Preferred organ donation method

שו”ת › Category: moral › Preferred organ donation method

asked 5 years ago

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 criteria for prioritization, instead of the donor interfering in the choice of the person who will receive, as is stated in the association of Rabbi Haber zt\”l.
In fact, it is clear to me that those who donate have the right to choose who they give to. And reality has proven that the method of giving choice has led to a jump in the number of donors, and is therefore welcome.
But this raised in me the fundamental question, what is really the most moral way? From a deontological perspective, interfering with a person’s preference to donate to those they feel closer to (by religion, nationality, family) seemingly violates morality. On the other hand, some argue that morality should remain personal, and it is better when it expresses this desire than abstract morality of theoretical weighing.
(This is actually related to the concept of “and you shall not ignore your message” as opposed to “you shall love your neighbor as yourself”).
What is the Rabbi’s position on the matter?

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מיכי Staff answered 5 years ago

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 who to donate to. A person has the right to do less moral things. So what? The same goes for the claim that the voluntary policy increases the number of donors. That is a fact. Does that mean that it is more moral to do so? Utilitarian yes, but deontologically not necessarily. As for the argument itself, all of this seems to me to be a futile discussion. A person can choose who to donate to 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 could ask whether it is better to donate to those close to you or to anyone the state determines, and there are two sides to that too. But the question as you phrased it, in my opinion, is not well defined.

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יצחק replied 5 years ago

Indeed, the question is whether it is morally better to give according to principled criteria that do not refer to the person's personal position at all (for example, principled rules will not distinguish between nationalities because that would be racist). This is supposedly purer altruism.

Or is there no “flaw”, or is there even a preference, for a more personal morality, so that preference would be given to those to whom one is truly more connected (a sibling who needs a kidney, a member of the same nationality, or just a friend one knows). Does this violate altruism? Is it more correct to make all decisions behind a “screen of ignorance”?

(Supporters of more personal morality talk about how abstract morality is not “human morality”, and that morality is something that is born out of “human interaction” and all sorts of other concepts that I don”t quite understand.
Although when I examine the halakhic position it clearly leans in this direction - the question is whether there is a moral basis for this or is it merely halakhic).

מיכי Staff replied 5 years ago

I don't think the question is a moral one, but rather a question of efficiency. There is an argument that if everyone cared about their relatives, the world would run better than cross-border altruism. Others believe that altruism is a more efficient method. It has a bit to do with 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 don't think the question is being asked on the deontological level where one judges the decision of an individual. The recommendation "the poor of your city come first" is not a moral recommendation, but a recommendation of efficiency. If everyone cares about the whole world, then nothing will come of it. It is better for everyone to care about their immediate environment, which they really care about, and in the end, this will bring greater good to more people. Of course, a state can decide to take the reins and steer altruistic activity. There is justification for this in certain cases. And again, the state's decision is not because it is more moral (deontologically) but because it is more effective (consequentially).