Organ donation: dead or alive?

Sunday 21 October, 10.30am until 12.00pm, Frobisher Auditorium 2

The Greek philosopher Epicurus said ‘as far as death is concerned, we men live in a city without walls’. No doubt it comes as certainly as we pay taxes, but are we so sure what it actually is? Can we put our finger on that dividing line between life and non-life? Seeking moral certainty about the big question is more than philosophical idling. The ethics of organ transplantation are largely based on ‘brain death’ - the certainty that brain activity is irreversibly over - to allow harvesting of organs from the cadaver while the heart is still beating. But, apart from divergences of scientific opinion as to just what counts as an irreversible loss of consciousness, there is considerable debate about what the ability of the body to survive such a loss might mean for the ethics of organ transplantation. There are cases, after all, in which the brain may be dead but the body survives. Some pregnant women have been declared dead by neurological criteria yet sustained the pregnancy for several weeks. Are we confident in saying that these living bodies are dead? Confident enough to harvest unpaired vital organs from them? Even to presume consent for donation in these cases? And what about cases in which medical opinion is convinced that the brain is going to die but has not yet? Might it ever be ethical to take much-needed organs in such cases or would it conflict with the requirement that doctors act only to save or at least extend life? Might it amount to a disguised form of euthanasia?

Central to this issue of course is just what we mean by being human and how we value autonomy and free will. If the state presumes our consent with respect to organ donation might it simultaneously contribute to an under-valuing of our ability to make free choices and to act altruistically? Is it a way of avoiding the hard arguments necessary to convince potential donors? Might it even lead to stigmatising the choice to opt out? Much of our morality rests on a feeling that we should treat a human as an end, never as a means, certainly not as a bag of spare parts. Who is it that should pronounce on matters of life and death? Do we trust doctors enough to make the decision for us? Medical ethics boards? Public opinion? Philosophers, theologians, politicians? At just what point is it safe to say we can become a means for someone else’s ends? At what point does death intervene and you end being an end?

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Dr Stuart Derbyshire
reader in psychology, University of Birmingham; associate editor, Psychosomatic Medicine and Pain

Steven Edwards
professor of philosophy of healthcare, Swansea University

Professor David Jones
director, Anscombe Bioethics Centre; co-editor, Chimera's Children: Ethical, Philosophical and Religious Perspectives on Human-Nonhuman Experimentation

Dr Sir Peter Simpson
chairman, UK Donation Ethics Committee

Hugh Whittall
director, Nuffield Council on Bioethics

Helen Birtwistle
history and politics teacher, South London school

Produced by
Helen Birtwistle history and politics teacher, South London school
Angus Kennedy convenor, The Academy; author, Being Cultured: in defence of discrimination
Recommended readings
Human Bodies: donation for medicine and research

Debates Over Ethics.

Nuffield Council on Bioethics

The state’s skewed line on moral issues makes me worried about giving it automatic ownership of our bodies after death

Under presumed consent I am not confident the state would feel a duty to treat a corpse with reverence after death or use it solely to help others live

Francis Phillips, Catholic Herald, 8 October 2012

Fabrice Muamba was 'dead' for 78 minutes

Doctor reveals star needed 15 shocks to restart heart.

Alex West, Sun, 15 August 2012

Presumed consent: nationalising our organs

There is a desperate need for organs for transplant, but taking them from the dead without consent is no solution.

Tom Bailey, spiked, 7 August 2012

Vatican Radio tackles organ harvesting in light of questionable ‘brain death’ criterion

The controversy surrounding the questionable criterion of ‘brain death’ used to determine when life-support devices are turned off in preparation for organ harvesting was addressed in a May 8 interview with Dr. David Albert Jones on Vatican Radio.

Thaddeus Baklinski, LifeSiteNews, 9 May 2012

What and When Is Death?

All living things die. This is not new and it has nothing to do with technology. What is new in our technological age, however, is an uncertainty about when death has come for some human beings.

Alan Rubenstein, New Atlantis, 2009

Who’s afraid of xenotransplantation?

Using pig organs in humans could save thousands of lives. So why is Britain driving research away?

Stuart Derbyshire, spiked, 3 October 2008

Living people matter. When you're dead, you're dead

Brown's proposal on organ donation could end needless deaths that stem from the misguided instincts of the few

Polly Toynbee, Guardian, 15 January 2008

Organ Transplants (CTS explanations series)

This booklet outlines the main questions and concerns, explains Catholic teaching and systematically grapples with particularly difficult questions.

David Albert Jones, Catholic Truth Society, 2001

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