Resolved: Just governments ought to presume consent for organ procurement from the deceased.
This is a challenge to soccerisfun, who expressed interested in this topic. It will be debated similar to a LD topic, though not verbatim.
I affirm and value morality. This value is best because ought implies moral obligation. The value criterion is util or maximizing the overall good. This is best because it's what policy makers look at when making policies.
I agree to your definition of PC, ANY STUDIES THAT USE SOFT CONSENT ARE NONTOPICAL. All my studies are about hard consent and specifically proper implementations of the topic.
Contention 1: PC Increases Donation Rates
Source (1): "With some notable exceptions (see, e.g., Johnson and Goldstein 2003, 2004), most previous studies have pointed out that, on average, PC countries do not produce significantly higher organ donation rates. Moreover, several authors have hypothesized that this lack of correlation may be explained by the fact that PC laws are rarely enforced and that, in practice, family consent is always required before organs are extracted. In this article, we argue that legislative defaults on organ donation may affect the consent decisions of the families, even if they are not enforced. First, we use a simple model to illustrate how PC laws may affect organ donation rates. In addition, using a panel of countries, we show that, once other determinants of organ donation are accounted for, cadaveric donation rates are 25% to 30% higher on average in PC countries. The magnitude of this estimate does not vary much across the different specifications of our empirical model. Furthermore, using the panel structure of our data we are able to reject the presence of additive fixed effects."
The key part is "once other determinants of organ donation are accounted for". If my opponent's evidence cites one example where PC wasn't implemented properly, prefer my evidence.
Source (2): "Studies reviewed Five studies comparing donation rates before and after the introduction of legislation for PC (before and after studies); eight studies comparing donation rates in countries with and without PC systems (between country comparisons); 13 surveys of public and professional attitudes to PC.
Results The five before and after studies represented three countries: all reported an increase in donation rates after the introduction of PC, but there was little investigation of any other changes taking place concurrently with the change in legislation. In the four best quality between country comparisons, PC law or practice was associated with increased organ donation"increases of 25-30%, 21-26%, 2.7 more donors per million population, and 6.14 more donors per million population in the four studies. Other factors found to be important in at least one study were mortality from road traffic accidents and cerebrovascular causes, transplant capacity, gross domestic product per capita, health expenditure per capita, religion (Catholicism), education, public access to information, and a common law legal system."
Both these cards take other factors into account
Lives and Money (3)
"Higher rates of organ donation not only result in saved lives, but [also] frequently in saved financial resources. Spain esti- mates that its 10,000 renal transplants save approximately $207 million every year (L"pez-Navidad et al., 2002). Compared to dialysis, transplanting a kidney is beneficial both in quality of life for the patient and in money spent. In the United States, there are currently over 50,000 people on the waiting list for kidney transplants, which potentially represents a large savings in healthcare expenditures."
So higher rates save lives and money, leading to a benefit for the community on the whole.
Solves Illegal Organ Markets (4)
"Organ trafficking operates in various ways. Victims can be kidnapped and forced to give up an organ; some, out of financial desperation, agree to sell an organ; or they are duped into believing they need an operation and the organ is removed without their knowledge. Some victims are murdered to order if a large sum has been paid in advance. This is what Susan Sutovic thinks happened to her son.
This illegal trade has risen to such a level that an estimated 10,000 black-market operations involving purchased human organs now take place annually " more than one every hour " according to WHO. It estimates that organ trafficking accounts for five to 10 per cent of all kidney transplants worldwide.
Children, especially those from poor backgrounds or children with disabilities, are often targeted. In May this year, an eight-year-old British schoolgirl died at a clinic in India, and her family say they suspect she was "murdered" by medics intent on harvesting her organs. Gurkiren Kaur Loyal"s parents took her to see a doctor in the Punjab, when she began suffering from dehydration, and within seconds of receiving an injection she collapsed and died. During the post mortem, Gurkiren"s organs were removed and have not been returned. The Birmingham coroner told the family that without them, or the Indian post mortem report, he is unable to record a cause of death."
