Mandatory Organ Donation for the Common Good

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Michael Sandel introduces to readers in the beginning of his book: “Justice: What’s the Right Thing to Do?” that there are three approaches in thinking about justice in order to gear America towards a politics of the common good. The first of which is maximizing welfare. He compares the idea of maximizing welfare to a utilitarian way of thought by indicating that utilitarians answer questions challenging justice by making sure happiness is maximized overall. To explain his perspective on maximizing welfare, he uses philosopher Immanuel Kant to reject utilitarianism. Kant favors to respect the right of each person to pursue their own ends as rational and autonomous beings. The second approach in thinking about justice is respecting freedom. Sandel compares the idea of respecting freedom to libertarianism in which people are free. Kant seems to favor this approach to justice better. Along with Kant, Sandel uses philosopher John Rawl’s perspective throughout his book as well. Rawls seems to reject both utilitarianism and libertarianism and instead favors a society in which people live behind a veil of ignorance so that people of society can live in equality. Sandel portrays that he disagrees with both the arguments of Kant and Rawls regarding justice. The last approach to justice that Sandel introduced early on in his book was promoting civic virtue.</p><p>Because of this disagreement with both Rawls and Kant, Sandel proposes the perspective of yet another philosopher: Aristotle. According to Aristotle’s view of justice, it depends on the telos, or purpose, of an institution; to administer rights means to place citizens where their roles fit which should enable them to figure out their talents (Sandel 200). Sandel sides the most with Aristotle’s point of view regarding justice and to promote civic virtue when answering questions that challenge justice in society.

