There are long waiting lists for organ donors; why should I donate my organs to someone who won't return the favour? I'd rather donate them to someone who would.

But that's only fair.

As an analogy, it's like healthcare/insurance taxes - you pay them regularly in the hope that if you ever need it, they'll pay for you.

Why would you expect to receive an organ if you're not willing to offer yours?

It's not just that; it's punishing people who want to benefit from a system they refuse to "pay" into.

What if I off-shore my earnings to avoid paying tax; what if I vote Republican. Does consenting to organ donation make me a worthy person despite anything else you may disagree with?

Reciprocity is not some outlandish concept: If you're unwilling to help out, you don't get to join the mutual aid pact.

That’s irrelevant. If you just treat organ donation as an exchange system, an “organ-bank club” if you will, you don’t need to bring judgement into it.

Parent post was hinting at judgement though.

No shame, no punishment. It’s just an organ sharing club, join it or don’t join it.