August 29, 2005


Delivering a body blow to science
(Matthew Syed, Timesonline, August 29th, 2005)

Three things can happen to a dead body: it can be dumped in a grave to be eaten by worms, cast into a crematorium to be incinerated or donated to the medical profession for the good of mankind. You might have thought that public policy would emphatically favour the latter. But no, the Human Tissue Act, of which the main provisions come into force next year, seems to assign greater value to corpses than to living people in desperate need of an organ donation

Not only has the Government failed to grasp the nettle of “presumed consent” (in which everyone is assumed to have consented to the use of their organs unless they have explicitly registered an objection), but also new draft guidelines advise doctors to allow relatives to veto organ removal, even when the deceased carried a donor card. A pathologist friend of mine told me this week that objections are typically expressed thus: “Oooh, I couldn’t possibly bear the thought of Johnny being cut up like that!” To give legislative weight to such fastidiousness is absurd.

If this sounds cold-hearted, let me give you some statistics that will really chill your blood. Today more than 8,000 people in the UK are waiting for an organ transplant, many in considerable pain. Last year 452 died while waiting in hope. Many lose their lives before they even get on to the waiting list. Why allow the relatives of the recently deceased, who often admit later that they would have made a more rational decision had they not been asked at a time of emotional distress, to trump such vital interests? [...]

The fundamental problem with our approach to ethics, manifested in both our mythologising over corpses and embryos, is our inability to separate emotion from policy. The only factor that should enter our moral and legal deliberations is that of welfare, a concept that is meaningless when applied to entities that lack self-consciousness. Never forget that the research that we are so reluctant to conduct upon embryos and dead bodies is routinely carried out on living, pain-sensitive animals. This double standard will come to be seen by future historians as one of the great barbarisms of the age.

Those now old enough to remember the sensitivity with which the issue of donated organs was originally viewed, and all the soothing assurances about free and informed choice that were given, may be taken aback by Mr. Syed’s vehemence, but they shouldn’t be. His is the enraged voice of thwarted humanism, whose oh-so-respectful tolerance for demurral rests entirely on the assumption that dissenters are an unenlightened breed from a primitive past, not without charm perhaps, but doomed to extinction as rational progress winds its way to inevitable triumph. Let anyone pause for a sober second thought and out come the knives.

Like most of his ilk, Mr. Syed cannot see any connection between how we treat the dead and how we treat the the living because that connection is an irrational one, although very real. It would be fun to ask him whether, starting from the point where they were dead anyway, he would have approved of the Nazis’ use of the bodies of their victims to provide wealth and material comforts for the living or what he thinks the psychological effects on the genocidal killers would have been had they been obliged to give their victims traditional, sacred burials.

More (From Ch 11, Heretics, G.K. Chesterton, 1905)

This total misunderstanding of the real nature of ceremonial gives rise to the most awkward and dehumanized versions of the conduct of men in rude lands or ages. The man of science, not realizing that ceremonial is essentially a thing which is done without a reason, has to find a reason for every sort of ceremonial, and, as might be supposed, the reason is generally a very absurd one--absurd because it originates not in the simple mind of the barbarian, but in the sophisticated mind of the professor. The teamed man will say, for instance, "The natives of Mumbojumbo Land believe that the dead man can eat and will require food upon his journey to the other world. This is attested by the fact that they place food in the grave, and that any family not complying with this rite is the object of the anger of the priests and the tribe." To any one acquainted with humanity this way of talking is topsy-turvy. It is like saying, "The English in the twentieth century believed that a dead man could smell. This is attested by the fact that they always covered his grave with lilies, violets, or other flowers. Some priestly and tribal terrors were evidently attached to the neglect of this action, as we have records of several old ladies who were very much disturbed in mind because their wreaths had not arrived in time for the funeral." It may be of course that savages put food with a dead man because they think that a dead man can eat, or weapons with a dead man because they think that a dead man can fight. But personally I do not believe that they think anything of the kind. I believe they put food or weapons on the dead for the same reason that we put flowers, because it is an exceedingly natural and obvious thing to do. We do not understand, it is true, the emotion which makes us think it obvious and natural; but that is because, like all the important emotions of human existence, it is essentially irrational. We do not understand the savage for the same reason that the savage does not understand himself. And the savage does not understand himself for the same reason that we do not understand ourselves either.
Posted by Peter Burnet at August 29, 2005 6:21 AM

I'm one of those old-fashioned types who thinks that saving a life (or helping to enhance the life of a sick person) is usually a good thing.

(Especially so if one had the excuse of experiencing a relative, friend or acquaintance badly in need of a transplant but suffering---or dying---because no donor could be found.)

