Whole Body Gestational Donation

( 2 ) Opt out organ harvesting is ethical.

The person's body and the organs therein are no one's property to "harvest" after death. As much would imply the person's body is the property of the state, and it is simply for the duration that the person's soul occupies the body that it is lended to the person.

( 10 ) A violation of bodily autonomy would only occur if a person's articulated preferences were neglected.

In other words, I would consider any use of the body without articulated permission a violation of bodily autonomy.

1. Whenever a person dies, he/she loses her/his civil personality and then he/she lacks his/her own right to claim.[ * (Yet, an authority represented by their interests can take decision on order to complement someone's interests)

2. Public order must prevail over private. A judge must decide and authorize an organ donation if the health and life of others is at risk, even if the donor had not expressed his agreement or disagreement while alive.

However, the consent requirements for organ donation are extremely loose, in comparison with consents required for other forms of medical intervention. Recent legislative changes in the UK, for example, mean that a person’s organs may be harvested without any clear indication that they wished for this to happen. Should we expect something more demanding than this, if we include WBGD among the uses of a person’s body after their (brain) death? If so, why, given that we accept such minimal requirements for ‘normal’ organ donation? Perhaps one answer here is that WBGD is not something that people understand or have knowledge of. Therefore ‘deemed consent’ such as the organ donation framework relies on, is not properly informed. People who fail to opt out of the organ donation system can be regarded as having passively consented to something they have sufficient knowledge about. Everyone has heard of organ donation. No-one has heard of WBGD. Moreover, WBGD is qualitatively different in that it entails ventilation over an extended period. And, of course, its aim is not ‘life-saving’ per se as organ donation is usually understood to be.

if the health and life of others is at risk

Unlike any other form of organ donation, WBGD imposes no risks on the ‘recipient’. It has the additional advantage of conveying significant clinical benefits on women who make use of it. If WBGD were offered as an alternative to pregnancy generally, the clinical benefits would be striking. It is here that I diverge most significantly from Ber. Ber argues that only the neediest of claimants should have access to WBGD – those who have clear medical contra-indications to pregnancy or lack a uterus altogether. The problem with this is that pregnancy itself should properly speaking be medically contra-indicated for women generally.

It is well known that pregnancy and childbirth carry significant health risks, even in affluent settings with sophisticated healthcare systems [26, 27]. To expose oneself to risks comparable to pregnancy and childbirth would be deemed foolish and pathological in any other context. I have previously shown that in a comparison between pregnancy and measles, pregnancy comes out considerably the worse in terms of morbidity and mortality [28]. Yet concerted medical efforts are focussed on ridding ourselves of measles, while women are expected to submit themselves to the greater risks of pregnancy and childbirth almost without thinking about it.

My initial problem is with the word 'harvesting'. The citizenry as a crop; the government as reaper. There is something very skewed about that concept, even before the ethics of the situation - properly called dismemberment of dead bodies.
The ethical consideration rests on one question:
Is leaving one's body to the nation an articulated condition of citizenship?

what is the ethical distinction when both are harm reducers and life enablers? How would this distinction block the concluded entailment?

if you grant that opt out organ harvesting is unethical,

Otherwise, interpreting our bodies as property it looks like a religious belief rather than ethical one...

But the treatment as an object, or consumer item, whose possession is to be legally decided presupposed its status as property. It is presumed the property of the occupant as long as he's in possession; his to leave in a will, like anything else he owns. There is nothing either ethical or religious about that: it's a thing that can be argued over, arbitrated, cut up, portioned out and used.
The only question here, who has a right to decide how it will be used, absent the owner's explicit instruction.

If it is consider as one’s possession with the status as property, why suicide is condemned by both religion and laws?

In the other hand, I still think that the only third part capable of deciding on other someone’s interests can be the judges. As I said, each of us have a lot of private interests but the public order is over to self care.

It should be noted that if one's body is made property of the state, that "state" is in fact only a surrogate term for a collection of (usually highly corrupt) individuals who hold power. In other words, one's body becomes the property of other individuals - slavery.

