On the first one, we might ask the next of kin if they know what the donor wanted, but this is a very different thing from asking their personal permission.

It’s interesting that authorities say they respect next-of-kin wishes for the pragamtic reason that they fear an anti-transplantation campaign from outraged relatives. Given the expressed opinions in surveys of most of the population, I’d think such a campaign would be counterproductive by raising the profile of the issue. Have there been such campaigns in opt-in countries?

While I want to reiterate that Kieran is right. Walker did an amazing job with this story—the whole thing, I wonder if time and patience might prevent some folks from hearing my favorite part (the middle). So here are the timestamps of Kieran’s contributions for Timberites:

0-3:50: Though it’s Walker’s voice, rather than Kieran’s, I highly recommend the whole intro. It lets you know that Kieran’s work framed the story.
3:50-6:30 – K: variation in procurement rates depend on organization
36:00-36:40: K: exploitation as something conceptually different from a market.
38:30-40:15 K: “crowding out” explains why financial incentives don’t always work.

a priori I’d be sceptical that opt-in or opt-out arrangements don’t have much effect.

here’s a link to a paper of mine that looks at the data on this issue. It turns out that opt-out (or presumed consent) systems do not typically work as most people in English-speaking countries think.

To refuse permission for a dead body to be used to help the living in whatever way possible is just immoral, and grief is no excuse any more than it would be for any other grossly immoral action. Absent prior instructions to the contrary from the putative donor, the next-of-kin should not even be asked – it’s literally none of their business.

I haven’t read your book, Kieran, but a priori I’d be sceptical that opt-in or opt-out arrangements don’t have much effect.