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Thank you for downloading this episode of the moral maze
from BBC Radio 4. Good evening. Possibly only the pentagon is as fond of
euphemism as the medical profession. Take elective ventilation,
it sounds like something out of an air conditioning catalog but actually it's
an outlawed medical procedure
on the ethical frontiers of life and death, right and wrong,
altruism and autonomy. To some it calls into question the very purpose of
humanity.
It's come up this week in a report by the British Medical Association which is
much exercised by the shortage of
organs for transplant 8,000 people in this country are waiting for one
up to a thousand die every year still waiting. The BMA lists all sorts of
measures that might help.
A presumption of willingness to donate, for instance. You'd have to opt out if you
didn't want your organs used.
That's already being considered in Wales. Elective ventilation is the most
controversial idea.
It means keeping the body of a dying or even technically dead person going
solely in order to harvest their organs. It's illegal in this country because the
law says treatment must be in the patient's interest.
The BMA while careful not to express an opinion
wants the issue opened up to debate. So
let's go. Would this be a long overdue antidote to the moral squeamishness
that's costing more and more lives
a minor procedural change that will make no difference to a dying patient
but all the difference in the world to those who receive their organs.
Or is this the antithesis at the altruism that should be the moral driver of organ
donation.
Worse, the utilitarian reduction of humanity to a kit of potential spare
parts.
That's our moral maze tonight. On our panel Melanie Phillips, social commentator on the
Daily Mail,
the former Conservative cabinet minister Michael Portillo, Claire Fox from the
Institute of Ideas,
and Ann McElvoy, public policy editor of The Economist.
Michael Portillo, are you keen for your organs to be used if you should be unfortunate
enough to pop yer clogs?
I would be dead at the time and therefore it should be of no concern to me
at all.
When the human body is already regarded as a kit of parts,
we've crossed that line sometime ago. we have organ donations,
and I think people are now trying to draw a line in a rather uncomfortable place,
they're saying
that the system by which we consent is that where the line should be drawn.
I would've thought that if you wanted to have a really firm moral position
you'd say that the human body is sacred and shouldn't use for donations at all.
Melanie Phillips? Err, well, I have
a big problem with organ transplants in general because
Um, I am not at all easy about the definition of
death that is used, but the issue of,
the specific issue of elective, err, err ventilation I find
totally abhorrent. The idea that we are, as Michael has just said no more than this
sum of all body parts, um, I think is a reductive view of humanity
err, which regards us as merely,
um, bits and pieces to be used for the purpose of others, and
that way lies a terrible fate for all of us.
Ann McElvoy. Well, I'm just very uncomfortable with this idea that many if not most of us would expect
to have and organ if we badly needed it
and yet at the same time we don't make it easier to have
that supply which is so absolutely vital. I think there are moral questions here.
This is an unnatural justice that
isn't being regarded by those who say that it's just a reductive view or it's
about spare parts,
it's actually about a kind of moral duty that we do have to other people after
our death.
Claire Fox. Well I'll willingly donate my organs
but I want to make them a gift I don't want presumed consent that
would effectively make my vital organs a national property
I don't want the state to act to donate my organs to save the lives over there
because I can't be relied to make that moral choice myself so think it undermines
autonomy
and altruism, and just very quickly on elective, err,
ventilation, I think it does change human bodies into means to an end and
Not an end in itself, so I'm very nervous about that.
Panel thanks very much indeed. Our fist witness is Henry Campbell who is
a kidney patient of the campaign of the Kidney Research UK
and has undergone two kidney transplants himself.
He's on the line now from York. Mr. Campbell can you tell me
it'll have to be brief I'm afraid, about the experience of kidney failure,
and how it's colored your views of these issues. Good evening.
