No-one is arguing that this wouldn't work. Even moving to a "hard" opt-in scheme where next-of-kin couldn't override the donors wishes wouldn't produce the same increase in healthy donors that opt-out will, because people are lazy, procrastinate and don't really believe they could die next week. Like writing your will, or telling your wife that you love her*, filling in the organ donor form is one of those tedious tasks that somehow never quite gets done.
And yet, there is opposition (of course). It's a matter of principle, as Matthew D'Ancona points out:
"At the heart of this debate – understandably emotional on both sides – is a basic point of principle. Does everything, including our bodies, belong to the State unless otherwise indicated?"Why is the heart of the debate the point of principle, and not the lives at stake? What's so great about following principles?
Now, don't get me wrong. The principle that we should limit State involvement in our lives is generally a good one, and there are lots of nice and juicy examples throughout history to tell us why. But that doesn't mean that we can mindlessly apply it to every situation, and congratulate ourselves on making the right decision. In this particular instance, the dilemma for those who want to apply the principle of minimal State interference is as follows:
Do the wrong thing: save 1,000 lives per year
Do the right thing: permit 1,000 preventable deaths.
So why is it so important to stick with the principle? Remember, we didn't find this principle carved in the living rock - we derived it by looking at what happened in other situations, where we saw that excessive State interference led to bad results. But those were other situations. In this situation, there are clearly good results to be had. What is the downside of laying aside the principle in this case? There seem to be two basic answers:
1) We should stick with the principle because State interference is bad. This is just a circular argument: it's good to follow the principle, because it's bad to not follow it. What, in this instance, is the downside of permitting State interference? Could it be that there isn't one, other than temporarily, and in specific circumstances, not following the principle?
2) If we abandon the principle now, it'll be harder to argue for it when we need it. This is just weak. If you can't make a case for, say, freedom of the press on its own merits, without needing to buttress your argument with reference to completely different issues, you might wonder how worthwhile the principle is. And again, your future ideological impregnability is coming at a price of 1,000 lives per year.
Principles are good and useful - while they lead us to good ends. The point at which they start leading us to bad ends is the point at which we should be asking just how universal they are.
*Note to my wife: this is a joke. Also, I love you.**
** Note to self: if you get run over tomorrow, this could just be unbearably tragic.