Organ donation and transplantation are notable hallmarks in medicine. Medical advancements are significantly confronting complicated conditions through organ transplantation and related practices such as grafting. Over the years, the procedures have grown and developed. However, organ donation and transplantation are surrounded by various ethical and legal issues. This paper discusses these issues in detail and elicits the relationship between them. The analysis is in line with both the support and opposition of organ donation and transplantation, particularly in Australia. The paper will also provide my personal stance and the final ethical decision by leveraging several theoretical perspectives – deontology, consequentialism, and the virtue theory.
The Ethical and Legal Dilemmas
The ethical and legal dilemmas are the breeding grounds of the involved organ donation and transplantation controversies which revolve around the shortage of organs up for donation. The persons in need of organs by far outweigh the number of people donating them. Going by the surveys conducted by the Australian Medical Association (AMA), the current supply of organs does not meet the demand (Mena Report, 2016). The number of patients awaiting organ transplantation significantly grows every day. The case remains to be so in various organs which are mainly donated and transplanted which include the heart, lung, kidney and liver (Consolo & Wigmore, 2014). It is argued that the shortage of organs influences the distribution of organs or promote organ trafficking thus commercialising this sector.
The Australian government has developed various responses to this concern. The country has platforms in which people are expected to register as organ donors. It also encourages the discussion of donation decisions with one’s family. Given that the country at one time had high rate of failures in organ donation and transplantation, the country has established a National Clinical Taskforce to improve the situation (Mena Report, 2016). That is why the process of donating and transplanting organs in the country is complex. It engages a large number of people and organization apart from donors, recipients and the respective families in order to ensure the success of the process. Although the situation has improved owing to these responses, organ donation and transplantation continue to receive sharply polarised opinions. This has seen this sector host support and opposition in concrete levels in relation inequality, organ distribution and the commercialisation of organ donation and transplantation.
Increased Inequality
As expected, the supporters centre their argument on the gift of life because donating an organ offers an individual a chance to survive and live. Both cadaveric and living organ donation play a pivotal role in supporting life. Hence, it is imperative for people to willingly donate their organs because transplanting is not feasible without the donation of organs. In 2014 alone, Australia recorded 378 donations giving a new life to about 1,100 patients across the country (Australia News Service, 2016). There is thus a dire need for organ donation and transplantation. Although supporters agree to the increased inequality in accessing donated organs, they believe that the situation will improve because Australia has established legal mechanisms to seal the existing gaps. For instance, the transplant system has created different aspects of addressing the problems associated with the donated organs. Usually, the system has it that the organ first goes to the individual who needs it the most.
However, the critics suggest that the system operates unfairly under the guise of saving human life. They term the established legal mechanisms as dubious and ineffective meaning the state of inequality is bound to grow even further. According to them, the system does not honour the legal framework therein and there are instances in which the person who needs the organ the most is not the one who gets it. The case is especially so given that the system also takes into account geographical factors. To this end, the sickest individual in an “unfriendly” geography is not guaranteed to benefit from the organ. Therefore, organ donation and transplantation is characterised by wide disparities.
The critics continue to argue that although we claim we are saving a life, we are doing it unfairly by encouraging disparity. Remember that the donor offered his/her organ in good will. It means that unfair distribution of the organs appears to exploit the donors. That is why despite of Australian government vehemently supporting organ donation and transplantation, the country is among regions that has low rates of donation in the world. Moreover, given that Australia is now one of the countries with successful donation and transplantation procedures, it is sought by various wealth people across the globe in need for transplantation. Critics equate this to exploitation of the country’s transplant systems (Hyde & White, 2014). The fact is that there are Australians in need of organs but remain in the waiting list while rich people from other countries benefit from the few organs available.
Addressing Distribution Problem
The supporters agree that the distribution of donated organs is not living up to its expectation. Candidates scheduled for organ transplantation, particularly liver transplant, grow tremendously owing to the increased concern of obesity epidemic and ageing (Van Dijk, Hilhorst & Rings, 2014). The situation is weighing down the problem of distribution. The proponents thus claim it would be paramount for countries to augment the awareness of organ donation. Maximising public awareness on the situation of organ donation and transplantation would help in streamlining the distribution. It will compel more people to donate organs leading to equal distribution. It is extremely difficult to ensure equal distribution with the current low rates of organ donation. They recommend investment in outreach programs to attract new donors in different parts of the state. People should be fed with comprehensive information surrounding organ donation including the number of people who die annually while on the waiting list.
