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 procurement and transplantation have been a controversial subject surrounded by intense legal criticism as well as legislative issues all around the world. As such, the selection process, a protocol for organ processing, the health and state of donors, and the methodology for allocating these organs to patients are all part of the ethics and concerns surrounding organ transfer.
The Canadian Medical Association (CMA) (2014). Organ and Tissue Donation and Transplantation. Ottawa: Canadian Medical Association.
The Canadian Medical Association reflects on the significant advancement in surgery, drugs and supportive medical care especially in the improvement of success rates during organ and tissue transplants. 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. In this policy update, the CMA identifies 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. 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.
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. This 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 unravelled by a single solution. As such, the inclusion of ethics experts, lawmakers and medical professionals is important for regulating the procedures.
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 paper 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. Keeping in mind the precious value of an organ, the complex network of patients, donors and the bodies make the transplantation process a unique event. 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.
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 are 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.
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 to receive the care they so much need to sustain their lives.
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 instils 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 diversity tend to limit acceptability and willingness to donate organs, the author insists that an understanding of these societal 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 multireligious nations similar to Malaysia.
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 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 enrol in long-term compliance programs that ensures organ sustenance and function. The author explains 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.
The Anscombe Bioethics Centre. (2014). On the Ethics of Organ Transplantation: A Catholic Perspective. Birmingham: Liaison Design.
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. In 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 and this report therefore not only represents the Catholic Church’s stand on matters of organ donation and transplant but also the entire Catholic community’s perspective worldwide.
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, and that is live kidney donation. Due to the high demand which is unmet by the deceased donors, live kidney donation is now increasingly common. 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. Considering the fact that the law stipulates that donations should not be the cause of a person’s death further complicates the prevailing contention. Additionally, the rise of black-market practices go against the moral and legal principles of financial benefits from transplants. This article provides key elements in addressing organ trafficking to include screening and preventing organ failure, legislation to control living donations, equitable organ allocation without any form of discrimination and prohibiting organ trafficking. The article therefore addresses contemporary matters regarding the ethical debate of do 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.