Ethics of Organ Transplantation, Research Paper Example

Introduction

In general terms, the concept of ethics relates to how we conduct ourselves from a moralistic, obligatory and virtuous standpoint. Whereas personal ethics are more in keeping with our personal values and commitments to others, professional ethics tends to be more holistic by nature and relates to those standards we uphold in our professional lives. In certain professions these can be very serious and have life threatening consequences, e.g. Doctors, Lawyers, Bankers, etc. (Mizzoni, 2009)

The ethics surrounding organ transplantation is constantly evolving as demand for donated organs increases worldwide. This has created an ongoing debate on various ethical issues arising out of advances in medical science that enable more successful organ transplantations, and developments in organ sourcing. The argument supports that in general terms organ transplantation is a good thing but the ethical considerations are centered around adequate controls and disciplines imposed by the medical community.

Organ Transplantation

There seems little doubt that organ transplantation is one of the modern miracles of medical science. Many people live longer lives because of the generous and selfless acts of organ donors. Despite this, under the surface exists a myriad of potential ethical dilemmas. These types of problem and ethical issues have increased in scope with the progressions made in modern medical practice. (Munson, 2001)

Types of Ethical Issues: There have been numerous ethical questions that have threatened to undermine organ transplantation, for example:

In the sourcing of organs questions have been raised such as – should alcoholics be allowed liver transplants, should we pay for transplantation organs, or are transplants really justified in term of the huge costs involved? Procurement and distribution resides at the very heart of the ethical debate – how do we ethically source the organs, and what is the decision making procedure in deciding who gets the organ? The procedure is costly and really only available for those with lots of money or adequate insurance protection. There is also the question of consent; someone has to agree to the transplant taking place. Yet we are witnessing organ trading from undeveloped countries where people are selling their organs for cash, or are even being coerced into doing so. Medical tourism is on the increase where those requiring a transplant can, for example, travel to India for the procedure. In these circumstances, should the patient and the doctor be concerned about the ethical sourcing of the organ?

Eventually medical science will advance to where the use of DNA can be manipulated and the use of stem cells may permit the generation of new organs from the patient, thereby creating less rejection problems. This still appears a considerable distance in to the future and will create a new set of ethical dilemmas. (Caplan, 1998).

The recent Declaration of Istanbul on Organ Trafficking and Transplant Tourism, which has signatories from medical associations worldwide, has created a set of principles under which it recommends international bodies and NGOs should monitor organ transplantation from a trafficking point of view. (Declaration of Istanbul, 2013) It also puts in place a large custodial group to oversee and promote the principles worldwide. It was developed out of a series of World Health Organization resolutions over a number of years that attempted to address the ethics of transplantation arising out of high demand for organs and organ trafficking. The very existence of the Declaration indicates the extent of the trade in organ trafficking and transplant tourism. It can be argued that the trade should be regulated, rather than banning it, as even though economics may force a donor to donate a kidney, for example, the poverty of the donor is not something that the medical profession can directly influence. The better route would be to educate and counsel the donor in order that they can make an informed and autonomous decision. (Radcliff-Richards, 2012)

Part of the donor’s autonomous decision-making process (or that of their family) on whether an organ should be donated often involves religious views on organ donation. In the Christian religion, it was Pope Pius X11 (1876-1958) who supported the general concept of organ transplantation where it was to be used for medical purposes in order to save lives. It was considered that even in death, if the organs of the body could help in saving the lives of a living soul, it was both a noble and moral act. The main thing is the respect of the dead body and the care taken in removing the organ by a skilled mortician. In addition, they would also restore the body back to decent presentation for burial.

The majority of religions appear to struggle with the battle between the morality and altruism of organ donation, and the individual standards and/or rulings of each religion. For example, both the Jewish and Muslim religions preclude the violation of the deceased and therefore live donation is considered more acceptable, and the Muslim faith requires that donors (and often the doctors involved in the transplant) be of the Muslim faith. Awareness of these dilemmas is crucial in persuading donors in our multicultural societies to donate, and recipients to accept, organ transplants in order to save life. (Oliver, 2010)

Conclusion

Although…. The ethical guidelines laid down by The American Society of Transplantation for its members include a useful summary of the ethical issues or organ donation, as follows:

All parties involved in organ transplantation should be regarded as autonomous and their individual viewpoints should be respected – this includes religious, personal or other types of opinion on the ethics and morality of transplantation; all parties must be provide with all the information available on the pros and cons of transplantation, in a private and confidential environment; decisions relating to transplants must be based on medical criteria, in a fair manner and without discrimination; donors and patients should expect and receive quality care; if the donor is or is likely to be deceased, treatment withdrawal and determination of death must be undertaken applying standard processes – if the donor is alive, decisions to donate must be made without coercion, with no financial profit. (American Society of Transplantation, 2013)

References

American Society of Transplantation. (2013, April 1). AST Statement on Ethics in Organ Transplantation. Retrieved from http://www.myast.org/about/statement-ethics

Arthur L. Caplan, D. H. (1998). The ethics of organ transplants: the current debate. New York : Prometheus Books.

Declaration of Istanbul. (2013, April 1). Declaration of Istanbul on Organ Trafficking and Transplant Tourism. Retrieved from Declaration of Istanbul on Organ Trafficking and Transplant Tourism: http://www.declarationofistanbul.org/

Mizzoni, J. (2009). Ethics: The Basics. London: John Wiley.

Newton, L. H. (2003). Ethics in America, 2nd Edition. New York: Prentice Hall.

Oliver, M. (2010, October 20). Organ donation, transplantation and religion. Nephrology Dialysis Transplantation.

R.Munson. (2001). Raising the dead:organ transplants, ethics and society. Oxford: Oxford University Press.

Radcliff-Richards, J. e. (2012). The Case for Allowing Kidney Sales. In S. Holland, Arguing About Bioethics (pp. 252-255). New York: Routledge.