About Organ Donation/Transplants Ethics and Issues

One of the most important advances in the medical profession is the science of transplanting human organs and tissues. This procedure not only saves lives but also returns vital functions of patients suffering from chronic crippling diseases that are difficult to treat. For a long time, organ donation and transplant have been a controversial subject surrounded by intense legal criticism as well as legislative issues that have sparked various controversies around the world. As such, the ethics and issues concerning organ transplant include the donation process, the procedure for organ procurement, the health and state of donors and also the methodology of allocation of these organs to the patients.

Canadian Medical Association. (2014). Organ and Tissue Donation and Transplantation. Ottawa: Canadian Medical Association.

The significant of advancement in surgery, drugs and supportive medical care especially in the improvement of success rates during organ and tissue transplants are emphasized by the Canadian Medical Association. These developments translate to numerous changes in practices and procedures hence the need to reflect on both the new and existing ethical issues concerning organ donation and transplantation and subsequently develop practical solutions. For this reason, the CMA provides real-life applicable policy guidelines which emphasize on the fundamental responsibilities of physicians in fairness, harm prevention, autonomy and prevention of suffering and disease. In other words, as a globally reputable organization, the CMA guidelines stipulate the need for observing protocols concerning organ allocation, upholding the virtues of free and informed consent, privacy, timely access to bodies and most of all, equitable and efficient treatment. The relevance of this book to the topic lies in its ability to identify the primary moral principle of organ and tissue donation as the Dead Donor Rule which stipulates that organ donors have to be dead so that the procurement can take place.

Consolo, H. K., & Wigmore, S. J. (2014). Ethical and legal issues associated with organ donation and transplantation. Elsevier, 32(7), 333-337. https://doi.org/10.1016/j.mpsur.2014.04.015.

In this source, the authors place significant emphasis on the utilization of both legal and ethical frameworks in the resolution of organ donation and transplantation challenges. Apparently, the answer to the diverse ethical challenges is multifaceted and to an extent, quite complex. It means that for an agreement on best practices to take place, then the ethical principles of policy must be streamlined with the societal values or aligned with the best compromise available. Evidently, the medical procedures of organ donation and transplants will maintain its course with regard to challenging moral questions in the law and also medical ethics. For effective contribution, healthcare practitioners require the participation and understanding of the principles involved so that informed decisions are made with the support of morals and legal guidelines as well. Simply put, this resource contributes to this topic by insisting on the need to constantly develop better and effective frameworks because the organ donation and transplanting challenges are unlikely to be unraveled by a single solution. As such, the inclusion of ethics experts, lawmakers, and medical professionals is important for regulating the procedures. This journal is relevant to the topic as it provides the ethical and legal issues that are associated with organ donation and transplantation.

Howard, R. J., & Cornell, D. L. (2016). Ethical Issues in Organ Procurement and Transplantation. Dr. Peter A. Clark (Ed.), InTech, DOI: 10.5772/64922. Available from: https://www.intechopen.com/books/bioethics-medical-ethical-and-legal-perspectives/ethical-issues-in-organ-procurement-and-transplantation.

The Ciba Foundation in its first multidisciplinary meeting in 1966 to discuss ethical and legal challenges in organ transplants, the issues that came up in the same year persist to date. These issues range from the organ procurement processes, death during donations, removal of organs from live donors, organ shortage, incentives for increased supply as well as operational issues in the respective transplant facilities. Fair allocation, patient selection, organ modification and inadequate resources are all issues that are concerning. In this resource, the authors illustrate the magnitude of the ethical aspects and the existing reality that they are here to stay. For this reason, the article is relevant to the topic given that it indicates that the most workable solutions include the improvement of patient access to organs, increasing chances of successful transplants, and also improving the availability of organs and transplantation services. Therefore, this information serves as a warning about the impending new ethical challenges provided that organ shortage persists.

Jonsen, A. R. (2012). The Ethics of Organ Transplantation: A Brief History. AMA Journal of Ethics, 14(3), 264-268.

