Organ Transplant Ethics

The demand for organ transplant is quite large that there is not enough supply available.

It has been growing by 15% since 1988. In China, for example, about 2 million people require organ transplants but they can only serve about 10,000 per year. In the US, there are more than 100,000 people that require organ transplants, of which about 65% are still
waiting to be served in a year or so. In Latin America, the list is long with about 50,000 people waiting to be served.

Death Rates

It is estimated that close to 60% die from failure to get an organ transplant. This statistic was not able to account a number of patients who are not being registered by their doctors to line-up for organ transplantation.

However, aside from the scarcity of available donors, there are also several ethical concerns associated with organ transplantation. One of these concerns is the technology use or the donor source, which are as enumerated as follows:

    1. Autograft is a technology in which the tissue being used comes from the person itself in which the graft is taken from one body part to another body part of the same person. This type of transplant is commonly used for skin grafting;

    2. Allograph here, transplantation is made from same species but genetically different;

    3. Isograph a form of transplantation in which the donor and recipient are genetically identical (i.e., identical twins);

    4. Xenograph a cross-species transplantation technique that particularly makes use of animal organs to humans.

Controversial

Among the aforementioned technologies, xenograph or xenotransplantation garners the most controversies that circle around physiological and ethical issues.

Ethical issues associated with animal organ transplant include laboratory use of pigs, baboons, and other animals, the alteration of the animals genetic make-up to match that of the recipient, and respect for the rights of the animals, among others.

The Black Market Stigma

Another ethical concern is transplantation tourism which in large cases exploiting to the poor and clearly violates human rights. There is an undeniable presence of black market for organs where a lot of people willfully sell their organs for subsistence.

People from third world countries such as the Philippines, India, Pakistan, Iran, etc. are selling their kidneys for less than a thousand dollars to about two thousand five hundred dollars.

Unfortunately for these donors, the surgical removal of one of their kidneys is not oftentimes done properly. Donors are also not fully informed of the consequences of their decisions.

The bigger question is – should organs be “commercially” marketed as it only encourages more people to sell their organs. This also raises an issue that since organs and organ transplantation procedures are very expensive, poor people who need transplantation are less likely to get an organ than well-off people.

In the US, they have instituted a regulatory body that will handle matching logistics. This is the Organ Procurement and Transplantation Network (OPTN), which is tasked to facilitate organ matching, development of policies, collection and management of scientific data, and a host of other responsibilities.

They also regulate the distribution of organs among the registered patients to ensure that organs are equitably distributed among their registered patients. Their criteria for prioritization include biological
compatibility, near death situations, and prognosis for long-term survival if transplanted with a new organ. They claim that their policies are not discriminatory and have no regard for race or societal stature.

There are also those who were forced against their will to donate an organ. There is a growing concern particularly among cause-oriented groups that China is “harvesting organs” from their prisoners. They issued press statements that their main sources of organs are only executed criminals to counter the reports. However, Amnesty International, a non-government organization, expressed concern that the average number of execution does not match the number of donations made.

Rampant Kidney Theft

Criminal cases on kidney theft are another case of forced donation. These are rampant, particularly in third world countries, in which a person is being drugged only to find out the next day that his/her kidneys are stolen.

Another ethical concern is legal death. Potential donors are wary on how doctors declare brain death. They are afraid that when they are in a critical state and because of the organ(s) they promised to donate, doctors will not ensure or exert efforts to revive them.

The Mayo clinic however disputes this fact and says that (1) doctors focus on saving their patients life and not another person, and (2) a person who signed for organ donation is tested more thoroughly to ensure that the person is dead before removing the organ from his/her body.

There is also a concern on the lifestyle of the recipient. The question being asked is should smokers and habitual drinkers be entitled to organ donation or should those whose organs failed due to illness be prioritized. A similar concern is – can failed organ
transplantation be entitled to another organ donation.

Another is if a person who had previous organ transplantation but resorted to his/her bad habits should be entitled to organ transplantation.

These are issues that gather different views. Some sectors will say that since it was them who brought the misfortunes to their lives, they have to suffer the consequences.

On the other hand, the more forgiving sectors would say that it is life that is more important and regardless of what a person is, he/she is entitled to have another chance in life.

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