Ethical issues in organ transplantation and donor sourcing

Organ transplantation has been regarded as one of the greatest medical fetes of the century since it provides an effective way of extracting organs from the deceased or living donors to the patients suffering from the terminal failure of their vital organs (Abuona,2003,p.54). The technological and scientific advances in medicine have made the concept of organ and tissue transfer a significant issue in the field of medicine. Caplan and Coelho (1998) in their study on the ethics of organ transplant indicated that the rise in the incidence of failure of the vital organs as well as the inadequate organs supply, main from the cadavers has created an imbalance in the organ demand and supply. The consequence has been a long waiting list as well as death within the waiting period. These events coupled with the resulting acts such as transplant tourism, illegal harvesting of organs from the poor, race as well as class inequities (Stein,2004,p.223) in the transplant systems among other have posed an ethical dilemma to the very idea of organ transplantation. The other issues being the ethics in receiving of organ transplants from cadavers, methods of allocating cadaver organs, death certification, uses of organs extracted from fetuses, organ transplantation sourced from living donors, organ sales for transplantation, the use of organ transplants from executed prisoners, the acceptance of financial incentives as a result of organ donations, the use of stem cells as well as cloning in the process of transplantations as well as the use of animal organs as well as xenotransplantations as outlined by Abuona (2003).In this work we explore all of these ethical issues with a recommendation on the best course of action to take so that the concept of organ transplantation is carried out within the limits of ethical and moral standards. Health care practitioners also have the responsibility of ensuring that they perform their roles and medical duties in a professional manner.

The shortage in the supply of human organs has caused some of the most serious ethical issues in medical history as a result of the ever rising cases of organ transplantations. Some of the worst practices in this regard are the sale of organs by entrepreneurs for purely financial gains in certain parts of the world via a systematic exploitation of the poor for the sake of the wealthy individuals as pointed out by Pattison (2003,p.11).

Organ transplants from cadavers

The Center for Bioethics (2004) indicated that cadaveric organ donation form one of the most suitable methods of obtaining organs. This is because a single cadaveric donor is able to provide organs for a large number of individuals. The organs or the tissues to be extracted may largely depend on the level of dame to organs or tissues as well as the cause of death. A single cadaver can provide several organs. At the moment, if a person passes away, the organs may just be donated if they consented to do so prior to their death (The Center for Bioethics, 2004). An individual's consent to have their organs donated is made while they are still alive and sometime appears on their driver's license. After such consent, nothing happens until the time that they have died. Should the organ donation wishes of a deceased person be unknown, then the hospital, organ procurement organization or physician should approach a member of the deceased family in order to obtain a written consent before removing the organs. The use of written consent has not helped in increasing the number of organs donations. What has proven to be more effective is the application of the principle of 'presumed consent' (Abuona, 2003,p.56) whereby the general society approve of the idea that each and every adult who happens to die is treated as a potential donor unless they have indicated their objection This principle has been employed in several countries in Europe as well as Asia on moral and legal grounds with the aim of preserving the 'gift of life'.

Death certification

Prior to removing organs from potential donor and before any request are forwarded to their families, it is necessary for the patients to be declared 'brain dead' by medical doctors. Cardiorespiratory death alone is not sufficient. In many parts of the world, the newly accepted concept of death is 'brain death' (Norton,1992).It is therefore appropriate for the donor's death to be satisfied by a doctor who is not involved in the transplantation prior to organ extraction.

Organ transplantation sourced from living donors

The main ethical issue in the living donor organ transplant is where the donation should be directed or anonymous. A directed donation may be seen as unethical since it may loead to some recipients 'jumping' to the top of the waiting list.

Organ sales for transplantation

The rather flourishing international human organ trade in developing countries of the world that has a shortage of cadaveric organs coupled with conspicuous wealth disparities like in the Middle East has lead to the development of a deplorable medical practice. In this practice, the poor are duped into selling their organs such as kidneys to have them transplanted to the wealthy clients.

Conclusion

Issues of organ transplant such as ethics in receiving of organ transplants from cadavers, methods of allocating cadaver organs, death certification, uses of organs extracted from fetuses, organ transplantation sourced from living donors, organ sales for transplantation, the use of organ transplants from executed prisoners, the acceptance of financial incentives as a result of organ donations, the use of stem cells as well as cloning in the process of transplantations as well as the use of animal organs as well as xenotransplantations must be addressed in order for the practice to be moral and medically acceptable. These will ensure that we have sustainable organ transplant programs that are free from all kinds of ethical concerns