One thing people haven't commented on so far is how spectacularly more complex the organ donation system would have to become to manage a system where people get to freely specify who should get their organs.
With a dead person's property it's more straightforward, since transfer isn't as complex and demanding a process as an organ transplant - and yet to accommodate the entire spectrum of people's wishes requires an entire speciality of the legal profession. If you have to deal with all that (or even something approaching that) on top of the usual administrative faff of transplants, I can see the successful transplant rate falling through the floor.
(There's some good evidence that the law on organ donation - opt-in or opt-out - makes a huge difference to the number of technically available donors but far less to the number of actual successful transplants. The big effects in the latter come rather from investing in streamlining the administrative process of decision-making, allocation, matching, transport and so on.)
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One thing people haven't commented on so far is how spectacularly more complex the organ donation system would have to become to manage a system where people get to freely specify who should get their organs.
With a dead person's property it's more straightforward, since transfer isn't as complex and demanding a process as an organ transplant - and yet to accommodate the entire spectrum of people's wishes requires an entire speciality of the legal profession. If you have to deal with all that (or even something approaching that) on top of the usual administrative faff of transplants, I can see the successful transplant rate falling through the floor.
(There's some good evidence that the law on organ donation - opt-in or opt-out - makes a huge difference to the number of technically available donors but far less to the number of actual successful transplants. The big effects in the latter come rather from investing in streamlining the administrative process of decision-making, allocation, matching, transport and so on.)