Understanding Organ Donation and Transplantation - Research Paper Example

? Organ Donation s Hundreds of people around the world die every single day because of unavailability of organs for organ transplantation. Major illnesses may cause major organs of the body to lose their function while accidents may also severely damage organs inhibiting them from serving the human body and in such cases it becomes immensely important to replace the organ with a new organ through transplantation surgery in order to make sure that the person survives. The organ used as a replacement in the surgery is donated by another human being known as the organ donor. The organ donor may be a cadaver or a live human being. The most important organs that are donated are kidneys, heart, liver, pancreas, lungs, bone marrow, skin and cornea. However, the procedure involved in donation of an organ or transplantation of an organ is never easy and is shrouded by a number of ethical dilemmas. These ethical dilemmas and unawareness about the need and nobility of organ donation makes procurement of organs a difficult task and therefore several issues need to be addressed to make organ donation a success. Understanding Organ Donation and Transplantation: The major cause for organ donation is its need for transplantation. Hospitals are filled with patients waiting for a matched organ since their own organs have failed to work owing to either illness or damaging accidents. Organ procurement for a patient itself is a very tough task since it is very important to find a donor whose organs will match that of the patient. The organs donated by a human or a cadaver are distributed to those in need and these new organs are then used to replace the old organs of the patients by transplantation procedure. Transplantation surgeries are very complex in nature and needs to be done intricately in order to assure that the new organ will function properly in the patient’s body. Once the surgery is completed it is the post-surgery time that is the most crucial time. After the organ is replaced it is expected that the body of the patient will accept and successfully integrate the new organ as its own without triggering any immunological response to the implanted foreign body. Now days, patients are given medicines known as immunosuppressant drugs which helps to suppress the body’s immune response against antigens. Once the body successfully integrates the new organs and the organs functions properly in its new body the procedure of organ donation and that of transplantation is deemed successful. Organ Donation- Who Donates Organs It is said that organs procured from a single body can save up to 10 lives and improve the life quality of many others. The most important donators of organs are cadavers. When people die on the road or at the hospital or are near to death and if they have agreed to become organ donors, minutes after the death time is ascertained the fresh organs are harvested and taken immediately for transplantation. Many a times, living people often become organ donors for example they may donate a kidney since it is known that a person has the ability to survive on one good kidney itself. Other organs that can be procured successfully from a living donor includes portion of lungs, intestines, pancreas and liver. However, the most important and perhaps the most talked about donors are the brain dead patients. They are deemed most important since most of their organs are fresh and functional. Brain dead patients are ones who do not have the ability to live by themselves and often survive with the help of ventilators. Most of these patients never recover from the brain dead stage and are deemed “dead” though in medical terms the heart of the patients still beats. THE ETHICAL DILEMMAS The most important issues surrounding the noble work of organ donation are the several ethical dilemmas that come with it. It is important to understand the very core of these problems and take necessary steps to mitigate them. However, there are several types of ethical dilemmas that shroud the matter of organ donation. Ethical problem- Organs from Brain Dead Patients In most countries brain dead patients are recognized as potential donors. In Germany for instance “the transplantation law (TPG) has been added. According to this law, every ventilated patient with diagnosed brain death is a potential organ donor” (Homme & Neeser,2002,p1291).Brain dead persons are those who have received a severe brain injury to the brain stem and have lost the functionality of the brain and brain stem reflexes. Brain dead people are one of the most important donors of organs. However, the first important ethical dilemma is difficulty is ascertaining that a person is really brain dead since a wrong decision by the physician may hamper the patient as well. There are several tests that physicians use to determine that the person is truly brain dead. Clinical examinations showing that the patient has no brain activity or reflex is done to determine that the patient has lost his/her capability of living on his/her own. Furthermore more clinical tests like cerebral angiogram or EEG are done to ascertain the stage. Since families of brain dead people play an important