Clinical Organ Donation and Transplantation - Essay Example

Organ Donation Name Institution Date Table of Contents Table of Contents 2 Introduction 3 Ethical, social and legal issues in organ donation by cadavers 3 Ethical, social and legal issues in organ donation by living donors 5 Ethical, legal and social issues in organ donation in the UAE 8 Conclusion 11 References 12 Introduction Clinical organ donation and transplantation has been identified as a gripping medical advancement of century as it offers a means of providing the gift of living to people having terminal failure of crucial organs, which needs the involvement of other human beings and society through donating organs from living or deceased individuals. The expanding event of vital organ failure along with the insufficient supply of these organs, particularly from cadavers has generated a huge gap amid organ demand and organ supply , which ahs led to long waiting times to get an organ , along with an increasing rate of deaths whilst waiting. These incidents have raised numerous ethical, societal and moral issues concerning supply, the schemes of organ allocation and utilization of living organ donors as volunteers. Organ transplant surgery is one of the outmost accomplishments in medical science (Price, 2001). Individuals with failing or non functional organs and are doomed to encounter death can now be offered a novel lease on life through the kindness of organ donors who are willing to offer part of their individual bodies to enhance or save the lives of other people. Nevertheless, there are several ethical, social and legal issues and controversies pertaining to organ donation. This paper looks at ethical, social and legal issues concerning organ donation and their implications in the UAE context. Ethical, social and legal issues in organ donation by cadavers There is a high need for human organ donation and transplantation. In the real sense, the demand surpasses the supply of transplantable human organs. This discrepancy has promulgated legislation and these laws tries to control the scant resource and to assist establish an evenhanded national scheme to allocate organs where they are capable of doing the most good. Veatch (2003) argues that there exists an extensive state and federal ideas of controlling tissue and organ donation and transplantation. These regulations and laws have been promulgated in order to address a wide range of issues, entailing complicated legal, moral and medical issues involved in the process of donation and transplantation of organs. One of the key issues tackles the massive demand for organs in the context of insufficient supply of functional organs. These legislations are usually viewed by medical professions, lawmakers as well as the general population as a means of ensuring that the most impartial distribution of organs. Nevertheless, the several regulations and laws regulating organ donation can complicate the procedure of attaining organs. Subsequently, individuals with queries on organ transplantation or donation are required to look for advice from a knowledgeable attorney on this field of law (Veatch, 2003). According to Potts and Evans (2005), there are numerous reasons for shortage of human organs for transplantation. Possibly the most universal reason for organ shortage is that individuals are diffident to donate organs. The other reasons are that physicians might ignore to enquire of members of a family whether they would approve to donation of organs when a relative dies. In other incidents, the wishes of the departed to donate her or his organs might not be acknowledged by people who are in a position to act upon these wishes. Lastly, members of the family might object removal of organs from their deceased relatives, in spite of the departed’s wishes or intent to the contrary. Potts and Evans (2005) note that several state and federal statutes closely control organ donation. Therefore, in order to obtain an organ for donation, medical practitioners as well as the society must have an understanding of the regulations and laws governing organ donation and also understand the course of majority of the key significant legislation. Numerous states have promulgated laws that deduce consent of the decent to give tissues or organs in particular limited situations. These rules are very restrained in scope. Bosek (2006) argues that in spite of these legal provisions, the excellent way of ensuring that the tissues or organs of a person will be donated for transplantation after his demise is to let his relatives be discerning his will to donate. This is particularly proper when one believes that medical practitioners heavily depend on the desires of the relatives when making decisions on whether to remove useful organs. Healthy living individuals might donate renewable tissues such ass platelets, blood, sperm or plasma and others that are non essential to the health of the donor such as eggs. Nevertheless, an individual might not donate organs essential for sustaining the life of the donor such as heart, lungs or liver. Wilkinson (2007) argues that there are two majoe ways through which a person can let other people know on one’s pronouncement to donate an organ. An individual can fill an organ donor card or execute a durable power of the attorney for the medical care, or a living will with details on the kind of care the person would wish to be given prior to death. This document is also supposed to offer particular instructions for disposition of the body of the person after death, entailing donation of organs. By doing so, a person is legally eligible to donate an organ. Ethical, social and legal issues in organ donation by living donors Majority of organs from transplant are obtained from cadavers, but this source have not succeed in meeting the expanding requirement for organs for organs and therefore attention have shifted to organ donation from living donors. According to McSteen and Peden-McAlpine, (2006), donation of organ by living donors has a distinctive dilemma because physicians should put the life of a healthy person into risk in order to improve or save the life of the sick person. Transplanatation surgeons have