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Source: (consider it)
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Thread: My body and welcome to it
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que sais-je
Shipmate
# 17185
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Posted
Two friends have mine have just got rid of their organ donor cards. They did so on the advice of the brother of one of them (a professional Catholic theologian based at some institute for advanced study).
The argument was that if you were near death a doctor might be tempted to keep you alive in order to maintain your organs in a suitable state for later use. When a suitable recipient comes along the doctor might then turn off the life support - which, my friends were told, would be murder - to harvest the organ(s).
This sounds like the usual thought experiment deployed to show the incompleteness of utilitarian ethics. Except that in the thought experiment the patient isn't necessarily going to die anyway. My first thought was that they had misunderstood a philosophical example for actual advice but my friends are both intelligent people, one mathematician, the other an historian.
By chance my wife and I were creating LPAs (Lasting Powers of Attorney for non-UK readers) for each other at the time. We decided to include an 'end of life clause' to the effect that, if we were brain dead, the hospital should have absolute freedom to do what it felt would be in the best medical interest. If any of our organs are still worth donating we could be kept 'alive' as long as they wished. The NHS has after all kept us alive for the whole of our lives - refusing to return the bits when no longer usable by us seems churlish.
What do shipmates think? And could any expert on RC theology tell us if my friends correctly understood the Catholic position?
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"controversies, disputes, and argumentations, both in philosophy and in divinity, if they meet with discreet and peaceable natures, do not infringe the laws of charity" (Thomas Browne)
Posts: 794 | From: here or there | Registered: Jun 2012
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tclune
Shipmate
# 7959
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Posted
Your view seems eminently sensible to me, which may either give you solace or pause...
--Tom Clune
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Posts: 8013 | From: Western MA | Registered: Jul 2004
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Bostonman
Shipmate
# 17108
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Posted
I can't speak to the particular theological vision expressed.
But it seems to me that they accept that organ donation, in general, is a good thing, and so their argument is structured like this: "I will not do [Good A] because [Good A] provides the opportunity for other people to do [Bad B] to me." In this case, "I will not [be an organ donor] because [being an organ donor] provides the opportunity for other people to [keep me alive and then kill me to use my organs]." This structure makes very little sense to me. If we think of examples with much more likely Bad B's than an unethical doctor, we get completely absurd and frankly un-Christian results. For example: "I will not [work at a homeless shelter in a rough neighborhood] because [working at a homeless shelter in a rough neighborhood] provides the opportunity for other people to [mug me on the way home]." That line of thinking is bizarre to me. Here's why: it's blaming the victim. It places the responsibility for someone else's sin against you on you. No, you can't be sure that the doctor won't unethically murder you. But then again, can you ever be sure that a doctor won't unethically murder you? Of course not.
(I'd also, of course, just empirically dispute the claim that a doctor would ever have to wait to find a suitable match for you. If my knowledge of medical TV shows says anything, it seems like it's usually the other way around... There are very long waiting lists, and as soon as an appropriate donor appears there's a very short wait.)
Posts: 424 | From: USA | Registered: May 2012
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mousethief
Ship's Thieving Rodent
# 953
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Posted
quote:
Originally posted by que sais-je:
My first thought was that they had misunderstood a philosophical example for actual advice but my friends are both intelligent people, one mathematician, the other an historian.
Being a good mathematician or a good historian doesn't necessarily make one a good philosopher or good ethicist.
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This is the last sig I'll ever write for you...
Posts: 63536 | From: Washington | Registered: Jul 2001
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Chesterbelloc
Tremendous trifler
# 3128
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Posted
Organ donation is explicitly taught about in the Catechism of the Catholic Church:
quote:
Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as a expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.
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"[A] moral, intellectual, and social step below Mudfrog."
Posts: 4199 | From: Athens Borealis | Registered: Aug 2002
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IngoB
Sentire cum Ecclesia
# 8700
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Posted
quote:
Originally posted by que sais-je:
They did so on the advice of the brother of one of them (a professional Catholic theologian based at some institute for advanced study).
Really?! Goes to show what that is worth these days...
quote:
Originally posted by que sais-je:
The argument was that if you were near death a doctor might be tempted to keep you alive in order to maintain your organs in a suitable state for later use. When a suitable recipient comes along the doctor might then turn off the life support - which, my friends were told, would be murder - to harvest the organ(s).
