PHI FPX 3200 Assessment 4 Robbing the Dead: Is Organ Conscription Ethical?

Organ transplantation is a necessary medical procedure that can save the lives of patients suffering from organ failure. However, the demand for donor organs far outweighs the supply, leading to a shortage of available organs. This shortage has led to the exploration of alternative options, including conscripted organ procurement. Collecting organs from deceased people without their express permission is termed organ conscription (Pemberton, 2022). However, this raises critical ethical questions about the respect for the autonomy and dignity of the deceased and their families, as well as the fairness and equity of the organ allocation system. This assessment focuses on the ethical concerns surrounding the use of conscription organs and the importance of regulating the availability of donated organs.

Moral Concerns Related to Organ Conscription

Organ transplantation has the potential to save thousands of lives each year. However, due to the scarcity of available donor organs, many individuals are forced to wait on long waiting lists for years. In the US alone, there are currently over 100,000 people waiting for organ transplantation, and in 2021, over 33,000 organ transplants were performed. The most commonly transplanted organs in the US are kidneys, livers, hearts, lungs, and pancreas (American Transplant Foundation, 2019).

Organ conscription, or the procurement of organs from deceased individuals, has been proposed as a solution to this shortage of available donor organs. However, this procedure leads to several ethical issues regarding the dignity and consent of the deceased individual (Zambrano, 2023). Another issue is the potential for exploitation of vulnerable populations. Without proper safeguards and regulations, it is possible that individuals may be coerced or manipulated into consenting to organ donation. This raises questions about the validity of informed consent and the potential for unfairness in the distribution of donated organs. Conscripted organ procurement may be necessary to address the shortage of available organs for transplantation (Martínez-López et al., 2022). 

It is crucial to ensure that the policy is conducted ethically and that appropriate legal regulations and safeguards are in place to protect the well-being of an individual. However, if organ conscription is implemented, it must be done in a manner that is both ethical and respectful of the deceased (DeCamp et al., 2022).

Compare and Contrast Examples of Organ Donation Policy

When it comes to organ donation policies, there are various approaches that different countries adopt. One of the main ethical considerations is the balance between informed consent and patient autonomy. Informed consent is the process of obtaining explicit permission from patients before any transplantation takes place. Patient autonomy, on the other hand, refers to individuals’ rights to make decisions regarding their participation as a donor (Gogineni, 2022). In countries like the United States, organ donation is based on an opt-in system, where individuals must explicitly register their consent to become donors. In the US, healthcare providers must obtain informed consent from the patient or their family members before any transplantation can take place. The process of obtaining consent may be complex and involve discussions with the patient or their family members, as well as ensuring that the patient’s wishes are respected (Ahmad et al., 2019).

Questions about Fairness and Justness

Access to organ transplantation is crucial for individuals with organ failure in order to survive. However, the availability of organs is limited for transplantation, leading to disparities in access to organs and unjust allocation practices. In the US, there are no policies made for pre-death consent, and taking organs from the deceased can raise a number of ethical and moral issues. Some individuals may not have access to organ transplantation programs due to financial constraints or lack of information, which can create inequalities in access to life-saving procedures (Golden, 2022). Moreover, individuals requiring immediate transplantation may face lengthy evaluation processes and extended waitlists, which may be considered unjust. Thus, it is important to ensure that organ procurement and allocation are done in an ethical and equitable manner to promote fairness and justice for all individuals in need of organ transplantation.

Strategies for Increasing Public Acceptance

To address the scarcity of available organs for transplantation, increasing public acceptance of organ donation is crucial. Strategies to increase public acceptance include public education campaigns, community engagement, legislative approaches such as opt-out policies, donor registries, and encouraging families to discuss their wishes about organ donation. Public education campaigns can dispel myths and misconceptions, while community engagement can help build trust and address cultural or religious concerns (Lewis et al., 2020). Opt-out policies have been effective in some countries, and donor registries can provide a reliable source of information for healthcare providers and families. Encouraging families to discuss their wishes about organ donation can also increase acceptance and advocacy. A multi-faceted approach that incorporates these strategies can help to increase the number of available organs for transplantation, ultimately saving more lives (Delgado et al., 2019).

