Ethics of the Sale of Body Parts - Report Example

Ethics of the Sale of Body Parts April 22, Introduction Organ donation is often a the last opportunity an individual has for survival. Organs that are currently able to be donated include kidneys, liver, heart, lungs, pancreas, and intestines. Many tissues are also able to be donated such as the cornea, connective tissues, bone marrow and heart valves (Organ Donation, 2004). Advancements are made in the field of organ donation at a rapid pace; expanding or improving the quality of life for many. Becoming an organ donor is very simple as it is a choice offered when registering to vote, getting or renewing a driver’s license or ID card or placing this in your living will in most states. Laws pertaining to organ donation have been created in order to make the process one which does not discriminate and one which is available to all patients meeting specific health criteria rather than socio-economic status, ethnicity, or gender. Current Laws and Policy Regarding Organ Donation Unfortunately the supply of available organ us far from meeting current demands. It is estimated that over 90,000 people are on waiting lists and many have sought new and creative initiatives in order to increase the supply of organs (Georgetown Edu,2012). This field is still one of the most regulated fields in medical care. While there are federal laws there are also state laws which may be more specific or defining in policy. Those facilities who perform transplants are members or the Organ Procurement Organization and as such have standards and policy which must be followed. Facilities which participate are considered a ‘host’ and are responsible for properly identifying, maintain and evaluating donors (HRSA, 2012). Authorization must be obtained and the organ mist be properly handled to ensure it remains viable. In evaluating potential donors death must be pronounced and the donors medical history must be screened for factors that would affect the function of the organ. There are very specific screening procedures for each organ or tissue which rules out many potential donors. Host facilities must participate in the sharing of the waiting list of candidates for organ transplant. Referrals must come from specialty units and those placed on the waiting list are screened and rated with a priority. In order to prevent preferential treatment organs which are procured from transplant must be handled by a facility other than the one where the organ is to be received. Those who are non-citizens of the United States may also be referred for organ transplant. Policy prevent discrimination and in these cases adherence to policy preventing discrimination are to be followed. All potential donors a panel of tests are administered which include information such as electrolytes, serological testing, hepatitis screening, chest x-rays and numerous more. Each organ or tissue has more specified and specialized screening processes. Kidney donations must meet a defined matrix which includes factors such as age and creatinine. A history of hypertension will be evaluated and the cause of death must also be considered carefully. Blood types must match when transplanting kidneys and those with a zero-antigen match are usually selected first from the pool of candidates as they are less likely to experience total organ rejection. Information such as this is shared within Unet which is a compilation of all donors on the waiting list. Kidneys are one of the most transplanted organs with high success rates (HRSA-2, 2012).Kidneys are shared first to the most suitable local matches; if there are none then regions are defined which are next allocated the kidney; if a recipient is not found with the region a match is sough nationally. Liver transplant patients are scored with a different system weighs their mortality risk against the medical urgency of their condition. Candidates are assigned a status with points given for factors such as creatinine, bilirubin, age, stage of liver failure, renal failure and Glasgow coma stages and described as status 1A or IB (HRSA-3,2012). Other consideration in liver transplantation is social activities or drug use, sepsis and the standard panel of testing. A liver recipient is much less likely than that of a kidney recipient to locate an appropriate match donor. It is an important point to mention that one with liver failure may be less able to survive the transplant or accept the organ without total organ rejection. The pancreas allocation policy has many of the same testing procedures however unlike other organs BMI plays a crucial role in waiting list placement. Pancreas and kidneys are often transplanted together with many patient’s being diabetic or pancreas’s which do not function as they should. The thoracic organs which include the heart, lungs or a combination are allocated locally first. Candidates must meet one of numerous criteria such as total artificial heart with pediatric patients also meeting certain requirements such as being on a ventilator (HRSA-4, 2012). Depending upon the diagnosis it will be decided where your placement will be on the waiting list and how likely you are to receive a transplant in time. Obtaining a Kidney Transplant After you have gone through the extensive testing procedures to determine your ability to survive a transplant as well been cross matched to determine your suitability you will be placed on the national transplant list though local matching recipients are chosen first. Once a suitable donor has been found you will need to get to the facility as quickly as possible to prepare for surgery. Your health information will be taken as well as insurance information as transplantation is very costly though it is covered by state programs