Routine Removal

Routine Removal

The most aggressive approach is called routine removal. In this regime, the state owns the rights to the body parts of people who are dead, and their organs can be removed without asking anyone’s permission. Though it may sound grotesque, routine removal could increase the supply of organs available to patients. And it would have that beneficial effect without intruding on anyone who has any prospect for life.

Thaler and Sunstein describe this approach as unused by U.S. states at the time of their account. They note that some states had previously permitted medical examiners performing autopsies to remove corneas without consent. Where this rule was used, the supply of corneal transplants increased dramatically. In the state of Georgia, for example, routine removal increased the number of corneal transplants from twenty-five in 1978 to more than a thousand in 1984.12 The authors argue that extending routine removal to kidneys could prevent premature deaths but would conflict with widely held views about donors’ rights. Many people who would gladly agree to be organ donors (including the two of us, who have in fact so agreed) would nevertheless object to a law that allows the government to take parts of people’s bodies without their explicit consent, after death. Such an approach violates a generally accepted principle, which is that within broad limits, individuals should be able to decide what is to be done with and to their bodies. The authors regard these objections as decisive despite the potential benefits.