Significance of the Consent

The concept of consent is highly relevant and significant in the context of organ donation, as it is a critical ethical and legal requirement for the procurement of organs for transplantation. Consent refers to the voluntary and informed agreement by an individual to donate their organs after death. It is a fundamental principle of medical ethics and is essential for respecting individual autonomy and ensuring that an organ donation is a voluntary act (Madden et al., 2020). The United States has adopted a consent-based model for organ donation, which recognizes the inherent right of individuals to make decisions about their own physical being, even in death. This model upholds the ethical principles of autonomy and self-determination, which require healthcare providers to respect the wishes of patients and honor their agency (Childress, 2022).

Irrespective of the model utilized, the principle of autonomy remains paramount. This means that without consent from the individual, it is illegal and immoral to utilize their organs. The significance of consent regarding organ donation is crucial, as it reflects the ethical and legal frameworks that guide the field (Font et al., 2020). By adhering to the principles of autonomy and self-determination, healthcare providers can ensure that organ donation is conducted in a manner that is respectful and considerate of the patient’s needs and desires. Through these efforts, the field of organ donation can continue to make a positive impact on the lives of individuals in need of life-saving transplantation.

Consequences when Donor Consent is Absent

The absence of donor consent can lead to violations of individual autonomy and distress for family members. It can also create disparities in access to organ transplantation programs and raise concerns about justice (Hutchinson et al., 2019). In countries with presumed consent models, individuals who object to organ donation may be considered potential donors, causing further ethical dilemmas. Overall, the absence of donor consent can have significant consequences that impact individual autonomy, justice, and equity in organ donation programs.

Alternative Policies for Availability of Donor Organs

The shortage of available donor organs for transplantation is a major issue in the medical community. In the United States, some advocates have proposed revising laws and regulations related to organ donation in order to increase the supply of available organs. This would involve shifting the default position from requiring explicit consent from donors to allowing organ procurement unless individuals have explicitly opted out. Studies have shown that countries with presumed consent policies have higher rates of organ recovery and better patient outcomes (Steffel et al., 2019). Another proposed solution is to establish a market with financial incentives for organ donation. However, this proposal raises cultural and societal implications, as the sale of organs is prohibited in many countries and could create ethical concerns.

Public education campaigns are also crucial to increase the availability of donor organs. Educating individuals about the benefits of organ donation and addressing concerns about donation can increase participation rates. Additionally, some experts argue that improving the infrastructure for organ donation, including better communication between hospitals and organ procurement organizations, could increase the number of available organs (Purwaningsih, 2020). Overall, implementing new policies and educational efforts can help address the shortage of available donor organs for transplantation.

Consequences of Continued Donor Organ Shortages

The consequences of continued donor organ shortages are significant, with many individuals facing prolonged illness, reduced quality of life, and increased mortality rates. The absence of available organs exacerbates already existing health disparities and inequalities, disproportionately affecting underserved communities with limited access to healthcare.

This results in a reduction in overall societal productivity and contributes to increased healthcare costs due to prolonged hospital stays and treatments (Neizer et al., 2020). The desperation for organs also drives individuals towards the black market, where there is an inherent risk of transmitting infectious diseases and exploitation of vulnerable individuals. Additionally, those who cannot afford to seek alternative treatments or travel abroad for organ transplantation are left without viable options (Sunjaya, 2019). Therefore, it is imperative to find alternative solutions to increase organ availability, which include education campaigns, increased donor registration, and policy changes to improve the efficiency of organ procurement and transplantation.

Conclusion

In conclusion, while organ transplantation is a critical medical procedure that saves many lives every year, there is a significant shortage of available donor organs. Conscription organ procurement has been suggested as a potential solution, but this raises ethical concerns about the respect for the autonomy and dignity of the deceased and their families, as well as the fairness and equity of the organ allocation system.

Strategies to increase public acceptance of organ donation include public education campaigns, community engagement, legislative approaches such as opt-out policies, donor registries, and encouraging families to discuss their wishes about organ donation. Ultimately, it is crucial to ensure that organ procurement and allocation are conducted ethically and equitably to promote fairness and justice for all individuals in need of organ transplantation.