On the other end, the critics suggest that awareness would still not be effective without the improvement of the current state of distribution. People need to see situations in which certain regions are not being exploited. For instance, it is common today for transplant system to commend the shifting of organs from high donating areas to other parts of the country. This kills the motivation to donate since it appears as if the high donating areas are the “organ farms”. The hard fact is that people will be reluctant to donate knowing that the organ may not even help the sickest persons who are more close to them. Therefore, awareness should be increased in all regions across the country to cancel out the impression of “organ farms”. Otherwise, there should a valid explanation provided in the events where the impression persists (Hyde and White, 2015). The legal system must establish regulations that will prevent exploitation of high donating regions in order to affirm the worth of organ donation and transplantation.
Commercialisation of Organ Transplantation
The supporters believe that this is not a gruesome problem because the Australian government has developed measures to curb the commercialisation of this important process. The legal and transplant systems have emphasised that organ donation should be altruistic and voluntary. Going by the Australian law, organ donation should be an expression of concerns about the wellbeing of others driven by egalitarian and moral acts (Australia News Service, 2016). To this end, there should be no payment between recipients and donors. Compensation should only be allowed where the donation is accompanied by certain inconveniences. The law spells out that the donation of an organ for monetary reasons is an unethical practice which undermines human values. As a result, the law increases the protection of poor and vulnerable donors to prevent instances that may see them become victims of organ trafficking thus promoting “transplant tourism”.
The critics have a different line of opinion. They fear that organ donation and transplant may grow into organised crime. There are cartels ready and willing to compromise the system for financial gain. Therefore, organ donation and transplantation can become a major problem just like the state of human trafficking. Even with the presence of stringent measures, organised crimes have the potential of undermining the legal system and successfully undertaking their ill activities. In an era where illegal activities such as drug and human trafficking are consuming the national expenditure in efforts to reduce and eliminate them, the organ trafficking may aggravate the situation. In Australia, human trafficking is too secretly organised to accurately determine its level (Hyde and Chambers, 2014). Critics worry about the commercialisation of organ donation and transplantation getting to that level. To this end, the critics recommend the employment of proactive measures by, for example, increasing the exploration of other organ sources such as animal and artificial organs.
Personal Reasoned Position and the Final Ethical Decision
Organ donation and transplant is a pertinent issue because it is a matter of life and death. Arguments should be on how to improve its state because abandoning it is not an option. The problem is that most critics focus on tarnishing it as if they advocate for the abolishment of organ donation. Although the critics have argued that there are other sources of organs such as the use of aborted foetuses and stem cells, the country has not yet arrived at a promising scale in the utilisation of these sources. Regardless of the strides made by animal and artificial organs, their full potential has not been secured. That is one of the reasons the National Clinical Taskforce on organ donation and transplantation was introduced at the first place (Phillipson, Larsen-Truong, Pitts & Nonu, 2015). It is worth noting that just like the critics are expressing concern in the prevention of the organ donor’s exploitation, medical professionals are also protecting organ recipients by ensuring they acquire standard organs.
Hence, humans remain to be the best sources of organs. We cannot let people die while we are in a position to help them. Important is increasing awareness about organ donation and transplantation. However, in the process of awareness, the public should be told even the hard facts. It is expected that even with awareness, some regions will respond highly than others leading to the disproportionate donation of organs. That way, the public can be made to understand that different patients need the organ in varying degrees. Consequently, distribution is necessary for organs to derive its maximum benefit. With this knowledge, even the shifting of organs from one region to another in serving patients who are in need the most will not kill the motivation of donating organs.
