Running head: ROBBING THE DEAD: IS ORGAN CONSCRIPTION ETHICAL?

Robbing the Dead: Is Organ Conscription Ethical

Daphnee Newton

Capella University
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Abstract

Clinical organ transplantation has been recognized as one of the greatest medical advances of the

century. It’s a way of giving the gift of life to people who have terminal failure of vital organs

which requires the donation of others living or deceased to save their lives. The increasing need

of vital organ failure and the inadequate supply of organs, especially from cadavers, has created

a huge gap between organ supply and organ demand, which results in a long wait time to receive

an organ as well as an increasing number of deaths while waiting.

ROBBING THE DEAD: IS ORGAN CONSCRIPTION ETHICAL? 3

Robbing the Dead: Is Organ Conscription Ethical

The long wait times for organs has raised many ethical, moral and societal issues

regarding supply, the methods of organ allocation, the use of living donors as volunteers

including minors and those who are incarcerated. These issues have led to the practice of organ

sale by entrepreneurs for financial gains in some parts the world through exploitation of the poor,

for the benefit of the wealthy. The need for such organs have also lead to black market organs

through violence, threat of violence, kidnapping to steal the needed organs, and even death.

The advances in immunology and tissue engineering, the use of animal organs,

xenotransplantation, offers promising solutions to many of these problems, they do however

raise additional ethical and medical issues which have to be considered by medical profession as

well as society. The medical profession and society must review the ethical and moral issues as it

relates to the problem of organ supply versus organ demand and the appropriate allocation of

available organs. It deals with the risks and benefits of organ donation from living donors, the

appropriate and acceptable methods to increase organ donation from the deceased through the

adoption of the principle of 'presumed consent', the right methods of providing acceptable

appreciation and compensation for the family of the deceased.

Another issue to review deals with the appropriate and ethically acceptable way of

utilizing stem cells for transplantation from adult versus fetal donors, tissue engineering and the

use of organs from animals. There is much research and data in support of organ and tissue

transplantation which states that the it can be more beneficial and lifesaving if everyone involved

in the process, including physicians and medical institutions, respect and consider the best

interests of the patients, as well as honor the ethical, moral and religious values of society.
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The quality of medical care for individuals suffering from organ failure is better today

than it was when the first organ transplantation was performed. Diseases that were once a death

sentence or that left afflicted individuals with little hope of regaining normal function are now

routinely treated. When it comes to organ failure we can do more and we can help more people

than ever before both extending and improving life for the afflicted.

The waiting list and waiting time for organs have increased so transplant centers

especially those in large urban areas have relaxed the criteria of donor eligibility choosing to use

organs from donors who are older or sicker, including drug users and those with infectious

diseases. People who get organs today are in some cases sicker than people who got organs in

the past. There is not enough adequate data on the differential outcomes of using such extended

criteria organs.

There are laws, policies, and procedures in place to prevent illegal, unethical, and

dangerous organ procurement. The laws are in place to protect the rights of the recipients and

the organ receivers. The first policy is aimed to ensure that all deceased donors are truly dead.

There is a clear criteria for discerning when death has occurred guided by brain death and thus

the policy and law further states that the medical professional who pronounces a patient dead

should not be the physician who procures the organs. Donor consent along with respect for

family is another policy aimed to ensure that organs are only procured with the explicit prior

consent of donors and/or their surviving family members. Another law/ policy is allocation by

justice and love which aims to establish a fair system of allocating organs procured from the

deceased. This takes into account a range of factors such as the amount of time spent on the

waiting list, the compatibility of organ donor and organ recipient, the urgency of a patient's
ROBBING THE DEAD: IS ORGAN CONSCRIPTION ETHICAL? 5

medical condition, the likely benefits to be gained by the patient from receiving an organ

transplantation, and the age of the potential recipient.

The very best possible outcome that can take place in the next few years would be a way

of washing the organs clean of all immunoglobulins and stripping them of all the donors DNA, if

that could be done any organ could go into any person without a cross-match and without fear of

organ rejection or the need for lifelong immunosuppressant drugs. This is evidence by infants

less than 6 months old have no established immune system so when these children are in need of

a transplant they can receive an organ from any other child without rejection and without lifelong

drug therapy. If this could be done on a greater scale the need for black market organs would no

longer be a threat and manner of the moral and ethical concerns would no longer exist.
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References

American Nurses Association, Code of Ethics for Nurses with Interpretive Statements,

Washington, D.C.: American Nurses Publishing, 2001

Aulisio, M. P., Moore, J., Blanchard, M., Bailey, M., & Smith, D. (2009).

Institute of Medicine, Organ Donation: Opportunities for Action (The National Academies

Press, Washington, DC 2006).

Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let's at least

talk about it. American Journal of Kidney Disease, 39(3), 611–615.

www.who.int/mediacentre/news/statements/201