Regarding compulsory organ donation, while making anything compulsory may run against the grain (including seat belts? or flouride?), I'm not sure I can agree that it's as sinister a project as is made out. (Would compulsory blood donations, for those able to donate,---at least in locales other than Transylvania---be considered sinister as well?)

On the other hand, the preferred approach might be, perhaps, through education. Though I can already sense that any attempt to promote organ donation through education would likely be labeled propaganda of the most revolting kind churned out by an interfering, controlling government, unwilling or unable to keep its hands off other people's organs.

Certainly, one of the mainstays of a free society is that people who want to be egotistical and selfish, have every right to so be.

Which brings us, perhaps, to cryogenics---"the fourth way?"---which Mr. Syed (rhymes with "dead"?) doesn't even deign to consider....

As for me, three cheers for mortality (though, dear Lord, not just yet, of course).

Posted by: Barry Meislin at August 29, 2005 8:10 AM

This should be a "no-brainer" (sorry about that).

Pause for a moment, and imagine that that you are serious injured. Your "case" is worth x$ to the medical establishment is you survive and 5x$ is your organs are harvested, sort of the way your house is more if it is torn down for a shopping mall.

Posted by: Lou Gots at August 29, 2005 10:14 AM

I'm already an organ donor and am seriously thinking of leaving my body to scientific research. Anybody know the pros and cons about this?

Posted by: erp [TypeKey Profile Page] at August 29, 2005 10:16 AM

I can understand the objection to compulsory or by default organ donation, but to allow relatives to override my donor card on basically a whim? What's the point of that or a will, then?

Posted by: Annoying Old Guy at August 29, 2005 10:27 AM

The three options are to bury her, burn her or dump her— unless, of course, she's an eater.

Posted by: Raoul Ortega at August 29, 2005 10:44 AM

Erp - I can't think of any cons of donating your body to science, other than not being able ot have an open casket at your funeral.

Posted by: Dudeman at August 29, 2005 10:45 AM

I wonder how Mr. Syed feels about necrophilia and cannibalism.

Posted by: Governor Breck [TypeKey Profile Page] at August 29, 2005 11:05 AM

Chesterton's point is very well taken. There was a fatal car/motorcycle accident in our neighborhood last year. The friends of the deceased bikers erected a shrine on the corner, complete with cross, flowers, and several bottles of booze.

Funerals are for the benefit of the survivors, not the deceased. Cultural practices vary, but the condition and disposition of the corpse is very important to many. Many Catholics still believe that the body will be resurrected on Judgment Day in the condition in which it was laid to rest. The disposition of the deceased should certainly not be left to the state to dictate.

Posted by: Robert Duquette at August 29, 2005 11:13 AM

Larry Niven wrote (writes) a series of science-fiction stories in which the need for transplant organs drove the imposition of the death penalty for crimes such as, eg, shoplifting.

Posted by: Mike Earl at August 29, 2005 11:27 AM

...manifested in both our mythologising over corpses and embryos...

Corpses and embryos - same thing.

Posted by: Shelton at August 29, 2005 11:57 AM

Correction Shelton:

Potential corpses (old people, sick people) and embryos -- same thing.

Posted by: Jim in Chicago at August 29, 2005 12:06 PM

Mike - There was a medical study indicating that hospitals make fewer efforts to save organ donors than non-donors. It was attributed to a diversion of doctors' attention to efforts to assure collection of the organs and their delivery in a fresh state immediately after death.

Robert - Catholics don't believe that people are resurrected on Judgment Day in the condition they were laid to rest. Rather, they are resurrected in perfect health. As Aquinas, a little pudgy, said, "On that day I will be corporeal, but not corpulent."

Posted by: pj at August 29, 2005 1:24 PM

pj: I am personally aware of one such case involving a liver transplant patient and a famous doctor. The donor was young, in a coma on a respirator, and was disconnected and declared dead after only 24 hrs. because he was a match. The case provoked many medical students and residents to revoke their donor status.

Posted by: jd watson [TypeKey Profile Page] at August 29, 2005 2:39 PM

I will not consent to be an organ donor for just the reason raised by JD Watson - I don't trust the medical establishment to wait until I am dead - heart stopped, brainwaves flat, body cooling, and chances of resusitation zero.

Posted by: Keith R at August 29, 2005 7:53 PM

Not an ethical nor moral component comment.
I just want to know how you remember so much of what you've read that you have ready a great Chesterton quote for just one of your many daily posts?
I continue to stand in awe of your reading skills, and of course am avidly awaiting the book which'll showcase your writing and thinking skills even more than this blog.

Posted by: Mike Daley at August 29, 2005 11:41 PM