( 2 ) Opt out organ harvesting is ethical. — fdrake

This is where I would disagree.

The person's body and the organs therein are no one's property to "harvest" after death. As much would imply the person's body is the property of the state, and it is simply for the duration that the person's soul occupies the body that it is lended to the person.

The totalitarian's gushing wet dream, of course. Only one step left to go, and that is to claim the soul also.

The person's body and the organs therein are no one's property to "harvest" after death. As much would imply the person's body is the property of the state, and it is simply for the duration that the person's soul occupies the body that it is lended to the person. — Tzeentch

I think there's two ways to take this, the first is going down the path that you can harvest people's organs without seeing the bodies as property, the second is that ( 2 ) is an assumption in the argument for establishing a conditional, rather than an argument for the claim. Perhaps that misinterpretation is my fault. I think the second path is more relevant; the truth or falsity of ( 2 ) doesn't figure in the validity of the argument, only "IF ( 2 ) is true THEN (the argument's conclusion)" matters. The argument is indifferent to whether ( 2 ) is true.

Ah, I see.

In that case I would probably interject here:

( 10 ) A violation of bodily autonomy would only occur if a person's articulated preferences were neglected. — fdrake

To impose the cost of having to articulate one's preferences to avoid having one's body laid claim to seems baseless because of what I said earlier. The state has no right to the person's body, so no right to impose costs on the person for keeping the state the hell away from it.

In other words, I would consider any use of the body without articulated permission a violation of bodily autonomy.

In other words, I would consider any use of the body without articulated permission a violation of bodily autonomy. — Tzeentch

Fair! Then you'd see opt out organ harvesting as unethical. Which is also consistent with the argument.

I've added notes to describe the logic of the argument @Tzeentch. They're in the *s. Whether the inferences really hold are still up for debate.

Especially helpful for dummies like me. :lol:

Nah, my presentation was unclear. I appreciate you engaging with it.

[quote]( 2 ) Opt out organ harvesting is ethical.

I think there's two ways to take this, the first is going down the path that you can harvest people's organs without seeing the bodies as property.[/quote]

After reading the well written arguments on this topic (interesting thread, @fdrake) I end up in the conclusion that Opt out harvesting is fully ethical because as premises 4 and 5 indicate:( 4 ) Opt out organ harvesting is ethical because it is more beneficial than harmful. (premise)
( 5 ) Generalising from 4, a procedure performed to a dead body is ethical if it is more beneficial than harmful. (same justification as line 2).
Then, we can conclude that we can "obviate" someone's consent if it would help others.

In the other hand, there is always been a deep debate on if we should consider our bodies as "our properties". Allow me to share with you an interesting jurisdictional opinion regarding to this topic by the Supreme Court (of Spain, my country)

1. Whenever a person dies, he/she loses her/his civil personality and then he/she lacks his/her own right to claim.[ * (Yet, an authority represented by their interests can take decision on order to complement someone's interests)

2. Public order must prevail over private. A judge must decide and authorize an organ donation if the health and life of others is at risk, even if the donor had not expressed his agreement or disagreement while alive.

1. Whenever a person dies, he/she loses her/his civil personality and then he/she lacks his/her own right to claim.[ * (Yet, an authority represented by their interests can take decision on order to complement someone's interests)

2. Public order must prevail over private. A judge must decide and authorize an organ donation if the health and life of others is at risk, even if the donor had not expressed his agreement or disagreement while alive. — javi2541997

Thanks for this detail Javi! I think the argument in the paper uses something like ( 1 ) as an assumption - losing civil personality occurs with death. You have also highlighted a flashpoint in the article - an ambiguity about what "articulated consent means", and also what informed consent entails.

Specifically this considers whether: "an authority representing (the dead's) interests" may, and needs to, be consulted on whether the procedure respects the potential donor's wishes. If it were established that that is the only ethical form of opt out organ donation, it would undermine any point in the argument which said "articulated consent" - which is perhaps equivocated with every form of consent. IE, someone articulating consent on your behalf may be an exclusion to this.