The argument is pants. Of course, we can imagine an evil doctor who harvests organs from people who still could live (obligatory Monty Python reference, not for the squeamish). But assuming that we are talking about "properly brain-dead" people on life support, then clearly this applies:
quote:
Encyclical "Evangelium Vitae":
Euthanasia must be distinguished from the decision to forego so-called "aggressive medical treatment", in other words, medical procedures which no longer correspond to the real situation of the patient, either because they are by now disproportionate to any expected results or because they impose an excessive burden on the patient and his family. In such situations, when death is clearly imminent and inevitable, one can in conscience "refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted". Certainly there is a moral obligation to care for oneself and to allow oneself to be cared for, but this duty must take account of concrete circumstances. It needs to be determined whether the means of treatment available are objectively proportionate to the prospects for improvement. To forego extraordinary or disproportionate means is not the equivalent of suicide or euthanasia; it rather expresses acceptance of the human condition in the face of death.
It requires "extraordinary or disproportionate means" to keep a brain-dead person "alive". More properly speaking, a de facto corpse is being kept "warm" here. This is done here for pragmatic reasons until the organs are needed, and the former owner of that body has at least implicitly agreed to this procedure (so it is not an act against the proper decorum in dealing with corpses). Stopping to supply this "aggressive medical treatment" is not equivalent to euthanasia, states the pope. Hence it cannot be murder to do so (how does one murder a corpse?). It may make us a bit squeamish, but that's because the idea of living body with a dead brain is horrible, not because the doctor is doing evil there.
quote:
Originally posted by que sais-je:
What do shipmates think? And could any expert on RC theology tell us if my friends correctly understood the Catholic position?
With a grain of salt concerning "expert" status: as you have related it, I do not think that this is a proper interpretation of RC theology.
By the way, I do acknowledge that there are some valid concerns as far as the declaration of being "brain-dead" is concerned. But that is a scientific and medical issue. I assume in the above that the doctor is in fact capable of determining "brain-death" in an accurate manner. If this is not the case, and I have seen some worrying hints that this is not the case, then indeed things become a lot more complicated morally.
[ 04. January 2013, 18:50: Message edited by: IngoB ]
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They’ll have me whipp’d for speaking true; thou’lt have me whipp’d for lying; and sometimes I am whipp’d for holding my peace. - The Fool in King Lear
Posts: 12010 | From: Gone fishing | Registered: Oct 2004
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Trisagion
Shipmate
# 5235
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Posted
I'm not a Moral Theologian and I'm not even a particularly moral Theologian and so would want to hear what the brother of your friend actually said/wrote before giving it full consideration but broadly I'd agree with what IngoB posted.
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ceterum autem censeo tabula delenda esse
Posts: 3923 | Registered: Nov 2003
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Avila
Shipmate
# 15541
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Posted
This may be a bit of a tangent but I had a funeral today where we buried the deceased with her husband in a village church alongside lots of relatives, her brother has reserved the space next to them - the last plot in the family corner.
It struck how different people view, value the body and where it ends up. The cost of a funeral seems to go up and up as well.
I decided some time ago and last year got the paperwork sorted to donate my body to an anatomy school. If anything is useful for transplant they get first dips and then I don't go to the med school (they need a mostly complete cadavar)but otherwise I go there, and it is a church only memorial service.
I can decide this having no spouse or children to consider, it is the cheapest option and also makes the leftovers useful for training new doctors etc.
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http://aweebleswonderings.blogspot.com/
Posts: 1305 | From: west midlands | Registered: Mar 2010
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que sais-je
Shipmate
# 17185
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Posted
Thanks to everyone. It seemed crazy to me, but then lots of things in this world do (especially some of my friends). I'm glad you all think it's crazy too.
InGoB said: I assume in the above that the doctor is in fact capable of determining "brain-death" in an accurate manner. If this is not the case, and I have seen some worrying hints that this is not the case, then indeed things become a lot more complicated morally.