In this journal article, Albert Jonsen explains that the core problem in organ transplantation is the limited supply of organs. For this reason, various nations have come up with organ transplantation Acts that identify and fairly distribute organs to recipients. However, with the ever-changing policies and developments, loopholes arise including the possibilities of clinician bias. These events call for the need to evaluate patients for suitability while at the same time ensuring the adherence to the transplant policies. The challenge of organ tourism also complicates the matter even more. As a senior ethics professional in California Pacific Medical Center, this paper not only addresses ethical issues concerning organ donation and transplanting in a personal perspective but also in a widespread approach. The inclusion of these issues into policies informs the public and government officials on the importance of creating a stable structure that is based on ethics, practicability and efficient policies. Thus, Jonsen’s article is relevant to the topic due to the precious value it place on an organ, the complex network of patients described as well as donors and the bodies which make the transplantation process a unique event.

Marcus, A. D. (2016). The Difficult Ethics of Organ Donations From Living Donors. The Wall Street journal, https://www.wsj.com/articles/the-difficult-ethics-of-organ-donations-from-living-donors-1466993281.

In this Journal article, the author illustrates a real-life case scenario in which diverse ethical viewpoints clash when it comes to organ transplants and donations. One of the long-standing principles of organ transplants states that vital organs are obtained only from a dead individual. Death from donation is therefore unacceptable. As such, doctors in the present scenario found it unethical to remove kidneys from a live donor without his direct authorization as well as the possibility of harm or even death of the donor following removal. Some of the issues raised by doctors include the possible unethical act of taking organs prior to death, a donor doing something courageous by giving up vital organs before dying and the possibility of obtaining organs from a dying person similar to the act of withdrawing life support. The validity of these moral challenges highlighted by this article and the expression of specific concerns by professional medical practitioners further exemplifies the authenticity of the source as well as pointing out the real debates that take place in the contemporary world concerning live kidney donations makes it applicable to the topic of interest.

National Health and Medical Research Council. (2016). Ethical guidelines for organ transplantation from deceased donors. Canberra: Australian Government Organ and Tissue Authority.

The Australian Government through the National Health and Medical Research Council offers a set of guidelines for which the process of organ donation and transplant should take place. The document acknowledges the importance and the positive impacts that the organ transplant plays in the lives of patients with complex diseases. In Australia, most of the donors are deceased individuals who are too few to satisfy all the people requiring the organs. This means that many patients die prior to the reception of the appropriate organ transplant intervention. This shortage prompted the government to develop organ allocation decisions and policies that are ethically upright and transparent using the moral principles and values. The role of the health department in decision-making is brought out extensively, especially when the responsible stewardship of the scarce organ resource is required. As such, through the government initiatives, needy patients are assisted in receiving the care they so much need to sustain their lives. For this reason, the document attests to the ethical guidelines to be followed for organ transplantation from deceased donors, therefore, making it relevant to the topic.

Robson, N. (2012). Organ Transplants: Ethical, Social, and Religious Issues in a Multicultural Society. Social Science Research Network, 1-18.

Various advancements in organ donation and transplant technology instill hope for the treatment of critical diseases. In this article, the author identifies the primary issue surrounding donation and transplanting of organs is ethics. With particular regard to Malaysia, social, cultural and religious issues are roadblocks to the realization of the full potential of organ transplanting strategies. As such, although these social, cultural and religious diversities tend to limit acceptability and willingness to donate organs, the author insists that an understanding of these social aspects is crucial for healthcare providers and patients to come to a consensus. The article goes on to highlight the various ethical problems including how to prioritize patient transplants, economic and social class influence, the cost of operations, consent, procurement and also religious viewpoints. Based on the fact that the demand for organs exceeds the available transplants, this paper offers a valid contribution to an understanding of the issues experienced in multi-ethnic, multicultural and multi-religious nations similar to Malaysia. The focus on multicultural society issues such as social, ethical and religious explains its relevance to the topic.

Simpson, P. J. (2012). What are the issues in organ donation in 2012? British Journal of Anaesthesia, 108(1), 3-6. https://doi.org/10.1093/bja/aer352.

In this article, Simpson explains that in some nations, organ donation is considered an unselfish philanthropic act done by the donor whether they are alive or dead. The recipient is thus required to enroll in long-term compliance programs that ensure organ sustenance and function. The author asserts that in such situations, the medical practitioners must comply with the existing laws which include obtaining the organs under optimal conditions as well as the highest standard possible. Similar to the other resources mentioned before, there is more demand than the available transplants can cater for leading to the development of the typical ethical issues related to procurement, cost, and so on. This article goes a long way in elucidating much more clearly the importance of developing stringent guidelines to prevent disagreements and contentions that may hinder needy patients from receiving the much needed care. Clearly, the source sheds more light on the need to create a balance between demand and availability for organ donation to continue. It is an important factor which makes it relevant to the issue under study.