Organ trafficking only increases because the demand is not met, increased rates solve.
Contention 2: Preserves Autonomy on the Whole (5)
"Proponents of PC can plausibly claim that under their proposal there will be fewer mistakes than under the current system. They can claim this not only because a majority of Americans prefer to donate their organs, but also because it is plausible to believe that a person who does not want to donate is more likely to opt out under a system of PC than a person who does want to donate is to opt in under the current system. This belief is based on the idea that most of those opposed to organ transplantation have conspicuous religious or moral objections of which they themselves are very aware, and that as a result these people are unlikely to neglect to opt out of a system of PC, unlikely in the same way a Quaker is unlikely to forget to register as a conscientious objector to the draft, or as a Jehovah"s Witness is to forget to inform her physician of his opposition to blood transfusion. The wish to donate one"s organs, in contrast, is usually tied to religious and moral values that are relatively unremarkable, and so people who wish to donate are less likely to register their preference."
Basically the majority of people want to donate, and this also avoids mistakes because people who don't want to donate will have strong reasons and thus remember those and they will make sure to opt out. This applies under util because people not being able to do what they want is obviously bad.
No neg RVIs or NIBS: RVI"s destroy my ability to read theory because you can collapse in the NR; incentivize you to be abusive in the NC because you can just go for RVI or one dropped condition in the 2NR. You can win off truly abusive positions just by virtue of the last speech with new arguments - making 1AR theory a game over for me. Destroys education because you are incentivized to be abusive and then collapse the theory plus the RVI. I will have to win something with less time since I have to focus on multiple issues as well.
All neg counterplans must have 2 solvency advocates - only way to differentiate between actual lit and fringe blogs. I can"t prepare for infinite NCs so at least ignore ones that are complete crap.
Presume aff: a. You assume a statement is true if it sounds reasonable. b. Strat skew: I have to debate blind, but the neg can alter their strat since they speak second; he gets new arguments last and convince you last, advantages that influence judges.
A. Interpretation: The neg may not contest the aff framework or read an alternate framework. B. Potential Violation: The neg violates if they contest my framework or read an alternative framework, or read an interp which allows them to do the above. C. Standards
1. Strat Skew: Because you can specifically write a case to beat my AC, there"s no way I can win both framework and contention level. Letting me choose the standard combats this skew. And, there"s an empirically proven skew in favor of the neg. This is key to fairness since if I don"t have time to make arguments I can"t debate. This is key to education, since if I run out of time, I"m forced to make blippy arguments that no one understands.
2. Depth over Breadth: It"s better to spend an entire debate round arguing about the implications of a theory than to be forced to barely understand multiple frameworks. This way we can spend more time discussing my framework, and better understand the arguments. This is key to fairness since without understanding arguments we can"t debate them. This is key to education since it ensures we truly understand arguments. 3. Real world education: If we don"t have to debate which framework is better, we can focus on the implications of the theory. This is better for real world education since it"s more useful to know what deontology entails for everyday decisions, then to simply know that it"s better than util.
1. Fairness is a voter to ensure that the judge votes for the better debater not the better cheater.
2. Education is a voter because debate is educational and schools fund debate so that kids learn.
First, FW. My opponent says that the instigator has the right to choose the rules, but in the round structure, rules are only in Neg first speech. I agreed to his rules and round structure and NOWHERE in the rules does it say Neg chooses FW. I agree to the rules of the debate, I'm just using legal LD techniques. When he says similar to an LD debate, now he's just picking and choosing which rules benefit him. I didn't troll, use a K, forfeit, and if at all, he's using semantics here- I'm just using things used in LD to make debate fair. Since I'm affirming, I ought to have the right to choose what I'm affirming, so I define PC as hard consent. I can drop AFC since there is no time skew, but let me explain why I'm winning FW.
His FW says people should be free from extraneous control. But won't this let people murder others? Obviously that is an immoral action. Also, morality encompasses liberty because it's still immoral to infringe on others writes. But I'll be winning under his FW too.
