The state of Nevada is currently considering a bill that would change its organ donation system from an opt-in to an opt-out program, meaning that if citizens don’t opt-out the state has the authority to confiscate organs after death. It’s a program that may help with the organ donation list but could also lead to some deeply troubling ethical situations.

Organ donation is a very personal decision, one that people make often based off their religious faith and personal beliefs. But Nevada wants to take some of that decision-making away from its citizens and instead opt them all into an organ donation program, unless they opt out.

Called Senate Bill 134, it would require that any applicant to the department of motor vehicles be automatically registered as an organ donor unless they opt-out. This legislation was proposed by a heart transplant recipient, 30-year-old Ashley Biehl.

In a letter of support, she wrote, “In conclusion, approximately 7,300 people die every single year in the United States waiting for an organ transplant. Senate Bill 134 seeks to help alleviate that burden and reduce the number of unnecessary deaths by making more organs eligible for donation. Further, 90% of the population supports organ donation, and by approving an opt-out system, people would still have every freedom to choose not to be a donor. This bill has the potential to really truly save many, many lives. The uncertainty of waiting on a transplant is excruciating; I know firsthand. I full-heartedly support Senate Bill 134 and respectfully urge the committee to move forward with the passing of the bill. I am more than happy to answer any questions you may have.”

Organ donors, those both living and deceased, save lives, but opting everyone into the system raises the possibility of some significant ethical challenges. 

Take Ashley’s situation, for example. According to her own statement, there was confusion and disagreement over what her donor, Jessica, actually wanted when it came to organ donation.

In her statement, Ashley wrote, “Jessica had registered to be an organ donor through the DMV. After splitting from her first husband, Jessica met a new man, and they became engaged, while her divorce remained pending. When Jessica was declared brain dead, the organ procurement team contacted Jessica’s family and asked if they knew her wishes. Jessica’s fiancé immediately stated that they had never talked about it and he was absolutely unwilling to sign the forms required for her to become an organ donor. However, Jessica was still legally married. Her husband stepped in and decided: if she had registered to be a donor, that was what she wanted, and he would honor her wishes. Another recipient received her kidney, and Jessica’s life went on to mean the actual world to me and another recipient, even though we’d never met her.”

But what did Jessica really want? It appears that there are two or three different perspectives from her closest loved ones. If asked on her death bed if she still wanted to become an organ donor, would she have affirmed her initial decision or changed her mind? That’s a question she’s, unfortunately, unable to answer.

There’s also concern about whether or not physicians could stop treatment or deny certain treatments in order to best preserve the body and harvest it for organs. Ashley argues that this will not be the case. One hopes she is right. 

She wrote, “Further, this bill would eliminate the myth that doctors do not help save people who are organ donors. While this is, of course, a myth to begin with, a common concern is that medical professionals will not work as hard to save people who are registered organ donors. Senate Bill 134 would eliminate these concerns because everyone would presumptively be an organ donor, unless they opted out, which no member of the care team would know in advance.”

Unfortunately, due to abortion and the growing use of assisted suicide and euthanasia, death has seemingly become a treatment for certain situations and conditions. For example, if a prenatal test comes back positive for a condition like Down syndrome, many medical professionals almost automatically suggest abortion. 

There’s also the terrible case of Chris Dunn, a man from Texas. He had an undiagnosed medical condition, and the hospital requested to remove his life-sustaining medical treatment due to the state’s controversial 10-day rule, which permits hospitals to deny treatment and allow the patient to die unless they are able to secure a move to another health facility or get a court order of protection.

Melissa Conway of Texas Right to Life, which had been advocating on Dunn’s behalf, said “One month after Houston Methodist Hospital determined that Chris’ life was not worth living and that his condition was not even worth diagnosing and treating, Chris succumbed to his illness.”

Wesley J. Smith, a prominent advocate on issues related to assisted suicide, euthanasia and bioethics, wrote for National Review on the topic, stating, “If doctors ever start taking organs without explicit permission of donor or family — even if allowed by law — there will be hell to pay. Indeed, if we reverse our presumptions from opt-in to opt-out, I believe we could end up with fewer donated organs, with increased disputation and litigation. It’s just not a risk worth taking.”

A pro-life world view requires Christians to believe that every human life, no matter the condition or situation, is worth living. 

Organ donation is a vital, lifesaving process but it’s also one that requires sympathy, empathy, sensitivity and great wisdom to navigate. Good intentions do not necessarily equate to good policy, especially given how wrought and fraught this particular issue can be.