Organ Donation

INTRODUCTION

WHAT IS ORGAN DONATION?

According to Gruessner, organ donation is the act of giving one or more organs for transplantation into someone else without compensation. He also stated that it is a personal yet complex decision for the person which is also intertwined with various medical, legal, religious, cultural, and ethical issues.

Organ donation is a topic which contains many conflicting views. To some of the public population organ donation is a genuine way of saving the life of another, to some it is mistrusted and to others it is not fully understood.

Watch this video from FuseSchool - Global Education to have a glimpse about organ transplantation and the ethical issues regarding this topic.

WHAT ARE THE ORGANS THAT CAN BE DONATED?

A DECEASED CAN DONATE

HEART
LUNGS
KIDNEYS
LIVER
INTESTINES
PANCREAS

A LIVING PERSON CAN DONATE

PART OF A LUNG
A KIDNEY
PART OF THE INTESTINE
PART OF THE LIVER
PART OF THE PANCREAS

OTHER TISSUES THAT CAN BE DONATED

BLOOD
CORNEA
HEART VALVES
SKIN
BONE TISSUES
TENDONS

WHO CAN BE AN ORGAN DONOR?

About anyone, at any age, can become an organ donor but anyone younger than age 18 needs to have the consent of a parent or guardian.

For organ donation after death, a medical assessment will be done to determine what organs can be donated.

Certain conditions, such as having HIV, actively spreading cancer, or severe infection would exclude organ donation.

Having a serious condition like cancer, HIV, diabetes, kidney disease, or heart disease can prevent you from donating as a living donor.

PHILIPPINE LAW ON ORGAN DONATION

The Republic Act No. 7170, known as the Organ Donation Act of 1991, is an act authorizing the legacy or donation of all or part of a human body after death for specified purposes.

CLICK HERE TO LEARN MORE ABOUT THE LAW

DISCUSSION

ETHICAL ISSUES REGARDING ORGAN DONATION

ORGAN SHORTAGE

Not everyone that needs organ transplantation can be accommodated immediately. The hospital's transplant team will decide whether a patient is a good transplant candidate. Each hospital has their own criteria for accepting candidates for transplant. If the hospital's transplant team determines that one is a good transplant candidate, they will add the patient to the national waiting list. The number of people in need of transplant increases and some patients die while waiting for a donor.

CONCEPT OF DISTRIBUTIVE JUSTICE

Distributive justice theory 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.

EQUAL ACCESS

Organs allocated according to equal access criteria are distributed to patients based on objective factors aimed to limit bias and unfair distribution.

Equal access criteria include:

Length of time waiting (i.e. first come, first served)
Age (i.e. youngest to oldest)

MAXIMUM BENEFIT

The goal for maximum benefit criteria is to maximize the number of successful transplants.

Examples of maximum benefit criteria include:

Medical need (i.e. the sickest people are given the first opportunity for a transplantable organ)
Probable success of a transplant (i.e. giving organs to the person who will be most likely to live the longest)

SUPPORTERS OF EQUAL ACCESS DISTRIBUTION SAY...

"Everyone should have equal access to organs because everyone could potentially benefit from the system."

SUPPORTERS OF MAXIMUM BENEFIT DISTRIBUTION SAY...

"Organs should be distributed so that the greatest benefit is derived from every available organ."

Knowing that there are more people who need organs than there are organs available, how would you answer the questions above? Are you in favor of equal access distribution or do you believe in the maximum benefit distribution?

ORGAN DONORS

One way to avoid the ethical problems associated with the shortage of transplantable organs is to increase the number of donor organs. However, fears abound that policies to maximize organ donations could go too far – leading to organ farming or premature declarations of death in order to harvest organs.

Many, if not most, people agree that taking organs from any source is a justifiable practice within certain ethical boundaries. Controversies result from an inability to define exactly where those boundaries lie. Everyone may have their own unique ideas about the boundaries they would like to see concerning the following three sources of transplantable organs: cadaveric donors, living donors and alternative organ sources.

CADAVERIC ORGAN DONORS

Currently, once a person dies, his or her organs may be donated if the person consented to do so before they passed away. A person’s consent to donate their organs is made while still living and appears on a driver’s license or in an advance directive. After consenting to donate organs, nothing happens with that information until the person dies.

A person is considered dead once either the heart stops beating or brain function ceases (called brain death). After death, the organs are taken from the deceased person’s body. If possible, the deceased person may be kept on life support once they have died until the organs can be taken, in order to preserve the organs until they are removed.

If the deceased person’s organ donation wishes are unknown, the hospital, physician, or organ procurement organization will approach a family member to obtain consent to remove the organs. The family members with the authority to do so is generally determined by this hierarchy:

SPOUSE. IF NO SPOUSE, THEN…
ADULT CHILD. IF NO ADULT CHILDREN, THEN…
PARENT. IF NO PARENTS, THEN…
ADULT SIBLING. IF NO SIBLINGS, THEN…
LEGAL GUARDIAN

Since one cadaveric donor can provide multiple organs, this is a natural place to look to increase the number of available organs. Efforts to increase the number of cadaveric donors have met with much debate and controversy. These are five primary strategies currently under consideration for the future.

LIVING ORGAN DONORS

A person with organ damage or organ failure may look for a living donor to donate an organ, allowing the patient to bypass the national waiting pool to receive a cadaveric organ.

