Introduction heart, lungs, liver, pancreas, and intestines. Organ

Introduction

Organ donation and/or
transplantation has been a commonly used medical treatment in the 21st
century. Since there is an increase number in the population with individuals
suffering with serious diseases affecting the predominantly organs; development
of variety transplantations was established. Common organs that are solid
transplantable is the kidney, heart, lungs, liver, pancreas, and intestines. Organ
transplant is a surgical operation where a failing or damaged organ in the
human body is removed and replaced with a new one (Center for Bioethics, 2004).
The role of an organ transplant is to replace the function of the prime organ
that can no longer be significant to the body. With an organ donation and/or
transplant, many ethical implications are raised that are associated with the donor, the recipient, the diversity of cultural and
traditional concepts, and the allocation of limited resources. The purpose of this paper is to discuss the history, the
occurrence of ethical issues that emerges with organ transplantation, the pros
and cons, and the current debate on organ donation and/or transplantation.

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History

Over the last decades, the
enhancement of successful organ transplants has given hope and new life to the
ailing patients. Originally in 1954, the first successful kidney
transplantation was implemented. According to Center for Bioethics (2004), the
first kidney transplant was taken from an identical twin brother and
transplanted into the other twin brother and evidently worked for eight years. Although
there was successfulness of a kidney transplant from a living donor, the
inquiring minds proceeded to perform a successful kidney transplant from a
cadaveric, which lasted for almost two years. Since the first kidney transplant
in 1954 was successful, the medical practice advanced their knowledge, which
lead them to many accomplishments for the first liver and heart transplant in
the 1960s. However, with these transplants, the effectiveness of their function
did not act long. In 1966, the first effective liver transplanted was conducted
and worked for over one year and in 1967, the first successful heart transplant
was implemented and lasted for only two-in-half weeks (Center for Bioethics,
2004).  

In the 1970s, the involvement of
laws was legally documented. According to Center for Bioethics (2004), the
Uniform Organ Donor Card was organized in all 50 states in 1972. This act legally
stated that any individual over the age of eighteen could donate their organs.
Another act in 1972 was also establish, known as the End Stage Renal Disease
Act. This act provided insurance coverage for kidney transplant under the
regulation of Medicare.

With the years still passing by,
medical practices are still enhancing the performances of organ
transplantations. In 1981 and 1982, the first heart-lung and artificial heart was
transplanted and lasted for five years (Center for Bioethics, 2004). When any
type of organ transplant is performed, the individual’s body must be
immunocompromised to prevent organ rejection. With having this knowledge, the
first immunosuppressant drug, known as Cyclosporine was created and approved by
FDA in 1982. This drug elongated the quality of life for the individual, as
well as for the transplantable organ. With the enhancement of medical knowledge
and technology, another successful transplant occurred in 1996. The “split
liver” transplant is performed when the cadaveric liver is split into multiple
pieces to be distributed as a transplant into more than one person (Center for
Bioethics, 2004). As the medicals advances keeps improving, so are the laws.
The National Organ Transplant Act (NOTA) was passed in 1984, to finance
procurement organizations and prevent the sale of organs. In 1986, the Omnibus
Reconciliation Act was passed in hospitals to ask permission to family members
to donate the patient vital organs when they are dead (Center for Bioethics,
2004). This act established the coverage of organs that may be otherwise
terminated.

Ethical Issues of Organ Donation/Transplantation

With the increase of diseases
involving and metastasizes major organs, the needs of organ donation also increase
as a result. As the needs of organs increase, multiple individuals are put on
waiting list and not always guaranteed that they will received an organ; which leads
to the occurrence of ethical implications.

 Ethical Issues Associated with Donor

There are two forms of organ
donors, such as a deceased (cadaver) donor or a living donor. When obtaining a
transplantable organ from a cadaver donor, its important to understand the
essential of natural death. According to Ballie,
McGeehan, Garrett, & Garrett (2013), when taking care of a patient that
is brain dead, it becomes very difficult to determine if the individual can be
considered dead. This issue raises concerns because once an individual becomes
brain dead, the center of attention is transition from saving the patient to
now saving the organs as quickly as possible. Death is considered a change in
the status of the human, being characterized by the irreversible loss of
significant organs to the body; but this generalize definition cannot resolve
the debate over the criteria of death (Ballie, 2013).  

