Health Care and Ethics Term Paper

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ethics regarding organ donation by brain-damaged people. The writer explores how a brain-damaged person is defined, and whether or not the donation of organs from that person is ethical. There were 15 sources used to complete this paper.

The field of medicine has advanced mankind to arenas never before thought possible. Today doctors can take entire organ systems out of one person and place them in another and the recipient can live for many years with transplanted organs. Hearts, lungs, kidneys, livers, eyes and many combinations of them are just a few of the organs that are transplanted worldwide today. As the medical community continues to advance age and quality of life the need for more organs has reached the critical stage. One of the most argued and passionate debates in the medical community today is whether or not it is ethical to remove organs in the case of a brain dead person. It is a debate that is heated on both sides of the topic and one that will not easily be resolved. Those who believe it is ethical point to the lives that are saved because of the donated organs while those who are not for it believe it is unfair to the families as well as the brain dead patient. While it is a hard decision for the family of the brain dead person to make, the rules and criteria for being declared brain dead are stringent, and they are not going to be revived. This means that their organs can either go to waste or they can save the life of several people. Because the brain dead are going to die anyway it is better to let their organs save lives than to waste them and let those who needed the organs die.

BRAIN DEATH

Before one can grasp whether or not brain dead patients should donate organs for those who need them it is important to understand what constitutes brain death. Part of the objection to brain dead donors is the possibility that they may come awake therefore the families hesitate to allow organ harvest because they fear the eagerness to harvest will supercede the attempt to save the patient's life.

Justice Barry O'Keefe was told the family of the 37-year-old man said he now had some body movement, had reacted to verbal suggestions and his eyes followed relatives visiting him. I am concerned but for the intervention of the court, this man would now be dead,"the judge said in the New South Wales Supreme Court (Judge, 2000).

The family wanted to have him declared brain dead and be able to donate his organs, but the court said no. They all went to court. The judge was shown that the patient was being fed through a stomach tube. "That doesn't sound like he is dead?," the judge asked. "Certainly not to the family," Mr. Mills replied. Annette Northbridge urgently applied to the court on March 12 to stop the hospital withdrawing treatment to her brother, the youngest of six children whose father died in February (Judge, 2000). "

The judge did not allow the brain death certification and the removal of life support and the patient woke up. This is a rare occurrence and one that does not mean total recovery, but it happens and that causes detractors of organ donation of brain dead organs to fight against its passage (Judge, 2000).

Brain dead is established when the body seems to function but it is through the use of machines and there is no recordable activity of the brain. When one is said to be brain dead one is said to have no hope of recovery. The brain does not register any activity and it does not register any waves, thought patterns or other things that indicate the brain is functional. Brain death usually marks the end of life and the family often makes the difficult decision to turn off the machines and let life cease. The donation of organs from a brain dead patient is a highly controversial issue. Families who hung on to hope may think the hospital did not do everything it could to save the patient because it wanted to harvest the patient's organs for transplant. This has been refuted world wide by transplant organizations as well as hospital staff members who insist that everything possible is done for the brain dead person and it is only after all efforts prove futile that the delicate discussion about organ transplant and donation take place.

DONATION

Many nations have low rates of organ donation, in particular Australia.

It has been pointed out clearly that Australia's performance is poor, particularly compared with other western nations," Dr. Opdam said. While Australia had a donation rate of about 8.6 donors per million populations (Has, 2000), Spain averaged 33.6, the United States 21.4, Western Europe 13.8 and New Zealand 10.2. Dr. Opdam said it was not known why Australia had such a low rate compared with other countries (Has, 2000). She said it could be a range of factors, from different types of mortality, to a lack of intensive care beds, to religious or cultural concern about the donation of organs and tissues (Has, 2000). Even within Australia there were big differences between donation rates, with South Australia averaging 24 donors per million, while Victoria and New South Wales averaged about 10 people per million (Has, 2000). Dr. Opdam released a "death audit" she and others had conducted of 12 Victorian hospitals, which looked at possible donor candidates (Has, 2000). In more than 5,500 deaths looked at over an 18-month period, her team found 156 medically-suitable donation cases (Has, 2000). Of those cases, just 37 ended up donating organs and tissues, while in 42 cases the chance for donation was missed for a variety of reasons. Dr. Opdam said doctors in accident and emergency wards might have to send patients with no hope of survival to an intensive care unit (Has, 2000), instead of ceasing treatment. This would ensure the maintenance of organs and tissue until a decision could be taken on possible donation (Has, 2000)."

This presents the brain dead dilemma because the person is kept "alive" on machines for the purpose of keeping tissues healthy, but the family mistakenly believes that the loved one is in fact alive and any hint of discussion regarding organ donation sounds like a request for murder to them (Has, 2000).

It is ethical to procure organs for donation and transplant from brain dead patients because the criteria is so stringent to declare someone brain dead that it cannot be construed as unethical (Donation, 2001). When a person is declared brain dead they have performed certain required criteria to make that determination. It is ethical to use the organs of a brain dead person because they are only alive by machines, they are not really alive. The use of these organs has the potential to save thousands of lives each year.

Health Minister Michael Wooldridge said on average two people died every week while waiting for an organ to become available."The rate of organ donation in Australia has been declining and is unacceptably low (Donation, 2001),"Dr. Wooldridge said (Donation, 2001). Since launching the donor register in November last year, Dr. Wooldridge said more than 30,000 people had joined but many more supported donating their organs and should add their details to the list (Donation, 2001). "Although many others have registered as donors through state driver's licence systems, the majority of Australians have taken no formal steps to register as intending donors (Donation, 2001)," he said. "This is despite research that shows that more than 90 per cent of Australians actually support donation (Donation, 2001)."

Many cultures believe that the giving of a gift is the kindest thing one can do for another person. The problem when it comes to brain death and organ donation is that the gift is not always given by the giver, but the family is instead asked to decide to give the gift, thereby giving up hope for their loved one (Smith, 1998). To many families it might feel like killing their loved one to save the life of another but if one studies the research around brain death criteria one will find that the loved one is already gone. The ethics are strong and solid. The medical community has the ability to keep tissue alive through the use of artificial machines but if that ability was not there the person would positively be dead. If one looks at it this way they will see that the brain dead organ donation is not really an ethical question, but a scientific one.

Ethical issues have always been apparent in the transplantation process and are becoming more evident as the demand for organs increases. The basic question is how just and ethical are the new policies enacted to encourage organ donation, considering that they affect the total public and benefit the small percentage of patients who…

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