Organ donation problem essay

Once consent is given, an organ is removed and transplanted into the patient with a few hours. It cannot be stored. Living donors can donate parts such as one of their kidneys or parts of a liver, a pancreas or intestines. A deceased person can donate the above organs and organs, heart, liver and pancreas.

Other body parts that can be donated include tissues such as the skin and bone marrow, and blood and platelets.

Organ Donation Facts & Info | Organ Transplants | Cleveland Clinic

Organ donation is a very beneficial process. A person who is about to die because of organ failure is able to get a second chance at life due to the organ transplant. Some of the organs that assist in saving lives are the heart and the liver.

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Another benefit with organ donation is in relation to the furthering of medicine through research. Some people donate their organs, as they approach their death, to medical institutions for purposes of research. With that research, experiments carried out help in finding new and better ways of treating conditions such as diabetes and cancer. A person who receives an organ for transplant usually gets a second chance at life. In effect, for Titmuss, voluntary blood donation was held to reflect important ethical and socio-cultural norms.

It should be noted that in Titmuss thesis, a clear line is drawn between society and the market. Markets are represented as arenas in which the exchange of goods and services takes place in an impersonal, self-interested and amoral manner, with the ultimate goal that of profit maximisation. This is contrasted with voluntary blood donation systems that are characterised by the moral nature of their transactions, which bring about and maintain personal relationships between individuals and groups. Titmuss was especially clear and emphatic where it came to the considered social importance of the gift and necessity of ensuring that blood should not be treated as a commercial commodity.

As he saw it, a voluntary system based on the gift brings out the best in people; it fosters the individual expression of altruism and regard for the needs of others. Titmuss work has been hugely influential. On its original publication in The Gift Relationship provoked substantial debate regarding the relative qualities and worth of voluntary unpaid and paid blood and organ donation systems, a debate that continues to this day.

It has also contributed to the gift of life s having become the dominant organising principle and doctrine for a majority of the world s blood and organ donation systems. Blood and organ donation is considered an altruistic act in most countries, with legislation in these countries including Australia outlawing any material benefit for donation. In Australia s case, the gift of life doctrine is clearly expressed in and underpins the principles that guide the clinical sector and community awareness and education activities.

Information provided to the Australian community by the organ donation sector, awareness campaigns, and clinical and ethical guidelines make constant reference to the gift of life doctrine as the basis for current practice. For example, the ANZICS guidelines, Statement on Death and Organ Donation , state that current practice is based on the donation of organs and tissues as being an unconditional altruistic, non-commercial act.

They state that donation of organs and tissues is an act of altruism and human solidarity that potentially benefits those in medical need and society as a whole. Thus, voluntary blood and organ donation has come to be viewed as a selfless and altruistic act, and one that should not be compelled in any way. As such, the act has been associated with strong moral connotations. This poses a number of problems, as outlined below.

Organ donation is not necessarily an heroic act; nor is it necessarily a moral act. People do not always or entirely donate their organs for selfless or altruistic reasons. For example, Siminoff and Chillag found that families of deceased donors often regard organ donation as a way of giving meaning to the death or of allowing the person to live on in others.

The Institute of Medicine of the National Academies argues that the motives of organ donors are no less complex than those of regular gift givers. These, the Institute contends, may reflect a combination of generosity, perceived obligation, and a desire to be regarded with favour. Indeed, Titmuss himself acknowledged that blood donors give their blood for a variety of different reasons:.

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No donor type can, of course, be said to be characterised by complete, disinterested, spontaneous altruism. There must be some sense of obligation, approval and interest; some awareness of need and of the purposes of the blood gift; perhaps some organised group rivalry in generosity; some knowledge that fellow-members of the community who are young or old or sick cannot donate, and some expectation and assurance that a return gift may be needed and received at some future time. To donate , Titmuss notes, is to give implying an altruistic motive. All this is not to suggest that altruism plays no role in people s decision whether or not to donate their organs; clearly it does, to a greater or lesser degree.

