Ethical Implications of Non-Heart Beating Organ Donation, Article Critique Example

Summary

The author openly discusses in this article, a dilemma facing not only the nursing profession, but the public as well when people are bombarded through advertisement to donate organs. In these advertisements she emphasized that the appeal to emotion is so strong a picture of grieving relates is always painted showing how relieved they are when an organ is donated for loves ones (Valko, 2002)

However , the author points to the fact that in the zeal to extend life for a dying person many ethical boundaries are crossed when this happens in a manner whereby the legal rights of the donor is compromised through removal of organ before brain death occurs. Hence, the legal infiltration of non-heart beating organ donation becoming a non ethical practice (Valko, 2002)

Further, Valko (2002) relates that the actual practice of bypassing legislation of non- heart beating organ donation which comprises 2% of all organs donated, contradicts legislation which specifies that, ‘all efforts to save your life have been exhausted” and brain death has been determined’ (Valko, 2002).Once the patients’ relatives can give consent for the plug to be pulled while there is still heart beat, this gives health care the privilege to donate the organ before death (Valko, 2002).

Clearly, she declared that within the past decade authorities have not been abiding by these rules. An argument she offered for the change posited by those superseding the ruling is that when organs are taken from dead people transplants have been unsuccessful. As such, without seeking a change of the legislation to provide justice to donors, due to contemporary developments within the science, health care has taken upon itself to make changes on its own (Valko, 2002).

Ethical dilemma and effect on nursing practice

Code Gray; Ethical Dilemmas in Nursing espoused by Joan Sawyer (1968) offered four situations whereby nurses can find themselves caught in a trap during their practice in making a decision of justice for patients. Case four stipulating that, ‘a nurse caring for a terminally ill patient faces a conflict between fidelity to her commitment to relieve suffering and the promise made to the patient’s family’ (Sawyer, 1984) is linked to Nancy Valko (2002) article relating ‘Ethical Implications of non-heart beating organ donation.’ The sensitive decision nurses usually have to make is when they are the ones to disconnect respirators from patients when doctors give this order.

There have been cases in history when respirators were removed; patients continued breathing even though unconscious to make a decision for themselves. A memorable case written upon nursing history books is Karen Quilain whose parents went to court to have doctors remove her ventilator and she lived nine years after dying from pneumonia (Quinlan, 1977).

This ethical issue emerging in nursing practice today as any other requires that the nurse resorts to the ethical standards upheld by the nursing board and organization through which they function. It is true that a nurse can be dismissed for not carrying out doctors’ orders to disconnect a ventilator from a patient when relatives request that it should be done. The nursing body should offer necessary representation for the individual. Here is where a real dilemma could ensue when a nurse is dismissed for maintaining justice towards a patient and he/she is left in an ocean of uncertainty by the governing body. Non-heart beating organ donation circumvention appears to be a popular practice with immense monetary rewards for persons involved.

Ethical resolution

Valko (2002) further clarified that when patients’ donor do not stop breathing after orders have been given to remove ventilators, either the transplant could be canceled or the patient returns to the ward. In most situations they die since all treatment was withdrawn. The resolution here is for the nurse is to continue treatment and seek support of their nursing organization in maintaining autonomy and justice in nursing practice.