For the most part, I’m unconcerned. Especially in a country where organ donation is opt-out, there are plenty enough people dying already; the rich don’t need to kill me specifically for my liver. There’s another one floating around somewhere out there. Any potential corruption would take the form of the rich and powerful placing themselves at the top of the recipient list, a problem which is also reduced if organ donation is opt-out—more organs floating around means that even if the rich and powerful put themselves at the top of the list, more people will still get the organs they need.

Re: China, that’s a different situation entirely. I don’t think those forced abortions were opt-in or opt-out. The Chinese government doesn’t seem to give its subjects many opts at all

The best argument I have against that happening is that the people saving lives are not the people who manage the donor list. If you’re in a car accident and paramedics arrive, they see an injured person, and they treat the injuries. They don’t see the list of who needs an organ, they probably don’t even check your ID until theyve stabilized you. They will take you to the hospital, where someone else will attempt to stabilize you, or determine that you cannot be saved. And even then, they’ll send you to someone else to harvest the organs, and send those to someone else who determines where they are needed.

There is no single person who decides if your organs are worth more than your life. And if one person does try to make that call, there are a lot of others involved they may not let it happen, and acting out of procedure will raise a lot of questions.