To some degree, that has always been the case. ...

But the present question concerns power over dead bodies, ...

Have at it!

How do brain-dead human beings become the exclusive and legitimate holdings of this organization?

Those organizations (supposedly) are there to help others or preserve nursing and caring. If they are aware of someone who dies and their organs can help others, they can ask a judge to authorize organ donation on behalf of that person to preserve the health and life of others.

In a similar vein, would you feel differently about this if the organs were used for cosmetic surgery rather than surgery that is medically necessary.

( 11 ) Harms to the living derive from the denial of bodily autonomy.

One might argue that WBGD involving brain-dead women has no implications for living women, any more than harvesting the heart from a brain-dead man has an impact on living men. However, perhaps this is disingenuous. WBGD necessarily involves the separation of women’s reproductive functions from their very consciousness. Even if no-one would suggest that this should alter the way we regard ordinary women and their pregnancies, it might send an implicit message, or reinforcement to deeply entrenched assumptions and prejudices. The prospect of the unconscious woman’s body, filled and used by others as a vessel, is a vivid illustration of just what feminists have fought against for many years.

These feminist concerns, however, might be mitigated if men could also participate in WBGD. The prospect of male pregnancy is not, as many would imagine, fanciful, or a piece of science fiction. In 1999, Robert Winston told reporters that there were no intrinsic medical problems with initiating a male pregnancy: the danger would be in the delivery. We already know that pregnancies can come to term outside the uterus [31]. The liver is a promising implantation site, because of its excellent blood supply. However, as Winston noted, this could be risky – even fatal - for the person carrying the pregnancy. But for brain-dead donors, the concept ‘fatal’ is meaningless: the gestator is already dead. Thus, even if the liver is damaged beyond repair after the gestation, this would not pose a problem except insofar as it might mean that male gestators could carry only one pregnancy, rather than many consecutive ones.

The prospect of the male gestator could thus appease some feminists who might otherwise feel that brain-dead gestation is a step too far in the objectification of women’s reproductive functions.

But the law is not enacted to solve ethical issues but to reach equity. That's why I see it is fine if a judge needs to make a decision because we consider judges and courts as third parts who resolve problems of the societies and they interpret what should be someone's wishes if the interests of a person is at risk.

Am I right in thinking you're suggesting that because these decisions are made by judges and laws, a dead person's articulated informed consent is not required?

But the law is not enacted to solve ethical issues but to reach equity. That's why I see it is fine if a judge needs to make a decision because we consider judges and courts as third parts who resolve problems of the societies and they interpret what should be someone's wishes if the interests of a person is at risk.

they interpret what should be someone's wishes if the interests of a person is at risk

One of the main debates is to consider if a third person can decide on someone's interests when such individual is no longer available to do it by himself.

1. Is this clause generally known by the population as part of their civic obligation? I.e. is it explicitly articulated in law?

Having taken possession of the body for harvesting, does the state undertake the responsibility for dignified disposal of whatever is left? Or, having appropriated the useful bits, does it download that effort and expense on the family?

Should they be kept alive so that we may harvest their organs should the need arise?

Prolonging ventilation and somatic survival in brain-dead patients is undoubtedly a disturbing prospect. WBGD involves treating the patient’s dead body as a means to an end, rather than as an end in itself. The patient moves from being the focus of medical concern, to being a repository of tissues that can be used to benefit others. The prolongation of the ventilation period exacerbates our awareness of this. Yet this is already a part of our organ donation process. Organ donors are almost invariably patients who are already being ventilated, as part of their medical treatment. If the patient is deemed to be a suitable organ donor, ventilation will be continued along with other interventions to ensure that the organs will be maintained for transplant in optimal condition. Thus, we already prolong ventilation in order to facilitate organ donation.

