Presumed Consent’s Time Has Come

Presumed consent simply means that everyone is presumed to be an organ donor unless they opt out.  Under our current system no one is presumed to be an organ donor unless they opt in.  That is the altruistic approach, “It’s the right thing to do so everyone will do it.”  But they don’t, and around 100,000 people have died since 1995 waiting for people to do the “right thing.” 

Presumed consent’s time has come.  Don’t ask me why, but the ethicists, the numbers crunchers and those who are so smart they can tell us what to think, say presumed consent is highly controversial, faces innumerable roadblocks, will take a long time, cost a good deal of money and in the end won’t work.  To prove their point they will show you thousands of pages of Excel spread sheets that will cause you to get dizzy and fall on your head.  I’ve always thought that if you torture numbers long enough they’ll confess to anything, these folks prove it.

We know that some very powerful, influential people and organizations will vigorously oppose presumed consent because they are anti-almost everything, mostly they are think tankers, bureaucrats, professors of obscurity, editorial deep thinkers and ethicists.  None of them eat or drink, they unplug from the wall each morning and join their counterparts in a breakfast of toasted standard error, poached average deviation and a dollop of confounding factor. 

These same negative thinkers existed when President Kennedy said we were going to the moon, a somewhat understandable conclusion being as no one had ever done it.  King Ferdinand of Spain didn’t have a plan either when he funded Columbus’ journey across the “Ocean Sea.”  But with presumed consent there are existing plans — the ones used by Italy, Spain, Belgium, Norway, France , Finland, Austria, Switzerland and Sweden.  In the  20 years since Belgium adopted a presumed consent policy less than 2 percent of the population has registered an objection to organ donation that is 98 percent acceptance  (The UK, incidentally, is seriously considering adopting a presumed consent program).

This is America folks.  We don’t give up!  Where we would be if we quit trying every time someone in authority said, “It can’t be done.”  Most certainly, there would be no USA (breaking from the British Empire? — Impossible!).  We’ve always been surrounded by people of great power with absolutely no vision, for example:    

 “I think there is a world market for maybe five computers.” Thomas Watson IBM Chairman 1943,     

 “Everything that can be invented has been invented.” Charles H. Duel, Commissioner U.S. Patent office 1899,

“We don’t like their sound, and guitar music is on the way out!” Decca Recording Co. 1962 as they rejected the Beatles.  

There are always naysayers, “Can’t be done” people.  It’s about time we told them to crawl back into their black holes of negativity and stay there.  We don’t need negative thinkers, we need problem solvers.  In the mid to late 70’s I worked for Minnesota Governor Rudy Perpich who told me that if I ever brought him problems he’d fire me.  “Bring me solutions,” he said, “And together we’ll choose one that will work.”  My God, what uncommon common sense.   

 The organ shortage in the U.S. is so severe that each year the gap between available organs and the number of people who need them continues to widen.  It is so bad that as many as 19 people die every day while waiting.  Think about real, not statistical death.  Real death is 19 funerals, 19 grieving families and 19 good people forever gone.  This is not about statistics it is about real people and the most profound of human issues, living and dying.  To allow the technocrats to reduce this national tragedy to columns of numbers is shameful.  Shame on them for doing it and shame on us for not standing up to them (I wonder if any political candidate has given any thought to naming a Secretary of People whose only job would be to remind government types that we are people with names. I don’t know anyone named 27 or 1,000,006, do you?).    

Do the math, the longer we wait to try something new the more people will die.  Each of us shoulders the responsibility of helping to tend to the sick.  Isn’t that a major tenet of almost all religions?  Since when did Americans see their neighbors dying and refuse to help them?  As Mark Twain said, “That’s un-American, it’s un-British, it must be French!”   

It is time for action, time to take some chances, make a mistake or two, but we must try!  I can’t remember who said it but the quote went something like, “If you’re not making mistakes you’re not trying anything!”  I’m not asking for us to take shots in the dark in hopes we will hit something, but rather to use the experiences and the evidence developed by knowledgeable people around the world and put it to use.  We don’t have to reinvent the wheel, we just need to add a wheel to the one we have so the carriage can move?  

