Organ Donation Is a Controversial

Organ donation is a controversial ethical subject that must be discussed to see how this donation is just for the donor and beneficial to he recipient. The shortage of donors in the country has led to serious problems for those looking for a transplant. It is felt that donations should somehow be connected with self-interest because altruism alone is failing to meet the demand for organs.

It has been a surprising observation that the shortage of human organs has worsened in recent years. According to reports, as more and more individuals are registering for transplantation of organs, the shortage is becoming even more acute and many patients expired while waiting for a suitable organ. The shortage of the organs for the transplantation has resulted in the decline in the quality of the life, and has adversely affected the health conditions of the patients in critical condition. The non-availability of the organs for the transplantation has been responsible for death warrants against the patients; the physicians in most of the cases do not place the irrespective patients in the waiting list due to the critical situation (Kliemt, 2000).

According to several reports, the increase in use of the living donors is another reason for the shortage of the organs for transplantation, "in 2001, the number of living donors exceeded the number of cadaveric donors" (Alexander, 2004). However, the availability of the cadaveric donors is expected to reduce the conditions which have caused surge in the living donations. The organ procurement system is based upon the presence of altruism, however the motivational programs which were initiated for the purpose of organ donation were not successful, therefore "altruism is a fine thing but it is in short supply" (Alexander, 2004), therefore it has been suggested that "we may hope for love but should plan on self-interest" (Alexander, 2004). It has been recommended that incentives scheme shall be launched to motivate the individuals towards donation, "financial compensation is the most discussed option, but reciprocity proposals are another possibility" (Alexander, 2004). According to the current legislations, the compensation offered to the donors and their families for organ donation is considered to be illegal. According to National Organ Transplant Act of 1984, "It shall be unlawful for any person to knowingly acquire, receive or otherwise transfer any human organ for valuable consideration for use in human transplantation" (Alexander, 2004). However due to the shortage of organs, the American Medical Association, the American Society of Transplant Surgeons and the United Network for Organ Sharing has mutually agreed upon the concept of financial compensation.

The United Network for Organ Sharing considers "organs as national resource, owned in common" (Alexander, 2004), therefore what the society has experienced is the "tragedy of the common" (Alexander, 2004), where each individual will like to accept the organ, however will be least interested in donation. The flaws have been reverted through the policy of no-give, no-take, "under this system in order to receive an organ the individual has to previously signed their organ donor card" (Alexander, 2004). The merit of such policy is that "it satisfies most people's moral intuitions, the people are comfortable with the morality of reciprocity, those who are willing to give should be the first to receive" (Alexander, 2004).

In 2004, ethical issues related to the death and organ donations were discussed by the Kennedy Institute Journal if Ethics in their September issue. The main highlight of the issue has been the proposal, "expanding donation beyond death and non-heart beating organ donation by redefining death and/or providing exceptions to the dead donor rule" (Nancy, 2005). The journal published the claim of an ethicist, which stated that the competent patient has the choice to remove the organs prior to death, provided that the directive was issued in advance. There have been some controversies about the description of the brain death, vegetative state and coma, and do these terms interpret "a living or dead person as an opportunity to change the rules about organ donation" (Nancy, 2005). There has been suggestion by the medical community that EEG test shall be dropped from the hospital's policy on brain death tests, the test is often required for the purpose of organ donation.

Some other proposals have been floated, which have requested change in the organ donation rules, the proposed rules include the requisition of the patient or family consent for donation, "which legally assumes that everyone is automatically willing to be an organ donor unless they have documented an objection to it" (Nancy, 2005). In some of the states in North America, certain regulations have been enforced relevant to organ donation which compulsorily requires the signature on organ donation card, irrespective of the family objection. Among such proposals, "the most outrageous proposal has been the performing outright euthanasia to obtain organs" (Nancy, 2005).