Soylent green *UPDATED*

One of the most striking things about the Jewish Bible is the respect it demands for dead bodies. As a result, Jewish ritual holds that the dead cannot be mutilated in any way and must be interred as quickly as possible — preferably within 24 hours of death. Desecration is anathema to the Jews. Many people ascribe this respect to the Jewish belief in resurrection. Others though, believe that there is one other element to the requirement that bodies be treated with respect, which is the fact that the Jewish religion arose during pagan times — and pagans were deeply committed to body mutilation.

In pagan cultures, which had no separation between “church” and state, the religious leaders would routinely sacrifice people to the Gods and then, before or as part of the death process, the victims’ brains and internal organs would be ripped out by the priests for study and ritual cremation for the gods. (The story of Isaac is, as everyone knows, the definitive Biblical statement against human sacrifice.) Even if people weren’t deliberately sacrificed, but died for other reasons, the state priests could still desecrate the corpses for religious purposes. The instant burial required under Jewish law was almost certainly an effort to protect bodies from assault by pagan priests. To this day, religious Jews will not allow themselves to be cremated.

I was thinking of the pagan state’s interest ripping out the deads’ internal organs when I read this, out of England:

Gordon Brown has thrown his weight behind a move to allow hospitals to take organs from dead patients without explicit consent.

Writing in The Sunday Telegraph, the Prime Minister says that such a facility would save thousands of lives and that he hopes such a system can start this year.

The proposals would mean consent for organ donation after death would be automatically presumed, unless individuals had opted out of the national register or family members objected.

Pragmatically speaking, Brown is right — a lot of perfectly good human organs go to waste when they could be put to use in the living. Nevertheless, there is something creepy and frightening about the state harvesting dead bodies, and it made me think of Jews in pagan times. On the one hand, you had the Jews with their tremendous respect for humanity, and their rules aimed at elevating the human condition and, on the other hand, you had the pagans who viewed the body as something that could be folded, spindled and mutilated depending on how the priests interpreted the whims of the Gods.

The other reason to get worried about this proposal is the “soylent green” nature of it. Once the government gets into the business of harvesting body parts — especially if it’s the same government that runs the health care system — you might want to go somewhere other than a state hospital if you’re at imminent risk of death. Once in the hospital, you may discover to your cost that it’s cheaper for the government to let you die so that it can use your organs for someone who might subsequently be less of a burden on the health care system than you are. Indeed, the plan seems to be set up precisely to achieve that cost effective goal:

But patients’ groups said that they were “totally opposed” to Mr Brown’s plan, saying that it would take away patients’ rights over their own bodies.

There are more than 8,000 patients waiting for an organ donation and more than 1,000 a year die without receiving the organ that could save their lives.

The Government will launch an overhaul of the system next week, which will put pressure on doctors and nurses to identify more “potential organ donors” from dying patients. Hospitals will be rated for the number of deceased patients they “convert” into donors and doctors will be expected to identify potential donors earlier and alert donor co-ordinators as patients approach death. [The emphasis is mine because, if this isn’t scarily Orwellian, I truly don’t know what is.]

Organ donation can be a great gift and I honor those who decide to make it a part of their death. Nevertheless, I cannot conceive of a situation in which it should be anything but voluntary. Having the same government that provides medical treatment make the decision is the stuff of the worst kind of Utopian totalitarianism.

UPDATE: The above story was from the right leaning Telegraph, which presents the plan as something upsetting (something with which I agree). Here’s how the left leaning Guardian presents the same story, with the focus on the needy transplant recipients, not on the state’s increasing control over life, death and after death:

A revolution in the way organs are donated for transplant is called for today by the government’s chief medical officer as concern grows over the acute shortage of donors and the rise in unnecessary deaths.

An expert report to be published this week says that every major hospital in Britain must have an organ donor specialist skilled in persuading grieving families that the hearts, lungs, kidneys and other vital organs of their deceased relatives should be used to save the lives of others.

Sir Liam Donaldson, England’s chief medical officer, will back the findings of the government’s taskforce on organ donation, but wants to go further and introduce a new system of donation because the shortage of organs is so severe. Three people a day are dying while on the waiting list for a transplant as the demand for a new organ is rapidly outstripping their supply.

Donaldson is advocating a system of ‘presumed consent’, where everyone in Britain would be presumed to be a donor unless they had specifically opted out, or unless their families had objections.

‘We have one of the lowest rates [of organ donation] in Europe, far lower than Spain,’ he told The Observer. ‘We have one thousand or more patients dying on the waiting list each year, and there is a lot of suppressed demand, with doctors not even referring patients on to the list because there is no hope for them. That is a lot of patients dying.

‘I think at the moment people often don’t know whether their relative would have wanted to be a donor. Families are being approached when they are in a very distressed condition and, faced with uncertainty, their default position is to refuse consent. Often the quality of their dealing with clinical staff is not as good as it should be – the dialogue could be better. It does require considerable skill to handle such sensitive situations.’

Today we reveal the heartbreak of those who are waiting for organs and the uplifting stories of families who have consented to donate, and launch a campaign for the UK to move to the new system of presumed consent so that hundreds more lives can be saved.

As for me, having read that, I still find too Orwellian the thought of the government, in all its bureaucratic splendor, deciding who lives and who dies, and desecrating the dead in between those two extremes.