The process of taking functional organs and tissues from one person for transplantation into another individual is called organ donation. Whereas, any part of the body that performs a different and special function is referred to as an organ. Transplantation takes places quite successfully today between well-matched human beings. Majority of the organ recipients are able to live five or more years. Skin, cornea, bone marrow and kidney transplants are the most common today. Moreover, lung and heart transplants are also gaining precedence. In commonplace terms, organ donation is the removal of working, healthy organs from the body of an individual who had pledged while being alive that his organs could be donated to a person requiring it. Usually the tissues or organs are taken out in a manner similar to surgery. Moreover, all the incisions are clogged at the end. Organ donors can include people of all ages. It is not restricted to any particular group, nor is it restricted to any certain age limit. In the present era, organ transplantation is widely recognized as of the most gripping medical advancements. It is almost the elixir of life to individuals with deteriorating organs who require other fellow beings to donate them organs. With the increasing cases of organ failure in society and the insufficient supply of organs, there is an enormous gap between organ supply and organ demand. Subsequently, it takes ages for a person with deteriorating organs to get functioning organs from another being. Moreover, numerous deaths have been reported in that waiting.
Thus, these events have aroused moral, societal and ethical concerns regarding the allocation of organs, supply and the use of surviving donors as volunteers, including those who qualify as minors. Unfortunately, it has spurred the practice of selling organs by money-makers for their own monetary gains and vested interests in many parts of the world by exploiting the poor. This has spurred corrupt practices where organ donation is concerned (Shroff, 2009). While we are on the subject of organ donation, an ethical issue is the procurement of organs and tissues. Firstly, this includes the buying and selling of human organs and tissues: There are some people who believe that human organs and tissues ought to be bought and sold in order to quantify the supply and show deference for other people’s autonomy. On the other hand, there are people who believe that treating any part of the body like a saleable good is a violation of human dignity. Organ donation has evolved considerably in the last 50 years. Following is a history of the procurement of organs and tissues. • Successful transplantation of various organs
Initially, organ transplantation started with kidneys, but now it has diversified to lungs, livers, hearts and other organs. It has slowly evolved to encompass various parts of the body. Progress in organ donation and cadaveric practices
To decide who can donate organs has been a continuously evolving process. Firstly, it started with living donors and later moved on to include dead and brain dead donors. Even today, there are debates about growing and limiting the qualified donors. In the year of 2001, the surviving donors managed to even outnumber cadaveric donors. This was a milestone in the history of the United States. Formulation of anti-rejection drugs to enhance development and success The formulation of anti-rejection drugs has compounded the success of organ transplants. In the 1960s and 1970s, immunosuppressant drugs were used to increase the success rate of organ transplants (Flaman, 2008). Cyclosporine was stumbled upon in the 1980s. It greatly improved the success rate for patients undergoing transplants. The overall results were also improved. A phenomenon called xenotransplantation also became well-known – this entails the usage of animal organs for human transplantation. Subsequently, the first xenotransplantation was conducted
in 1986. This breakthrough means of transplantation started gaining popularity and researchers started performing more intensive studies on it. The number of people who required organ transplantation started to multiply. The discovery of the first artificial organs
In the 1980, the first artificial heart transplant took place which was followed closely by the American public and the news media. This basically involved segmenting organs into pieces (either from cadaveric donors or surviving donors). In 1996, the first split liver transplant too place. It permitted one cadaveric liver to be used among several patients who required a transplant. Stem cell research: This basically involves the examination of human embryo and adult’s cell in an endeavor to find out how organs are development and what stimulates their development. There are certain ethical concerns regarding how organs and tissues are obtained. For instance: a pharmaceutical company in France buys placentas from 110 Canadian hospitals in order to produce blood products and vaccines. However, there are some poor people in countries, such as India, who sell their kidneys for $700 or even more than that. There have also been cases reported in India where people have gained consciousness after a kidnapping incident, only to discover that one of their organs has been removed in that process (Caplan, 2010). In regards to this issue, there are people who draw a difference between waste matter of humans, certain body parts that happen to regenerate such as blood