Nudging toward Bethlehem: Organ donation without consent

posted at 3:47 pm on September 4, 2009 by Pundette
[ End of Life Issues ]   

I’ve written before about attempts by institutions to change cultural norms by creating default options which “nudge” the masses in the direction desired by the elites. I called it “horribly insidious: a subtle extension of the nanny state where numerous decisions are pre-made and pre-packaged for us, and the exact opposite of what it once meant to be an American: independent-minded and self-determining.”

This proposal concerning our organs, made by Obama’s “regulation czar” in his 2008 book, is an outrage, amounting to organ donation without consent:

Cass Sunstein, President Barack Obama’s nominee to head the Office of Information and Regulatory Affairs (OIRA), has advocated a policy under which the government would “presume” someone has consented to having his or her organs removed for transplantation into someone else when they die unless that person has explicitly indicated that his or her organs should not be taken.

Under such a policy, hospitals would harvest organs from people who never gave permission for this to be done.

Outlined in the 2008 book “Nudge: Improving Decisions About Health, Wealth, and Happiness,” Sunstein and co-author Richard H. Thaler argued that the main reason that more people do not donate their organs is because they are required to choose donation.

Sunstein and Thaler pointed out that doctors often must ask the deceased’s family members whether or not their dead relative would have wanted to donate his organs. These family members usually err on the side of caution and refuse to donate their loved one’s organs.

“The major obstacle to increasing [organ] donations is the need to get the consent of surviving family members,” said Sunstein and Thaler.

Read on. This idea is a real horror. It has nothing whatever to do with the merits of organ transplants or a person’s beliefs regarding this personal issue. It’s about one group making the decision for others.

Sunstein elaborates on the concept of “nudging”:

“We think that it’s time for institutions, including government, to become much more user-friendly by enlisting the science of choice to make life easier for people and by gently nudging them in directions that will make their lives better,” they wrote.

“…The human brain is amazing, but it evolved for specific purposes, such as avoiding predators and finding food,” said Thaler and Sunstein. “Those purposes do not include choosing good credit card plans, reducing harmful pollution, avoiding fatty foods, and planning for a decade or so from now. Fortunately, a few nudges can help a lot. …”

Very progressive I’m sure. But what gives one entity — especially the government — the right to nudge an individual, through default options built into regulations and laws, toward a particular course of action? Who are they to make a judgment on our credit cards, our snacks, or our kidneys? The whole “nudge” concept presupposes that one group knows what’s best for the rest of us. It’s elitist to the core.

Cross-posted here.

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