My, Err, involvement with,
with with the kidney world is is has been a ??? one to say the least and
mmm a to pra??? it I went into kidney failure when I was 17, I've been
on dialysis
twice, um, first time for seven months, second time for two years, and I've had
two transplants, and the most recent one is of a year ago last month,
is functioning well, and, you know what what when you're diagnosed with
with kidney failure, err, the effect it has on you is huge, not only you but your family
as well,
and time you totally got to rethink your life from a dialysis point to view, there's
all these questions coming at you
which type of dialysis you want to take, the ???sy feeling unwell at the
time
and so it does ensure that you are given a
a whole, battery of things to deal with and it's quite difficult at the
time
when you'll not feeling your best. Now I understand but having gone through that
Experience, what does that
lead you to think about these particular issues
It enables me to think in such a way that
organ donation is a hugely important
thing it gives people, gives kidney patients certainly a new lease of life
when you do receive the kidney,
there's 7,000 people on the waiting list waiting for a kidney
who otherwise would be on dialysis. If those people could be transplanted
through an opt-out, err soft tissue opt-out policy which I would,
and charity Kidney Research UK would endorse, this would
totally revolutionized the lives that these people have, I think that's
that's important. Claire Fox.
I agree with the problems of chronic shortage of organs for transplants and
I'm delighted that it's been so successful for you,
but can I just ask you, are you not avoiding the obvious way to increase the
number of organs
which is the active persuasion, morally motivating your fellow citizens?
I think the,
I think and educational view point is
is important I think with the opt-in
policy at the moment that's clearly not working, so something needs to be done
and through a soft tissue opt-out policy which
would include this educational
view point and would include ensuring that we do have more intensive beds on
some
the wards in the hospital and would ensure that there are
more coordinators at hospitals would encourage
people to think about the issues around
organ donation if there was an opt-out, soft tissue opt-out policy.
Yeah, but you're saying it's not working So it can only be not working for two
reasons really;
either that your argument or my arguments are not persuasive enough,
or the people actually don't want to donate their organs.
And is there not a danger that you either can't win the arguments so you're trying
to get the state to do it for you or trying to cheat,
or secondly the you are actually usurping the autonomous decision of
certain citizens for whatever reasons not to donate their organs.
You know it's ??? too because people are still able to opt-out
so they do have that decision themselves the decision is there,
it's just been reversed. But the presumption is obviously from
volunteering to conscription you know that and
you wouldn't want to change if you didn't think that it was going to
actually lead to more
you know, let's be honest you think more people will have to make an argument
against
why can't you make a better argument for, is my point. The stats are
that
you know, at the moment twenty to twenty-five percent of people are ???
opened and registered, but when questioned,
a far higher percentage would actually sign up, sort of
eighty to ninety percent and so surely those stats indicate that
a soft tissue opt-out policy with some caveats would insure that
that these people would be, would have their feelings,
fulfilled. I mean another, another viewpoint is also the research
side to things, because that's also extremely important,
and you know, a transplant doesn't last forever, they only last 10 to 15 years so
at, you know, from a charity's point of view that's why kidney research
is is at the forefront of this, because they are investing into the research
side of things, which is so crucial
in ensuring the existing transplants can last for longer.
Melanie Phillips. One of the issues we're discussing this evening is of course
elective ventilation. Do you accept that people can be in favour of
organ transplants but not in favour of being
of people opting out, of an opting out system and
in turn, not in favor of elective ventilation?
Sorry, could you repeat that again please? Do you accept that people can be in favour
of organ transplants but not in favor of elective ventilation?
Okay, I would say
that they, they can be, because I think
they're two different
things. I mean from personal viewpoint I agree with the idea of
elective ventilation I think it's good to have this, that, this
this debate but, I think they are, I think they are separate
separate things for the moment. I think it's a contentious issue to get,
to go down and I think ideally I think the debate needs to occur
first before you can start drawing parallels. Okay but let's look at
elective ventilation because as I understand you are in favor of
that.
I'm in favor of the idea more than the actual
concept a the moment. Okay we're not going to get into the philosophical distinction
between and idea and a concept, I think, at the moment
but I wanted to ask you, I mean, no one
would pocket possibly fail to be aware of your
predicament, and ???ery sympathetic to it, but clearly
your interests a as a potential recipient of an organ,
I've already been a recipient Indeed