Now to the NC. His first contention says something that you can ignore because of one part of that quote: "unless small, well-designed pilot studies established that it would be effective." The quote says if PC doesn't increase donation rates, then it's bad. But if I win donation rates, then his contention drops. Since the whole Util debate will boil down to donation rates regardless, you can ignore this. If one of us wins donation rates, we're also winning this contention, so you can ignore it.
Now his second contention is the more important one, as it is a rebuttal to my first contention. But his evidence is pointless. It just says the US has a high donation rate despite not using PC. Compare this to this scenario: The smartest kid in the class doesn't study and gets an A. Does that mean not studying is good? NO. PC is stil effective because my study had before and after scenarios. If the US were to implement PC, it would increase even more. And remember my study takes into account other rates affecting donation (the Abadie and Gay one certainly does). So what are you going to believe, one example or a meta-study that takes everything into account, before + after scenarios, and more? Clearly you are going to prefer my evidence, so I'm winning PC increases rates, so I'm saving lives and money. That is a clear win under Util, but let me just prove I'm winning under his FW as well as I refute his third contention.
Now to the third contention. A huge flaw in his argument is the Squo actually protects autonomy LESS.
Currently, the status quo is a system of opt-in: you need to sign documents in order to donate. PC is PC- you need to sign documents in order to NOT donate. With that in mind, let's consider his argument.
The majority of people want to donate, so I respect the wishes of more people. A presumption to donate given statistics is the most likely way to respect the wishes of the dead " means I outweigh on probability " also non-unique to your autonomy violations since we make presumptions either way. Source 1:
"Under any system whatever, we are forced to make some very general presumptions concerning the wishes of persons about the uses of their organs after their deaths. And under any system we must receive and implement autonomous expressions of preference that do not conform to the general presumption. That is the form of what we do now, but the present substance is problematic. We presume now for all persons that there was a will not to donate; (") The consequences of presuming in this pattern are often gravely unfortunate; familial distress is commonly caused by the mere request for consent, and the refusal of it often results in the loss of human lives that might otherwise have been saved. But in addition to its unfortunate results, the present system is wrong, wrong because it undermines in practice the very principle upon which it was supposed to have been built. As it must, it incorporates into law and practice a presumption about what people generally want to happen to the organs of their bodies after death, but the presumption thus incorporated is one now known to be inconsistent with the actual wishes of most persons, (...) As early as 1968, support in the United States for organ transplantation from cadavers was shown to be strong and widespread.8 By 1975, still an early date from the perspective of organ transplantation, a majority of those even in rural and relatively unsophisticated areas expressed positive support for organ transplantation. In regions more sophisticated, in Los Angeles County, for example, and in Houston, those supporting organ donation (even back in 1975) were more than three fourths of the whole. In Liverpool in 1979 that figure was 93%."
The squo causes family dissent in some cases and respects the wishes less often, and it save fewer lives. There will be a system no matter what, so my opponent loses this point because more people want to donate than not donate. But here's proof that donation is favored by most. Source 2:
"The system of PC actually preserves autonomy. 13 If individuals have not discussed their wishes regarding organ donation with their relatives prior to death, and are not on the organ donor register, then under the current system their wishes may not be fulfilled. Around 70% of the UK population are not on the organ donor register and around 40% of families refuse organ donation following a relative"s death, so based on the reports that 90% of the population support organ donation, this means that up to 30% of individuals who would have wished to donate their organs do not have their wishes granted. (") Under a system of PC, even if all of those who are against organ donation fail to PC, it would go against the wishes of 10% of the population at the most. "
So it is clear more people want to donate than not, so I'm winning autonomy. His cards apply to the squo as well, and I showed I respect more people's wishes. And remember in my first speech I showed that people are very likely to remember to PC, because those reasons tend to be strong. AND consider that the extra donations will save lives - saving one alive person's life is more important than respecting the wishes of a dead person EVEN if you don't buy my turn.
