Organ Donation Ethics: A Casuist Analysis of Routine-Salvage Versus Opt-in Models

Organ transplantation remains an ethically complex issue, in part due to the growing disparity between organ supply and demand. This paper applies a casuist ethical framework to analyze the moral justifications of two models of organ procurement by comparing organ donation to inheritance and public resources. The opt-in model aligns with the principle of bodily autonomy, treating organ donation as a personal decision akin to leaving behind an inheritance. It ensures explicit consent, allowing individuals full control over their postmortem bodily integrity. However, this model often results in lower donation rates due to inaction. Conversely, the routine-salvage model views organs as a public resource, prioritizing societal welfare by increasing the donor pool and reducing organ shortages. This approach raises ethical concerns about presumed consent and potential violations of autonomy. Casuist analysis suggests that while bodily autonomy remains a crucial ethical principle, it is not absolute. The opt-out model presents a pragmatic solution, forcing society to weigh the ethical importance of individual autonomy against the moral imperative to save lives.