STEPHEN GLOVER: I find the idea of the State owning of organs sinister
28th February 2019

As a new presumed consent law clears the Lords… STEPHEN GLOVER asks: Why do I find the idea of the State taking ownership of our organs so sinister?

Who owns your body? You probably think you do. But actually the State thinks it has a valid claim on your organs. It has been casting an avaricious eye on them for some time.

As a result, a new law will be introduced in England in the next few days, having cleared its final hurdle in the Lords, which will presume that you consent to having your organs removed after your death. Such arrangements already exist in Wales.

Unless you have specifically opted out, doctors will be able to remove your heart, kidneys or whatever it may be. This seems a pretty revolutionary, even sinister, step, and it amazes me that this law has wound its way through Parliament, and is awaiting the Queen’s automatic approval, with so little public debate.

In the case of presumed consent, the authorities are motivated by a desire to save more lives

Needless to say, I am strongly in favour of more people voluntarily donating their organs since there’s no doubt that hundreds of people die every year while waiting for a new heart or kidney that never appears.

I admit I don’t carry an organ donor card, but that is largely because the idea that anyone would want my heart, or indeed any other of my organs, is risible. At best they might be displayed in a bottle for medical students to marvel at.

But if I were a fit and healthy 25-year-old, I hope I would do the right thing and carry a card so that, if anything untoward happened, bits of me might be of use to someone else.

Only about a third of people carry a card, while research suggests that some 80 per cent are happy in theory to bequeath their organs. It seems the take-up of voluntary organ donation could be much higher than it is.

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But that, of course, would involve the Government going to the trouble and expense of evangelising more than it has been prepared to do. How much easier for the powers-that-be to turn the problem around, and declare that, unless you make a hue and cry, your organs belong to the State.

My objections rest on two grounds. One is philosophical: your organs are your own. The other is practical: what has happened in Wales suggests that ‘presumed consent’ may actually reduce the number of available organs.

Let’s examine the philosophical considerations first. Over the past few decades the idea has grown up that the State in some way owns your life, or at the very least has responsibility for it.

The most obvious example of this tendency is officialdom’s insistence that adults should wear seat belts in cars. Although no one else’s life is put in peril if you don’t, all of us are now required by law to do so.

Before the wearing of seat belts was made compulsory in front seats in 1983, there was a ferocious debate about whether the State had the right to force us to buckle up.

I admit I don’t carry an organ donor card, but that is largely because the idea that anyone would want my heart, or indeed any other of my organs, is risible

Now almost everyone accepts the legal obligation, I suppose because most of us can see that in this matter the State is right, and wearing seat belts appreciably lessens the chance of death or serious injury in the event of an accident.

Nevertheless, an important line had been crossed, and the relationship between the individual and the State had been subtly, though fundamentally, changed.

So we should hardly be surprised that the State should come back and inform us that, contrary to what we had previously believed, it has some sort of stake in our organs.

It is perfectly true that in so doing the State displays benevolent motives — as it did when it made us wear seat belts for what it deemed was our own good. In the case of presumed consent, the authorities are motivated by a desire to save more lives.

The trouble is that in this worthy enterprise they are forced to rely on doctors. I naturally revere these usually wonderful people. We are all of us grateful for the great good they do. But recent history reminds us they are not gods.

For example, as the Mail revealed several years ago, doctors surreptitiously developed the Liverpool Care Pathway. Without relatives being informed, terminally ill patients were drugged up and steered ineluctably towards death in their final days.

Or consider what happened at Alder Hey Children’s Hospital in Liverpool. Between 1988 and 1995 — which is not very long ago — the organs and body parts of hundreds of deceased children were removed without parental consent, and stored for medical purposes.

Is it altogether fanciful to imagine that in the new era of presumed consent, a well-meaning doctor might feel under pressure not to prolong the life of a dying patient so that his or her organs could be whipped out as soon as possible?

The risk of the new law is that patient trust will be eroded. How much more morally sound, it seems to me, is the present practice of inviting people to identify as donors.

Wouldn’t it be far preferable to encourage and develop this way of doing things rather than embracing presumed (one might more accurately say ‘presumptuous’) consent?

And then there are practical objections. Ministers have claimed that the new arrangements will save up to 700 lives a year, but there are good reasons for doubting that this will be the case.

In 2015, Wales introduced a new opt-out system very similar to that which England is now adopting. And yet there has been small dip in the number of deceased donors — from 64 in 2015-16 to 61 in 2016-17. As a result there was a drop in organ transplants in the principality from 214 to 187.

In fact, under the old law in Wales, as in England until now, organs were taken from a dead person who had not signed up as a donor provided that he or she had not opposed such a procedure, and that relatives agreed. (Under the new law in England, families will still have the right to block the removal of organs from a deceased relative if they knew that he or she was fervently opposed to organ donation.)

It’s significant that in Wales some 180,000 people have now specifically opted out of the new system on the grounds that it is coercive, and the pool of potential donors has not increased in the way that was envisaged. This figure equates to some three million people in England.

Moreover, according to unpublished analysis by an organisation called NHS Blood and Transplant, hospitals are so short of key specialists, and equipment needed to keep organs viable, that the health service may not be able to harvest extra organs — if, indeed, more are produced.

Wouldn’t it be ironic if, despite the State heavy-handedly laying claim to our bodies, we ended up with a state of affairs no better than what we have at present, with hundreds of people dying for lack of replacement organs?

Respectable organsiations such as the Nuffield Council on Bioethics (an independent body which examines issues thrown up by medical advances) have suggested that the Government should put more effort into encouraging people to be donors.

And yet this Tory Government has preferred to assert part-ownership of our organs. Is it possible that, at any rate subliminally, ministers relish the idea of extending State power? I’ve little doubt that one day they’ll be back for more.


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