In theoretical perspectives, deontology, consequentialism and the virtue theory will govern this decision. While the deontology theory insists on the natural intuition to do the right thing, the virtue theory focuses on the acquisition of traits ideal for critical thinking (Hurka, 2014). Under these theories, organ donation will appear as the right thing to do. It is a selfless move in a system where empathy is the essential tool. Everyone can potentially be a victim of this system. Thus, the need to donate an organ, when one is in a capacity to do so, cannot be over-emphasised. With the theories, people can response to organ donation positively.
Even better, it will enhance efficient responses to strategies put in place to garner organs, particularly in cadaveric donations. For example, the governments have established a presumed consent on cadaveric organ donation for persons who are either 16 or above this age (Australia News Service, 2016). It means that once a person dies, his/her organs can be donated unless the individual claimed otherwise before dying. More so, individuals would not tolerate the buying and selling of organs since this is reducing the human body to a commodity thus violating human dignity. Commercialisation of organs cultivates inequality given that the wealth can easily access organs thus “buying” life. As the Australian law puts it, under the theories, individuals will view organ donation as a voluntary and altruistic move.
However, the consequentialism theory may contribute to this aspect positively or negatively. Under the positive perception, people can easily choose to donate their organs since the practice involves a sound consequence, which is saving another person’s life. On the other hand, the theory can adore practices such as falsely pronouncing the death of a person in order to benefit from his/her organs. It can also promote human trafficking since the buying and selling of human organs can be justified. Some people, especially the rich patients in need of organs, may rejoice in the death of others. For example, one of the factors that have greatly minimised the number of cadaveric organs is the reduction of car accidents. Victims of road accidents substantially contributed to the realisation of cadaveric organ in the country (Consolo & Wigmore, 2014). The situation has changed following the various campaigns such as the installation of safety belt and airbags aimed at fighting car accidents. A consequentialist may not warmly welcome such improvements. It is bad news in cases where organ donation is approached as a “business”. Therefore, consequentialism is inappropriate. It can lead to undesirable outcomes, worse being the commercialisation of organ donation and transplantation.
Clearly, voluntary and altruistic organ donation is the way to go and the transplant system needs immense improvement. Solid awareness should be created, and regulations heightened to increase organ donations and prevent the commercialisation of human organs. This is the right thing to do because we cannot afford to let people suffer or die for fears of organ trafficking among other ugly aspects associated with organ donation and transplantation. Nevertheless, donated organs should be first provided to victims who need them the most despite the lifestyle they led prior to falling ill. It is essential to consider the ethical issues relating to organ donation particularly on the issues concerned with commercialisation of the practice
References
Australia News Service. (2016). Australia's Organ and Tissue Donation and Transplantation Rates Improve In 2015. State News Service.
Consolo, H. K., & Wigmore, S. J. (2014). Transplantation: Ethical and legal issues associated with organ donation and transplantation. Surgery (Oxford), 32(Transplantation), 333-337. doi:10.1016/j.mpsur.2014.04.015
Hurka, T. (2014). Consequentialism vs. Deontology. Oxford University Press. doi:10.1093/acprof:oso/9780199233625.003.0008
Hyde, M. K., & Chambers, S. K. (2014). Information sources, donation knowledge, and attitudes toward transplant recipients in Australia. Progress in Transplantation (Aliso Viejo, Calif.), 24(2), 169-177. doi:10.7182/pit2014799
Hyde, M. K., & White, K. M. (2015). Exploring Donation Decisions: Beliefs and Preferences for Organ Donation in Australia. Death Studies, 34(2), 172-185. doi:10.1080/07481180903492604
Mena Report. (2016). Australia: Minister Nash releases independent organ donation and transplantation review. Mena Repo
Phillipson, L., Larsen-Truong, K., Pitts, L., & Nonu, M. (2015). Knowledge of, beliefs about, and perceived barriers to organ and tissue donation in Serbian, Macedonian, and Greek Orthodox communities in Australia. Progress in Transplantation (Aliso Viejo, Calif.), 25(1), 91-99. doi:10.7182/pit2015550
van Dijk, G., Hilhorst, M., & Rings, E. (2014). 6: Liver, pancreas and small bowel transplantation: Current ethical issues. Best Practice & Research Clinical Gastroenterology, 28(Ethical Issues in Gastroenterology), 281-292. doi:10.1016/j.bpg.2014.02.003
