Since its inception, the institution of postmortem organ transplantation has faced the problem of organ shortage: Every year, the demand for donor organs vastly exceeds supply, resulting in the deaths of approximately 8,000 individuals in the United States alone.1 This is in large part due to the fact that the United States, for the most part, operates under an “opt-in” policy in which people are given the opportunity to voluntarily opt-in to organ donation by registering as organ donors.2 In the (...) United States, a person’s organs will not be removed for transplantation purposes unless she has registered as a donor or her family gives their consent for organ removal.3 Jointly, these policies generate a situation where we do not retrieve as many organs as we could. (shrink)

According to a prominent view of organism persistence, organisms cease to exist at death. According to a rival view, organisms can continue to exist as dead organisms. Most of the arguments in favor of the latter view rely on linguistic and common sense intuitions. I propose a new argument for somaticism by appealing to two other sources that have thus far not figured in the debate: the concept of naturalness, and biological descriptions of organisms, in particular in ethology and ecology. (...) I show that if we hone in on the relevant notion of naturalness, we can show that organisms can continue to instantiate the natural property being an organism after death. (shrink)

Most people accept that if they can save someone from death at very little cost to themselves, they must do so; call this the ‘duty of easy rescue.’ At least for many such people, an instance of this duty is to allow their vital organs to be used for transplantation. Accordingly, ‘opt-out’ organ procurement policies, based on a powerfully motivated responsibility to render costless or very low-cost lifesaving aid, would seem presumptively permissible. Counterarguments abound. Here I consider, in particular, objections (...) that assign a moral distinctiveness to the physical boundaries of our bodies and that concern autonomy and trust. These objections are singled out as they seem particularly pertinent to the stress I place on a distinctive benefit of the particular policy I defend. An opt-out system, resting not on the authority of ‘presumed consent’ but on the recognition of a duty to one another, has the prospect of prompting people to understand more richly the ways in which they are both physically embodied and communally embedded. (shrink)

The question, what measures to address the shortage of transplantable organs are ethically permissible? requires careful attention because, apart from its impact on medical practice, the stance we espouse here reflects our interpretations of human freedom and mortality. To raise the number of available organs, on utilitarian grounds, bioethicists and medical professionals increasingly support mandatory procurement. This view is at odds with the Catechism of the Catholic Church, according to which ‘[o]rgan donation after death is a noble and meritorious act’ (...) but ethically impermissible absent consent. Those who concur with this position, but would oppose conscription on independent philosophical grounds, have not yet found a voice in the Western tradition comparable in strength to the utilitarian basis of the policy’s support, for Kantian and Aristotelian ethics, too, lend themselves to a requirement that we make our organs available to others when they can no longer serve ourselves. One finds an ethical wedge against conscription in an unexpected philosophical locale: the ‘fundamental ontology’ of Heidegger’s Being and Time, where pertinent individual choices arc protectively over what happens post mortem. Heidegger’s perspective on this issue thus meshes, not with other philosophical voices, but with Catholic doctrine—a surprising convergence of atheistic and theistic approaches to our flourishing whose ground I address in the article’s conclusion. (shrink)