such as Medicaid and Medicare. Insurance companies may have their own guidelines for deciding organ transplant is a necessary procedure and you be expected to pay large co-payments in some cases. While you are waiting for you donation it is important to follow the prescribed health regiment of your health care team. This may include weekly blood work, restrictive diets, medications, activity or the avoidance of activity, dialysis, and any other prescribed maintenance therapy necessary to remain as healthy and strong as possible in order to tolerate the transplant. Possible complications those associated with any surgery involving anesthetic and also that your body will reject the organ completely despite the anti-rejections drugs you will be placed on immediately. Recovery time varies though a patient is generally able to go home in a few days though they may still have a drain inserted. Full recovery should be expected around 6 weeks. Depending on blood type average waiting time is 3 to 5 years. The list is in the order of waiting time, tissue type and blood type (Kidney Link, 2013). Obtaining a Liver Transplant The process of obtaining a liver transplant may be very different than that of obtaining a kidney. Generally these patients have less chance of finding a matching organ before their disease has made them unsuitable and unlikely to survive donation. While these recipients are on the waiting list according to status priority is given to the closest match in the local area considered the highest priority while still being strong enough for such a major surgery. This can be somewhat difficult to determine and maintain at times. These patients may tend to be hospitalized more with electrolyte imbalances, portal hypertension, elevated ammonia level and all of the symptom’s which accompany liver failure up to the point of kidney failure when the patient is considered no longer suitable for transplant. Once multiple organs began shutting down it is not likely a transplant will be performed. Though when a transplant is found the wait time is relatively short, some as short as a few months to a year mortality is high because of the low availability of these organs. The patient can expect a much longer recovery time and a higher chance of organ rejection. The patient will need to be vigilant in their medication regimen before and after transplant and avoid all risky behaviors. Case for Finding an Organ on the Black Market As an individual struggling to survive it would be a difficult decision not to make every attempt possible if it were affordable. Though not ethical on the part of the physician or medical team in the exchange or organs for sale it is more ethical for one whose time is running out. The benefits of this are guaranteed availability due to your financial status and ability to pay. This is extremely unethical from the viewpoint of theirs who are on the waiting list and may be in more critical condition that you who feel that had they had the finances they too could survive. It is a sad situation to contemplate. Case Against Finding an Organ on the Black Market Finding an organ on the black market means the rigid procedures and policy put in place to protect the patient are no longer guaranteed. If the medical team is willing to sale an organ to the highest bidder is it not possible they are also willing to transplant a hepatitis positive liver or kidneys that are not an appropriate match? If they are not following the standards written by the United States Department of Health then there is no way to trust that they are following any similar policies when it comes to your health. In other countries this is more common and actual medical centers perform these procedures and one thing to consider is that their standards are already different than ours. I would want to investigate their transplant policy and ensure physicians were trained physicians. If a major or crucial mistake is made such as in the matching or transplanting a diseased organ what recourse do you have? Costs to be considered would be travels expenses and those expenses related to staying in a foreign destination until you are recovered. The chances of finding an organ sooner if you are able to pay for it be beneficial in kidneys though liver transplants for sale are likely much more expensive and unlikely because of their lack of availability. It is very unlikely that a match who is also looking on the black market matches a donor and is healthy enough to travel abroad where organ sales are more common. References’ Organ donation; (2004). Postgraduate Medicine, 115(1), 67-67. Georgetown Edu. (2012). PCBE: Organ Donation Policy. PCBE: Organ Donation Policy. Retrieved April 22, 2013, from http://bioethics.georgetown.edu/pcbe/background/crowepaper.html HRSA. (2012, September). Minimum Procurement Standards For An Organ Procurement Organization. US Department of Health and Human Services. Retrieved April 22, 2013, from http://optn.transplant.hrsa.gov/PoliciesandBylaws2/policies/pdfs/policy_2.pdf HRSA-2. (2012, September). Allocation Of Deceased Kidneys. US Department of Health and Human Services. Retrieved April 22, 2013, from http://optn.transplant.hrsa.gov/PoliciesandBylaws2/policies/pdfs/policy_7.pdf HRSA-3. (2012). Allocation Of Livers. US Department of Health and Human Services. Retrieved April 22, 2013, from http://optn.transplant.hrsa.gov/PoliciesandBylaws2/policies/pdfs/policy_8.pdf HRSA-4. (2012). ALLOCATION OF THORACIC ORGANS. US Department of Health and Human Services. Retrieved April 22, 2013, from http://optn.transplant.hrsa.gov/PoliciesandBylaws2/policies/pdfs/policy_9.pdf Kidney Link. (2013). The Waiting List. The Waiting List. Retrieved April 22, 2013, from http://www.kidneylink.org/TheWaitingList.aspx Read More