Introduction
Organ donation is the removal of organs or tissues of the human body from a recently died person or from a living person for the sole purpose of transplanting. The people from whom the organs are removed are called donors. Numerically, dead donors are more than the living ones. Through a surgery, the organs and tissues are removed and then the incisions are closed.
Different countries have different laws which allow either the potential organ donor or his relatives to consent or dissent to the donation.
Organs and Tissues Which Can Be Donated
Organs that can be donated include the heart, intestines, kidneys, lungs, liver and pancreas. These are got from a brain-dead donor or a donor where the family has consent for donation after cardiac death, known as non-heart-beating donation. Tissues that can be donated include bones, Tendons, corneas; heart valves femoral veins, great saphenous veins, small saphenous veins, pericardium, skin grafts and the sclera. These tissues are only got from dead people. Part of the liver or pancreas and the kidney can be donated from living donors.
Recipient Protection
Though organ-related infections are rare, safety tests are conducted to ensure that the organ is not infected with a disease that could harm the recipient.
Organs from a person who has an active or recent case of cancer (except a brain tumor which has not spread or certain mild kinds of skin cancer) who has ever had a blood cancer or who has certain infections diseases including HIV and severe bacterial or fungal infections at the time of death are not accepted. Bodies and tissues of people with such conditions may be donated for lab research or education. It is only about 1% of people who die in hospitals who can donate organs. This is because most of these people die from infections cancer or organ failure. Donation of organs by HIV+ people to other HIV+ people under some circumstances has been proposed in some countries and in fact it has been passed into law in Illinois.
Legislations Regarding Organ Donation
The least restrictive legislation approach to donation if the donor has not explicitly dissented is the dissent solution. According to this solution, the donor has to explicitly dissent to donation during his lifetime. In another solution referred to as extended dissent solution, relatives may dissent in the event the potential donor has not consented. Most countries with consent solutions experience substantial organ shortages while most of the countries with dissent solutions have no waiting list or shortlist for donations. Although the Uniform Anatomical Gift Act standardizes rules among various states in the United States, the donor is required to make an affirmative statement during her or his life that she or he is willing to be an organ donor.
In the United Kingdom organ donation is voluntary and no consent is presumed.
People who wish to donate their organs after death can register in a national database called the Organ Donation Register. This database is available to all NHS hospitals. This helps them to determine whether someone was a donor or not when he or she dies. In case of a patient’s death, hospital staff may ask relatives if they would be willing to donate the organs or not.
Bioethical Issues in Organ Donation
Deontological issues
Some modern bioethicists disagree on the moral status of organ donation.
Groups like the Roma oppose it on religious grounds. However, most of the religions in the world support organ donation. They view it as a charitable act of great benefit to the community. Involuntary organ donation is made impossible by issues surrounding patient autonomy, living wills and guardianship. Philosophically, semantical issues surround the morality of organ donation. There is an ongoing debate on the meaning of life, death, human and body.
Jewish medical ethics regard organ donation as a charitable act but on condition that the donor must be dead before the removal of the organ and that the organ will be treated respectfully. Cloning which is used to produce organs with an identical genotype to the recipient is controversial. This happens especially when an entire person is brought into being with the sole purpose of being destroyed for organ procurement. The ethical issues involved with creating and killing a clone may outweigh its benefit.
Teleological issues
On utilitarian grounds, the organ donors are often impoverished and those that can afford black market organs are typically well-off. This makes those in need of organs be put on waiting lists for legal organs for indeterminate lengths of time. Since the demand for organs outweighs the supply it has given rise to a black market often referred to as transplant tourism. Some people say that those who can afford to buy the organs exploit those who are desperate enough to sell their organs. Others argue that the desperate should be allowed to sell their organs to improve their social status.
Political Issues
Adequate funding, strong political will, the existence of specialized training, care and facilities increase donation rates. Expensive legal definition of death would also go a long way in increasing the pool of eligible donors. Some political decisions such as the motorcycle helmet laws and drunk driving laws have unintentionally lowered the organ donation rates.
Work cited
Antonia, C. Noello, “Increasing Organ Donation” Journal of the American MedicalAssociation. 1992.
Ian, Ayers “Unequal Racial Access to Kidney Transplantation.” 46 Vand. L Rev 805 (1993).
Vernellia, Randall “Slavery, Segregation and Racism: Trusting the Health Care system Ain’t Always Easy! An African American Perspective on Bioethics” 15 St Louis V. Pub L. Rev. 191 (1996).