organ donation (issue on morality)

7/23/2019 Organ Donation (Issue on Morality)

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Organ Donation

ARANDIA, Gigi Aleckz N

THES004 Fundamentals of Moral Theology


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An introduction.


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Overview

Organ Transplant A surgical operation where a failing or damaged organ

in the human body is removed and replaced with a new

one.

Typically refers to transplants of the solid organs

Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.


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Overview

Organ A mass of specialized cells and tissues that work

together to perform a function in the body.

Any part of the body that performs a specialized

function


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Overview

Graft The process of removing tissue from one part of a

persons body and surgically re-implanting it to replace

or compensate for damaged tissue.

Grafting is different from transplantation because itdoes not remove and replace an entire organ, but

rather only a portion.



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The transplant process.


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Doctor checks the patients eligibility for a transplant Doctor refers the patient to a transplant center

Transplant center evaluates:

Health and mental status

Level of social support

If no readily available living donor or is ineligible for a

living donation, they are placed into the waiting list

for a cadaver organ donation

An organ procurement organization (OPO) takes the

organs into custody once the organs become available



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A computer program determines, ranks and matchesorgan donations to possible recipients on the waiting

list

Blood type, organ size and type

Distance from the donor organ to the recipient Level of medical urgency

Time on the waiting list



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If a match occurs, the organs are offered to thefirstpatients transplant center, fulfilling these questions:

Is the patient available and willing to be transplanted

immediately?

Is the patient healthy enough to be transplanted? If these are true, the OPO delivers the organs to the

transplant center for the transplant process

This entire process must occur very quickly as organs are

only transplantable for a short time period after theyve

been removed.



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General procedure:1. Make an incision in the body near the failing organ

2. Cut the arteries and veins that run to the organ

3. Remove the organ through the incision

4. Take the new organ and insert it into the body throughthe incision

5. Connect the new organ to the arteries and veins

6. Close the incision

Long road to recovery Possible rejection



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Moral, ethical and medical issues.


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Death medically defined

Irreversibly dead body Brain death irreversible cessation of all functions of

the brain, including the brainstem

Coma or unresponsiveness

Absence of brainstem reflexes Apnea suspension of external breathing

*higher-brain death

Non-heart beating irreversible cessation of

cardiopulmonary function

Ellen Bridget Linde, RN, BSN. Speaking up for organ donors. Issues in Nursing. January 2009


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Not an easy decision to make

Surrogate decision maker Substituted judgment standard

Best interest standard

Ellen Bridget Linde, RN, BSN. Speaking up for organ donors. Issues in Nursing. January 2009


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The organ shortage (2004)



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United Network for Organ Sharing. http://www.unos.org/index.php
http://www.unos.org/index.phphttp://www.unos.org/index.php


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Organ Procurement and Transplantation Network. http://optn.transplant.hrsa.gov/
http://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/


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The organ shortage

Distributive justice how to fairly divide resources Not one right way of distribution, but rather many

Criteria:

Equal access

Length of time waiting (i.e. first come, first served)

Age (i.e. youngest to oldest)

Maximum benefit

Medical need (i.e. the sickest people are given the first opportunity for

a transplantable organ)

Probable success of a transplant (i.e. giving organs to the person who

will be most likely to live the longest)

United Network for Organ Sharing (UNOS)

Maintains the list for the national waiting pool*



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Donor organs

Donor organ sources: Cadaveric (dead) donors postmortem

Living donors inter vivos

Alternative organ source

Organ farming

Premature declarations of death in order to harvest organs



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Will the doctors be anxious to hasten death in orderto transplant organs for a waiting recipient?

First and foremost, doctors primary concern is for the

patient in their care. In addition to steps outlined in this

brochure taken by Catholic hospitals, it should be notedthat the medical team working to save the life of an

individual is completely separate from the transplant team

that performs the organ transplants.

Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.


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Organ Donation by Living Donors

Physicians must risk the life of a healthy person to saveor improve the life of a patient.

Directed donation loved one or friend

Pressure

Compulsion Non-directed donation general pool, top of waiting

list

Motivation

Directed donation to a chosen stranger Biased and unfair

Buying and selling

Robert D. Truog, M.D. Ethics of Organ Donation by Living Donors. The New England Journal of Medicine. 4 August 2005.

Massachusetts Medical Society.


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Requirements

Since the time of Pope Pius XII, , based upon theprinciple of fraternal charity, but only when certain

requirements are met:

The necessity of informed consent legitimately given by the

donor or one who speaks for him.

The physical and psychological risks incurred by the donor

must be proportionate to the good sought for the recipient.

The donor must be aware of these risks and the

proportionate good.

To destroy the healthy functioning or intrinsic beauty ofone's body, even to delay death of another, is morally wrong.

http://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.html


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What the Catholic Church says.


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http://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplants


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How can I stay informed when makingimportant end of life decisions?

Catholics who are considering organ donation should

know that the Church has no official position on the

particular medical criteria that should be used fordetermining when death has occurred. The Church relies

on the expertise and judgment of scientists, clinicians, and

ethicists for such questions. Catholics should, however, be

informed about the ways in which death is determined inCanada and the distinct ethical issues for organ

transplantation that may arise with each method.


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How do opinions differ on the definition of deathwithin the Catholic community?

