Q&A: The Preferable Way to Donate Organs
The Preferable Way to Donate Organs
Question
I once saw a claim by the Ministry of Health that the purest altruistic choice in organ donation is to donate through a state authority that has fixed ethical prioritization criteria, rather than having the donor intervene in choosing the person who will receive it, as happens in the association of Rabbi Haber of blessed memory.
In practice, it is clear to me that someone who donates has the right to choose to whom he gives. And reality has shown that the approach of giving that choice led to a jump in the number of donors, so it is a blessed thing.
But it raised for me the principled question: what really is the most moral way? From a deontological perspective, a person’s preferential intervention in donating to someone he feels closer to apparently harms morality (by religion, nationality, family). On the other hand, some argue that morality should remain personal, and that it is preferable when it expresses that desire rather than an abstract morality of theoretical calculation.
(This is actually connected to the concept of “do not hide yourself from your own flesh” as opposed to “love your fellow as yourself.”)
What is the Rabbi’s position on this subject?
Answer
First, there is no contradiction between the claim you present from the Ministry of Health and the claim that a person has the right to choose to whom to donate. A person has the right to do less moral acts. So what? The same applies to the claim that the voluntary policy increases the number of donors. That is a fact. Does that mean that it is therefore more moral to act that way? From a utilitarian perspective yes, but from a deontological one not necessarily.
As for the claim itself, all this seems to me like a rather idle discussion. A person can choose to whom to donate and do so according to criteria. He himself can decide to let the state choose if he does not have enough information. Therefore this comparison is empty of content in my opinion. One can ask whether it is preferable to donate to those close to you or to whomever the state determines, and that too has two sides. But the question as you formulated it is, in my opinion, not well defined.
Discussion on Answer
I do not think the question is a moral one, but rather a question of efficiency. There is a claim that if everyone takes care of those close to him, the world will function better than with boundary-crossing altruism. Others think altruism is a more efficient method. This is somewhat related to the Left (which believes in centralized management of the market and society) versus the Right (which believes in an invisible hand and a free economy).
In any case, I do not think the question is asked on the deontological plane, where one judges the decision of a single person. The recommendation that the poor of your city take precedence is not a moral recommendation but a recommendation of efficiency. If everyone worries about the whole world, nothing comes of it. It is preferable for each person to care for his immediate surroundings, which he actually cares about, and in the final analysis this will bring greater good to more people. Of course, a state can decide that it takes the reins for itself and directs altruistic activity. There is justification for that in certain cases. And again, the state’s decision is not because that is more moral (deontologically), but because it is more efficient (consequentially).
Indeed, the question is whether it is morally preferable to give according to principled criteria that do not refer at all to the person’s own personal position (for example, principled rules would not distinguish between nationalities because that involves racism). That would seemingly be a purer altruism.
Or perhaps there is no “defect,” or there is even an advantage, to a more personal morality, such that preference is given to those to whom he is genuinely more connected (his brother who needs a kidney, someone of the same nationality, or just a friend he knows). Does that impair altruism? Is it more correct to make all decisions behind a “veil of ignorance”?
(Those who support a more personal morality speak about how abstract morality is not “human morality,” and that morality is something born out of “human interaction,” and other kinds of concepts that I do not really understand.
Though when I examine the halakhic position, it clearly leans in that direction—the question is whether there is a moral basis for that or whether it is only a halakhic one).