The article tries to parry this attack through biting the bullet then a tu quoque. The relevant section is this:

However, the consent requirements for organ donation are extremely loose, in comparison with consents required for other forms of medical intervention. Recent legislative changes in the UK, for example, mean that a person’s organs may be harvested without any clear indication that they wished for this to happen. Should we expect something more demanding than this, if we include WBGD among the uses of a person’s body after their (brain) death? If so, why, given that we accept such minimal requirements for ‘normal’ organ donation? Perhaps one answer here is that WBGD is not something that people understand or have knowledge of. Therefore ‘deemed consent’ such as the organ donation framework relies on, is not properly informed. People who fail to opt out of the organ donation system can be regarded as having passively consented to something they have sufficient knowledge about. Everyone has heard of organ donation. No-one has heard of WBGD. Moreover, WBGD is qualitatively different in that it entails ventilation over an extended period. And, of course, its aim is not ‘life-saving’ per se as organ donation is usually understood to be.

It attacks the legitimacy of deemed consent for current organ donation practices - specifically because people do not typically understand what they've signed up for with organ donation. One relevant point is that bodies are kept on respirators to pump the body full of oxygen. If people were aware that their body would be kept in such a state as their organs were removed, would that impede consent? More precisely, if people do not need to know such details to count as giving consent in organ donation, what distinguishes this from WBGD?

This paints a picture of consent in ethical opt out organ donation: the potential donor has not provided a written statement of intent. Furthermore, deemed consent is seen as acceptable when your wishes are not known and who is arguing on your behalf could not give informed consent due to not knowing your mind on the details of the procedures.

So, the article argues, while it may be true in principle consent is required, in practice organ donation's deemed consent requirements cannot be guaranteed to respect the potential donor's wishes. If you grant this renders opt out organ donation unethical, then one side of the constructive dilemma has been chosen.

If you insist that, nevertheless, WBGD is unethical and opt-out organ harvesting is ethical, it may need to be on a different basis than "deemed consent" through a third party.

if the health and life of others is at risk — javi2541997

This is another counterpoint discussed in the article; though in this case they break the direct comparison with organ harvesting and transfer and into a broader harm prevention framework:

Unlike any other form of organ donation, WBGD imposes no risks on the ‘recipient’. It has the additional advantage of conveying significant clinical benefits on women who make use of it. If WBGD were offered as an alternative to pregnancy generally, the clinical benefits would be striking. It is here that I diverge most significantly from Ber. Ber argues that only the neediest of claimants should have access to WBGD – those who have clear medical contra-indications to pregnancy or lack a uterus altogether. The problem with this is that pregnancy itself should properly speaking be medically contra-indicated for women generally.

It is well known that pregnancy and childbirth carry significant health risks, even in affluent settings with sophisticated healthcare systems [26, 27]. To expose oneself to risks comparable to pregnancy and childbirth would be deemed foolish and pathological in any other context. I have previously shown that in a comparison between pregnancy and measles, pregnancy comes out considerably the worse in terms of morbidity and mortality [28]. Yet concerted medical efforts are focussed on ridding ourselves of measles, while women are expected to submit themselves to the greater risks of pregnancy and childbirth almost without thinking about it.

The author argues that the harm prevented by WBGD would actually classify it as an excellent medical procedure. The risks of pregnancy to a living person could be totally mitigated by the use of a dead one. And those risks are quite considerable.

In that respect, the intervention is construed not as life saving in the sense that someone will immediately die without the its use, it's construed as life saving in the same manner as a vaccine; prevention, rather than cure.

Nevertheless, that is a distinguishing feature of opt out organ harvesting from WBGD - it raises the question, what is the ethical distinction when both are harm reducers and life enablers? How would this distinction block the concluded entailment?

