ORGAN DONATION MUST BE MANDATORY

Organ donation must be mandatory

Introduction

The history of organ donation dates back to 1954 when the first successful kidney transplant occurred. This involved twin brothers, Ronald (donor) and Richard (recipient). Richard was suffering from chronic nephritis (Shelley, 2010). This preparation for this transplant took five years and added eight years to Richard’s life. Since the success of this transplant, there have been a series of kidney transplants and transplants of other organs such as the skin, pancreas, liver, and heart. The transplantation success rate is 90% for kidneys, 84% of hearts and 80% for livers (Shelley, 2010).

Organ donation brings about ethical issues that are not so easy to unveil as regards to what people claim in the determination of what would happen to their bodies before and the aftermath of death (Margolis, 2009). This raises questions, such as “Is there any respect for the human body in doing this?” or“Will it be comfortable to accept an organ from another family?” or “How can people address the needs of those people whose organs have failed?” (Bernat, 2008).  Nonetheless, organ donation has proven to be an essential and successful procedure in today's healthcare. Organ donation entails persons voluntarily offering their organs for transplant (Margolis, 2009). In this context, the act of donating an organ to another person can be considered as an element of humanity.  Humanity is the quality or state of being humane—the ability to show compassion, kindness, mercy and empathy (Margolis, 2009).

The element of donating organs brings about important issues ranging from practical to ethical ones. Organ donation should be mandatory because it is humane and life-saving. Furthermore, even if organ donation cannot be required, through the evidence presented, readers may be persuaded to voluntarily donate their organs and tissues when they die and to act upon their decision to donate.

Background

According to Paola, Walker, and Nixon (2010), there are two types of organ donations: living and deceased.  Bernat (2008) shows that organs that are donated are used to replace those that have failed to function.Organ donation has demonstrated significant benefits to patients by extending life expectancy as well as improving the quality of life (Bernat, 2008).Nonetheless, every year about 3,000 to 4,000 people in the United States die while waiting for a kidney.  Eleven people die every day while waiting for a transplant (Cohen & Vella, 2013). If people were allowed to sell their extra kidneys freely, many more lives would certainly be saved.  However, selling organs from donors who are alive is illegal in every country apart from Iran (Hippen, 2008). The practice of organ donation for monetary gain, as mentioned by Abadie & Gay (2006), leads to a situation whereby the demand for human organs for donation outweighs their availability, resulting in an increase of the gap between supply and demand. According to Hinkley (2005), the above-mentioned gap has contributed to using other animals as sources of material for transplantation into humans.

Background 1

Mandatory organ donation would equalize the supply and demand and decrease the potential for people to sell their organs.  This does not mean that the possibility for organ sales should be completely eliminated in cases where donating an organ is not life-threatening to the donor; however, the potential organ sellers must be informed of all the risks. The problem could easily be redressed by making potential sellers undergo counseling so that they are given all relevant information (Cohen & Vella, 2013).  Additionally, if lack of informed consent is a reason to make organ donation illegal, then voluntary organ donation itself should also be illegal.  This is because both types of donor, whether paid or voluntary, undergo surgery, and therefore they are both exposed to same risks; hence, they face similar consequences (Margolis, 2009). Further, people should be given the freedom to take on the risks if they want to, owing to the fact organ donation is no longer as dangerous as it was initially.

Mandatory organ donation has an advantage in that it would lessen the potential for money exchanges. It should be taken into account that it is even more dangerous to for wait for voluntary donations, since it encourages illegal organ harvesting and selling.On the other hand, it is important to note that consent to some action is only valid if there is no other reasonable alternative to the said action (Potts, 2007). This then demonstrates a situation of desperation to the extent of willingness to donate an organ. For one to be willing to succumb to an extreme measure, it is understood that the alternatives must be very bad (Cohen & Vella, 2013). The alternative could be, for instance, starvation, homelessness or even death. Consequently, if a person's situation is so dire leading them to resort to organ donation, then donating their organs is considered as the best alternative and making organ donation mandatory would be taking away such a person's best option. To this effect, Potts (2007) state that trying to bring exploitation to an end using prohibition, is as useless as working on ending slum dwelling by evicting the slum dwellers using bulldozers. This only makes things worse for the victims.

Background 2

Voluntary organ donation perpetuates the situation in which there is a demand for organs.  As regards the issue of unfairness in organ donation, then all treatments that only the rich have access to because of their economic ability would be unfair and therefore ought to be made illegal! Mandatory organ donation would create more equal access for the rich and the poor to receive medical care.  Voluntary organ donation undermines the medical profession on the ground that it involves profit making. This therefore infers that selling of organs should be banned. What should be done to mitigate the fear herein is to make organ donation mandatory and to seal loopholes that would lead to any human sacrificing their lives by donating their hearts for any reason. Rather, prohibiting the sorts of organ donations that would lead to loss of life would be consistent with the goal of the medical profession, which is committed to saving lives.

