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A Catholic Moral Analysis of Legislative Defaults in Organ Donation

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Contemporary Controversies in Catholic Bioethics

Part of the book series: Philosophy and Medicine ((CSBE,volume 127))

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Abstract

One strategy that has been implemented in numerous nations, particularly in the European Union, to try to increase the availability of transplantable organs is to legislatively change the default option for organ donation from one that is opt-in to one that is opt-out. In an opt-in system, an individual is required to unambiguously consent for organ donation, usually by signing and by carrying an organ donor card, for his organs to be harvested upon his death. In contrast, in an opt-out system, a person is required to unambiguously reject organ donation to prevent his organs from being procured for transplantation upon his death. This change in social policy cannot be justified, because the requirement for informed consent is an integral element of the Catholic Church’s teaching on the morality of organ donation and transplantation for at least three non-negotiable reasons. First, informed consent respects the essential formality of the donated organ as a gift that one person gives to another in an act of charity. Next, informed consent prior to organ donation allows the donor to intend a friendship of virtue with the organ recipient, even in cases where he will not live to meet his friend. These friendships sustain the common good. Finally, informed consent affirms and protects the intrinsic dignity and inviolability of the human organ donor who alone is able to give himself away to another person through the materiality of his body.

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Notes

  1. 1.

    For a discussion of the organ shortage in the U.S.A. and the loss of life that results from it, see the data analysis by Humphreys (2014).

  2. 2.

    At the time of this writing, countries that have an opt-out system of presumed consent include Armenia, Austria, Belarus, Belgium, Chile, Colombia, Costa Rica, Croatia, Czech Republic, Ecuador, Finland, France, Italy, Luxembourg, Norway, Poland, Russia, Singapore, Slovak Republic, Slovenia, Spain, Sweden, Tunisia, and Turkey. For details, see Rosenblum et al. (2012).

  3. 3.

    For examples, see the position statements of the British Medical Association (2012) and of the Canadian Liver Foundation (2010).

  4. 4.

    For scholars who have recently advocated for systems of presumed consent, see Bird and Harris (2010); Rieu (2010); Cronin and Harris (2010); den Hartogh (2011); and Saunders (2012). For scholars who have opposed systems of presumed consent , see Potts et al. (2010); and Fabre (2014).

  5. 5.

    This chapter is a substantially revised, expanded, and updated version of Austriaco (2009).

  6. 6.

    For a phenomenological study of the gift, see Schmitz (1982, pp. 34–63). Also see the seminal work by Mauss (1966). For a comprehensive summary of recent research on the meaning of the gift and the practice of gift-giving and gift-receiving, see Mayet and Pine (2011).

  7. 7.

    For discussion, see Johnson and Goldstein (2012); and Smith et al. (2013).

  8. 8.

    Consider the following: Imagine a government system where individuals have an opt-out system for charitable giving. In this system, the IRS would withhold 10% of a taxpayer’s income to aid the poor unless he opted-out of the “tithe” in a public manner that would be recorded on his driver’s license. Many individuals I have talked to resist such a system because they find it coercive, especially in light of the individual mandate associated with the Affordable Care Act . I think that the same would apply to an opt-out system for organ donation.

  9. 9.

    For representative views, see Chouhan and Draper (2003); Herz (1999); and Spital (1996). Mandated choice was first proposed by Veatch (1976, pp. 272–3).

  10. 10.

    The comprehensive definition of mandated choice articulated in this paragraph is taken with slight modification from Chouhan and Draper (2003, p. 158).

  11. 11.

    Mandated choice has been endorsed by the American Medical Association (2015, Opinion 2.155) but has been rejected by the British Medical Association (2000).

  12. 12.

    For a representative example of this objection, see Prottas (1995).

  13. 13.

    For a representative example of this objection, see Klassen and Klassen (1996).

  14. 14.

    For discussion, see Klassen and Klassen (1996); and Siminoff and Mercer (2001).

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Authors and Affiliations

  1. Departments of Biology and of Theology, Providence College, Providence, RI, USA

    Nicanor Pier Giorgio Austriaco O.P.

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  1. Nicanor Pier Giorgio Austriaco O.P.
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Correspondence to Nicanor Pier Giorgio Austriaco O.P. .

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  1. College of Osteopathic Medicine, Marian University, Indianapolis, Indiana, USA

    Jason T. Eberl

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Austriaco, N.P.G. (2017). A Catholic Moral Analysis of Legislative Defaults in Organ Donation. In: Eberl, J. (eds) Contemporary Controversies in Catholic Bioethics. Philosophy and Medicine(), vol 127. Springer, Cham. https://doi.org/10.1007/978-3-319-55766-3_31

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