For the additional information about the pros and cons of organ donation, you can watch this video from the Buzzle YouTube channel.

DID YOU KNOW?

Paying people to donate their kidneys is one of the most contentious ethical issues being debated at the moment.

The most common arguments against this practice include:

Donor safety
Unfair appeal of financial incentives to the economically disadvantaged
Turning the body into a money-making tool
Wealthy people would be able to access more readily

ALTERNATIVE ORGAN SOURCES

With the state of discrepancy between organ donors and people waiting for an organ transplant, researchers and advocates have begun to consider non-traditional donation. Some potential non-traditional sources of organs are:

ANIMAL ORGANS

Animals are a potential source of donated organs. Experiments with baboon hearts and pig liver transplants have received extensive media attention in the past. One cautionary argument in opposition to the use of animal organs concerns the possibility of transferring animal bacteria and viruses to humans.

ARTIFICIAL ORGANS

Artificial organs are yet another potential option. The ethical issues involved in artificial organs often revert to questions about the cost and effectiveness of artificial organs. People who receive artificial organ transplants might require further transplanting if there is a problem with the device.

STEM CELLS

Stem cells are cells that can specialize into the many different cells found in the human body. Researchers have great hopes that stem cells can one day be used to grow entire organs, or at least groups of specialized cells. The ethical objections concerning stem cells have focused primarily on their source. While stem cells can be found in the adult human body, the seemingly most potent stem cells come from the first few cells of a human embryo. When the stem cells are removed, the embryo is destroyed. Some people find this practice morally objectionable and would like to put a stop to research and medical procedures that destroy human embryos in the process.

ABORTED FETUSES

Aborted fetuses are a proposed source of organs. Debates address whether it is morally appropriate to use organs from a fetus aborted late in a pregnancy for transplantation that could save the life of another infant. Many people believe that this practice would condone late-term abortions, which some individuals and groups find morally objectionable. Another objection comes from people who fear that encouraging the use of aborted fetal organs would encourage “organ farming,” or the practice of conceiving a child with the intention of aborting it for its organs.

Reflection

Organ donation is a big issue not only by medical but ethical. Currently, 15 countries are the most willing to donate organs including India, Turkey, Spain and etc. On the other hand, there are religious denominations that do not agree with organ donation. These facts proved that not everyone agrees on this matter. But looking on the brighter side, there are various advantages of organ donation. One of the significant advantages is, the gift of an organ can save the life of a transplant recipient. For this reason, we can see how organ donors can transform the life of someone who needs a transplant. Therefore, I strongly support organ donation.

According to the Republic Act No. 7170 or otherwise known as "ORGAN DONATION ACT OF 1991 AND IMPLEMENTING A SYSTEM OF DEEMED CONSENT", an act authorizing the legacy or donation of all or part of a human body after death for specified purposes. Under the said Act, the people who are willing to donate for transplantation purposes from both deceased and living donor is in the spirit of "bayanihan". Also, to weaken the black market in organ selling as the necessity for it is dissipated by the availability of legitimate avenues to receive organs.

The number of patients on waiting lists for organ transplants continues to grow every year, and the shortage of organ donation has been a long-standing issue facing transplantation for years. Everyone deserves a second chance to live that is why we must look at the good side of organ donation because dealing with this issue, it should not be forgotten that this is a discussion of life and death, where a decision is made on who lives.

This issue is also regarding real people who are suffering, and decisions made based on good ethics and proper understanding of organ donation. Both the community and physicians should therefore approach organ transplant positively and objectively and treat ethical. Organ transplantation is unequivocally one of the “miracles” of modern medicine and describes as life-saving. Donating an organ for free can save or lengthen a person’s life. Many people can live long and healthy lives with the help of an organ donor and we should be one of those. But it is still our choice if we want to donate or not. Make your choice now!

REFERENCES

Britannica. (n.d.). Organ donation. Retrieved from https://www.britannica.com/topic/organ-donation

Center for Bioethics. (2004, February). Ethics of Organ Donation

Congress of the Philippines. (1992, January 7). Republic Act No. 7170. Retrieved from https://lawphil.net/statutes/repacts/ra1992/ra_7170_1992.html

Khatri, M. (2020, February 13). Organ Donation and Transplant. Retrieved from https://www.webmd.com/a-to-z-guides/organ-transplant-donor-information

McCarthy, N. (2018, July 27). Infographic: Where People Are Most Willing To Donate Organs. Statista Infographics. Retrieved from https://www.statista.com/chart/14894/where-people-are-most-willing-to-donate-organs/

Gatchalian, W. (2019, July 1). House Bill No. 2315. Republic Act No. 7170. Retrieved from https://www.congress.gov.ph/legisdocs/basic_18/HB02315.pdf

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Organ Donation

by Carolain D. Bansa

Transplants transform lives and reshape futures - and these life saving procedures wouldn't be possible without a simple yet selfless decision from an organ donor. Organ donation is a controversial topic that needs to be addressed and discussed. In order to make a decision, one must carefully analyze the relevant facts, data, observations, and arguments.

Did you know that each individual donor has the potential to save 8 lives and improve the lives of over 75 others? and its impact is beyond just the donors and receivers.

Learn more about Organ Donation and its Bioethical Principles by watching the informative video below.

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