PHIL103: Moral and Political Philosophy

Since the 1st successful kidney transplant in 1954 done between two identical twins organ transplantation has become a life-saving procedure for many disease conditions hitherto considered incurable. Clinical organ transplantation has been recognized as one of the most gripping medical advances of the century as it provides a way of giving the gift of life to patients with terminal failure of vital organs, which requires the participation of other fellow human beings and of society by donating organs from deceased or living individuals. The gap between the demand for organ transplantation and the supply of donor organs is growing. The waiting list of the United Network for Organ Sharing has grown from 21,975 names in 2000 to 32,722 in 2008 Fig. (1).

Figure 1.

The gap between the demand for organ transplantation and the supply of donor organs (UNOS) publications

The scarcity of organs has dire consequences. And an average of 19 people dies each day waiting for a transplant that never comes. The World Health Organization WHO global observatory showed that in 2009 about 100,900 people receive a lifesaving organ transplant, representing only less than 10% of the global needs Fig. (2). the entire issue has raised serious ethical concerns and the debate over

Figure 2.

Number of Transplants done worldwide WHO publication

them rages unabated. As further advances are made in such areas as cloning, the ethical debate should grow more intense. The increasing incidence of vital organ failure and the inadequate supply of organs, especially from cadavers, have created a wide gap between organ supply and organ demand, which has resulted in very long waiting times to receive an organ as well as an increasing number of deaths while waiting. These events have raised many ethical, moral and societ al issues regarding supply, the methods of organ allocation, and the use of living donors including minors. It has also led to the practice of organ sale by entrepreneurs for financial gains in some parts of the world through exploitation of the poor, for the benefit of the wealthy the ethical questions are complicated by an outgoing debate over the definitions of certain key terms such as life, death, human, and body. One example is the definition of brain death. People have been confused over the issue because of the highly public cases of people recovering from comas even after many years. The distinction between the idea of brain death and coma becomes a matter that must be clearly defined. A family that is asked to donate body organs from dead relative on the basis of brain death must be confident that there is no hope of recovering. Other ethical issues of organ donation are considered bioethical an important one is the idea of cloning. The technology that would allow the cloning of genetically matched clones for the purpose of body harvesting another issue is known as xenotransplantation which involves the harvesting of certain compatible animal organs for use in humans. A whole new plethora of ethical issues surround this idea due to fear from animals and the diseases might transmitted form them, or to protect them, even animal rights groups have joined in these debates. There is no question that body donation and organ donation will remain a hot topic for many years to come. Organ transplantation in general, and kidney transplants in particular, are fraught with ethical issues and dilemmas worldwide, about which there is ongoing debate, especially because of the shortage of organs The ethical questions associated with transplantation are many. Is the human body a commodity? How should decisions be made about who should receive scarce organs? Who should pay for transplants? Should someone who has received one organ transplant be given a second transplant? Or should people who have not had a transplant be given priority over those who have already had one? Should one person receive several organs or should several people each receive one? Should one person have a second transplant when the first one fail or should a different person be given a first chance at new organ? Should people who have young children be given an organ transplant over a single person? Should young people be given an organ transplant over an elderly person? Should age and whether or not a person has children even matter? Should organs be given to people who have abused their bodies (smoking and drinking etc, ) or only to people whose organs are damaged by disease? Should hands or other appendages, which are not essential to life, be transplanted? Who can "donate" the organs of people who cannot give informed consent to the process? Should money now spent on transplantation be put to other uses? Is it possible to prevent the coercion of some donors? Should suicidal individuals be given an organ transplant? What if they attempted suicide in the past but are not currently contemplating suicide? Should people who can't afford expensive anti-rejection drugs be passed over for a transplant? Should people who don't have Insurance and can't pay for a transplant be allowed to go on the National waiting list? Should condemned prisoners receive organ transplants? What if they are serving a life sentence without parole? Should country lawmakers be involved in transplantation? When should courts be involved in these questions?

The questions go on and on; the answers are never simple. Knowing that there are more people who need organs than there are organs available, how would you answer these questions? Are your answers based on a belief of equal access or maximum benefit distribution?

Source: Ehtuish Ehtuish, https://www.intechopen.com/books/understanding-the-complexities-of-kidney-transplantation/ethical-controversies-in-organ-transplantation
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