Presumed Consent’s Time Has Come
Posted by Bob Aronson
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 http://virtualmentor.ama-assn.org/2005/09/pfor2-0509.html (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