Ethical Dilemmas of Organ Transplants

According to Shaw (2011), organ transfer raises several ethical and emotional issues, especially in discussions around anonymity protocol. They take something from one persons life to save anothers. Some different opinions have come about regarding organ transplants: if the patient is brain dead or they went through cardiac death, should the organs be available to a recipient who needs them to continue life? I believe that organ transplants are helpful and ethical; they have the potential to save lives.

Utilitarian perspective proposes that the value of something is determined by its usefulness regardless of the consequences (Mill & Shar, 2002). Regarding organ transplants, utilitarian perspective applies to a persons morals. Beneficence to me is an important piece to the utilitarian perspective. Beneficence is the promotion of happiness and good in the most people possible. As stated before, utilitarian perspective applies to a persons morals; beneficence is based on those morals too. Since utilitarianism is based on morals, it is good that it is illegal to sell organs in the United States; it would increase donation, encouraging people to donate their organs and potentially want to participate in physician assistant suicide (Giuliano, 1997).

Deontology perspective defines actions as right or wrong (Kant, 1996). The main goal is to do what is best for the most people, no matter the belief or feeling behind the decision. Kants theory relates to organ transplant as human life as sacred and inviolable (Kant, 1996). He believes that one person cannot use another person to get better.

The perspective I am taking on organ transplants is utilitarian perspective because of my personal morals. Taking organs from the recently deceased not only saves lives but it would save time and money for the doctors doing the transplantation. Utilitarian does not rely on wealth to favor an individual for organ transplants. Anyone, poor or rich, should get a same chance of life saving according to who comes first on the waiting list.

As it was said before, organ transplantation has brought up many ethical dilemmas. These issues vary from biomedical and philosophical ethics to organ allocation and consent and coercion (Shaw, 2011). In most cases, people hear mostly about a patient that is willing to donate their organs when they become brain dead. The most popular organs that are transplanted are those most vital ones: heart, liver, and kidneys (Giuliano, 1997). That patient would have their organs distributed to potentially ten people and help live longer lives. The only downfall to cadaver donation is that the transplant must be done as soon as possible (Baille et al., 2018). The ethical dilemma in this example is the question of when is life officially over; is it when the soul reenters another life or when the soul enters eternal happiness (Baille et al., 2018)?

Another non-ethical argument is if someone is desperate enough to get an organ transplant because their own organ failed, then what if the donors organ does not take in the recipients body? According to Joralemon and Cox (2003), many of those who die before receiving an organ might very well have died within several years even with a replacement organ. But, if someone is brain dead, and they gave their consent, they could leave their impact on someones or multiple peoples lives. According to IRB Advisor (2018), especially for research purposes, if the organ is manipulated, then informed consent has to be obtained from the recipient. But it is interesting to see why someone would argue saving others, though, especially if its a ?dying wish.

In other more popular cases, people hear of the inter vivo transplants, meaning both the donor and the recipient are both still alive (Baille et al., 2018). This is the type of transplant that occurs when someone could use a new kidney, for example. Besides consent, the only way this seems ethical is be sure the donor is not seeking suicide. This type of transplant is ethical, in my opinion, because most of the time, it seems the donor is family or someone close to the recipient. Even if they were not close to each other, the donor would be saving a life. Yes, humans were born with two kidneys, but people can function with one unless they need a good one, for illness reasons, for example. On the other hand, inter vivo transplants could be perceived as unethical because, for example, an alcoholic needs a liver and they get one. Legally, health care workers must do the procedure, but ethically, they do not agree with the situation.

From the recipients perspective, they are in a desperate situation, but they still need to decide if getting that transplant will do more good than harm (Baille et al., 2018). Quality of life needs to be taken into consideration for the recipient and their family. Recipients have trouble expressing gratitude and saying thank you to donors and donor families was hard for them to do, not only because anonymity protocol prohibits unmediated relations between donors, donor families, and recipients in the New Zealand context, but because physical factors make repaying ?the gift impossible (Shaw, 2011).

Sadness, pain, and stress are expressed by close family and friends around someone who is actively dying. These emotions are shown during interviews with them when the subject of donating the patients organs comes up. During the interview, the health care worker clarifies what brain death is and explains the option of organ donation (Marujo Nunes et al., 2016). This is where the family decides to donate the organs or not and is essentially the most important part of the whole donation process (Marujo Nunes et al., 2016). Another purpose of the family interview is to provide emotional support to the family and friends through the difficult time.

When working in the health field, workers need to use their legal advice, making sure that they do not use their ethical values to find a solution. For example, if two patients, one having alcoholism and the other had liver disease, were both waiting on a new donor liver to become available, they need to go with the patient that has been on the list the longest. Most would want to just give the organ to the patient with liver disease because that patient did not put themselves in that situation whereas the patient with alcoholism caused their liver to fail. According to Giuliano (1997), if a patient receives a kidney from a relative, they do not have to wait on the list for that organ.

To recap, there are four principles aiding in ethical decision making that include: making sure that the benefits are greater than the risks, making sure the practice is not doing harm to the patient, respecting the patients independence, and lastly, justice (Mitzel & Snyders, 2002). I believe that organ transplants are ethical and have the potential to save a lot of people. Behind all the ethical dilemmas, people just need to remember the good morals.

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