thus been very wary in using living donors as sources of organs for transplantation. As surgical outcomes and techniques have improved, nevertheless, this procedure has gradually expanded. Living organ donors are usually related to the sick person, but this isn’t always the case. Close friends and spouses regularly give organs to sick loved ones. Majority of individuals who aspire to donate organs might decide to donate these organs to people they don’t know (McSteen & Peden-McAlpine, 2006). According to Potts and Evans, (2005), there are three major groups of donation by living individuals namely direct donation to a friend or loved one; nondirect donation, whereby the donor offers an organ to the universal pool for the organ to be transplanted into the person at top of waiting list; and direct donation to an unfamiliar person, in which donors select to donate to a particular individual with whom they do not have prior emotional association. Every form of donation prompts unique ethical, legal and social concerns. With direct donation to a friend or a loved one, worries emerge on the immense pressure that people can be put on to donate, making the people who are not willing to donate to do so to feel that they have been coerced. In such cases, transplantation programs are usually willing to recognize a credible medical pretext, so that the individual can bow out charitably. Equally significant, nevertheless, are circumstances in which individuals feel coerced to donate in spite of the outcomes to themselves. Such a feeling of coercion isn’t odd. In such cases, simply getting the informed assent of relative is inadequate and physicians are forced to prevent individuals from making latently life threatening forfeits unless chances of success are proportionately large (Price, 2001). Nondirect donation increases diverse legal, social and ethical issues. Price (2001) argues that the drastic altruism that induces an individual to make a latently life threatening decision forfeits for an unfamiliar person calls for cautious scrutiny. It must first be established why a person is willing to donate his organs to a stranger. Investigations must be conducted to determine is the donor is attempting to compensate for low self esteem or depression or harboring expectations of becoming a part of the life of the organ recipient. Therefore, transplantation teams are obliged to evaluate possible donors in every dimension and forbid donations that produce serious concern. Direct donation to unfamiliar person raise identical ethical and legal queries with additional wrinkles. Direct organ donation to unfamiliar person normally happens when the patient advertises for the need of the organ publicly, on billboards or television or on the internet (Arthur & Coelho, 2002). Advertising for organ donation isn’t illegal, but has been greatly discouraged by transplantation community. Arthur and Coelho (2002) note that two core oppositions is that direct donation to a unfamiliar person is unjust and that it intimidates the view that the organ isn’t a product to be sold or bought, but is rather a gift of life. Several individuals dispute that just as people have the right to donate to charities of their choice, they must be capable to give their organs. Practically, nevertheless, this implies that people with the most coercing stories and the ways to publicize their predicament are likely to be the ones to attain the organs other than people who are in dire need of these organs. This strikes several ethicists as unjust. According to Arthur and Coelho (2002), dissimilar to monetary gifts, they dispute that organ transplantation needs involvement of social institutions and structures, such as hospitals and transplantation teams. Therefore, the argument is that these organ donations are legally subject to the societal requirements of equality and transplantation centers must refuse to allow allotment of organs based on everything but ethically relevant criteria. Ethical, legal and social issues in organ donation in the UAE Organ donation and transplantation which is a major miracle of the 20th century has improved and prolonged lives of several patients across the globe, including UAE. According to Bosek (2006) the numerous great clinical and scientific advances of devoted health professionals, along with countless deeds of kindness of organ donors as well as their families have made organ donation and transplantation a life saving remedy and also a shinning sign of human unity. Organ shortage as a result of organ failures in UAE as well as the rest of the globe has made world health organization and organ donation and transplant bodies to request the national governments, working together with non-governmental and international organizations, to come up with implement inclusive programs for prevention, treatment and screening of organ failures and for laws to be developed and executed to govern recovery of organs from the living and deceased donors consistent with global standards so as to raise the figure of organs that are donated under transparent regulatory scheme that ensures recipient and donor safety. According to Underwood, (2010), thousands of individuals across UAE can get life saving organs after the UAE ministry of health approved the utilization of organs form cadavers. Even though transplantation of organs in the UAE was made legal in 1993, the law didn’t include the medical description of death which made it unfeasible to utilize organs from dead persons, who needs to be ventilated to permit time fro an appropriate transplant person to be gotten. However, the nation currently has an appendix with the essential rules and definitions governing organ donation and transplantation practice. Underwood (2010) argues that the nation permits transplants of lung, pancreas, heart, liver and kidney. Consent for organs to be utilized for transplant must be offered by the will of the dead person or by their relatives. Once it has been confirmed that a person is dead by three specialists entailing a neurologist, an organ is removed at the ministry of health approved centre. The ministry must collaborate with health authorities in order to develop and control