Sandel uses many relatable examples in which justice is challenged to explain the need in America for a politics of the common good. For example, he tells a story in which he asks whether it is just to discriminate against Callie Smarrt, a student who was a cheerleader at Andrews High School in West Texas but was kicked off because she suffers from an uncontrollable disability: cerebral palsy (Sandel 184-185). This situation challenges justice because it is unfair to discriminate against Callie if she performs according to the purpose of a cheerleader. The purpose of a cheerleader is developed to be to hype up the crowd, so Callie does just that and should therefore not be discriminated against. Sandel explains that this coincides with Aristotle’s way of approaching justice: that is, determining the telos of an activity before allowing people of society to question justice. </p><p>To address the need in America for a politics of the common good, the government should implement mandatory organ donation to all citizens. Sandel proposes applications of justice, one of which is mandatory national service. This will, according to Sandel, imply a sense of shared sacrifice in society towards the common good which will promote overall solidarity. </p><p>The government should make organ donation mandatory for all citizens because patients suffering from terminal organ failure would have the chance to live if a healthy organ was offered to them. Authors R.F Saidi and S.K. Hejazii proclaim in their article “Challenges of Organ Shortage for Transplantation: Solutions and Opportunities” that the shortage of organs is indeed “the greatest challenge facing the field of organ transplantation today” (Saidi and Hejazii par. 1). Without new organs, people suffering from diseases causing terminal organ failure cannot be saved indefinitely. Thus, more healthy organs need to be donated and accessible to these patients in need. After a mandatory organ donation law under presumed consent was passed in Brazil in 1997, a journal article was written by Everton Bailey dissecting this very law. Bailey mentioned that supporters of this law believed that Brazilians in need of organs for transplantation will benefit as there will be increases organs available for transplantation (Bailey 710). This belief ensures that more healthy organs available will lead to a better society since patients would get another chance to live because of the impact of a peer’s organs. Thus, the status of organ donation needs to be shifted to be mandatory in order to give dying patients an opportunity to live.</p><p>Furthermore, the government should make organ donation mandatory because human lives are not lost in order to promote a politics of the common good. Thus, humans that have already passed have the ability to subconsciously save the life of a fellow citizen and promote shared sacrifice. Many supporters of presumed consent favor this system because without it, usable organs are wasted because people fail to acknowledge their suffering peers (Fabre 568). If healthy organs are capable of saving a valuable life, then why take them to the grave and waste them? For example, in 2012, Jemima Layzell, who died suddenly from a brain aneurysm at the age of 13, died with healthy organs but was never a registered donor. Her family had good faith that she would want her organs donated in order to positively impact others, so they decided to donate them. As a result, a variety of her organs were transplanted to eight patients, and all eight lives were saved (Brown par. 1). This outcome would not have been possible without the heroic decision of Jemima’s family. Because she had already passed, a life was not sacrificed to fulfill this act. Instead, it was initiated by natural causes that no one has control over; thus, this example of a real-life organ donation promoted shared sacrifice since a variety of her organs were shared to save the lives of many. Situations similar to Jemima’s can go in many directions, including the family refusing to donate the healthy organs. However, if organ donation was mandatory, her family would not have needed to decide, it would have already been assumed that these organs would be donated and used to save lives. Therefore, mandatory organ donation needs to be implemented because it promotes an environment in which shared sacrifice and unity lead to a politics of the common good. </p><p>Mandatory organ donation is feasible because opt-in systems, such as presumed consent, have already been implemented in foreign countries. Making organ donation mandatory all together will take the presumed consent system to a higher level and allow for an environment of the common good. Presumed consent with family override halts organ donation. The United Kingdom’s Organ Donation and Transplantation Directorate revealed that one reason why healthy organs that have the potential to be transferred, but never did, was because of relative refusal (Bird and Harris 1012). By making organ donation mandatory, relative refusal would be against the law. This change would essentially terminate this problem in regards to the lack of organs. Furthermore, once Belgium passed a presumed consent law regarding organ donation, the number of kidneys available to transplant increased by 114 percent over a five year period (Chouhan 157). Because a system of presumed consent has already been applied to other countries, such as Belgium, it can also be applied in the United States. Also, not only was it applied, but it also significantly benefited society by increasing the availability of organs. Although presumed consent is not the same as mandatory organ donation, making organ donation mandatory is only a step above presumed consent. Since presumed consent is feasible in multiple countries, therefore, so would mandatory organ donation in the United States. </p><p>Although mandatory organ donation aids patients suffering from organ failure, citizens’ freedom is challenged by mandatory organ donation which is ultimately unethical and above the law. Opposers of the presumed consent system argue that “[p]resumed consent is the absence of an objection, and the absence of an objection cannot be taken as informed consent. It has never previously been acceptable in clinical practice. Presumed consent will erode this fundamental principle, for no good reason” (Fabre 569). Essentially, any system that does not force people to donate their organs respects people’s decisions, and should respect these decisions. They should be respected because they are decisions of autonomous beings which is essential in respecting people (Chouhan 160). This rationale based on autonomous beings and having the freedom to object relates to that of philosopher Immanuel Kant in Sandel’s book, “Justice: What’s the Right Thing to Do?”. Aristotle disagrees with Kant’s perspective because Kant’s argument relies on citizens’ freedom to choose, not to put people of society where their roles belong in nature (Sandel 201). The purpose of organ donation, as Aristotle would put it, is not to be able to freely choose where organs belong after death, but to save a life with those organs instead. So, politicians should focus on the purpose of organ donation when considering mandatory organ donation and not the freedom to choose. </p><p>Similarly, opposers of systems close to mandatory organ donation argue that some citizens are at a loss by living in countries that implement these laws. For example in Brazil, opposers of the presumed consent law, which became effective in 1998, fear that the poor and illiterate will be vulnerable to the law and suffer unfairly due to their lack of knowledge to opt-out (Bailey 708-709). This is valid since many poor and illiterate people across the world do not have access to education about ethical laws such as presumed consent. However, in the United States, the public educational system is better than that of Brazil’s, which indicates that poor and illiterate Americans still have access to gaining more knowledge about mandatory organ donation. Also, with mandatory organ donation, citizens do not have the option of opting out as they do in presumed consent. So, this does not change how fair the system is to an average citizen compared to a poor citizen. </p><p>All in all, Michael Sandel’s argument reveals that justice should be approached by promoting civic virtue. One way this can be implemented and will help lead towards a politics of the common good in America is through a form of mandatory national service, such as mandatory organ donation. The government should make organ donation mandatory for all citizens because patients suffering from terminal organ failure would have the chance to live if a healthy organ was offered to them. Furthermore, the government should make organ donation mandatory because human lives are not lost in order to promote a politics of the common good. Thus, humans that have already passed have the ability to subconsciously save the life of a fellow citizen. These two reasons work together to promote a sense of shared sacrifice throughout all Americans which, as a result, will also promote solidarity. In other words, this gives Americans of different backgrounds and status the chance to come together and help save lives.

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