What is Organ Donation?

Many people suffer because they are in need of an organ transplant, but there are few organ donors. Across the USA there are many people currently on waiting lists in desperate need of an organ transplant. Many of these people will not receive an organ transplants due to the low quantity of donors and high demand for organs. People should automatically be registered organ donors until they state they do not wish to be.

Under the current law people choose to become an organ donor either by completing a donor card or ticking a box on their driving licence application. People may not make their wishes clear to family members and if a donor card or licence, indicating the choice of organ donation, is not available then the opportunity for donation may be missed. Waiting lists for organs continue to grow and lives are lost because of limited availability of hearts, lungs, livers, kidneys and intestines Whilst someone in need of a liver or kidney may be the recipient of part of a liver or a kidney from a living organ donors, the number of organs available for transplant is very limited.

Presumed-consent organ donation could prevent the needles suffering or loss of life of many people. In countries like the United States, which do not mandate organ donation (unless it is to ensure that the wishes of those who do not want to donate their organs after their death be followed), there is an ongoing shortfall of organs available for donation. As of October 2014, there were nearly 124,000 persons waiting for organs or tissues, whereas only 8,279 people donated organs or tissues between January and July of 2014. About 21 people die each day in the United States while waiting for a donated organ. Rebecca J Frey and James E. Waun The Gale Encyclopedia of Senior Health: A Guide for Seniors and Their Caregivers Vol. 4. 2nd ed. Farmington Hills, MI: Gale, 2015. P1590-1593. (Library Source)

Seeking remedies for the shortfall of organs has also involved identifying and attempting to alter attitudes and role behavior of physicians and nurses. In Western Europe, serious attention has been given to the use of "presumed consent" or "opting out" as a way to increase the number of cadaveric organs. This is a system that legally allows the use of a deceased patient's organs for transplantation, unless the patient had formally registered the desire not to be a donor. This system has resulted in notable increases in organ procurement rates in a number of European countries. There is evidence, however, that if the "opting out" system requires the next of kin to be informed about organ removal from their dead relative before it is done, physicians may be less inclined to initiate the procurement process and families more likely to object to the donation. Opinion polls have shown that there is a strongly held and wide-ranging resistance to its establishment as a basis for organ and tissue procurement in the United States, as well as in Great Britain and the Netherlands. It has been suggested, but not systematically investigated, that "opting out”rather than "opting in”may run counter to the social expectations and cultural values of individuals, families, and health professionals in these societies. Organ Transplants, Sociocultural Aspects of Renne C. Fox and Judith P. Swazey. Encyclopedia of Bioethics. Ed. Stephen G. Post. Vol. 4. 3rd ed. New York, NY: Macmillan Reference USA, 2004. P1953-1959. (Library Source)

There are valid arguments for and against presumed-consent organ donation systems. SUPPORTERS ARGUE - The majority of U.S. residents want to be organ donors, so it makes sense to institute regulations where the law defaults toward people being organ donors. Many countries in Europe have adopted presumed consent, and have significantly higher organ donor rates than the United States. States can switch to presumed-consent systems while preserving individual liberties and respecting the rights of those who choose not to donate organs for religious or other reasons.

OPPONENTS ARGUE - Presumed consent is an overly aggressive and intrusive policy that runs contrary to the U.S.'s exaltation of individual freedom. There are less heavy-handed methods that can increase both organ donation awareness and the number of Americans who register as donors. Adopting a presumed-consent policy could even prompt a public backlash against organ donor registration efforts, actually shrinking the organ donor pool. ("Organ Donation: Should states adopt presumed-consent organ donation systems, automatically registering everybody as an organ donor unless a person opts out?") Issues & Controversies, Infobase Learning, 28 June 2010, https://icof.infobaselearning.com/recordurl.aspx?ID=2502. (Library Source)

The perception of how organ donation works and the fear that the process of donation may be open to exploitation may further challenge support for presumed consent organ donations . The Human Tissue Act (2004) regulates and provides oversight for the removal , storage, use of and disposal of human bodies, tissues and organs. Organ donation rates suffer because of a number of public misconceptions, which campaign organizers work to correct. The most common myths include: belief in the existence of a black market for transplantable organs, concerns that the organ allocation system benefits wealthy or well-connected people in need of a transplant, the belief that doctors or other medical personnel can cause or accelerate the death of patients in order to procure their organs, and a lack of distinction between a coma or persistent vegetative state and actual brain death. Generally speaking, Americans lack critical knowledge about how the organ allocation system works and about the separation of the functions of trauma-focused medical teams (as well as other medical specialties) and those of transplant-focused teams, all of which serve to create a system of checks and balances that might operate to ease fears about becoming a potential organ donor. Several researchers have suggested that the source of these fears lies in the entertainment media, as demonstrated by content analyses and experimental studies, and that pressure should be exerted to persuade writers and producers to stop creating movies and television episodes that depict organ donation inaccurately.

Organ Donation - Susan E. Morgan. Encyclopedia of Health Communication.

Ed. Teresa L. Thompson. Vol. 2. Thousand Oaks, CA: SAGE Reference, 2014. P1001-1003. (Library Source).

With an increased aging population the waiting lists for organ transplants will continue to expand. There are compelling arguments for and against presumed consent but in the end the possibility of saving many human lives should be placed above all else, including family and religious beliefs. A single donor may impact the lives of many people. However, the single largest obstacle to organ transplantation in the twenty-first century is the scarcity of transplantable organs. In fact, there would be no transplantation of organs if the concept of donation did not exist. For that reason, it is helpful to consider some facts about organ donation and to take note of some efforts that have been made to increase the pool of organs available for transplantation. Corr, Charles A., and Donna M. Corr. "Organ Donation and Transplantation." Macmillan Encyclopedia of Death and Dying, edited by Robert Kastenbaum, vol. 2, Macmillan Reference USA, 2002, pp. 650-657. Gale Virtual Reference Library.

Presumed-consent would prompt conversation with next of kin regarding the wishes related to organ donation. Making an informed decision may ease the impact on next of kin to make the decision at a difficult time. Regardless of any written or oral expression of wishes that an individual might make, next of kin are likely to be key decision makers in this matter. Lack of discussion among family members about their wishes is the single most significant barrier to organ donation. Thus, public education campaigns have urged potential donors to "Share your life. Share your decision. Charles A., and Donna M. Corr. "Organ Donation and Transplantation." Macmillan Encyclopedia of Death and Dying. (Library Source).

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