WODC: Organ Procurement and Just Societies

I also want to apologize for the huge delay for posting this round, I was really busy. I know we have little time to debate so I promise I will be posting the next rounds after 3 to 12 hours after bsh1 posts his. It will depend mainly if I'm sleeping or not. Because of the rules I will present my case in this round. Opt out vs other systemsI want to clarify something before I present my arguments. This is not a opt out vs opt in debate. The resolution says "A just society ought to presume consent for organ procurement from the deceased". This means that Pro is advocating for an Opt out system but he is not mentioning a rival system anywhere, so I can pick any system I want that doesn't presume consent, even if it-s not an Opt In one. I believe that a just society ought to use a "mandated choice" system and do not make assumptions about the choices of the citizens. I will present y arguments against the presumed consent or Opt out system and then I will present my arguments for Mandated choice system. Arguments against Presumed Consent (PC)1. PC is not consistent with what we consider just. There is a reason we don't presume consent for a lot of activities. We consider just to be asked about our choices before making assumptions about them that could affect our rights or our wishes and specially before an invasive procedure. Not making assumptions about our choices is just even if those assumptions could save lives, like in the case of a lot of other medical procedures. Because PC is not consistent with already established moral truths, we can't think a just society would/should presume consent for organ procurement from the deceased.2. PC and problems with rights and wishesThe position Pro is advocating in this debate has some dangers related to rights and wishes. The fact that in Pro's system, one person has to give an explicit "refusal" creates the possibility of affecting the rights and wishes of the living. It is true that there is a difference in rights between the living and the deceased as well as the fact that only the living has wishes, but the wishes of the living may be related to what would happen with their own body after death. The fact that Pro's system gives the option of "not donating" makes it clear that these wishes are important and we should care about them, and the fact that it is possible for the organs of a death human to be removed because he didn't "opt out" is a problem. This problem gets worse if we talk about mentally incompetent adults that are not capable of understanding the concept of donation after death and may not be able to choose what they actually want, even though they may have wishes. The fact that it is just to presume non-consent instead of consent in the case of mentally incompetent adults shows that PC is not near the objective of a just society.3. PC doesn't ensure an increase in donations rate. "The US Institute of Medicine is concerned that the introduction of presumed consent without the appropriate public support could reduce donation rates in countries where autonomy is highly prized, such as North America. People may be more likely to donate when they feel they retain control of that decision rather than the law dictating that donation should take place. " [1]This is an important issue because it allows us to see that there are other factors that affect the donation rates. Factors like more investment and trust and support in the system or government. And this is exactly what happened in Brazil. [2]"Brazil switched to an opt-out system and ultimately had to withdraw it because it further alienated patients who already distrusted the country's medical system. " [2]There are more evidence that supports this argument, but I will present them in the rebuttals because are related to Pro's arguments and this argument is starting to look like a rebuttal. Arguments for Mandated Choice (MC)What is Mandated Choice? "Mandated choice, or required response, is a method of requiting competent adults to prospectively register their wishes regarding organ donation in advance of death through various registration mechanisms. " [3]In other words, competent adults have to answer the question “Do you wish to be an organ donor? ” and no assumptions about their wishes are made.1. MC is justBecause it takes into account the rights and the wishes of the citizens in all the scenarios, we can think of a just society using this system. It would not have the problems that the PC has because we are not assuming the decision and wishes of the people in any moment. MC is also consistent with accepted moral truths related to consent.2. MC alleviates the organ shortageBecause now the decisions of the competent adults are explicit and known, there will be more organ donors than before. For example, "In the United States, 85 percent of Americans say they approve of organ donation, but only 28 percent give their consent to be donors by signing a donor card. " [4]Because of MC, there will be 85 percent of Americans that give their consent to be donors. And example of MC in action is the case of Illinois since 2006. "In Illinois, a mandated choice system with multiple registration options has proven to be very successful. Illinois enacted the First-Person Consent Organ/Tissue Donor Registry on January 1, 2006. " [3]If we compare the almost 60% of people that consent to be donors in Illinois [5] with the 28% of people in the US that consent to be donors, we can see that MC causes an increment in the donation rates.3. MC is the best of two worldsMandated Choice has the advantages of the Opt in and Opt out systems without the disadvantages the mentioned systems. The reason of this is because the disadvantages of those systems are caused mainly by the fact that they are based on assumptions. Opt in system presumes non consent and Opt out system presumes consent.4. MC makes the decision easier and ensures autonomyBecause we are sure about the wishes the person had in most of the cases, a next of kin to make the decision is unnecessary. This means that the wishes of the people are followed accordingly and there is no need for the doctors to ask again for the decision to the family ensuring autonomy. This is not an issue in cases like Austria where a next of kin is not used either, but most of the countries that uses the Presumed Consent system still wait for the answer of the family in donation-after-death related issues. Conclusion-Presumed consent has too many problems related to justice. -Mandated choice is a better system that also share the advantages of presumed consent without affecting the rights or wishes of any citizen. -Mandated choice is preferred to be implemented by a just society. Sources1. . http://www.ncbi.nlm.nih.gov...2. . https://en.wikipedia.org...3. . http://www.thefreelibrary.com...4. . http://www.psychologicalscience.org...5. . http://www.donatelifeillinois.org...I thank bsh1 for this debate and await for his rebuttals.