Furthermore, obtaining a
transplantable organ from a living donor raises even bigger concerns. The
significance of a living donor donation is whether the organs are renewable,
paired renewable or nonpaired renewable sources. According to Ballie, McGeehan,
Garrett, & Garrett (2013), donation of renewable resources involves blood
or bone marrow as the paired renewable and nonpaired renewable resources
involves the corneas, kidney, heart and liver. There is only a minimum of
ethical issues related with renewable resources. Blood does not dispense any
harm or danger to the donor or the recipient only if the blood has been
properly screening for any infection or viruses. Donation of a nonpaired,
nonrenewable organ such as the heart or the entire liver from a living donor
spells death for the donor (Ballie, 2013). When transplanted a nonpaired,
nonrenewable organ the donor must provide an informed consent. An informed
consent must be provided because of the increase risk of organ inter vivos when
going under surgery. According to the National Academic Press (2006), the
demand for solid organs far exceeds the number of organs available from
deceased donors. When an individual decides to become a donor, they need to
know every detail, such as the risks and potential benefits associated with the
organ donation. It’s important for a living donor to have follow-up care to
manage the short-term and long-term health.

Ethical Issues
Associated with Selling Organs

Majority of people are against the
idea of selling their organs. When proceeding through the process to sell
organs, precaution is necessary. According to Ballie, McGeehan, Garrett, &
Garrett (2013), many ethical issues can occur from the widespread sale of
organs; such exploiting the poor and distributing organs with the ability to
pay; other than giving for the basis of needs. When less fortunate individuals
decide to sell their organ, they are deciding base of the needs of money and
not considering any of the long-term health affect that can occur. If the
selling of organs spreads, the distribution of organs would be based off the
amount of expenses instead of the need of medical help. According to the
National Transplant Act, it’s illegal to accept, receive or otherwise transfer
any major organ for own valuable reasons (The National Academic Press, 2006).
When an individual agrees to sell their organs, it opens the door to exploit
the poor and increase the risk for major complications. These complications can
occur due to unknown medical illness from the donor that were withheld from the
healthcare. There will never be a dignity amount on what a price should be when
selling an organ. According to the National Academic Press (2006), when
surveyed individuals who sold a kidney, they were still found in debt, living
below the poverty line, and develop a deterioration in their health status. Giving
in to market forces and making organs a commodity is fraught with dangers, and
erodes social, moral, and ethical values and is not an alternative that can be acceptable
to overcome the problem of organ shortage in a civilized society (Shroff,
2009).

Ethical Issues
Associated with Recipient

As the recipient or the person
that’s receiving the donation, they too have to deal with ethical demands. When
a recipient is determining to accept an organ donation, multiple considerations
are put to placed. According to Ballie, McGeehan,
Garrett, & Garrett (2013), the recipient must consider whether the
transplant will produce more harm than good, consider the effects of the
transplant on the recipient’s quality of life, the expense of the transplant
and if the health care team has properly informed the recipient of the process
of organ donation/transplant. These considerations help and prevent any
complications along the way of the organ transplant process. According to
Ballie, McGeehan, Garrett, & Garrett (2013), bribery is commonly known to
happen from the recipient and family. Most family believes that bribing the
hospital will increase their advantage to move up on the waiting list and be guaranteed
an organ. Bribery is unethical in organ transplant/donation because it
decreases the reasonable ethical basis for allocation of scarce resources
(Ballie, 2013).

Ethical Issues
Associated with Diversity/Cultural Concepts

The demands of transplants have
gone beyond the availability of donated organ which has resulted for multiple
people to go on the waiting list. Two minorities group, Black and Asian are
commonly known groups who are in need of organ transplant due to susceptible illnesses
such as hypertension, diabetes and certain forms of hepatitis, which result in
irreversible damage to prime organs (Johnson, 2015). Matching is very important
because transplants are more likely to be successful if there is a close match
between the donor and recipient. The ethnicity background is also important.
Religion and religious beliefs are contributing factors since certain cultures
does not permit or permit organ donation (Johnson, 2015).

                        Buddhism.

This culture is neither for or
against organ donation/transplant. However, they do believe that if a person is
dying for natural causes, the main focus should be on providing emotional
support and respect towards the individual instead of initially saving their
life. Certain circumstances in Buddhism believes organ donation can be seen as
an act of generosity to relieve the suffering for the individual (Johnson,
2015). The wish of dying person will decided base off the circumstances they
are enduring on if they would want to proceed with an organ transplant or not.