Background 3

There is an issue with alcoholism and liver transplants, which brings up the need for understanding the fact that alcoholism is a hereditary disease (Chakravarty et al., 2012).  In this case, the so-called self-induced disease is beyond the control of the alcoholic. Therefore, alcoholism ought to be treated like any other disease that is caused by foreign agents. There are other many diseases that people majorly contract due to acts of the patients themselves such as smoking that causes lung disease, over-eating that causes diabetes and contacting HIV as a result of engaging in unprotected sex(Hinkley, 2005). All these people are allowed to access treatment and therefore alcoholics should also be allowed to access necessary treatment.

Rebuttal

There exist objections to the practice of organ donation that have been partially mentioned above and they include exploitation of the poor, unfairness, undermining the medical profession and branding the whole concept as a slippery slope. It is said that the people who are at a high risk of selling their organs are the very poor or individuals in extremely dire circumstances (Bernat, 2008). Consequently, it is more likely that such donors would either be too uninformed or too desperate to consider clearly the possible risks and consequences of such surgeries (Hinkley, 2005).  This in turn implies presence of lack of informed consent in the transaction.  Notice is taken that in most cases, it is thought that coercion in consenting is only done by making the disadvantaged party sign a document at a gun point, yet desperation to the extent of resorting to selling one's organ has the same significance as signing a document at gun point (Abadie & Gay, 2006). Therefore, this note brings about worries that if organ donation remains voluntary, some people will be coerced into donating or selling their organs (Hinkley, 2005).

An implication of unfairness is demonstrated in the circumstances that the rich are allowed to have access to the luxury of buying a kidney, a privilege that the poor have no capacity to enjoy (Bernat, 2008). The medical profession is meant to save lives and has the element of saving lives as the sole/ major objective (Paola et al., 2010).  Since the practice of organ sales enshrines the profit making idea, voluntary organ donation can be seen as undermining the medical profession. 

The antagonists to organ donation believe that if organ donation is voluntary, people will eventually be selling all organs including those that can even lead to their death, such as hearts (Abadie, & Gay, 2006). As regards the issue of alcoholics and liver transplants, Chakravarty, Lee, Jan, Chen & Po-Huang (2012) state that every year around 1,500 humans in the United States die while awaiting liver transplant.  Since physicians working towards accomplishing their main goal of saving lives, it is reasonable that if there is a way that could be used to save lives, then everyone must be able to afford the service (Hinkley, 2005). It is important to note that livers are a non-renewable resource.  As such, liver failure due to alcoholism is considered a self-inflicted disease. (Chakravarty et al., 2012). This has resulted in an assumption that alcoholics should not equally compete with others for liver transplantation.

Conclusion

The above discussion advocates for mandatory organ donation. This is backed up by the idea that humanity demands that people act kindly towards each other.  Humane treatment of fellow human beings would go to the extent of sacrificing for the well-being of other humans. In essence, mandatory organ donation would be promoting the medical profession by ensuring the realization of the main profession’s objective of saving lives is achieved. To demonstrate commitment for this venture, xenotransplantation where possible is further recommended to minimize the huge difference between the demand for human organs and their shortage (Barber, Falvey, Hamilton, Collett & Rudge, 2006).  Looking at the objections to voluntary organ transplantation above, it is clear that the reasons to support mandatory organ donation are reasonable enough to be adopted. Furthermore, establishing mandatory organ donation would present an opportunity for people to practice humanity by developing more ways of saving lives. Indeed, it is humane for one person to donate one of their organs and save the life of another person.

References

Abadie, A., & Gay, S. (2006). The impact of presumed consent legislation on cadaveric organ donation: a cross-country study. Journal of health economics, 25(4), 599-620.

Barber, K., Falvey, S., Hamilton, C., Collett, D., & Rudge, C. (2006). Potential for organ donation in the United Kingdom: audit of intensive care records. bmj, 332(7550), 1124-1127.

Bernat, J. L. (2008). The boundaries of organ donation after circulatory death. New England Journal of Medicine, 359(7), 669-671.

Chakravarty, K. D., Lee, W. C., Jan, Y. Y., Chen, Y. C., & Po-Huang, L. (2012). Liver Transplantation. New Delhi: Jaypee Brothers Pvt. Ltd.

Cohen, D. J., & Vella, J. P. (2013). NephSAP.

Hinkley, C. C. (2005). Moral conflicts of organ retrieval. Amsterdam [u.a.: Rodopi.

Hippen, B. E. (2008). Organ sales and moral travails: lessons from the living kidney vendor program in Iran. Cato Policy Analysis Series, (614).

Margolis, J. (2009). The arts and the definition of the human: Toward a philosophical anthropology. Stanford, Calif: Stanford University Press.

Paola, F. A., Walker, R., & Nixon, L. L. C. (2010). Medical ethics and humanities. Sudbury, Mass: Jones and Bartlett Publishers.

Potts, M. (2007). Truthfulness in transplantation: non-heart-beating organ donation. Philosophy, Ethics, and Humanities in Medicine, 2(1), 17.

Shelley, J.L. (2010) History of Organ Transplantation. Des Moines University.