It is, instead, to point out that it is mistaken on empirical grounds to base a donation or gift system entirely in altruism and morality. While flattering, such a position presents neither an accurate nor a complete picture of the phenomenon the act itself. At the same time, a romanticised view of organ donation and human nature, and an insistence on pure altruism and voluntarism in donation also represents a poor starting point for policy-making.

Arguably, a far more realistic and effective approach is to institute a system that accounts for the widest possible range of motives for donation, while not compromising people s ability to make ethical choices in donation. Much of the logic behind such a policy approach has been clearly expressed by London School of Economics economist, Julian Le Grand.

Challenges in Organ Transplantation

Julian Le Grand argues that the post-war system of social security in the UK was based on certain assumptions concerning human motivation and behaviour. Crudely speaking, UK policy makers Democratic Socialists, in the main constructed the welfare system based on the implicit assumption that the state and its agents were, along with tax payers, selfless altruists, or knights. Individuals in receipt of welfare benefits, on the other hand, were assumed to be essentially passive recipients of state largesse, or pawns.

All of these assumptions were subsequently challenged, as it became increasingly apparent that welfare recipients were not happy with the low variety and level of services with which they were provided; that public officials and professionals were, respectively, not necessarily operating in the public interest or with only the welfare of their clients in mind; and, that those paying for welfare were typically resistant to this redistribution.

Thus, according to Le Grand, welfare recipients could not be said to have been pawns, or public officials, professionals and taxpayers, knights. There were found to be elements of the knight selfless altruism and knave self-interest in each of these players and their actions. It is difficult, if not impossible, to determine in most instances whether people will behave as knights, knaves or indeed in some more complex fashion. In such a situation of ignorance concerning human motivation, and bearing in mind that grounding social policy on a knight-, knave- or pawn-based strategy could have disastrous results turning knights into knaves, for example , Le Grand advocates the adoption of what he terms robust strategies : strategies or institutions that are robust to whatever assumption is made about human motivation.

Consistent with this argument, and with the evidence outlined above, organ donors and potential donors should not be viewed simply as altruistic and selfless knights. Nor should they simply be understood as knaves as calculating or economic agents who donate, or who would donate, largely out of self-interest. Rather, in policy terms, arguably it is best to hedge one s bets and conceive of donors and potential donors as knights and knaves to posit the coexistence of social commitment and self-interest.

Instead of being understood and treated primarily as selfless altruists, as is the case under current arrangements, donors and would-be donors would need to be understood and treated in neutral terms where it comes to their motivation and behaviour; they would need to be treated, first and foremost, as rational, autonomous decision-makers. This would be to recognise that many organ donors donate their organs simply because they have thought about it and consider it a sensible and necessary thing to do.

Such a move would also be to bring Australia s organ donation system in line with most of the nation s other public institutions including citizenship which are premised on the assumption of a rational, autonomous decision-maker. It should be noted that treating people as rational, autonomous decision-makers need not necessarily mean that they are acting as such in the context of organ donation. Personal beliefs mystical thinking, ancient fears and non-rational responses figure more or less prominently in people s decisions about whether or not to donate their organs, or to allow their relatives to donate.

Nevertheless, it is necessary to treat people as rational, autonomous decision-makers. Perhaps the most important reason for doing so is that this encourages people to behave as active and responsible citizens. This is a generic good and one that is independent of specific policy considerations, such as how to increase rates of organ donation.

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With regard to organ donation, people need to be treated as rational, autonomous decision-makers: firstly, for the reasons discussed above and throughout the remainder of this paper; secondly, because there is evidence that personal beliefs can be counterbalanced by rational arguments and the presentation of factual information; and, thirdly, because the provision of factual information and the full range of relevant issues is necessary to ensure informed consent on the part of donors. Thinking about the act of organ donation in such terms is not only a more accurate rendering of the situation, but also one that would be likely to increase rates of organ donation in the long-term, through appropriate institutional and cultural change.