Now to his rebuttals. I showed liberty is part of morality but allows things like murder, so I win FW. Now to donation rates. Like I said this is also his first two contentions- whoever wins this whole rates thing wins all of these points. His source ten says, "they have shown that relatives always seem to play a certain role in the opting-out systems and that in practice these systems do not always work strictly as such." Since I defined PC as a HARD CONSENT MODEL where only the deceased's wishes matter, his study is nontopical. Ignore that source. Source 7 says that too: "What he and his colleagues learned was that even in the countries with PC, donation was still discussed with the potential donor"s family at the time of death, even though doctors were legally permitted to transplant those organs. " Ignore source 7 as well. Page 12 of source 8 details this very well. Speaking of source 8, it mentions Austria as a country that uses the system I advocate for. (3) "Consider Germany and Austria, which are very similar countries. Germany has an opt-in system and a 12% donor rate (the percent of people registered to donate), while Austria has an opt-out system and a 99% donor rate!" As for source 9 on Brazil, guess what the true reason was? (4) "In response to widespread public and medical disquiet, the legislation was amended to make consultation with the family mandatory." And one case where it fails isn"t sufficient to turn- see (5) for why meta studies, something only I quote, are best. Then he brings up source 11, but his quote is nowhere to be found. The real conclusion? "In turn, an increase in organ supply under a presumed consent system could lessen or lay to rest some of the controversies surrounding the different alternatives being used or proposed for the proper allocation of certain human organs in a market constrained by a lack of supply. (...) In fact, providing citizens with this opportunity to opt-out at any time prior to their deaths will serve to accommodate certain constitutional concerns regarding an individuals" substantive due process right to personal freedom,27 including those of a religious nature." This refutes his autonomy argument as well. Thanks for the source! he basically just quoted something that turns his whole case.
I"ve shown how his studies are non-topical, why meta studies are the best, and my study has gone untouched- he just has alternate evidence that doesn"t take into account other factors and is non-topical. I also turned autonomy because most people want to donate, and he didn"t refute my evidence, which showed that people who don"t want to donate will remember to opt out. His first and second contentions can all be flowed under my first contention. I can win without FW bcause of that turn, but I proved liberty is worse than morality. Maybe if Brazil implements family consent, it will turn out badly, but a just government will not mess this up, plus as aff, I specify what I'm defending- and that was clearly stated as hard consent. If the aff is implemented, it will turn out well. Family consent being bad is not a reason to vote neg- Austria does the aff and they have insane donation rates and no backlash.
Judge, everywhere I look on my flow I see aff. Hopefully you do too, and vote aff. Thanks.
My opponent accepted to the rules I set forth, and those only, and cannot force any of his rules on me. This would be the same as me changing the rules in the middle of the debate. About LD... I was only referring to the structure of arguments, and that I would provide values and criterions. Hindsight reveals I should have explicitly pointed this out. However, imposing his drastic underview on me and defining PC as "SOFT" consent. Under the definition I provided, it doesn't rule out soft consent. Soft consent studies are topical and that cannot be changed by my opponent.
His underview mentions things like: "The neg may not contest the aff framework or read an alternate framework." First of all, this is blatantly untrue. It is inherently part of LD debate to have varying frameworks, as each side has different values and criterions, or at the very least, different interpretations. You can see this concept demonstrated by the NSDA (formerly NFL). 
Furthermore, these rules of voting apply specifically to LD debate, and I as I explained, this is only *similar* to an LD debate. Voting should be done like any other debate on DDO.
Also: I win the Neg. framework already because liberty is obviously harmed. Controlling donations by presuming consent violates freedom from extraneous control. Egalitarianism is harmed because PC disadvantages miniority groups. But I also win the Aff. framework because opt-in systems are inherently more moral. By violating rights, morality is infringed. Also, morality is achieved by saving more lives. To save more lives, it requires more donations. As I have and will demonstrate, I'm winning donation rates. By this token, I uphold the Aff. framework better than my opponent. Also, if that doesn't convince you, take a look at his util or maximization of overall good card. If presuming consent *harms* more people (disadvantages to minority groups, infringing on autonomy and liberty) than it helps (net increase in donation rates), then you still vote neg. I've demonstrated this already, but will continue to do so.
