|Sunstein: Take organs from 'helpless patients'
'Though it may sound grotesque, routine removal would save lives'
| October 12, 2009
TEL AVIV – President Obama's newly confirmed regulatory czar defended the possibility of removing organs from terminally ill patients without their permission.
Cass Sunstein also has strongly pushed for the removal of organs from deceased individuals who did not explicitly consent to becoming organ donors.
In his 2008 book, "Nudge: Improving Decisions about Health, Wealth and Happiness," Sunstein and co-author Richard Thaler discussed multiple legal scenarios regarding organ donation. One possibility presented in the book, termed by Sunstein as "routine removal," posits that "the state owns the rights to body parts of people who are dead or in certain hopeless conditions, and it can remove their organs without asking anyone's permission."
"Though it may sound grotesque, routine removal is not impossible to defend," wrote Sunstein. "In theory, it would save lives, and it would do so without intruding on anyone who has any prospect for life."
Sunstein continued: "Although this approach is not used comprehensively by any state, many states do use the rule for corneas (which can be transplanted to give some blind patients sight). In some states, medical examiners performing autopsies are permitted to remove corneas without asking anyone's permission."
Sunstein's example of medical examiners removing corneas, however, applies only to patients who are already declared deceased.
After defending the position, Sunstein conceded the "routine removal" 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."
Still, Sunstein did not add that the removal of organs from a living individual should be banned.
Also in the same book, CNS News previously noted Sunstein argued for removing organs from deceased patients who are not registered as organ donors, a policy not without precedent. Spain and some European Union countries have been debating accepting a law of implied consent.
Writes Sunstein: "A policy that can pass libertarian muster by our standards is called presumed consent."
"Presumed consent preserves freedom of choice, but it is different from explicit consent because it shifts the default rule. Under this policy, all citizens would be presumed to be consenting donors, but they would have the opportunity to register their unwillingness to donate, and they could do so easily. We want to underline the word easily, because the harder it is to register your unwillingness to participate, the less libertarian the policy becomes."
Sunstein continues: "Although presumed consent is an extremely effective way to increase the supply of organs available for transplant, it may not be an easy sell politically. Some will object to the idea of 'presuming' anything when it comes to such a sensitive matter. We are not sure that these objections are convincing, but this is surely a domain in which forced choosing, or what is referred to in this domain as mandated choice, has considerable appeal."
Sunstein advocates making it mandatory for all citizens to register either as an organ donor or as unwilling to donate their organs.
"Mandated choice could be implemented through a simple addition to the driver's license registration scheme used in many states. With mandated choice, renewal of your driver's license would be accompanied by a requirement that you check a box stating your organ donation preferences. Your application would not be accepted unless you had checked one of the boxes. The options might include 'yes, willing to donate' and 'no, unwilling to donate.'"
Government must fund abortion
Sunstein is not shy about his view concerning rights to life or abortion.
WND reported that in his 1993 book, "The Partial Constitution," Sunstein argued the government should be required to fund abortion in cases such as rape or incest.
"I have argued that the Constitution ... forbids government from refusing to pay the expenses of abortion in cases of rape or incest, at least if government pays for childbirth in such cases," Sunstein wrote.
The Obama czar asserts that funding only childbirth but not abortion "has the precise consequence of turning women into involuntary incubators."
Sunstein argues that refusing to fund abortion "would require poor women to be breeders," while co-opting women's bodies "in the service of third parties" – referring to fetuses.
Sunstein wrote he has no problem with forcing taxpayers to fund abortions even if they morally object to their money being used for such a purpose.
He wrote: "There would be no tension with the establishment clause if people with religious or other objections were forced to pay for that procedure (abortion). Indeed, taxpayers are often forced to pay for things – national defense, welfare, certain forms of art, and others – to which they have powerful moral and even religious objections."