Altruism is the current coin of the realm.  Supposedly it is the ideal motivator for organ donation even if it doesn’t work, which it doesn’t.  The mindset among the people who make these decisions is, “Yeah, presumed consent might work in Spain but not for long.  Just wait, it will fail — you’ll see!”  And then they crawl back into their depressing holes to return to crunching their nameless, faceless, emotionless numbers.   

The American transplant list is not just a list.  It is thousands of people who are dying.  Doesn’t that fact impress these green visored gnomes?   You or someone you love could be on that list very soon.  Don’t we owe these dying people something?  How would you feel if you were on such a list and you knew that no one was doing anything to make the list of donor organs exceed the list of people who need them.  That’s what it will take you know.  The number of available organs will have to exceed, not just meet, the number of people on the waiting list.  That is the only way we can stop the dying.

An added note and perhaps the subject of future blogs.  Maybe, just maybe there is no one solution.  Maybe we need to combine solutions.  How about a presumed consent/financial incentives approach?   Think about it.  Or, as one of our readers commented, “Cloning is a viable option. — we have the technology.”


About Bob Aronson

Bob Aronson is a former journalist, a Minnesota Governor's Press Secretary and talk show host. For nearly a quarter of a century, he led the Aronson Partnership, a Minnesota-based communications consultancy that prepared corporate and government executives for crisis situations, regulatory testimony, media interviews and Presentations. Among his clients were all three U.S. Mayo Clinic locations, 3M, general Mills, CH2M Hill, the U.S. Department of Energy and scores more. In 2007 bob had a heart transplant after suffering from idiopathic dilated cardiomyopathy for 12 years. Shortly after he got his new heart he founded the now 4,300 member Facebook support group, Organ Transplant Initiative. At the same time, he established the Bob's Newheart blog where he has posted nearly 300 columns on organ donation, transplantation and other health related issues. The Viewpoint blog was started in late 2016 and bears the name of the Radio Talk show Bob did from 1966 until 1974, when he resigned to become Minnesota Governor Rudy Perpich first Press secretary. Bob and his artist wife Robin, live in Jacksonville, Florida with their two dogs, Reilly and Ziggy. Bob is also a woodworker and makes all of the furnishings for Robin's art festival booth. He also makes one of a kind jewelry or "memories" boxes that he donates to select transplant patients, caregivers, donor families and others who have somehow contributed to making life easier for the ill, the elderly and the less fortunate. Bob is in the final stages of editing two full-length novels that will be available on Kindle when ready for release sometime in early 2017. One is a sci fi novel about an amazing discovery near Roswell, New Mexico and you will be surprised to find it has nothing to do with the Roswell story everyone knows. It features a woman scientist who investigates impact craters for the U.S. Department of the Interior, Dr. Rita Sylvester and her female student intern. The other book is a political thriller that introduces a new hero to the genre, Fargo Dennison.

Posted on February 28, 2008, in Presumed Consent and tagged , , , . Bookmark the permalink. 1 Comment.

  1. If presumed consent was implemented in the United States, the supply of organs for transplant operations would increase significantly. According to polls, about 90% of Americans support organ donation but only about 50% have bothered to register. If everybody was automatically registered, few people would bother to un-register.

    Presumed consent can only be implemented in the United States through legislative action – Congress (or state legislatures) would have to pass a law.

    In the mean time, there is an already-legal way to put a big dent in the organ shortage – allocate donated organs first to people who have agreed to donate their own organs when they die.

    Giving organs first to organ donors will convince more people to register as organ donors. It will also make the organ allocation system fairer. People who aren’t willing to share the gift of life should go to the back of the waiting list as long as there is a shortage of organs.

    Anyone who wants to donate their organs to others who have agreed to donate theirs can join LifeSharers. LifeSharers is a non-profit network of organ donors who agree to offer their organs first to other organ donors when they die. Membership is free at or by calling 1-888-ORGAN88. There is no age limit, parents can enroll their minor children, and no one is excluded due to any pre-existing medical condition


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