I read an article suggesting this in New Scientist recently - and a subsequent refutation in the following issue. I tend to see death in two senses: that of the human animal and that of
the human being. By the latter I mean what being human means to me for example, I would consider my 'self' no longer human if I could not communicate with others. At which point life would have no value to me, and beyond hoping the human animal part of me could be useful somehow, I'm happy to become res nullius. That sets the threshold much lower than brain death (illegally so at the moment).
I was interested by Avila's response which reminded me of a London Review of Books article (14/4/2011) in which Stevin Shapin comments
Uneasily positioned between the profane and the sacred, the corpse is venerated, abominated and feared. Sometimes we do science with it; more often we shudder and pass by on the other side. We invest it with so much emotion, and are so ambivalent about its identity, that we can scarcely bear to know what it really is.
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"controversies, disputes, and argumentations, both in philosophy and in divinity, if they meet with discreet and peaceable natures, do not infringe the laws of charity" (Thomas Browne)
Posts: 794 | From: here or there | Registered: Jun 2012
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Belle Ringer
Shipmate
# 13379
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Posted
I suppose, humans being flawed, there is some possibility of a decision being made when your body is on the knife-edge of life vs death, of a doctor deciding he wants the organs more than he wants you alive again. But first you'd have to be in really bad shape, one where ability to return you to meaningful life is questionable.
And maybe it's an age thing, but I'm finding that while I have a lot of plans for the next 30 years, the possibility of this plans being cut short by an over-eager doctor failing to take yet another measure to try to return my almost dead body to life, is not a major threat.
My drivers license marks me an organ donor. My choice. Although I've wondered at what age they consider your organs no longer worth transplanting.
Posts: 5830 | From: Texas | Registered: Jan 2008
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Lamb Chopped
Ship's kebab
# 5528
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Posted
I have trouble seeing why any doctor on my case would have any competing priority for taking my organs. It isn't as if he would get paid for them, he is highly unlikely to be a transplant specialist himself (if he's in charge of my case), and it's vanishingly unlikely that he has a relative in need who just happens to be a good match for me.
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Er, this is what I've been up to (book).
Oh, that you would rend the heavens and come down!
Posts: 20059 | From: off in left field somewhere | Registered: Feb 2004
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Gramps49
Shipmate
# 16378
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Posted
There are certain protocols for harvesting organs. You might want to check with NHS to see what the protocols are.
Posts: 2193 | From: Pullman WA | Registered: Apr 2011
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Belle Ringer
Shipmate
# 13379
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Posted
quote:
Originally posted by Lamb Chopped:
I have trouble seeing why any doctor on my case would have any competing priority for taking my organs. It isn't as if he would get paid for them, he is highly unlikely to be a transplant specialist himself (if he's in charge of my case), and it's vanishingly unlikely that he has a relative in need who just happens to be a good match for me.
Pressure/opportunity from an underground organ rings? "The problem of organ trafficking is widespread" Wikipedia See also Guardian. Assuming "it can't happen here" is not always wise.
But I'm not worrying unless maybe I land in a hospital in one of the wrong countries; in which case if there's a problem, having an organ donor card or not won't be what makes the difference.
Posts: 5830 | From: Texas | Registered: Jan 2008
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Taliesin
Shipmate
# 14017
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Posted
this is a good book on the subject
Denial of the Soul by Scott Peck, which explores some of the myths surrounding medical ethics and options.
On the original OP subject, yes it sounds like someone has reduced an arguement to its unlikely conclusion - isn't that one of those laws? reductium... google is my friend... reductio ad absurdum. Maybe not - but it feels similar to never (doing x) in case you tempt another into sin.
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Taliesin
Shipmate
# 14017
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Posted
quote:
Originally posted by Belle Ringer:
quote:
Originally posted by Lamb Chopped:
I have trouble seeing why any doctor on my case would have any competing priority for taking my organs. It isn't as if he would get paid for them, he is highly unlikely to be a transplant specialist himself (if he's in charge of my case), and it's vanishingly unlikely that he has a relative in need who just happens to be a good match for me.
Pressure/opportunity from an underground organ rings? "The problem of organ trafficking is widespread" Wikipedia See also Guardian. Assuming "it can't happen here" is not always wise.
