnishes a heroic action. Of course, those who backed this change in the law do not want anyone to become an organ donor against their will. Information packs were sent out to those who would be affected explaining the change in the law. Their intentions are good but the law is not.

The move towards deemed consent in organ donation is not in the best interests of our society. This change in the law in Wales ignores the value of the body that is prevalent in many cultures, it runs the risk of harming the dignity of the body, and, most significantly, by demoting the value of the body the whole person is downgraded too. In summary, organ donation is a great service to life and this change in the law detracts from that. From a Christian perspective, it is problematic to take the absence of a ‘no’ as a ‘yes’ where the body is concerned.

 


If you would like to register to be an organ donor:

https://www.organdonation.nhs.uk/register-to-donate/

If you live in Wales and wish to refuse to donate:
https://www.organdonation.nhs.uk/register-to-donate/refuse-to-donate/

If you have refused to donate but would like to change your mind:
https://www.organdonation.nhs.uk/register-to-donate/amend-your-details-on-the-register/

If you would like to appoint a representative to decide this for you:
https://nhsbtdbe.blob.core.windows.net/umbraco-assets/1050/appointing-a-representative.pdf


Sources:

http://www.cbcew.org.uk/CBCEW-Home/Legislation-Policy/2013/Organ-Donation
http://w2.vatican.va/content/john-paul-ii/en/speeches/2000/jul-sep/documents/hf_jp-ii_spe_20000829_transplants.html
http://www.bbc.co.uk/news/uk-wales-34964382
http://www.bbc.co.uk/news/uk-wales-politics-23127751
http://organdonationwales.org/?lang=en&utm_source=cardiff-and-vale&utm_medium=lhb-activity&utm_campaign=cardiff-and-vale
http://www.vatican.va/archive/ccc_css/archive/catechism/p3s2c2a5.htm
http://w2.vatican.va/content/john-paul-ii/en/speeches/1991/june/documents/hf_jp-ii_spe_19910620_trapianti.html


Clare Purtill is currently a research intern at Theos

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Image by Magnus D from flickr.com available under this Creative Commons License

Posted 8 December 2015

Science, Ethics, Society

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