My initial problem is with the word 'harvesting'. The citizenry as a crop; the government as reaper. There is something very skewed about that concept, even before the ethics of the situation - properly called dismemberment of dead bodies.
The ethical consideration rests on one question:
Is leaving one's body to the nation an articulated condition of citizenship?
A secondary question would be: Is the dead person's religion taken into account? Because a lot of religious people believe that their bodies, as well as their souls, are lent out by a heavenly entity, not an earthly one. They render their taxes onto Caesar, not their livers.

My initial problem is with the word 'harvesting'. The citizenry as a crop; the government as reaper. There is something very skewed about that concept, even before the ethics of the situation - properly called dismemberment of dead bodies.
The ethical consideration rests on one question:
Is leaving one's body to the nation an articulated condition of citizenship? — Vera Mont

I think I can give the same response to this as I did to @Tzeentch, if you grant that opt out organ harvesting is unethical, you already choose one horn of the constructive dilemma. Opt out organ harvesting and WBGD would both be unethical on this basis.

what is the ethical distinction when both are harm reducers and life enablers? How would this distinction block the concluded entailment? — fdrake

I think the ethical distinction between both practices lies in the extension of the free will of the donor. We can be agree with the fact that is more ethical when somone decides the destiny of his body afterwards.
But the law is not enacted to solve ethical issues but to reach equity. That's why I see it is fine if a judge needs to make a decision because we consider judges and courts as third parts who resolve problems of the societies and they interpret what should be someone's wishes if the interests of a person is at risk. We cannot take these premises so personally because (in my humble opinion) it would be a selfish act to opt out a donation when a someone needs it so urgently. Otherwise, interpreting our bodies as property it looks like a religious belief rather than ethical one...

Another example is on names and second names (I know it is off topic but I think is a good example): Each individual since is a kid has the right of having a name but imagine for a second that the kid is abused by their parents. I see acceptable if a judge removes his second name if it is necessary to protect the kid. It doesn't matter the consent of his parents if they are abusers...

Conclusion, it is possible to led judges to decide as third arbitrary parts for what could the best for the persons.

if you grant that opt out organ harvesting is unethical, — fdrake

I didn't. I made no ethical determination.
I asked what the legal position is as to citizenship, religious privilege and ownership of human bodies. It could be argued, for example, that if the family is responsible for legal and hygienic disposal of the body, they own it, once the occupant has departed, just as they inherit his house. If the state owns all unoccupied bodies of its citizens, it should also be liable for their dignified post-harvest disposal.

Otherwise, interpreting our bodies as property it looks like a religious belief rather than ethical one... — javi2541997

But the treatment as an object, or consumer item, whose possession is to be legally decided presupposed its status as property. It is presumed the property of the occupant as long as he's in possession; his to leave in a will, like anything else he owns. There is nothing either ethical or religious about that: it's a thing that can be argued over, arbitrated, cut up, portioned out and used.
The only question here, who has a right to decide how it will be used, absent the owner's explicit instruction.

What happens to one's corpse? It's either buried/cremated and in both cases, perfectly working organs are destroyed when they could actually save lives. I say we harvest organs of dead people. Why would they mind at all?

But the treatment as an object, or consumer item, whose possession is to be legally decided presupposed its status as property. It is presumed the property of the occupant as long as he's in possession; his to leave in a will, like anything else he owns. There is nothing either ethical or religious about that: it's a thing that can be argued over, arbitrated, cut up, portioned out and used.
The only question here, who has a right to decide how it will be used, absent the owner's explicit instruction. — Vera Mont

If it is consider as one’s possession with the status as property, why suicide is condemned by both religion and laws? Because someone needs to take responsibility in a public order and whatever I would do with my body it would make a reflect act. I don’t see that we are so free as long as we keep alive to decide on the volunteerism of the free will in our bodies.
In the other hand, I still think that the only third part capable of deciding on other someone’s interests can be the judges. As I said, each of us have a lot of private interests but the public order is over to self care.

