To have and to hold til death do you part?

You spend a lot of time thinking about it – how it feels, how hot or cold it is, its state of health, its levels of perfection or imperfection, how toned or flabby or marked or decorated or improved it’s looking. But how long do you intend to hold onto your body? Can you face the idea that once you’re dead, it’s no longer of any use to you, and you might as well pass it onto someone that has some use for it?

Although 70% of the British population agree with donating their organs in principle, nowhere near that number of people are actually on an organ donor list. Which puts Britain (like other countries, SA included) in a tough position: thousands of people waiting for transplants, and not enough organs.

I read today in the Independent Online that Britain’s chief medical officer has made a “radical” suggestion: that, at death, everyone should automatically become an organ donor – unless they’ve chosen to opt out. Known as a presumed consent system (or “opt-out” system) this is the reverse of the current “opt-in” system. At present, in Britain (as in SA), you’re only an organ donor if you’ve gone to the trouble of thinking about it, deciding to do it, and then getting yourself a sticker for your ID.

On the opt-in system, the UK had a donation rate of just over 12 people per million in 2003. Other EU countries which have switched to opt-out systems include Belgium, and the Czech Republic, with donation rates just over 20 people per million in 2004, and Spain, whose donation rates went up from around 17 to over 35 per million. The stats don’t really paint the picture clearly enough though: for every additional organ donated, someone gets a chance to have an operation that’ll most likely save their life. It’s hard to believe anyone could argue against this.

Ironically, the organ donor crisis in Britain (according to the Independent) is due in part to the success of increased road safety. Cars are safer, people are wearing seatbelts, the airbags are working and – I’m guessing – the strict DUI laws are paying off. Predictably, the healthiest organs come from those that died (or find themselves kept alive on life support systems)in the aftermath of a road accident. So increased road safety means less roadkill means fewer organ donors. Kinda creepy illustration of how one man’s meat is another man’s poison, but in the meantime, thousands of people wait for kidneys and other tissues which are getting buried in the ground.

And yet, as things stand, it looks highly unlikely that anyone will bite the opt-out line. The main argument against the opt-out system is that “protecting individual autonomy is more important than boosting transplant rates”. I wonder, though: what individual autonomy do you have after you are dead, though, over your physical body? And why would you want to take this body – that you’ve (hopefully), for so many year, lavished with so much attention and concern – and bury or burn it, rather than giving it back? Perhaps it’s the insistent myopia of my non-recyclable corneas, but I just don’t see the argument.


About Lisa

I live in South Africa with my husband and two small children, doing things, thinking about things and sometimes writing about them.
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4 Responses to To have and to hold til death do you part?

  1. Lara says:

    I think the issue is primarily emotive for the survivors of the deceased. If it were me, I would have no objection to my usuable parts being re-used. If it were my children, the horror of the loss of their lives would give me pause. I probably would not be selfish, but I would struggle in knowing they’d been cut up and were no longer whole. My instinct would be to protect, envelop and enshrine them, even though their dead bodies would be pretty useless as objects. It would be hard to have to confront the reality of the disintegration of what little was left of them. I know this happens naturally through decay or incineration; that’s not as wilfull as organ harvesting. But yes, I’d do it, I think. Where d’you get a sticker?

  2. Chipper says:

    I agree with you!! i don’t understand why people feel the need to burn or bury the body instead of giving life and hope to someone else through donation. I have “opt-in” and I have made it very clear to my family members that every last body part, organ, tissue, etc of my dead body should be donated. In my mind, the people who argue the other side of this issue, are a little selfish. If after my death I can help save a life, that would be my greatest gift while on this earth.

  3. Lisa says:

    Lara – the south african site has registration online at

  4. Lisa says:

    Chipper – yeah, quite. And something tells me very, very few of those people would “opt out” of receiving an organ if they were requiring one themselves.

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