The Anscombe Bioethics Centre. (2014). On the Ethics of Organ Transplantation: A Catholic Perspective. Birmingham: Liaison Design.

From this book, it is evident that religious organizations have substantive influence in policy-making, and the Catholic Church plays a significant role in the introduction and maintenance of consensus regarding the ethics of organ transplants especially in European countries with robust Catholic heritages. According to this report, the Catholic community supports the practice of organ donation and transplants especially with the support expressed through the popes and many other national and international hierarchies. The revised Catechism of 1997 explicitly acknowledges the conformity of organ transplants with the moral law as it seeks to offer good outcomes to the recipient. Similarly, organ donation is lauded as noble act of generosity provided that the actions conducted by healthcare providers are ethical, respectful, dignifying and beneficial. The Catholic Church is renowned for its contribution not only in religious aspects but also other spheres of life. The Anscombe Bioethics Centre report, therefore, does represent not only the Catholic Church’s stand on matters of organ donation and transplant but also the entire Catholic community’s perspective worldwide. Applicably, the explained catholic perspective of the ethics concerning organ transplant makes it pertinent to organ donation.

Wadhwa, K., & Kayes, O. (2013). Live kidney donation: what are our ethical responsibilities? Trends in Urology and Men's Health, 4(2), 25-28.

In this article, the authors delve into a slightly different aspect of organ donation and transplant which is live kidney donation. The book attests that live kidney donation has become increasingly common owing to the high demand which is unmet by the deceased donors. Wadhwa et al. ascertain that this practice brings about serious risks to the donor hence the rise of the ethical implications ranging from donations from living related or unrelated donors. The law stipulates that donations should not be the cause of a person’s death and thus this factor raises contention. Additionally, the rise of black-market practices tends to go against the moral and legal principles of financial benefits from transplants. The key elements provided in the article addressing organ trafficking including screening and preventing organ failure, legislation to control living donations, equitable organ allocation without any form of discrimination and prohibiting organ trafficking are greatly applicable to the topic of organ donation. The article’s strength is embedded in its ability to address contemporary matters regarding the ethical debate of doing no harm to healthy people against the need to assist an ailing patient. These ethical considerations have to be included in decision-making for live transplants.

References

Canadian Medical Association. (2014). Organ and Tissue Donation and Transplantation. Ottawa: Canadian Medical Association.

Consolo, H. K., & Wigmore, S. J. (2014). Ethical and legal issues associated with organ donation and transplantation. Elsevier, 32(7), 333-337. https://doi.org/10.1016/j.mpsur.2014.04.015.

Howard, R. J., & Cornell, D. L. (2016). Ethical Issues in Organ Procurement and Transplantation. Dr. Peter A. Clark (Ed.), InTech, DOI: 10.5772/64922. Available from: https://www.intechopen.com/books/bioethics-medical-ethical-and-legal-perspectives/ethical-issues-in-organ-procurement-and-transplantation.

Jonsen, A. R. (2012). The Ethics of Organ Transplantation: A Brief History. AMA Journal of Ethics, 14(3), 264-268.

Marcus, A. D. (2016). The Difficult Ethics of Organ Donations From Living Donors. The Wall Street journal, https://www.wsj.com/articles/the-difficult-ethics-of-organ-donations-from-living-donors-1466993281.

National Health and Medical Research Council. (2016). Ethical guidelines for organ transplantation from deceased donors. Canberra: Australian Government Organ and Tissue Authority.

Robson, N. (2012). Organ Transplants: Ethical, Social, and Religious Issues in a Multicultural Society. Social Science Research Network, 1-18.

Simpson, P. J. (2012). What are the issues in organ donation in 2012? British Journal of Anaesthesia, 108(1), 3-6. https://doi.org/10.1093/bja/aer352 .

The Anscombe Bioethics Centre. (2014). On the Ethics of Organ Transplantation: A Catholic Perspective. Birmingham: Liaison Design.

Wadhwa, K., & Kayes, O. (2013). Live kidney donation: what are our ethical responsibilities? Trends in Urology and Men's Health, 4(2), 25-28.