and non-regenerative human organs such as kidneys. There are many people who differentiate profit making from covering the donor’s expenses. If a donor has to pay for organs, this can put undue pressure on him. It nullifies a contract or free consent. There are some people who are also fearful of the fact that if the buying and selling of organs became a notorious business, then it would undermine the nobility associated with organ transplants. It could be detrimental if the organ just went to the highest bidder. The equity would be compromised upon as donating organs would depend upon the ability to pay rather than finding out how they should be distributed. There are some people who argue that this can be brought under control by monitoring sales. If the buying and selling of organs and human tissues is completely restricted, then it would drive the market underground. Since there are numerous controversies associated with
the buying and selling of human parts, there are many who believe that other alternatives should be adopted (Thomas, 2009). Media Publicity
There are several instances when an organ or tissue is acquired for a person by showcasing their need through the media. This could negate the other transplant channels through which it is normally obtained. Moreover, the correct criterion of selecting recipients, which is usually done on the basis of greatest needs and greater likelihood of benefit, can also be overlooked. However, publicity through media creates awareness in the public domain about the need for transplants and in the long run will increase the supply of organs and tissues. Voluntary consent basically entails a person making an intended offer to donate their organs after their demise. In the case of cadaver donation, a person can intimate their consent by advanced directives, such as by filling out the Universal Donor Card, part of their driver’s license. When the transplant is from a living donor, free consent is necessitated. However, it is best to have established consent regarding a deceased donor because this act exhibits love and responsible stewardship over one’s body. Moreover, it also communicates the wishes of health care professionals and family to the individual as well as others. When there is no pre-existing consent, the person who holds responsibility for the dead body should be approached regarding donation.
It is imperative that the wish of the deceased person should be upheld. Medical ethics in organ donation has become imperative. This is basically a system comprising of moral principles that applies judgments and values to the process of organ donation. Autonomy is the sole prerogative of the individual to choose what happens to him/her even if this means dying in the process. In this regard, even if a person wishes to contribute his organs to another and thus die, he should not be prevented from doing so. On the other hand, fidelity entails adhering to the choices of someone, even if paying no heed to them would save another person’s life. Confidentiality means protecting the names of the donor from being let out in public or as per the desire of the patient. Hence, if a person prefers to remain unnamed while consenting to donate organs, his wish should be upheld. The team performing the transplantation can ask questions, but foremost it is imperative to prioritize the desire of the patient over anyone else (Truog, 2005).
In order to address the ethical issues associated with organ donation stated above, it is important for health care professionals to be acquainted with the meaning of organ and tissue donation. They should be well-versed with the procedure of organ donation and to perform it in the best and most efficient manner possible. It would also be a good idea to render training to members of the health care team so that they can approach potential donors and families in a sensitive manner. To facilitate the process smoothly, they should be able enough to provide the necessary social and personal support during the process of mourning. Providers of health care also need to learn that respecting a dead person is a prerequisite of our humanity. It is also pertinent to mention that any reference to the deceased should be done with utmost sensitivity and using the most appropriate names. Furthermore, to compound the potential for transplants, providers of health care have a fundamental duty of raising the general level of awareness of needs. It should be done in a way that protects the rights and privacy of the patient, does not tamper with the medical process in any way and also does not remove attention from other urgent matters (NHMRC, 2012).
Shroff, Sunil, NCBI Legal and ethical aspects of organ donation and transplantation, (2009), Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779960/
Flaman, Paul, Organ and Tissue Transplants: Some ethical issues, (2008), Retrieved from: http://www.ualberta.ca/~pflaman/organtr.htm
Truog, Robert, The Ethics of Organ Donation by living Donors, (2005), Retrieved from: http://www.nejm.org/doi/full/10.1056/NEJMp058155
Thomas, Chris, Ethics around Organ Donation, (2009), Retrieved from: https://www.chf.org.au/pdfs/hvo/hvo-2008-1-ethics-organ-donation.pdf
NHMRC, Donating organs after death, (2012), Retrieved from: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e29.pdf
Caplan, Arthur, Organ Procurement and Transplantation: Ethical and Practical Issues, (2010), Retrieved from: http://www.upenn.edu/ldi/issuebrief2_5.html