But I'm not worrying unless maybe I land in a hospital in one of the wrong countries; in which case if there's a problem, having an organ donor card or not won't be what makes the difference.
two things - apart from, how grim and awful of course - I understand that in the UK, we are now ON the organ register unless we opt out at the drivers licence stage.
and, I once read (in Amnesty literature?) that China is able to schedule transplant operations (something other countries can't do because recipients are waiting for a donor so need to be ready to come in when called) because more and more offences are becoming capital crimes, and after the execution the organs go for transplants. The implication is of course that people are being executed so that their organs can be sold to the wealthy - I don't know if this has been challenged or investigated further since that report. Do we have any shipmates from China who would comment? I realise it's a big place and may have different laws or ethics in different areas.
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Soror Magna
Shipmate
# 9881
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Posted
A person in the developed world is waaasay more likely to be the one buying a kidney, not having one stolen.
Posts: 5430 | From: Caprica City | Registered: Jul 2005
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mrs whibley
Shipmate
# 4798
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Posted
quote:
Originally posted by Taliesin:
I understand that in the UK, we are now ON the organ register unless we opt out at the drivers licence stage.
Urban myth, I'm afraid. Much as many would like an opt-out system in the UK, because it is known that many more people would be willing to give their organs than are actually registered donors and because so many people die on transplant waiting lists, the system is still very much opt-in.
It may be that when you renew a driving licence it is easier to opt in than out, but noone is going to put you on the register without your express consent.
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I long for a faith that is gloriously treacherous - Mike Yaconelli
Posts: 942 | From: North Lincolnshire | Registered: Aug 2003
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que sais-je
Shipmate
# 17185
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Posted
quote:
Originally posted by Gramps49:
There are certain protocols for harvesting organs. You might want to check with NHS to see what the protocols are.
See (in UK) the NHS organ donor site
Taliesin said: I understand that in the UK, we are now ON the organ register unless we opt out at the drivers licence stage..
I think that may be proposed but it isn't the case yet as far as I can tell.
Belle Ringer: Although I've wondered at what age they consider your organs no longer worth transplanting. I wouldn't wish my brain on anyone these days - but would that be a donation from me or someone donating their body to me?
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"controversies, disputes, and argumentations, both in philosophy and in divinity, if they meet with discreet and peaceable natures, do not infringe the laws of charity" (Thomas Browne)
Posts: 794 | From: here or there | Registered: Jun 2012
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Taliesin
Shipmate
# 14017
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Posted
quote:
Originally posted by Soror Magna:
A person in the developed world is waaasay more likely to be the one buying a kidney, not having one stolen.
I don't think anyone's mentioned theft, have they? It's all about extortion and encouraging the terribly poor to give up organs for cash.
meanwhile, in that Guardian article it said :
The persistence of the trade is embarrassing for China. The health ministry in Beijing has outlawed it and has also promised to stop harvesting organs from executed prisoners by 2017, a practice that has brought international condemnation. so my query was correct.
Posts: 2138 | From: South, UK | Registered: Aug 2008
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Soror Magna
Shipmate
# 9881
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Posted
quote:
Originally posted by Taliesin:
I don't think anyone's mentioned theft, have they? It's all about extortion and encouraging the terribly poor to give up organs for cash. ...
I was referring to the people in the OP who fear that doctors will hasten their deaths (or keep them alive) to take their organs for transplant.
Posts: 5430 | From: Caprica City | Registered: Jul 2005
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Choirboy
Shipmate
# 9659
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Posted
quote:
Originally posted by Bostonman:
(I'd also, of course, just empirically dispute the claim that a doctor would ever have to wait to find a suitable match for you. If my knowledge of medical TV shows says anything, it seems like it's usually the other way around... There are very long waiting lists, and as soon as an appropriate donor appears there's a very short wait.)
Absolutely 100%, even considering the delay in tissue typing to find the best match, deceased donor kidneys are transplanted within 24 hours of the incident that causes death. There is no waiting. One can envision perhaps an unethical doctor pushing an accident victim over the edge to obtain organs, but not keeping them around waiting for a donor. That said, the docs in the ER have no incentive to do so - they are neither part of the organ procurement organization (OPO), nor do they do the transplants. Their interests are quite in the opposite direction entirely.
