Organ Transplantation

Last year was a milestone in organ transplantation. We celebrated 50 years in 2004, a Golden Anniversary of a Golden Age of utilitarianism. In today's transplant society, parts of organs, including kidneys and livers from healthy people, surpassed the number of transplanted organs obtained from so-called "cadavers".

 

In 2004 another ethical debate surfaced. Issues involving organ transplant came to the surface. In fact, the prestigious Kennedy Institute Journal of Ethics, devoted an entire issue involving, "Is the donor really dead?" Some ethicists suggested, expanding donation beyond brain death and non-heart beating organ donation (NHBD). By redefining death and/or providing exceptions to the dead donor rule. One ethicist said, "a patient, while still competent, may choose to have organs removed prior to death, through an advanced directive."

 

Ethicists cited an Ohio poll, which showed public confusion over the terms, "brain death", "vegetative state" and "coma" describing a living or dead person, as an opportunity to change the rules about organ donation. Some ethicists say that the public is not greatly concerned about brain-death issues. In fact, most of the public does not know anything at all about non-heart beating organ donation, where a person is declared hopelessly ill, but not brain dead, and has his or her life-support removed. When (or if) the heart stops, organs are removed for transplantation.

 

Because the demand for organs exceeds the supply, many ethicists and transplant experts are trying to develop new ways of increasing organ donation, usually, almost always without public input or awareness. In fact, the controversial issue of NHBD was developed in the early 1990's, to allow families or even conscious people on ventilators to withdraw life-support, so that organs can be harvested if or when the heartbeat stops, without a diagnosis of brain death. I would wager, most people are not aware of this. 

 

Strategies are being developed, to increase organ donation rules requiring a patient or family consent for organ donation,  to "presume consent", which legally assumes that everyone is willing to be an organ donor, unless they have documented objections.

 

Illinois has a 1st donor consent law passed January 1, 2010. This law requires that organ donation is acceptable, if the person has signed the back of their driver's license. It eliminates consent issues from family members.

 

The prestigious journal Critical Care Medicine, published an article by Drs. Robert D. Troug and Walter M. Robinson in which they stated, "We propose that individuals who desire to donate their organs, and who are either neurologically devastated or imminently dying, should be allowed to donate their organs, without first being declared dead".

  
As you can see there are many ethical dilemmas in organ donation, including, "is the donor really dead?" More will follow