Once upon a time, the reproduction of labor power was limited to surrendering your newborn to the shackles of economic bondage, in addition, of course, to whatever variable and surplus capital that could be extracted from you while you were still worth exploiting. Nowadays, the bourgeoisie have improved their rate of exploitation, without imposing greater demands on the output of labor itself–that is to say, without putting labor in greater mortal danger–the newfound ingenuity of which is typical of the characteristic benevolence that defines the capitalist class, to which the proletariat is eternally indebted for its rescue from the destitution that would surely ensue were it not for the employment opportunities so magnanimously created as part of the expansion of global capital. New York assemblyman Richard Brodsky unveils the master plan:

A New York assemblyman whose daughter is alive because of two kidney transplants wants his state to become the first in the nation to pass laws that would presume people want to donate their organs unless they specifically say otherwise.

Assemblyman Richard Brodsky believes the “presumed consent” measures would help combat a rising demand for healthy organs by patients forced to wait a year or more for transplants. Twenty-four European countries already have such laws in place, he said.

If he succeeds, distraught families would no longer be able to override their loved ones’ decisions to donate upon their death. And eventually, hospitals would be able to assume the deceased consented to have his or her organs harvested, unless the person refused in writing.

Given the costs of performing a transplant, it seems highly unlikely that one will receive a transplant without sufficient funds or insurance. Such a measure as proposed by Brodsky thus disproportionately benefits the upper class. Even if there were plenty of organs to go around, the lower classes would simply not be able to afford the transplant procedure. The demand for organs that is meant to be satisfied is really a demand from those sufficiently wealth to afford the transplant, though it is thinly disguised as a universal demand that would benefit all. Arthur Caplan exemplifies this thinking:

What can be done to increase the supply of organs that can be used for transplantation? In New York, as is true all over America, waiting lists grow every month and lives are lost because there are no hearts, kidneys, livers or lungs available. (Caplan)

If transplant procedures were made available regardless of financial need, an argument for presumed consent would be morally tenable; until then, this is yet another attempt by the bourgeoisie to exploit the lower classes through moral blackmail.

The New York Times put together a discussion that, with the exception of Mary Ann Baily’s contribution, manages to utterly and perniciously elide any pertinent criticism of the issue.

Many Americans don’t trust the government or the health care system. Some already fear that signing a donor card may make physicians give up on them too soon, especially if the hospital is likely to lose money on their care. This legislation, if enacted, might only ratchet up those fears. (Baily)

In addition to the class bias inherent in presumed consent, it is all too easy to see that doctors will be selective in their efforts to save an individual, given the potential for organ harvesting. Perhaps one might even start with a low-risk operation just to get a healthy individual on the operating table, and then “accidentally” kill the individual to obtain the organs.

While Sally Satel offers a generally inane but typically bourgeois perspective on the proposed bill, her most useful observation is to inadvertently expose the true motivations behind the harvesting plan: “The assemblyman’s package of bills contains a provision that would allow anyone who donates a kidney while living to receive a $1,000 state income tax credit” (Satel). So now we know that the bourgeois capitalist class thinks that your kidneys are really only worth a $1,000 tax credit.

Elaine Berg offensively suggests that this problem is merely a technical snag in the legal system:

The opt-out registries would have to be accessible to organ procurement organizations, which would be required by law to contact the registry every time there is a potential donor (we currently do this to determine folks who have registered to donate by opting in). Laws would have to specify that overriding a person’s wishes to opt out is illegal.

All of this can be done. There are nearly 110,000 people waiting for life-saving organs in this country. We are not waiting for a cure. The solution is in our hands. (Berg)

Of course, she neglects to mention how many of those 110,000 people can actually afford a transplant even if the needed organ were available. Her distorted moral standards also put a disgusting twist on individual rights:

Importantly though, in order to be considered, it is imperative that any system of presumed consent have robust safeguards to protect individual rights. There must be guarantees that every citizen is well-informed regarding their right to opt out, and the procedure to do so would have to be simple, accessible and barrier-free. (Berg)

The main concern here is to make sure everyone is entitled to formal rights, and that everyone is made well aware that one has formal access to these rights. The implicit assumption behind this facade is that as long as an individual is aware of his formal rights, any decision by the individual is consensual and legally bonding. The disingenuousness of this approach is belied by the total lack of emphasis on informing the individual about the actual consequences of a given decision. Merely being aware of the option to accept or decline is useful without real knowledge of the potential repercussions. The strategy here is clearly to beguile the individual into acquiescing and then shifting all responsibility to the individual on the basis of consent.