At the very least, it would result in more meaningful and productive policy debates. Re-casting organ donation to view the act of donation as one of rational utilitarianism rather than of selfless altruism would have a number of implications for Australia s organ donation system as it currently stands. These implications are briefly discussed below. As noted above, the National Clinical Taskforce on Organ and Tissue Donation argued in its report that Australia s opt-in system is fairer and gives people more of a choice than does the alternative opt-out or presumed consent system.

This position has parallels with the notion that people should not be forced into making moral decisions, a notion that is central to the gift doctrine. Rather, they should arrive at decisions such as whether or not they wish to donate their organs in an entirely un-coerced manner. Under a system dominated by the gift doctrine, their assumed altruism must not be compromised. However, where the would-be donor is assumed to be a rational, autonomous decision-maker, and the act of donation viewed as being not necessarily a moral one, there is no real impediment to obliging people to make such decisions.

The point is that they would need to think about the question of organ donation, and to make a commitment, one way or the other. This requirement is not unlike a number of other obligations currently placed upon Australian citizens. It is merely a matter of reciprocal or mutual obligation for people who may in the future need to draw on the pool of available organs. Treating organ donors as rational, autonomous decision-makers would be to empower them and recipients in several important ways.

Firstly, all organ donation system-related processes, including those associated with equity of access and fairness in the allocation of organs would need to be made genuinely transparent. This would be a necessary prerequisite in order for people to give their informed consent to donate under an opt-out system, rather than a focus on appeals to people s altruism, as is currently the case.

At present, the emphasis is placed on education and awareness campaigns to increase knowledge of and support for organ donation in Australia. But this is not the same thing as providing information on and engaging potential donors in all aspects of donation and allocation processes. It should be noted that much of the lack of transparency evident in Australia s current transplant sector is a result of variations in the processes used for different organs as well as differences between the states and territories.

The Taskforce has recognised this problem and acknowledges the need for increased transparency, as well as for the need to involve consumers and the wider community in the policy development process around organ allocation. The Taskforce has recommended the development of national waiting list criteria and allocation protocols, algorithms and processes. It has indicated that these must be seen to be transparent, equitable and must appropriately address the associated ethical, social and value concerns. While the Taskforce has flagged the need for greater community involvement in the consideration of such issues so as to better inform policy, protocol and criteria development, it did not consider the possibility of further donor involvement in the transplant sector.

More specifically, it did not consider the possibility of directed donation for deceased organ donors as well as for living organ donors. This would be to give donors themselves more of a say in how and where their organs are used. At present, only living organ donation can be directed as well as non-directed. Where directed donation occurs, a donor agrees to donate to an identified recipient, usually a relative or friend. The question is, why is the option of directed organ donation not made available to deceased organ donors?

The Taskforce notes that the allocation of organs is a complex process that entails the consideration of factors such as medical need, urgency and capacity to benefit.

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It should be noted that were conditions to be applied to organ donation, this could potentially lead to wastage of organs and increased administrative complexity. Nevertheless, this possibility should not discount consideration of the option. The problem with the directed organ donation option, of course, is that it introduces the possibility that donors could exercise discrimination in their choice of to whom their organ or organs should be allocated. In the worst case scenario, such an option would allow people to give vent to their biases and personal preferences at the expense of certain groups and individuals.

To illustrate, given that donated organs are a scarce community resource, a healthy-living organ donor may object to their organs being allocated to somebody who is affected by lifestyle diseases , rather than to somebody who is viewed as being in need of a transplant through no fault of their own. The hypothetical donor may reason that to donate an organ to somebody who leads a less-than-healthy lifestyle would be to waste a precious resource. Alternatively, deceased donors could indicate that they are happy for their organs to be allocated on an entirely non-directed basis, as is currently the case. According to the gift doctrine, donors give their organs in a selfless, altruistic and egalitarian manner.