WBGD would involve extending this prolongation considerably further. But ventilating someone for two days, two weeks, or two years makes little difference except insofar as it forces us to acknowledge and recognise what we are doing before we hasten on to the next stage. The justification for prolonging somatic survival in conventional organ donation is primarily the benefits that are expected to derive for others, but also the idea that if someone wants to donate their organs, it may be reasonable to take the steps to preserve the organs even when this is no longer directly in the patient’s medical best interests. The same criteria apply to WBGD; the period of prolongation is further extended, but the means and justification are the same.

So there is the added question of: should these brain-dead people be kept alive, used as incubators, so that someone else may become a mother?

Should they be kept alive so that we may harvest their organs should the need arise?

According to same laws the efforts and expense needs to be taken by the goods and money he or she left in the inheritance. If these are not sufficient, it needs to be paid by the goods of the successors and ultimately, public funds if the state is held accountable.

If they take the benefit, they should absorb the cost.

The dilemma could be if the state should or not take those benefits the public administration when is based on public resources.

But I admit here: my objection to reproductive use of the undead is aesthetic and practical, rather than eithcal.

A dead person has no 'interests'.

What happens to one's corpse? It's either buried/cremated and in both cases, perfectly working organs are destroyed when they could actually save lives. I say we harvest organs of dead people. Why would they mind at all?

A dead person has no 'interests'.

There was a very good episode of the TV series Boston Legal, wherein a widow donated her husband's body to a teaching museum https://www.bu.edu/articles/2019/to-do-today-see-inside-the-human-body-at-the-museum-of-sciences-body-worlds-exhibit/ and the daughter took possession, so she could bury it.

What happens to one's corpse? It's either buried/cremated and in both cases, perfectly working organs are destroyed when they could actually save lives. I say we harvest organs of dead people. Why would they mind at all?
— Agent Smith

I suppose we might as well have an opt-out system for having one's dead body used as a high-quality sex doll for necrophiliacs. Who would pass up on such an amazing opportunity to make others happy after their death?

So I find the opt-out program is morally wrong and unjust. The utilitarian argument for “presumed consent”, in this case using human beings as incubators without their consent, whether for organs or children, requires too much faith in human infallibility and authority for me to be comfortable with. It illegitimately considers human beings as state property. The acquisition of the human being as property was unjust. For these reasons I wouldn’t make it past the first premise.

Technically incorrect. A decedent's estate is just that.

the dead body should belong to the decedent's estate automatically, along with their assets (property and financial accounts) and income.

His interests are not under consideration, unless he made a legally binding will. The law does provide for a dead person's property to be disposed according to his will. In the absence of a written will, the state has the right to apportion whatever property is not legally claimed by an heir. If there are no heirs, the state becomes the beneficiary.
It seems to me the same rule applies to dead bodies.
The matter of ownership is decided between the heirs and the state. If there is no legal claim to the remains, the state can take possession.

If the widow already donated the corpse to the museum for scientific research, then the museum is now the legitimate "owner" of the corpse. The daughter is not legally covered to ask for the body of her father. Why she didn't opposed against the donation in the first place?

That started me thinking. Keeping a body alive for nine months would very expensive. If it weren't covered by insurance, only rich people could do it.

But the idea of my body sitting there for nine months with pumps and feeding tubes gives me an upset stomach.

That started me thinking. Keeping a body alive for nine months would very expensive. If it weren't covered by insurance, only rich people could do it. Probably very rich people. In my state, Massachusetts, it is a requirement that insurance plans cover fertility treatments, including in vitro fertilization, but surrogacy is not covered. I certainly wouldn't want insurance plans to be required to pay for this type of "treatment."

Aye. It's a sickening and horrifying idea. Though neither of those things mean it's wrong.

Ultimately perhaps the referenced argument by Ber is stronger, but likely to be even more repugnant - the donor body isn't dead, it's in a persistent vegetative state.

Treating people as means to an end devalues them individually and people in general. I don't get that same feeling from organ donation.

Even if they are brain dead? Still a person?

Even if they are brain dead? Still a person?

To their family and friends, yes.

why is WBGD devaluing people by treating them as a means to an end, but organ donation isn't?

