Books for the News, Sociology

Should participation in organ donation programs be presumed?

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A New York state assemblyman has proposed a measure that would change the way people opt-in to organ donation. Richard Brodsky wants to introduce a “presumed consent” system, in which, as the New York Times explains, “people would have to indicate in official documents — their driver’s licenses, most commonly — that they specifically don’t want to donate organs. If the box is not checked, it is presumed the person wants to donate.”
Over on the Room for Debate blog, the Times gathered a roundtable of experts on the subject of organ donation to weigh in on the proposed change. Keiran Healy, a Duke sociologist and author of Last Best Gifts:Altruism and the Market for Human Blood and Organs, published by the Press in 2006, suggested that the new law won’t have the intended effect: “Support for donation was built up by publicizing the now familiar idea that organ donation is a unique, even sacred, sort of gift. A naive presumed consent proposal would run straight into this established understanding of donation.” Healy goes on to say that countries like Spain and Italy, which already have presumed consent laws on the books, “do not outperform countries like the U.S. by any great margin.” (Healy responds to critics of his position on Crooked Timber today.)
So if organ and blood donations remain an opt-in system, why do people make this ultimate altruistic gesture? And why do donors literally give of themselves for no reward so that the life of an individual—often anonymous—may be spared? Healy explores these questions and more in Last Best Gifts. Check out Virginia Postrel’s 2007 review from the New York Times Book Review and more about the book here.