References

Ahmad, M. U., Hanna, A., Mohamed, A.-Z., Schlindwein, A., Pley, C., Bahner, I., Mhaskar, R., Pettigrew, G. J., & Jarmi, T. (2019). A systematic review of opt-out versus opt-in consent on deceased organ donation and transplantation (2006–2016). World Journal of Surgery, 43(12), 3161–3171. https://doi.org/10.1007/s00268-019-05118-4 

American Transplant Foundation. (2019). American transplant foundation. American transplant foundation. https://www.americantransplantfoundation.org/ 

Childress, J. F. (2022). Robert Veatch’s transplantation ethics: Obtaining and allocating organs from deceased persons. Theoretical Medicine and Bioethics. https://doi.org/10.1007/s11017-022-09574-3 

Costa-Font, J., Rudisill, C., & Salcher-Konrad, M. (2020). “Relative consent” or “presumed consent”? Organ donation attitudes and behaviour. The European Journal of Health Economics. https://doi.org/10.1007/s10198-020-01214-8 

DeCamp, M., Snyder Sulmasy, L., & Fins, J. J. (2022). Point: Does normothermic regional perfusion violate the ethical principles underlying organ procurement? Yes. Chest, 162(2), 288–290. https://doi.org/10.1016/j.chest.2022.03.012 

Delgado, J., Molina-Pérez, A., Shaw, D., & Rodríguez-Arias, D. (2019). The role of the family in deceased organ procurement: A guide for clinicians and policymakers. Transplantation, 103(5), e112–e118. https://doi.org/10.1097/tp.0000000000002622 

Gogineni, S. (2022). Organ procurement: An ethical analysis in relation to Emanuel and Emanuel’s four models. Etd.ohiolink.edu. https://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1652113520724472 

Golden, L. E. (2022). Considerations on the relationship between living organ donor and recipient. Transplant Psychiatry, 297–300. https://doi.org/10.1007/978-3-031-15052-4_39 

Hutchinson, E. F., Kramer, B., Billings, B. K., Brits, D. M., & Pather, N. (2019). The law, ethics and body donation: A tale of two bequeathal programs. Anatomical Sciences Education, 13(4), 512–519. https://doi.org/10.1002/ase.1922 

Lewis, A., Koukoura, A., Tsianos, G.-I., Gargavanis, A. A., Nielsen, A. A., & Vassiliadis, E. (2020). Organ donation in the US and Europe: The supply vs demand imbalance. Transplantation Reviews, 35(2), 100585. https://doi.org/10.1016/j.trre.2020.100585 

Madden, S., Collett, D., Walton, P., Empson, K., Forsythe, J., Ingham, A., Morgan, K., Murphy, P., Neuberger, J., & Gardiner, D. (2020). The effect on consent rates for deceased organ donation in Wales after the introduction of an opt‐out system. Anaesthesia, 75(9), 1146–1152. https://doi.org/10.1111/anae.15055 

Martínez-López, M. V., Díaz-Cobacho, G., Liedo, B., Rueda, J., & Molina-Pérez, A. (2022). Beyond the altruistic donor: Embedding solidarity in organ procurement policies. Philosophies, 7(5), 107. https://doi.org/10.3390/philosophies7050107 

PHI FPX 3200 Assessment 4 Robbing the Dead: Is Organ Conscription Ethical?

Neizer, H., Singh, G. B., Gupta, S., & Singh, S. K. (2020). Addressing donor-organ shortages using extended criteria in lung transplantation. Annals of Cardiothoracic Surgery, 9(1), 49–50. https://doi.org/10.21037/acs.2019.10.01 

Pemberton, D. (2022). Biographical lives and organ conscription. Theoretical Medicine and Bioethics, 44(1), 75–93. https://doi.org/10.1007/s11017-022-09603-1 

Purwaningsih, S. N. (2020, May 20). Organ transplant agreement between donor and recipient by notary. Www.atlantis-Press.com. https://doi.org/10.2991/aebmr.k.200513.119 

Steffel, M., Williams, E. F., & Tannenbaum, D. (2019). Does changing defaults save lives? Effects of presumed consent organ donation policies. Behavioral Science & Policy, 5(1), 68–88. https://doi.org/10.1353/bsp.2019.0005 

Sunjaya, A. F., & Sunjaya, A. P. (2019). Combating donor organ shortage: Organ care system prolonging organ storage time and improving the outcome of heart transplantations. Cardiovascular Therapeutics, 2019, 1–7. https://doi.org/10.1155/2019/9482797 

Zambrano, A. (2023). Organ conscription and greater needs. Cambridge Quarterly of Healthcare Ethics, 32(1), 123–133. https://doi.org/10.1017/S096318012200055X 673-020-09979-6 

PHI FPX 3200 Assessment 4 Robbing the Dead: Is Organ Conscription Ethical?