Even if you don't buy this, you prefer my framework because liberty is a fundamental right in just societies as well.
First of all, my opponent doesn't address medical experts being opposed to PC systems. He drops this argument. This contention flows to Neg., and I'll back it once more. "The Intensive Care Society... said that many specialists were worried that patients' families would no longer believe that doctors had their loved ones best interests at heart."  This was referring to a study by the ICS which found that around half of medical professionals were opposed to PC. However, my opponent does site donation rates, which also flow to my side, as I have and will demonstrate.
My opponent says that whoever wins donation rates wins the contention. He makes no refutation to this, and only says it should be ignored. To reaffirm that my contention is valid and flows to the Neg., I'll provide more evidence.
"Changing the organ donation process in this country from opt-in... to opt-out, which presumes someone’s willingness to donate after death unless they explicitly object while alive, would not be likely to increase the donation rate in the United States" 
An expert in the field, Dorry L. Segev explains how PC isn't a good option, "Opt-out is not the magic bullet; it will not be the magic answer we have been looking for. With opt-out the perception becomes, 'We will take your organs unless you take the time to fill out a form.' That's a dangerous perception to have. We only want to use donated organs from people who intended to donate."  Moreover, "there is no convincing evidence that PC would increase organ availability."  This insufficiency is supported by other sources as well. "There is also a lack of evidence that changing to PC would raise donor number."  Member of Parliament from Montgomeryshire Glyn Davies also agrees with this notion: "However, there is no firm evidence that a change to 'PC' will make any difference - and some evidence that it may do harm." 
He also points out that Spain's system wasn't beneficial because of the policy itself. "What was particularly interesting about the Spanish experience, was that the level of donation did not change for ten years - until in 1989, the government made several key policy changes, which led to a gradual increase over time to the outstandingly good current performance of today. Nothing to do with PC." 
As Glyn Davies mentioned, there is evidence that PC laws might have adverse or opposite effects. "People don't like any presumption. They like to make decisions themselves. PC (to donate) may have the opposite effect. It may put people off. Organ donation rates have increased year on year without changing the law. The difference has been organ donation co-ordination teams an dmore intensive treatment beds."  This shows PC potentially has the opposite effect.
Another paper supports this idea: "The built-in constraint on the number of potentially transplantable posthumous kidneys also underscores why a “presumed-consent” law7 is unlikely to yield the huge windfall of transplantable kidneys that would be needed to solve our organ shortage.8 More is needed." 
My opponent discredits my source explaining that the US has a higher donation rates by quoting half the source. The other part explains that that fact suggests that other factors unrelated to the policy itself are what impacts donation rates. This idea is supported by other sources as well.
"Studies show that an important aspect of many high-donor countries is a culture where donation is the 'norm' and expectations that someone will donate are high throughout the community. Some scholars suggest that this is even more important than the PC model." 
His comparison to studying is irrelevant because 1) they are totally different things, and more importantly 2) studying doesn't infringe rights like PC does.
He says that his studies are more accurate because they show before and after. However, the specific study he cites (Abadie and Gay) actually demonstrates the Neg. position. It reads "most previous studies have pointed out that, on average, presumed consent countries do not produce significantly higher organ donation rates."  It's mention of alleviating organ donation problems is irrelevant as well because the article also admits that more study is needed to show this is true.
However, the support for PC failure is quite strong. "It does not appear that by simply having presumed consent legislation on the books that donation rates will rise."  Also, there is little difference between countries that have PC and those that do not. "Despite the laws, the process of organ donation in those countries does not differ dramatically from the process in countries, such as the United States, that require explicit consent." 
Other countries have demonstrated failure or lack of success as well. "Brazilian government implemented a presumed consent system in February 1997, only to abolish it one year later, citing widespread public fear and criticism." 
Even the countries that have had "success" with the system find that the success is due to other factors. "Many scholars suggest that Spain’s public relations campaign and widespread knowledge and information about organ donation is the reason for their successful organ allocation program." 
