The ethics of organ transplantation
Decades ago, exchanging body parts through transplantation was considered experimental. Today, it is the standard intervention for patients who no longer respond to conventional medical or surgical therapies.
However, this has created implications involving autonomy and belonging, which has opposed moral consideration and legal concerns. There are questions about the ethics of taking organs from the living and the dead, and giving them to others.
It has been proven that, indeed, human organ transplantation has helped mankind, and that the growing need for these organs has progressively increased. The government has set up laws covering Organ Transplantation with several committees set up to meet the requirements of these rules, especially those pertaining to who are qualified to donate.
We have a living related donor that is limited to spouses, children and those related up to the 4th degree of consanguinity. Then we have the living nonrelated origin that makes up a greater bulk of transplant sources and deceased donors.
Among the related donors, many do not meet the criteria for donation because of several reasons. One of these reasons is that the related donor has a history of illness like diabetes, hypertension, pulmonary and renal illnesses or simply the spouses or children do not agree in donating. Thus, organ in a deceased donor, such as those in a hospital setting, has a negative response coming from the relatives or it is very difficult to initiate a request for organ donation unless an advanced directive of the living was previously given.
Most of these donors come from the lower strata of society and are vulnerable because of underlying financial concerns or the need to survive. The lack of supply of transplantable organs and tissues have prodded society to find new methods of procurement and innovative strategies for fairly distributing this scarce life-saving resource.
The Organ Transplant Ethics Committee has been confronted with looming questions about distribution, rationing methods, and procurement. We are deeply and emotionally affected when we have to say “NO” to the transplantation or disapprove for it to proceed.
By and large, the ultimate question we have to answer is: Did we violate the autonomy of a donor who is potentially a “new lease on life” provider for recipients? This is a reality faced by and prevalent in patients in the end-stage of renal disease.
The magnitude of transplantation requirements has increased over the years. For example, from 10,043 endstage renal disease cases in recorded in 2011, it has increased to 17,454 in 2014. On the other hand, the dialysis done from year 2001 to 2011 showed that in about 18,000 patients who underwent this procedure onlya 3,375 were converted to transplants.
The statistics will indicate the prevailing widening gap between transplantation and dialysis. Today with the coming of new technologies in medicine that focus on the prevention of rejection of the donated organs, the efficiency in organ transplantation has greatly achieved.
The advent of immunosuppressive drugs like Prednisone and Cyclosporine, that are used primarily to prevent the rejection of grafts and transplants, has proven itself beneficial in the advancement of Organ Transplantation. In recent years, the donor pool has been maximized to its efficiency in the procurement system, focusing more on commodification in allocation and distribution of the scarce organ.
There have been ethical debates that accompany transplantation, so it is important that we understand this particular technology and establish specific policies. Let it be known that transplantation has helped many people in society and should make us continuously examine the ethical questions that surround organ transplantation.