role in the procedure of organ donation it is important to make them understand that the patients is truly brain dead. A study conducted by Burroughs et al showed that most families do not support the decision of organ donation (Burroughs et al,1998,p156). There the process of gaining family consent is difficult since love and hope comes in the way because there have been instances when brain dead people are known to have “woken up” therefore, the families of brain dead people often hold on to the hope that the brain dead patient too might be able to recover from the brain damage and lead a normal life later on. In many cases the body of a brain dead person twitches of turns on their own which triggers hope among the family members however medically a muscular contractions of brain dead person are often responsible for this and these actions in no way mean that the person is not brain dead. Ethical problem- organs donation by Non-heart Beating Patients Organ procurement from non-heart beating patients also holds ethical problems of its own. Even though that NHBD (Non-heart beating organ donation) has the ability to raise the number of organs available for transplantation by up to 25% it is ethically controversial (Whetstine et al, 1992, p192). Both controlled and Un-controlled NHBD protocols are currently being followed in the U.S. and European countries. NHBD patients are not brain dead people but in most cases are cardiac patients who fail resuscitation attempts or who are taken off from life support systems. Once the life support is withdrawn, the patient becomes available for organ harvesting. Many experts deem this unethical since they believe that NHBD may trigger problems when the care givers would have to make the decision of withdrawing treatment. Another important problem associated with such organ donations is determining the period between life and death since in most cultures such interim time is not accepted or believed in. There is no way to determine or ascertain the number of “minutes” before organs can be harvested from a NHB patient. Many also believe that such patients are not really dead and are prematurely withdrawn from treatment or support for the sole reason of organ harvesting and transplantation. Ethical problem: Personal thoughts Voluntary donation forms a major part of the donation procedure however many of the donors face ethical concerns regarding the problem of organ donation since they are not fully aware of the facts involves. Some people believe that a positive decision of donating the organs will mean that the physicians would not take substantial care of the patients because they would become more concerned about harvesting organs. Some also have questions about what would happen to the organs after harvesting them. A major cause of concern among potential donors is whether or not they would be left disfigured after the invasive process of harvesting. Each of these personal ethical concerns is of immense importance at a personal level and thereby forms hindrance in the procedure for organ donation. Ethical problem: the organ distribution business There is a huge gap between demand and supply of organs especially organs such as kidneys. This has given rise to huge illegal businesses all around the world especially in poor or developing countries such as Bangladesh, Nepal, Indonesia, India, Myanmar etc. Trafficking of organs has become a booming business for many and many unsuspecting people fall victims. Tourist, prostitutes and children have often been drugged and surgery has been performed for the sole reason of procurement of kidneys from them. But this problem is not only of the poorer countries since most of these organs are sent to the U.S. and the European markets where buyers pay huge sums of money (Meyer, 2006, p17). Because of such malpractices and illegal business organ donation has lost its nobility and is often looked upon with suspicion. Ethical concern: The Religious viewpoint One of the most important barriers in the decision making of organ donation is the religious concern involved. The religious viewpoint “may be equally, or even more, important when live donation is discussed” (Oliver et al, 2010,p1). Most of these concerns surface since the people are not completely aware of what is allowed and what is prohibited by their respective religions. Most people have a notion that taking organs or giving organs to others is not accepted and may cause problems in the afterlife and many also believe that they may interfere with the circle of life and reincarnation notions. In fact most physicians stay away from such sensitive issues while discussing organ donation processes. Therefore, religious problem is a major setback but an equally important ethical concern. SOLVING THE PROBLEMS Organ donation is a very important work since donating organs has the ability to give life to more than just one person. However there is a huge considerable gap between the number of patients waiting for organs and the number of organs available to them for surgical purposes. The most important culprit for this is the ethical dilemma that individuals and their families face while making the important decision of donating organs for transplantation