July 30, 2008

No Hobgoblins Here

It occurs to me that my earlier thoughts about opt-out organ harvesting laws may be, in a significant way, fundamentally incompatible with my thoughts in the same post condemning laws forbidding the sale of one's own organs. This disturbs me somewhat less than it seems it ought to.

On the one hand, if my organs are my own property, then I get to say what happens to them, not the government. I ought not to have to take some affirmative action to keep the government from taking what is mine. And if I get to say what happens to my physical property, like my car or my house, once I'm dead, then I certainly should be able to say what happens to my body once I'm dead.

"Escheat to state" is always the last resort of the law of intestate succession. The proposed law in Canada would put the state first in line to get my organs when I die.

But on the other hand, harvesting organs may create a much greater social good than the somewhat silly idea of preserving my "right" have my organs rot or turned to ash uselessly, despite the fact that it is something of an upending of traditional notions of property rights and bodily autonomy. I need to go out of my way to have other parts of my property destroyed upon my death; why should my body be any different? Yeah, it's kind of yucky, but get over it -- isn't the question whether we're going to let thousands of lives be lost and tens of thousands degraded in quality to preserve the unasserted "property right" of someone who is already dead?

I suppose in one way, this is another permutation of utilitarianism versus deontology, the great philosophical struggle of the modern western world and to which no principled solution has yet been found.

And the problem has to be solved by law one way or the other, because the resource of viable human organs is evanescent because organs must be harvested soon after death if they are to be used effectively -- and because most people can be counted on to take no action one way or the other and will go along with the "default" provision of the law through inactivity. The great good that can be realized from organ harvesting requires that there be a sufficient supply of organs to save the lives of the living but very ill. So if there is to be organ harvesting at all, it makes sense to harvest as much as possible to avoid waste and to preserve life.

I don't think one necessarily has to be ideologically consistent about all things, all the time. It would be good if that were the case, but it's possible to take that to an unreasonable extreme. I like the idea of a free market economy as an ideal, but I also like the idea of the government participating in and sometimes manipulating that "free" market for a common benefit that the market would not realize on its own.

Maybe the way to reconcile my conflicting thoughts -- on the one hand, those organs are mine and the government should not simply presume to take them, and on the other hand, the government is uniquely situated to prevent the waste of those organs and realize a greater social good -- is to have the government pay my estate for my organs in the absence of any instructions otherwise. The payment would be a minor consolation to those I leave behind, defraying end-of-life medical care or funerary expenses.

Of course, that's an inconsistent thought with the idea that the government should be frugal as a general proposition; buying organs from dead people would wind up being quite an expensive undertaking in the aggregate. And the widespread prevalence of organ harvesting may well lead to a wide variety of unintended consequences -- one of my favorite science fiction writers contemplated this exact issue and theorized that society would impose capital punishment for nearly every kind of crime so that organs could be harvested from the criminals, creating a horrific and unjust society. And apparently it is also the subject of not one but two dystopian movies scheduled for release in 2009.

But the real point here is that in order to explore thoughts and weigh issues, sometimes one must entertain different kinds of thoughts and find a way to reconcile them. This can be intellectually difficult and after several mental returns to this morning's initial enthusiasm over the idea of changing the "default" law for organ harvesting, I find myself even more twisted between the differing imperatives that are implicated by this idea. It's the sort of mental uncertainty I enjoy and from which I think much intellectual profit can be derived, at least before the issue becomes ultrasimplified for political exploitation.

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