Most Catholic ethicist and clinicians accept brain death as

a valid way of determining when death has occurred. Pope

John Paul II in 2000 stated that the complete andirreversible cessation of all brain activity (in the

cerebrum, cerebellum and brain stem), if rigorously

applied, does not seem to conflict with the essential

elements of anthropology.(Address to the 18th International Conference

of Organ Transplant Specialists, August 2000)


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Transplants are a great step forward in sciencesservice of man, and not a few people today owe their

lives to an organ transplant. Increasingly, the

technique of transplants has proven to be a valid

means of attaining the primary goal of all medicine

the service of human life There is a need to instill in

peoples hearts, especially in the hearts of the young, a

genuine and deep appreciation of the need of

brotherly love, a love that can find expression in the

decision to become an organ donor.

- Pope John Paul II to attendees at the International

Congress on Transplant in Rome, August 2000


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Organ donation is a peculiar form of witness to charity. Ina period like ours, often marked by various forms of

selfishness, it is ever more urgent to understand how the

logic of free giving is vital to a correct conception of life.

Indeed, a responsibility of love and charity exists that

commits one to make of their own life a gift to others, if

one truly wishes to fulfill oneself. As the Lord Jesus has

taught us, only whoever gives his one life can save it (cf.

Luke 9:24).

- Pope Benedict XVI,

November 2008 Address at a Conference entitled,

A Gift for Life. Considerations of Organ Donation.


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The act of love, which is expressed with the gift of onesown vital organs, is a genuine testament of charity that

knows how to look beyond death so that life always wins.

The recipient should be aware of the value of this gesture

that one receives, of a gift that goes beyond the

therapeutic benefit. What they receive is a testament of

love, and it should give rise to a response equally generous,

and in this way grows the culture of gift and gratitude.

- Pope Benedict XVI,

November 2008 Address at a Conference entitled,

A Gift for Life. Considerations of Organ Donation.


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By donating your organs so that others may have life, youare in keeping with the Catholic Churchs teaching on

respect for life and the dignity of a human person.

The transplant of organs is morally acceptable with theconsent of the donor and without excessive risks to

him/her. Before allowing the noble act of organ donation

after death, one must verify that the donor is truly dead.

(Compendium of the Catechism of the Catholic ChurchSec. 2296, Compendium Sec. 476)


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[T]he Gospel of life is to be celebrated above all in daily

living, which should be filled with self-giving love for

others. . . . Over and above such outstanding moments,

there is an everyday heroism, made up of gestures of

sharing, big or small, which build up an authentic culture

of life. A particularly praiseworthy example of such

gestures is the donation of organs, performed in an

ethically acceptable manner, with a view to offering a

chance of health and even of life itself to the sick who

sometimes have no other hope.

(Evangelium Vitae, no. 86, original emphasis)



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Organ transplants are not morally acceptable if the donor

or those who legitimately speak for him have not given

their informed consent. Organ transplants conform with

the moral law and can be meritorious if the physical and

psychological dangers and risk incurred by the donor are

proportionate to the good sought for the recipient. It is

morally inadmissible directly to bring about the disabling

mutilation or death of a human being, even in order to

delay the death of the other persons (no. 2296).



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Human organ transplantation gives new hope, particularly to

patients with end stage diseases, to recover and regain an

acceptable and decent lifestyle. It provides a better quality of

life compared with alternative expensive and exorbitant

medical interventions (e.g., renal dialysis). Human organ

transplantation, however, cannot be separated from thehuman act of donation. John Paul II states that,

It is a decision to offer, without reward, a part of ones own

body for the health and well-being of another person. In this

sense, the medical action of transplantation makes possible thedonors act of self-giving, that sincere gift of self which

expresses our constitutive calling to love and communion. (20June 1991, no. 3)

CBCP Statement on Organ Donation Against Organ Sale. http://cbcponline.net/v2/?p=551


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We understand the poor and they should not be blamed.

There are other ways to help them but not through organ

sale. They are human beings and cannot be treated as

commodities. We encourage voluntary organ donation

from cadavers and also from living donors. We condemn

any form of organ sale and organ trade.

CBCP Statement on Organ Donation Against Organ Sale

CBCP Statement on Organ Donation Against Organ Sale. http://cbcponline.net/v2/?p=551


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References Ethics of Organ Transplantation. University of Minnesotas Center for

Bioethics. February 2004. PDF. Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics

Institute. PDF.

http://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplants.

Robert D. Truog, M.D. Ethics of Organ Donation by Living Donors. The New

England Journal of Medicine. 4 August 2005. Massachusetts Medical Society.PDF.

Ellen Bridget Linde, RN, BSN. Speaking up for organ donors. Issues inNursing. January 2009. PDF.


CBCP Statement on Organ Donation Against Organ Sale.http://cbcponline.net/v2/?p=551

United Network for Organ Sharing. http://www.unos.org/index.php

Organ Procurement and Transplantation Network.http://optn.transplant.hrsa.gov/
http://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://cbcponline.net/v2/?p=551http://cbcponline.net/v2/?p=551http://www.unos.org/index.phphttp://www.unos.org/index.phphttp://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/http://www.unos.org/index.phphttp://cbcponline.net/v2/?p=551http://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplants

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