My opponent tries to argue that the status quo protects autonomy less. This is blatantly false. Under the status quo, people have the condition and right to self-government (definition of autonomy ) is harmed by PRESUMING consent. I don't get the initial right to choose, so autonomy is harmed. This is still incorrect because autonomy refers to restricting rights, which the status quo doesn't do in the first place. This disproves his arguments against my C3, which actually don't pertain to the contention at all. C3 is about how PC violates liberty and egalitarianism by disadvantaging minority groups. He DROPS this argument and it flows to my side. I'll quickly address more specifically how minority groups are harmed.
PC harms autonomy , freedom of religion   , democratic principles , right to privacy , those who cannot speak English , the poor and dispossessed , those with less education , and minorities in general  , to name a few. The evidence supports this notion and should be weighted as such.
In his rebuttals, he mentions that people will know to opt-out. However, this is not necessarily the case. In fact, Wales had vastly different results. "Four out of 10 people in Wales are unaware of changes to the organ donation system." 
Since PC cannot save more lives, but does have ethical concerns, I win FW.
As I have demonstrated, presumed consent systems would be very harmful, and they include both hard and soft consent, as my opponent agreed to my definition which could apply to both. Once again, it is unfair for my opponent to appoint stipulations after he has already agreed to the ones I have set in place prior to his acceptance.
1. My opponent has dropped some of my arguments, including the basis of my C1 and C3. Those still stand strong and unrefuted.
2. My opponent has forfeited his chance to attack these contentions, as I specifically mentioned in the rules in R1 that my opponent CANNOT argue in R3, but simply point out why he/she should win.
3. I also mentioned in R1 that failure to comply to the rules and structure I set forth is an automatic loss. If my opponent does so, or argues in the last round, he/she AUTOMATICALLY loses.
4. I have refuted each of my opponent's points and defended my own with LOGIC and EVIDENCE both.
I have demonstrated that through both frameworks as well as logics, pragmatics, and morality in general, presumed consent is not just. For this reason, you have no option but to negate.
We can ignore the FW mishap because the rules weren't too precise. I assumed it was full LD but it turns out that wasn't the case. So let's see the FW arguments. He says his definition of PC doesn't rule out soft consent. "that is, in the absence of written instructions to the contrary, it is presumed the decedent has agreed to the donation of organs at the time of death." This is clearly hard consent only, like I said earlier. I can't argue, but it should be common sense that this definition is hard consent.
He says he's winning donation rates and autonomy but I will show why I'm winning both of these later.
So whoever wins donation rates wins his C1 and 2 and my C1. Once again, I showed that his evidence was based on family consent. e.g. "What he and his colleagues learned was that even in the countries with presumed consent, donation was still discussed with the potential donor"s family at the time of death, even though doctors were legally permitted to transplant those organs." from his #2, which is the same as 3. But instead of doing this again, let me rehash why I said my evidence is better. 1) It takes into account other factors. 2) It's a metastudy, so its unbiased. 3) It uses the right definition of PC. I also showed how Austria, one of the few countries that uses PC correctly, has a whopping 99% donation rate and that example flew through uncontested. PREFER MY EVIDENCE for all these reasons.
Now to autonomy, the other main point. He doesn't understand my refutation. I showed that in the status quo, people still have to interact with the government in order to make a decision. So I'm winning this for three reasons. 1) His offense is non-unique because the status quo forces people to opt-out, and if they don't their organs aren't donated- which isn't what most people want. 2) I quoted a medical expert who says the way they do policy is by assuming the more popular option WHICH IS DONATING, so I make sure more people have their choice honored. 3) People who opt out have strong reasons to do so and will remember to do so. I make more people have their true wishes honored, so I respect autonomy more. Thus I am winning under both frameworks.
Just keep this in mind when voting. We are looking at if a just government should implement hard presumed consent. It improves over opt in because it preserves autonomy more because most people want to donate, it increases donation rates when looking at the best study available, and if implemented correctly, can have donation rates of 99%. A just government would not turn it into family consent or pull a Brazil. As it stands, I beseech you vote aff. Thanks for the debate opponent.
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