these centers. With the scarcity of organ donors along with the ever expanding number of individuals waiting to undergo organ transplantation, utilization of cardiac dead donors has been seen as a way of increasing supply of transplantable organs. According to Levvey, (2006), this scheme is referred to as nonheart beating organ donation or organ donation after cardiac death. Non heart beating organ contribution has been supported as a way of increasing supply of the donated organs in UAE. Brain death preferred criteria for the determination of organ donor status. The ministry of health has guidelines for non heart beating organ donation that entail written locally consented non heart beating donor protocols, consent of family members for premortem cannulation, and civic openness of non heart beating donor protocols, family members choices and financial safety and establishment of death through termination of cardiopulmonary function by arterial pressure and electrocardiographic monitoring in controlled non heart beating donations. Non heart beating donation of organs is a choice only after members of the family of the patient having unrecoverable brain injury who doesn’t meet neurological criterion for brain death enquiry removal of ventilator support. After the members of the family request the removal of ventilator support, they are then approached on the choice of donation and this kind of organ donation, the members of the family who would be incapable of donating the organ of their love one under brain death criterion are now capable to do so (Levvey, 2006). Family members possess the power to deny or accept donation of organ as a choice, in spite of whether the sick person has signed the organ donation card. Even though the donor card has been signed by the patient expressing his wish to donate an organ, majority of hospitals in the UAE are presently depending on surrogate assent from the family members. Wilkinson (2007) notes that this assent may present a predicament to the members of the family , who are required to make a decision on whether to respect the signed organ donor card of the patient. This procedure can also become more intricate if the members of the family considering donation of organ don’t have adequate knowledge of the wishes of the patient or have uncertainty on the basis of their personal values. Subsequently, a once individual’s wishes, which are ether known orally or in a written form, may be override by the relative. If members of the family are not aware of the wishes of the patient, their deeds might be based on the emotions other than the desires of the patient. The predicament sourcing nonheart beating organ donation in the UAE is that diverse protocols are present in regard to the duration of time amid death, cardiopulmonary arrest and recovery of organs. It is best to determine death when a duration of time has passed after which the heart wouldn’t autoresuscitate (Levvey, 2006). In regard to organ donation by a living donor, the live donor is supposed to undergo full physicl and mental checkup and screening to ensure that the surgery doesn’t jeopardize her or his health. According to Gulf News (2010), the organs transplantation surgery is supposed to occur only in ministry of health centers, hospitals and clinics across UAE. The country has consented organ transplants from dead or live donors rather than relative of the organ recipient. In order to obtain an organ from a donor, the written assent of the donor along with his second or first degree relative is compulsory if the organ is to be transplanted after the death of the donor. The family members also preserve the right of donating organs if donor hadn’t offered written assent before his death. According to UAE organ donation ethics, a healthy person can give organs if she or he provides signed written assent confirmed by two individuals. In addition live donors who should be more than 21 years should be in a secure physical condition and must have a similar blood group as the person receiving the organ (Gulf News, 2010). Conclusion Organ donation by both living donors and cadavers is surrounded by several legal, ethical and social issues. The demand for organs for transplantation surpasses supply and this has made governments to develop and implement rules in a move to regulate control of this scent resource. In order to retrieve an organ from a dead person, the donating person have a signed organ donation card giving consent that his organ must be given to another person after his death. The shortage of organs for transplantation in The UAE has made the government to develop and implement inclusive programs for treatment, prevention and screening of organ failure as well as laws to govern the recovery of organs from dead and living donors. References Arthur C., & Coelho, D., (2002). The Ethics of Organ Transplants: The Current Debate . New York: Prometheus Books. Bosek, S., (2006). Organ donation and surrogate decision-making: an ethical analysis. JONAS Healthc Law Ethics Regul, 8(2):38-41. Gulf News, (2010). UAE approves new rules on organ transplants. Retrieved on June 13, 2012 from http://www.emiratilaw.com/default.aspx?action=DisplayNews&type=1&id=7508&Catid =2528 Levvey, J., (2006). Nursing challenges associated with non heart beating organ donation. Australian Nursing Journal, 13(9):43. McSteen K, & Peden-McAlpine, C., (2006). The role of the nurse as advocate in ethically difficult care situations with dying patients. Journal of Health, Population and Nutrition, 8(5): 259-269. Potts, M., & Evans, W., (2005). Does it matter that organ donors are not dead? Ethical and policy implications. J Med Ethics. 31(7)406-409. Price, D., (2001) Legal and ethical aspects of organ transplantation , 1st Edition. Cambridge: Cambridge University Press. Underwood, M., (2010). Transplant hope for thousands. Retrieved on June 13, 2012 from http://www.thenational.ae/news/uae-news/health/transplant-hope-for-thousands Veatch, M., (2003). The dead donor rule: true by definition. The American Journal of Bioethics , 3(1):10-11 Wilkinson, M., (2007). Individual and family decisions about organ donation. Journal of Applied Philosophy, 24(1):26-40. Read More