purposes. To me, these ethical problems even though they have firm standings and are highly sensitive maybe solved by spreading awareness and making people aware of the true medical facts. The most important step to solve the problem associated with organ donation is spreading awareness about the need of organs since it is important for people to understand that the right choice between giving second life to a patient and letting good organs decay in the ground. Individual cases need to be handled individually and with utmost care. Firstly, since most families are unsure about declaration of a brain dead family member it is important to first make then understand that a truly brain dead person rarely wakes up. The results for the tests must be explained to them carefully. It is also important to ensure that they understand that organ harvesting would in no way cause nay problem to the brain dead person since they have lost all brain activity of feelings and sensations. Secondly, in case of non heart beating patients it is important to make the family acquainted with the tests which determine  "irreversible cessation of circulatory and respiratory functions" or "irreversible cessation of all functions of the entire brain, including the brain stem" (Whetstine et al,1992, p193), where the patients who have not lost brain activity but have lost heart activity altogether are also deemed “dead” and in almost 100% cases these patients are irrecoverable from the this stage and eventually die. Personal ethical concerns are one of the major reasons as to why people stay away from organ donation. The sole way to tackle these ethical problems is to answer each and every question raised truly and with facts. This will help mitigate the anxiousness and suspicions involved and may enhance chances of organ donation. Illegal practices concerning organ donation also inhibits people from donating organs. Strict rules must be adopted and steps must be taken to stop this illegal business at a global level. An inter-governmental panel must be set up to ensure that all countries co-operated substantially in order to control the problem. The ethical concern associated with the religious problems of a patient is also important and needs to be addressed properly. A study of the major regions of the world Christianity, Hinduism, Sikhism, Buddhism etc will show that none of the religions have any problems neither with the process of organ donation nor with that of organ transplantation. The methods to mitigate and control the theological concerns of a potential donor is to make him acquainted with his own religion maybe with the help of a religious leader of the same religion and sect who may be able to explain to the donor the theological perspective of the matter at hand. Moreover, another way to enhance organ donation is by increasing incentives for donors. There is scope of such steps to become malpractices however severe stringent steps need to be there to identify potential and most importantly eligible donors only. This step needs to be included since may people might not have any ethical concern about organ donation or transplantation hut in spite of this tend to stay away from it because they do not see any personal gain in the matter. Since incentives would be portrayed as a personal gain people without any other ethical problems may also be expected to become potential donors as well thereby helping in reducing the gap between organs wanted and organ available. CONCLUSION Organ donation is a very important process since even with the scientific success in all field humans have no alternatives for organs and therefore have to rely on human organs itself for survival. The sole way to procure organs for survival is with the help and generosity of the organ donors. However, leaving the technical mechanism aside, most of the donor perspectives involve one or more than one ethical concerns. We have seen a number of ethical concerns ranging from personal ones, religious one and to ones where identification of potential donors becomes a concern itself. However, each of these concerns maybe controlled solely by spreading the awareness and sound knowledge about the concerns and personally answering the questions raised by individuals. This will help people understand the process of organ donation in a much better way and also get involved in the process of saving many more lives. REFERNCES Burroughs et al (1998). The stability of family decisions to consent or refuse organ donation: would you do it again? Psychosom Med, 60(2), 156-162. Homme, R., & Neeser, G. (2007). Organspende. Der Anaesthesist, 56(12), 1291-1303. Meyer, S. (2006). Traf? cking in Human Organs in Europe A Myth or an Actual Threat?European Journal of Crime, Criminal Law and Criminal Justice, 14(2), 208–229. Retrieved from http://mensenhandelao1112.wdfiles.com/local--files/verslagen/Silke%20Meyer%20-%20Trafficking%20in%20Human%20Organs%20in%20Europe.pdf Oliver et al (2010). Organ donation, transplantation and religion. Nephrol Dial Transplant, 1-8. Whetstine et al (2002). Pro/con ethics debate: is nonheart-beating organ donation ethically acceptable? critical care, 6(3), 192-195. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC137443/ Read More