The March, 2008, issue of First Things ran an excellent opinion piece by Gilbert Meilaender called The Giving and Taking of Organs. Meilaender quotes Paul Ramsey, whose The Patient as Person explored the moral ramifications of organ donation when the technology was still young. Ramsey (and Meilaender) explored three possible modes of receiving donated organs:

1. Voluntary organ donation (opt-in)
2. Automatic organ donation with an opt-out option (i.e. you would have to sign a document if you did not want your organs harvested after your death)
3. Buying and selling of human organs.

“If giving is better than routinely taking organs to prolong the lives of patients needing transplants, then it must aslo be said that routinely taking them in hospital practice would be better than for us to make medical progress and extend treatment ot patients by means of buying and selling cadaver organs. That society is a better and more civilized one, I have said, in which men join together in a consensual community to effect these purposes, than a society in which lives are saved routinely without positive consent and will of all concerned to do so. It must also be said, however, that a society would be better and more civilized in which men are joined together routinely in making cadaver organs available to prolong the lives of others than one in which this is done ostensibly by consent to the ‘gift’ but actually for the monetary gain of the ‘donor.’”

Meilaender makes many of the same points I made in my previous post on this topic, though he follows Ramsey in showing that the problems inherent in selling body parts are also inherent in the very act of transplanting body parts. These acts put our culture on the path of seeing the human body as a resource, a commodity, and a collection of parts rather than as an embodied human person.

However, he also does a great job explaining why voluntarily donating organs is less of a problem than an involuntary (opt-out) system or a commodity system. When someone gives a gift, he or she cannot so easily be severed from that gift. The act of giving a gift (of a body organ, for example) is an inherently personal act. Taking organs involuntarily or buying and selling them separates the organs and the persons from which they came. The person becomes a collection of parts, a resource, a commodity.

The main point made by Ramsey and Meilaender is that how we go about saving lives is of even greater importance than the ability to save lives. Gordon Brown, the Prime Minister of Great Britain, argued for an involuntary (opt-out) organ collection system, stating that such an act would be necessary to avert “an avoidable human tragedy.” This was much the same comment elicited by my previous post on this subject. I like Meilaender’s response:

It is the sort of language that can be used to justify almost anything that promises to help avoid the tragedy of death. And this is exactly the sort of language that, we have come to see, has often distorted the practice of medicine, teaching us to suppose that anything that can be done to ward off death must be done. But the deeper moral truth is that how we live, not how long, is what matters most. And among the possible “tragedies” with which we must recond would be to live longer by means that debase or undermine our humanity.

Critics call appeals to human dignity “ivory tower proselytizing.” As our culture makes the shift from a concern with human dignity to the utilitarian, materialistic concerns of the here-and-now, I think we will find ourselves realizing that the view from the ivory tower was better than the view of those who cannot see the forest for the trees. We have already sacrificed human dignity in the areas of preborn life, sexuality and fertility. We are beginning to downplay the dignity of the dying. In the end, what will we find we sacrificed for the sake of the quick fix?
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