Posts: 2994 | From: Minneapolis, Minnesota USA | Registered: Jun 2005
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que sais-je
Shipmate
# 17185
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Posted
quote:
Originally posted by Choirboy:
... the docs in the ER have no incentive to do so - they are neither part of the organ procurement organization (OPO), nor do they do the transplants. Their interests are quite in the opposite direction entirely.
There may be differences of ethos across different shipmates' countries. I hope NHS doctors in the UK don't see things in those terms.
Overall the views here would suggest the best chance of doing something useful with my ageing organs is just as a resource, a playground and (from what I've read) a source of obscene practical jokes for medical students. Which is fine by me. Allowing myself another 25 years gives me time to degrade the bits that are still working.
A plan of a C10 monastery in Jenny Uglow's history of gardening has a cemetery being used to grow nut trees (similarity of walnuts to brains?). I'm happy to be tree fodder. Maybe I could be composted and spread on my own allotment.
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"controversies, disputes, and argumentations, both in philosophy and in divinity, if they meet with discreet and peaceable natures, do not infringe the laws of charity" (Thomas Browne)
Posts: 794 | From: here or there | Registered: Jun 2012
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Carys
Ship's Celticist
# 78
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Posted
quote:
Originally posted by mrs whibley:
quote:
Originally posted by Taliesin:
I understand that in the UK, we are now ON the organ register unless we opt out at the drivers licence stage.
Urban myth, I'm afraid. Much as many would like an opt-out system in the UK, because it is known that many more people would be willing to give their organs than are actually registered donors and because so many people die on transplant waiting lists, the system is still very much opt-in.
It may be that when you renew a driving licence it is easier to opt in than out, but noone is going to put you on the register without your express consent.
Wales is in the process of legislating for presumed consent and archbishop Barry has spoken against this for reasons I still don't understand despite having gone to the seminar on it. He seemed to be saying against something else. Not sure where the debate is elsewhere in UK.
One of the key arguments for it is that the vast majority support donation but most of them haven't joined the register. Apathy is like that, so it makes sense to me to have the majority position as the apathetic one. Relatives could I believe still object.
Carys (who has joined the register on several occasions and seminar family know her wishes)
ETA Even though I'm on the register I probably won't be an organ donor because you have to die in a certain way to be useable.
[ 07. January 2013, 21:54: Message edited by: Carys ]
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O Lord, you have searched me and know me
You know when I sit and when I rise
Posts: 6896 | From: Bryste mwy na thebyg | Registered: May 2001
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Aravis
Shipmate
# 13824
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Posted
I think it's a mixture of apathy and superstition preventing people from signing up. Making the choice that someone can have your organs in the event of your death may seem like tempting fate.
Posts: 689 | From: S Wales | Registered: Jun 2008
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HughWillRidmee
Shipmate
# 15614
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Posted
quote:
Originally posted by que sais-je:
I'm happy to be tree fodder.
I'll go along with that - location chosen but hopefully vacant for a few years yet.
I carry the card, in the hope that some part of my body offers an improved quality of life for some poor sxx - the rest.....I've feasted off the products of the soil (directly and indirectly) for all my life, why not give what I can back for future generations?
Better said, and in verse too, by the Digital Cuttlefish
[ 07. January 2013, 23:15: Message edited by: HughWillRidmee ]
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The danger to society is not merely that it should believe wrong things.. but that it should become credulous, and lose the habit of testing things and inquiring into them...
W. K. Clifford, "The Ethics of Belief" (1877)
Posts: 894 | From: Middle England | Registered: Apr 2010
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Palimpsest
Shipmate
# 16772
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Posted
Oddly enough I find myself agreeing with IngoB. When I was talking to my brother the doctor about giving him a medical power of attorney, he told me that the problem is that it's easy to get on the recesciutaion equipment and much harder to get off, even when it's clear that there's brain death. When my mother died of a brain hemmorhage this last year, my brother took great care to get her on life support long enough to make sure there was no response and then got her off (much harder).
As for your friends, they remind me of the case in Israel. The Orthodox Jews refuse to sign up as organ donors. They went to court ( and lost I think) when the medical establishment said that priority for supplying organs would go to people who had signed up as donors.
I'd ask your friends if their aqueamishness would extend to not accepting an organ from the evil medical establishment.
Posts: 2990 | From: Seattle WA. US | Registered: Nov 2011
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