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https://studentshare.org/law/1400574-the-ethical-way-forward-for-procurement-of-organs.
According to the Medical Conditions Dictionary (2010), organ procurement is a set of procedures that includes the administrative, authoritative, and ethical processes observed in the acquisition of organs for transplant via affiliations, systems, or programs. The organ procurement procedure refers to obtaining consent from the donors or their family and close relatives and the transportation of the organs harvested from the donor to the respective health centers for further medical processing and eventual transplant to the recipient. Organ procurement began as a basic endeavor when affiliations that specialized in kidney transplantation obtained organs and used them to save lives in the same facility. As the demand for organs grew and the transplantation of other organs, such as the heart, small intestines, pancreas, liver, and lungs, became successful in practice, the need to develop enhanced and ethical organ procurement, distribution, and sharing agreements became crucial (Mancini et al, 2010). Because of the high demand for organs for transplant in current times, numerous organizations, through the efforts of physicians, scholars, and medical personnel, have started attempting to counteract the acute shortage to avoid deaths. The ever-increasing shortage of organs requires society to decide on specific yielding policies on procurement. In many countries, like the US, procurement of organs requires the explicit consent of the donor before his or her death. This policy is known as an opting-in system or expressed consent. By this policy, if an individual aspires to donate his organs after death, he should express this consent by signing a donor card. Explicit consent is always considered the informed consent of prospective donors. This policy relies on the donor’s full agreement to donate the organ to make it legally valid. Some of the improvements in the medical field relating to organ transplants include tissue typing, computerized kidney-matching, educational programs regarding organ procurement, and government-controlled systems that control the procedures of organ donors (Mancini et al, 2010).
The procurement procedure is a process that involves the initial identification of brain-dead givers. The authorized physician conducts this practice. Hospital guidelines and the laws of the state need to be followed in the determination of brain-dead patients. In every case of donation, after brain death, one will have to acquire consent by other means than expressed consent. Legally valid forms of consent for organ donation, in the case of a deceased patient, are delineated in the Human Tissue Authority Code of Practice, which include:
- A listing on the organ donor registers (ODR);
- Consent from a nominated delegate on behalf of the patient by prior agreement;
- Prior view of the witnessed statements of the prospective donor, generally by an individual who is an eligible relative;
- Where the desires of the patient are unidentified or cannot be established, consent or refusal from the individual(s) in an eligible relationship should be acquired.
“The shortage of deceased donors has resulted in an increased interest in living donation, but it must be noted that living donation of a kidney is associated with a risk of death to the donor of about 1 in 3,000, whilst living liver donation (adult to adult) carries a risk of death to the donor of up to 1 in 100” (Organs for Transplants A report from the organ Donation Taskforce, 2008).
The patients stay under ventilator machines while physicians conduct further procedures on them. On completion of verification of brain death, the procurement body gives guidelines and details of what needs to be done before transplantation. The main purpose is to allow discussion with the family of the deceased regarding the procurement of tissues or organs for further transplantation. (Hanto, et al, 2005).
Procurement body consultation augments consent by the concerned families, regarding willingness to authorize the donation of their relatives’ organs and tissues. Then the procedure of organ matching occurs. It requires diagnosis and processes that validate the successful transplantation of organs from the donor to the recipient. Careful removal of the organs is imperative in the surgical units; the donor receives the same treatment as people whose brains are alive. Another debatable issue is the eventual step in organ procurement before transplantation to the terminal patient. Since numerous patients are waiting for the transplantation with the procured organ, various schemes apply in the determination of the suitable recipient. (Mary, et al. 2010) postulates that factors such as waiting list time, illness severity, and proximity to the donor center will help to calculate the patient score: the one with the highest score qualifies for transplantation. The allocation system is, however, different from organ to organ, regarding the ischemic time for that given organ. ...Download file to see next pages Read More