I want to be an owner of different buildings in Madrid but at the same time I have to pay taxes for those real state properties because it is necessary to share a bit of my wealth with others…

If it is consider as one’s possession with the status as property, why suicide is condemned by both religion and laws? — javi2541997

Because in Christianity, humans, locks, stock, body, soul, progeny and livestock are the property of God, and only God has the authority to decide when and how they live, when and how they die. well, God and the king and the magistrates. The laws of modern western countries were all founded in Christianity. Even Islam has its roots in the Old Testament.
Those religious precepts, which also inform secular legislation and jurisprudence - hence the decades of legal struggle over women's rights, children's rights, ethnic rights, gender rights - did not anticipate the transplanting, farming, selling or harvesting of organs.

In the other hand, I still think that the only third part capable of deciding on other someone’s interests can be the judges. As I said, each of us have a lot of private interests but the public order is over to self care. — javi2541997

How is the public order affected by someone giving or not giving up their corpse for dissection? In fact, the awareness of potential transplantation is far more likely to cause law-breaking than the lack of that possibility. You get sick; your organs fail; you die; the state continues on without missing a beat.
Nobody owes you a kidney, not even the government. However, if you need a kidney and a transplant is almost certain to save your life, there is a great temptation to knock off your brother and take his, or buy a healthy young girl's from Bangladesh. The less rigorous legal and medical oversight is practiced, the more easily such illicit transactions take place.

It should be noted that if one's body is made property of the state, that "state" is in fact only a surrogate term for a collection of (usually highly corrupt) individuals who hold power. In other words, one's body becomes the property of other individuals - slavery.

It should be noted that if one's body is made property of the state, that "state" is in fact only a surrogate term for a collection of (usually highly corrupt) individuals who hold power. In other words, one's body becomes the property of other individuals - slavery. — Tzeentch

To some degree, that has always been the case. Under all legal system I know of, any person may be called to civic service, conscripted, detained, interrogated, imprisoned, and, if the death penalty is still on its books, executed by the state.
But the present question concerns power over dead bodies, when slavery is no longer an issue, only the allocation of parts.

To some degree, that has always been the case. ... — Vera Mont

Regrettably so. Luckily we as free individuals have a choice to resist such unethical practices!

But the present question concerns power over dead bodies, ... — Vera Mont

Note that 's idea seems to extend not just to the dead body, but to the whole person even while alive.

Have at it! — fdrake

This is a great discussion. I don't have strong feelings either way. Not to go on a tangent, but one thing bothered me. This from the article you linked:

Whole body gestational donation offers an alternative means of gestation for prospective parents who wish to have children but cannot, or prefer not to, gestate.

In a similar vein, would you feel differently about this if the organs were used for cosmetic surgery rather than surgery that is medically necessary.

I fully respect your arguments and words but I think you misunderstood my views on this thread or topic.
One of the main debates is to consider if a third person can decide on someone's interests when such individual is no longer available to do it by himself. The judges (or prosecutors in some special cases) hold this power to decide in the best interests of the persons or community involved. As I said previously, the law is applied to get equity not to solve ethical issues because that would be so ambiguous and the results could not be satisfactory at all.
But this is not an invention of modern states. Roman law already foresaw this judicial dilemma when the consent of someone was needed but impossible to get or provide. Then, jurists created civil figures to avoid these problems such as guardians, conservators, fiduciaries, the rule of the parents as authority etc... So, it is necessary to ensure such circumstances thanks to the guarantee of third parts who take the responsibility. This can be applied to make decisions toward donate someone's organs afterwards but there are some important examples as much as the subject of this thread. For example: People declared absent because they have disappeared and his whereabouts are unknown. I think it is necessary to ask a third person to please take care of such special issue. Thus, a judge can make decisions on the absent's interests without his permission. Otherwise, it could exists a lot of problems and difficulties just because we cannot get the consent of someone who we don't even know where is at...
Well, this is what happens to the dead people. Someone needs to make decisions in their names or persona because it is obvious that they no longer can do so.

A disturbing paper, but very interesting. I never knew of the opt-out system.

