Offering free funerals to organ donors is tantamount to trading in body parts
Think, for a moment, of the care we unquestioningly lavish on the bodies of soldiers who have been killed in battle. Wherever they have fallen, their bodies are retrieved — often at tremendous risk — and transported back to the comparative safety of a main camp.
There they are washed and made ready for that final journey home. In flag-draped coffins, the bodies are flown back to Britain, where they are ceremonially greeted by a solemn guard of honour and by the sombre crowds who come to pay their respects to someone whose heroism has meant the ultimate sacrifice.
No one who has witnessed the extraordinary scenes at Wootton Bassett and now at RAF Brize Norton can fail to realise how tremendously important honouring the bodies of the dead — and not only those of soldiers, but of leaders, rulers and ordinary, much-loved family members, too — is to human society.
Moving: The extraordinary scenes at Wootton Bassett and RAF Brize Norton illustrate the importance of honouring the bodies of the dead
It’s a deeply ingrained cultural tradition that goes back thousands of years.
But now, a recommendation from the Nuffield Council on Bioethics, an independent charity which reports on ethical issues, has put that tradition under a whole new set of pressures.
Faced with an intractable shortage of organ donors, they have suggested that people might be more amenable to signing up for donation if there was the promise that their funeral costs would be met by the NHS.
With the average funeral costing anywhere between £1,500 to £4,000, that represents a significant saving for an awful lot of people, and I expect that many, particularly those of modest means or facing financial pressures, would be very tempted.
It’s my firmly held belief, however, that this sort of temptation should not be placed before them.
Paying for organs is quite rightly illegal in this country but this, to all intents and purposes, is what the Nuffield Council’s recommendation amounts to.
Yes, it’s the bill for funeral costs that the NHS will be picking up, but what they get in return for that money is a whole new set of harvestable organs — heart, lungs, kidney, liver, eyes, and so on.
Wrong: Paying for organs is quite rightly illegal in this country but this, to all intents and purposes, is what the Nuffield Council¿s recommendation amounts to
These could be worth hundreds of thousands of pounds — in 2009 it was revealed that 50 foreigners paid around £75,000 each for private transplants of NHS organs.
So paying for someone’s funeral would mean that their organs had been bought just as surely as those snapped up by the ailing millionaire who jets off to a developing country where fewer questions are asked — and the donor may not necessarily be dead.
The Nuffield recommendations could also prove socially divisive in a way that many would see as completely unacceptable in a supposedly civilised country. The offer of a couple of thousand pounds or so at some unspecified date in the hopefully distant future will make little difference to a relatively affluent member of the middle classes as they decide whether or not to fill in an organ donor card.
But to poorer people — many facing the prospect of leaving almost nothing to their heirs — it could represent a very considerable sum indeed.
Could it not even result in the sort of Dickensian nightmare in which a whole new army of organ donors has been recruited from the most needy groups in society? Might it not even bring the risk of vulnerable individuals being put under pressure by unscrupulous relatives? Neither scenario, surely, is something we want to see happen in this country.
The gift of life: Those who sign up for organ donation could have their own funerals paid for by the NHS in a bid to boost number on the donor register
Please don’t misunderstand me; I am not against organ donation in general. As I’ve just outlined, what I am against is anything that smacks of paying for organs, and I’m also against anything that deliberately underplays the significance of what is a very important and highly individual decision: whether to become an organ donor or not.
The recent Government initiative, for instance, which saw people being invited to sign up as organ donors when they applied for their driving licence, was a step in the wrong direction.
Most driving licences are applied for by young people, who will be brimful of youthful optimism and who, at the time they fill in the application, will be far more excited about the prospect of driving than having to give serious thought to what happens to their bodies when they are dead.
I fear that many will end up ticking the ‘Yes’ box without giving it a second thought.
But organ donation does require serious thought; that’s why the principle of ‘informed consent’ is so important. Those considering joining the organ donor register need to know exactly what they’re signing up for and, just as importantly, what the implications are for the relatives they leave behind.
This isn’t necessarily a subject you’d want to address over the breakfast table, but would-be donors need to appreciate that there’s a huge difference between a body that has had two kidneys and a couple of corneas neatly removed, and a body that has been harvested for multiple organs and other body parts — organs that these days, I’m told, could go to several different recipients.
An old friend of mine was asked about organ donation when her daughter was tragically nearing death, and suddenly realised that the questions she most wanted to ask were ‘how many?’ and ‘which ones?’
Some will say she was being unnecessarily squeamish — that what happens to a body when it’s dead doesn’t matter. But it’s important that my friend’s apparent squeamishness — a feeling I know she shares with many — shouldn’t be written off as unreasonable.
In fact, it goes to the absolute heart of who we are as human beings.
Cleansing, honouring and respecting the bodies of our dead is what we have always done. It’s a supremely human — and humane — rite, and being invited to violate it involves the breaking of a very deep taboo that is sustained by almost every religion and by many non-believers, too.
Humane rite: Cleansing, honouring and respecting the bodies of our dead is what we have always done in our culture
And yet medical science pulls us relentlessly in the other direction, as it becomes ever more accomplished in re-using the organs of the body — spare part surgery, if you like — and, as a direct result, lays ever stronger claims to the bodies of our dead.
That will be fine for the altruistic minority, but not for the more undecided majority whose reservations are deep-seated and deserve to be respected, not airily dismissed.
Such well-founded reservations should not be crudely ‘bought off’ in the manner the Nuffield Council is now suggesting.
Funeral costs are a red herring. If people really are having trouble with such matters, we should revive the old tradition of people putting away money for their funeral over time. But that really has nothing to do with the debate about organ donation.
Of course, no one can be unsympathetic to those whose lives are blighted by illnesses that could be cured by organ donation. But paying for organs is not the way forward.
We need a more open and honest approach that equips people with all the information they need to make their choice. But, we also need to respect them when they turn round and say ‘No’.