                        Christianity.

Organ donation considered by
Christians is a genuine act of love and a positive stance to help others’
(Johnson, 2015). Christians believes that eternal life and preparing for death
should not be feared. God should not be question on what an individual is going
to endure. However, some Christians worrying about their family disapproval,
the danger to donate an organ or maintaining to keep their body intact for
resurrection.

                        Islam.

In Islam there are two beliefs with
regards to organ donation. The human body, whether living or dead, enjoys a
special honor and is inviolable (Johnson, 2015). The only consideration, the
Islam culture may permit organ donation is to save or significantly enhance the
life of another by the basis rules of the Shariah. Muslims can express or carry
donor cards if they wish to donate their organs. In Islam culture, the next of
kin of a dead person has the ability to give permission to obtain organs from
the body to save other people’s lives (Johnson, 2015).

Ethical Issues
Associated with Allocation of Limited Resources

With the enhancement of major
organs getting affected, there is a decrease amount of organ donors available.
Not everyone that’s placed on the waiting list receives an organ. According to
Center for Bioethics (2004) explains that on average, 106 people are added to
the nation’s organ transplant waiting list each day, 68 people receive
transplants every day from either a living or deceased donor and 17 patients
die every day while awaiting an organ. Organs donation must be proportionally
distributed. Having an equal criteria of organ donation, limits the bias and
unfair distribution of organs. According to Center for Bioethics (2004), states
that there is not one “right” way to distribute organs, but rather many ways a
person could justify giving an organ to one particular individual over someone
else.

Pros and Cons

Currently an increase of
individuals is in need of organ transplant to save their lives. Organ donations
increases the life of those individuals for a second chance at life. Having an
organ market and procurement organizations be ethical or unethical (Matesanz
and Dominguez, 2009). With having these resources, individuals with illnesses
can be prolonged to live, the living donor or the cadaver donor family express
a sense of goodness that may have came from a tragedy. However, negative
conflicts can intermix with the organ donor, the recipient and the medical
practices. Most family experience the feeling that when their family is on the
verge of their last breath, they believe the medical profession priority shift
from trying to save the patient life to trying to save the vital organs (Anker and
Feely, 2010). Many ethical issues, such as limited amount of resources,
cultural beliefs and the rights of the organ donor, family, and recipient can
interfere with the organ transplant process, which also interferes with that
individual life of living.

Current Debates for Organ Donation/Transplant

There are many debates going on for
organ donation/transplant. One debate focusses on if donation should be
mandatory, as another focus on if people should pay to donate, while another
debate focus on the benefits for the donor and the donor’s family. Legally by
law everyone is automatically an organ donor, unless a person refuses to donate
their organs (Cronin and Harris, 2010). Many individuals believe if organ
donation is mandatory, their right of freedom will vanish, and their first
amendment will be unused. The expenses of organ donation are very hard to
determine. When paying off the organ donor, it can express a person gratitude
on how thankful they are for their generous offer and willing to put their
health on the line to save others (Smith, 2016). Organ donation benefits can
have a significant effect on the recipient behalf to save their life, however
the donor or donor’s family in most of these cases are not respected (Culter,
2002). Most of these current debates for organ donation leads back to the
limited allocation of resources unavailable to the society

My Opinion on Organ Donation/Transplant

I believe organ donation is great
deed that is done to help save other people lives. Incorporating the ethical
issues associated with organ donation, however effects the living of the ailing
patient. Limited organ resources seem to be the biggest setback for organ
transplants. I believe organ donations should not be mandatory but the message
to donate should be broadcasting in a way that does not seem unethical. The
conflict for me with organ donation, is exploiting the poor. Everyone
experience the “lowest point” in their life and are willing to do anything to
come from it. However, donating an organ just because of financial needs seems
to be unethical to me. But, despite all the ethical implications that arise for
organ donation/transplant, individuals who are willing to donate and provide
their organs for others to live are considered a hero in my eyes.

Conclusion

The purpose of this paper is to
discuss the history, the occurrence of ethical issues that emerges with organ
transplantation, the pros and cons, and the current debate on organ donation
and/or transplantation. Overall, organ donation/transplant is a positive deed
to be done to save lives. The interference of ethical implications involving the
donor, the recipient, the diversity of cultural and traditional concepts, and
the allocation of limited resources creates intense debates in the society for
organ donation/transplantation.