I have to object from the get-go because there is no justification as to why the state, medical system, or any other organization should have sole property rights over brain-dead human beings.

So I’m stuck with a questions. How do brain-dead human beings become the exclusive and legitimate holdings of this organization?

How do brain-dead human beings become the exclusive and legitimate holdings of this organization? — NOS4A2

Those organizations (supposedly) are there to help others or preserve nursing and caring. If they are aware of someone who dies and their organs can help others, they can ask a judge to authorize organ donation on behalf of that person to preserve the health and life of others.

Those organizations (supposedly) are there to help others or preserve nursing and caring. If they are aware of someone who dies and their organs can help others, they can ask a judge to authorize organ donation on behalf of that person to preserve the health and life of others.

To me the judge isn't the sole proprietor of brain-dead human beings, so I would disregard his decision as illegitimate and unethical.

In a similar vein, would you feel differently about this if the organs were used for cosmetic surgery rather than surgery that is medically necessary. — T Clark

Edit: I misread that you were talking about opt out organ harvesting rather than WBGD, but my position's the same. Cosmetic use of organs vs clinical need. Clinical need seems very much a part of what's granted to make organ harvesting ethical.

Undecided. If you bracket the autonomy consideration; I think some element of medical necessity is required to stave off feminist concerns and curtail possible horrific cases of abuse. I'm honestly not sure what to think due to how much branching occurs in the argument in the paper. In general I think the weakest section is its rather trite response to possible feminist responses, and this speaks exactly to the harms engendered if it can be used for convenience. How that fits into my summary would be undermining this premise:

( 11 ) Harms to the living derive from the denial of bodily autonomy.

Because the harms done may also include institutionalising the objectification of women's bodies, which induces discrimination more generally rather than the specific denial of reproductive rights.

I'll quote it:

One might argue that WBGD involving brain-dead women has no implications for living women, any more than harvesting the heart from a brain-dead man has an impact on living men. However, perhaps this is disingenuous. WBGD necessarily involves the separation of women’s reproductive functions from their very consciousness. Even if no-one would suggest that this should alter the way we regard ordinary women and their pregnancies, it might send an implicit message, or reinforcement to deeply entrenched assumptions and prejudices. The prospect of the unconscious woman’s body, filled and used by others as a vessel, is a vivid illustration of just what feminists have fought against for many years.

These feminist concerns, however, might be mitigated if men could also participate in WBGD. The prospect of male pregnancy is not, as many would imagine, fanciful, or a piece of science fiction. In 1999, Robert Winston told reporters that there were no intrinsic medical problems with initiating a male pregnancy: the danger would be in the delivery. We already know that pregnancies can come to term outside the uterus [31]. The liver is a promising implantation site, because of its excellent blood supply. However, as Winston noted, this could be risky – even fatal - for the person carrying the pregnancy. But for brain-dead donors, the concept ‘fatal’ is meaningless: the gestator is already dead. Thus, even if the liver is damaged beyond repair after the gestation, this would not pose a problem except insofar as it might mean that male gestators could carry only one pregnancy, rather than many consecutive ones.

The prospect of the male gestator could thus appease some feminists who might otherwise feel that brain-dead gestation is a step too far in the objectification of women’s reproductive functions.

The paragraph seems to say the WBGD could not be discriminatory because it would be possible to implant babies in men in the same way. That response isn't just trite, it's unrealistic as AFAIK it could not be practically implemented. If it's not possible, the sub argument's premises don't hold.

Regardless, if it were granted as a "sci fi" thought experiment scenario, it may still follow. However, it would mean imagining a much different society than we're in now. One where WBGD didn't provide a unique vector for control of women's bodies. The question remains though - does it reinforce control and discrimination and how does it do so? In what sense does it objectify women's bodies? Then in terms of risk - is this mitigated in any way by making it only administered when it allows an otherwise unable parent to have a child - some kind of necessity of intervention? Can having a womb be rendered incidental to process?

