Organ Donation Ought To Be An Opt-Out System, As A Start

As we continue to hear health care-related horror stories from south of the border, I happen to think our Canadian universal health care works pretty well. It's far from perfect, as anyone who's had to wait months for an appointment with a specialist knows all too well. But it's still much, much better than what our American cousins have, for the most part (a well-off citizen of the U.S. may fare better than we do, of course, because he or she can just buy the best care).

But one change that I wish our government would introduce involves organ donation. As it stands right now, it's an opt-in system, meaning that each person has to indicate that they're willing to donate their organs upon death. An opt-out approach would mean that everyone, by default, agrees to donate (if needed), unless he or she specifically took steps to opt-out of the program. The opting-in used to be accomplished via a section on your driver's license, but I think they've even changed that now. I went to this link today and it appears that there's an OHIP database for it now (at least in Ontario!) but that it still operates as opt-in.

Given that virtually all of us are eligible for organ transplants in the event that we need them, it really ought to be opt-out on the donation side. In other words, only someone who had specifically declared that they weren't willing or able to donate organs in the event of their death would be "off-limits" for organ harvesting. I'd even go further than that, though. Let's call those who opt-in, Category 1. If you choose to opt-out, you should have to provide a reason, from one of two categories. If there's a medical cause, something that a physician would agree keeps your organs from being viable, then you're Category 2 and will be treated like everyone else, with the exception that your organs won't be used; if, on the other hand, you just don't want to do it, then you're Category 3 and should automatically go to the bottom of any donor recipient list that you might find yourself on at any point in your life. (And to keep people from just opting-out, and then opting-in upon being told that they need a life-saving transplant, I'd require a 3-year waiting period, for anyone pulling such a maneuver, before they'd be eligible to get into the "better queue" composed of Category 1 and 2 folks.)

I'm sure this may strike some as a mean-spirited attitude on my part, but I'm personally just sick of peoples' selfishness. If you expect more out of Life than you're willing to put into it - if, for example, you think that someone else should donate the organ that will save your life even though you're not charitable enough to return the favour when you die - then I really don't have a whole lot of respect for you as a person. It's a big world around us, and we need to be willing to consider "the other guy" at least some - if not most - of the time, in order for all the pieces to work together for the benefit of us all. I've railed in the past against people who won't donate blood (and yet will accept a transfusion), but organ donation asks even less of a person, since it only happens after they die. I can accept that someone might be afraid of needles and thus not want to give blood; but refusing to give up your organs after you die? That just seems like pure selfish behaviour to me, and I don't think people of that sort should continue to be treated the same as those with more generosity in their hearts and minds.