Madelein du Plessis 3635464

Ethics and Organ Donation

While on block with clinical practice I treated a patient who had been in the hospital for a while. One day during one of our sessions the patient asked me what is organ donation and how does it work?

Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin. That is when, the donor, while alive and well, made his or her choice clear to all his love ones.

Organs that can be donated: liver, lungs, heart, kidneys, pancreas and small intestine. Tissues you can donate are your skin, corneas, bone tissue including tendons and cartilage, heart valves and blood vessels.

Organ donation is an important matter and going over this topic with a superficial brush could lead you to the question: “What can be the ethical issues with the donation of organs?” The objective of this is not to pose answers to the ethical issues surround the donation of organs, but rather to encourage people to face some “hard issues” and then grow from “artificial intelligence” to compassion, allowing for uncertainties and respect for other opinions.

“Organ Donor Week”, was recently celebrated and we are witnesses of heroic stories and enormous relieve that were aired. August is also Organ donation awareness month (Organ door month, 2019).Hopefully with the effect that more people will take the bold step and become willing organ donors to relieve and revive the quality of live for fellow humans. In the light of, one tends to give unconditional support for such a worthy cause. That, however, could lead us astray from hard ethical issues associated with organ donation.

Some ethical issues that occurs is on the one hand the willing donor, at peace with his or her conscience decision, reaching out in compassion to a suffering fellow human, as facilitated by a trustworthy medical profession.

It I easy these nowadays to become an organ donor, just go onto the internet fill in your details and put and organ donor sticker on your Identification Document and License so that if something happens to you, you have those document with you and someone will be able to know that you are an organ donor (Dalal, 2015).

Have conversations with your loved ones about organ donation, even if you cannot commit at this moment, your loved ones will know more of your thinking and will be able to make a good decision when they might need to.

This all sound straight forward, all organized, but for the loved one who had to make the call, it stays a tough issue with emotional issues on both donor and receiver side.

There is also the issue, if it is ethical for donor’s family to know who the receiver is and vice versa. It can end up in subtle emotional bondage. There is also live donation, where you make a conscious decision to donate an organ, example kidney, which you can live without, to someone in need.

On the other horizon, we have scrupulous people using humans and their organs, illegally, as a business. People fall prey to kidnapping, human trafficking and organ harvesting as a lucrative business to support wealthy people, trying to improve their life expectancy at the cost of the poor and helpless. These people are also exposed to abuse, to bad social and hygienic conditions and stripped from their rights as humans.

In this situation it is not difficult to take the high moral road with strong opinions regarding ethical issues associated with the adjectives used to describe this case.

The prime ethical issue to contemplate here is, Exploiting. In between on the slippery slope one finds a host of scenarios with their own associated ethical issues. Willing donors, requiring compensation and hence “selling body parts” (illegally) to make a living (Saba, 2016).

That leads to the issue of exploiting people or Compensation for Organ Donation. Some people are in desperate need of money and decide to donate an organ to get paid, unfortunately a lot of these people get exploited and trade happens illegally.  That touches also on the issue of people requiring compensation for renewable stuff like blood (and even liver, nowadays). On the other hand, the “free” organs might not be so free for the receiver allowing a medical profession to make a killing. To peel open the ethical issues here requires contemplation of compensation for Organ Donation and what are reasonable costs for organ transplants

In the case of live donors, it also cost a lot to go through the procedure as it is not a small operation that is being performed and there is always a risk of getting infection too.

Reasonable Costs for Transplants is often a debate taken from general public and contained in boardrooms enshrouded in some secrecy. Information encountered “first-hand” through real case studies from our congregations reveals: A young man required more the R700 000.00 to undergo a kidney transplant in South Africa. In his case his brother was the donor. A young man working in India required the equivalent of R30 000 to undergo a kidney transplant there.

In both these cases there was no compensation for the donor, but in one case someone pocketed a lucrative compensation. Therefore although one can easily develop appreciation for the ethics involved with compensation for donors, but how ethical is the costs associated with transplants in the Western world? Or is capitalism of supply and demand a holy cow above any ethical scrutinizing. For the donor one can ethically reason (often on his or her behalf), why compensation can open a can of worms that should rather remain contained. But on the other hand medical cost can easily be justify, even when skyrocketing.

In some cultures and religions organ donation is a moral issue and does not allow any form of transplant or donation. Organ donation gets looked down on.

In conclusion there is a lot of ethical issues surrounding organ donation and it is a decision that should not be taken lightly. Although becoming an organ donor you can save up to 7 people at a time.

 

References

Dalal, R. (2015). Philosophy of organ donation: Review of ethical facets. World Journal of Transplantation, 44-51.

Organ door month. (2019, August 1). Retrieved from www.gov.za: https://www.gov.za/organ-donor-month

(and organ donation week is 26-30 August)

Saba, S. (2016). An ethical appraisal of financial incentives for organ donation. Clinical liver desease a multimedie review journal.