Human and person are not interchangeable, are you wanting to say the braindead are human or persons? I would say they obviously human, but not a person.

That doesnt mean that they are. That is a sentimental illusion people might use for comfort, but does not form an actual basis to claim anything.

What possible definition of “person” could you be using here that includes a biological entity with no mind in it?

I understand the distinction you are making between human and person. I meant to say "person" in the same sense you are using it. You and I disagree about whether or not people in a vegetative state are people. That's a matter of value, not fact.

You and I disagree about whether or not people in a vegetative state are people.

If hypothetically WBGD would be possible with a deceased body, would that change your mind about whether it's permissable?

Maybe. How do you define “person”?

The quick answer is because it feels that way to me. So what's the longer, more considered answer?....I guess the question is why do I feel that way. I guess it's because the person looks just like a normal person who is asleep, unconscious, or comatose. The look like a person. They breath. Their heart beats. I think devaluing their humanity devalues all the rest of ours too, which is a dangerous thing for a society to do except, as I said, for something vitally important.

Do you feel the same way about opt out organ donation?

Ok, but if you aren’t sure what a person is how can you know a corpse is still a person?
Aren’t you basing a conclusion (a corpse is a person) on something you aren’t able to even define (what a person is)?
At the very least it seems to me you should be no more confident that a corpse is a person than you are confident what a person is…no?

Is there anything wrong with that? Answer - no.

I disagree. Anything can be justified with “emotional judgements”, therefore it is a poor metric for justification.

True. So, then, it's okay to cut up dead brain-people and package them to sell for meat?

We reject cannibalism because it is not part of our "culture" and social norms.

but who knows what the future holds...

True. So, then, it's okay to cut up dead brain-people and package them to sell for meat?

But then, taking vital organs out of one person to save another from the same god's will to end his life, or using surrogates to thwart god's sentencing of a woman to sterility, was not in "our" culture until quite recently, and now we're comfortable with both. Logic follows: if it can be done, it can be legally mandated.

If we take a liver to help a sick person you will make him to live better or at least easier life.
It is not even close to cut up a person to eat him later on...

it is lascivious and only a psychopath wants so anxiously to do so.

Well two things, first it depends on the context under which you are asking that question.

Two, regardless of the above eating human meat has numerous harmful effects. Cannibal societies die out from the practice.

Sure, why waste all that food when people are starving?

I disagree. Anything can be justified with “emotional judgements”, therefore it is a poor metric for justification.

Ethical judgements are more than just emotional reactions but you are treating them the same in your argument.

It is accepted and ruled by modern societies that state's or social care support should depend on the effort of each contributor. It is just one of the basics principles to reach equity.

If I pay a considerable amount of taxes, I have the right to "get recognized" in the future. So, I guess, the "queue" of organs receivers should depend in such basic taxation rule or [logic] law.

In real life, hardly at all! The richest people in the world are taxed the least, and constrained the least by government regulation.

The richest use private insurances and the poorest perceive the help of the state and social healthcare.

I don't know about other European countries.

Japan

I actually do think that WBGD is likely to be ethical. After all, surrogacy is extremely expensive. If this can significantly reduce the costs of surrogacy, then why not aim for this?

The allegation is that surrogacy, while consensual, is exploitative. I don't fully subscribe to that logic because, like organ donation, it can significantly improve people's lives, including those who do the giving.

But the risk of exploitation can still be there if women are poor.

So, they could withdraw their consent to this while they were still alive.

But anyway, a brain-dead person, due to not being sentient any longer, no longer has any interests. Meanwhile, a sentient surrogate still does have interests, including the interest not to be exploited. So, the "injury" to the brain-dead person is less severe, so to speak.

Would WBGD really be worse than this?

But I think the argument in the paper makes a good case that the moral intuitions which make opt out organ donation ethical should also apply to WBGD.

My bottom line: It's unethical to presume informed consent, on the basis that the consent was not expressly refused.

Then that would apply to both.