But the law is not enacted to solve ethical issues but to reach equity. That's why I see it is fine if a judge needs to make a decision because we consider judges and courts as third parts who resolve problems of the societies and they interpret what should be someone's wishes if the interests of a person is at risk. — javi2541997

I think I see where you're coming from. Am I right in thinking you're suggesting that because these decisions are made by judges and laws, a dead person's articulated informed consent is not required?

Am I right in thinking you're suggesting that because these decisions are made by judges and laws, a dead person's articulated informed consent is not required? — fdrake

Exactly, because I consider judges as authorities who are able to make decisions or confirm consents in name of someone who is no longer capable to do those acts.

But the law is not enacted to solve ethical issues but to reach equity. That's why I see it is fine if a judge needs to make a decision because we consider judges and courts as third parts who resolve problems of the societies and they interpret what should be someone's wishes if the interests of a person is at risk. — javi2541997

The law is a result of legislation within a constitutional framework, which is based on stated moral principles. Every new law is assessed by a series of legal entities for concordance with those constituted principles. Jurists themselves swear to uphold a code of ethics when administering the law. So, when a judgment in law is carried out, it's done within those stated ethical standards.

they interpret what should be someone's wishes if the interests of a person is at risk

Only it's not interpretation in these cases; it's arbitration. If person whose religion professes the sanctity of the body died without knowing that he could be parcelled out like bushels of wheat, because he did not explicitly forbid it in writing, his interest would be violated by the harvesting policy. If the judge ruled in the favour of the dead man, several patients waiting for his organs would be at risk. Their interest can only be served by denying his interest.
But several patients, plus the medical institution plus the state would be better served by overruling the dead man's wishes - even if he did write them down.
And we don't even know the judge's moral convictions.

One of the main debates is to consider if a third person can decide on someone's interests when such individual is no longer available to do it by himself. — javi2541997

A dead person has no 'interests'. Yes, the law needs to consider, and if necessary, arbitrate matters pertaining to the care and treatment of persons who are incapable of making their own decisions, and have no personal advocates to represent their interest. And persons who are absent from the scene - in hospital in a coma, or missing in some action, but not yet legally presumed dead, need their interest safeguarded - this generally refers to property or familial rights.
None of those apply to a dead person. His interests are not under consideration, unless he made a legally binding will. The law does provide for a dead person's property to be disposed according to his will. In the absence of a written will, the state has the right to apportion whatever property is not legally claimed by an heir. If there are no heirs, the state becomes the beneficiary.
It seems to me the same rule applies to dead bodies.
The matter of ownership is decided between the heirs and the state. If there is no legal claim to the remains, the state can take possession.
There are only two ethical issues that seem me unclear:
1. Is this clause generally known by the population as part of their civic obligation? I.e. is it explicitly articulated in law?
2. Does this policy contravene standing policy regarding religious rights and privileges?
3. Having taken possession of the body for harvesting, does the state undertake the responsibility for dignified disposal of whatever is left? Or, having appropriated the useful bits, does it download that effort and expense on the family? (I know that in the forensic arena, where the body is examined for cause, means and manner of death, the state has a right to open the body and remove parts, but the body is then returned to the family for disposal.)

Presumably the bodies are kept alive in order to be used for the period of gestation. So there is the added question of: should these brain-dead people be kept alive, used as incubators, so that someone else may become a mother? Should they be kept alive so that we may harvest their organs should the need arise?

1. Is this clause generally known by the population as part of their civic obligation? I.e. is it explicitly articulated in law? — Vera Mont

Well, at least in my country is explicitly articulated in law. We have to check every state’s laws and see what they articulate towards the destiny of a dead corpse.

Having taken possession of the body for harvesting, does the state undertake the responsibility for dignified disposal of whatever is left? Or, having appropriated the useful bits, does it download that effort and expense on the family? — Vera Mont

According to same laws the efforts and expense needs to be taken by the goods and money he or she left in the inheritance. If these are not sufficient, it needs to be paid by the goods of the successors and ultimately, public funds if the state is held accountable.