Bioethics Discussion Blog: Organ Donation: Who, How,Why and also What are the Ethics? (5)

REMINDER: I AM POSTING A NEW TOPIC ABOUT ONCE A WEEK OR PERHAPS TWICE A WEEK. HOWEVER, IF YOU DON'T FIND A NEW TOPIC POSTED, THERE ARE AS OF MARCH 2013 OVER 900 TOPIC THREADS TO WHICH YOU CAN READ AND WRITE COMMENTS. I WILL BE AWARE OF EACH COMMENTARY AND MAY COME BACK WITH A REPLY.

TO FIND A TOPIC OF INTEREST TO YOU ON THIS BLOG, SIMPLY TYPE IN THE NAME OR WORDS RELATED TO THE TOPIC IN THE FIELD IN THE LEFT HAND SIDE AT TOP OF THE PAGE AND THEN CLICK ON “SEARCH BLOG”. WITH WELL OVER 900 TOPICS, MOST ABOUT GENERAL OR SPECIFIC ETHICAL ISSUES BUT NOT NECESSARILY RELATED TO ANY SPECIFIC DATE OR EVENT, YOU SHOULD BE ABLE TO FIND WHAT YOU WANT. IF YOU DON’T PLEASE WRITE TO ME ON THE FEEDBACK THREAD OR BY E-MAIL DoktorMo@aol.com

IMPORTANT REQUEST TO ALL WHO COMMENT ON THIS BLOG: ALL COMMENTERS WHO WISH TO SIGN ON AS ANONYMOUS NEVERTHELESS PLEASE SIGN OFF AT THE END OF YOUR COMMENTS WITH A CONSISTENT PSEUDONYM NAME OR SOME INITIALS TO HELP MAINTAIN CONTINUITY AND NOT REQUIRE RESPONDERS TO LOOK UP THE DATE AND TIME OF THE POSTING TO DEFINE WHICH ANONYMOUS SAID WHAT. Thanks. ..Maurice

FEEDBACK,FEEDBACK,FEEDBACK! WRITE YOUR FEEDBACK ABOUT THIS BLOG, WHAT IS GOOD, POOR AND CONSTRUCTIVE SUGGESTIONS FOR IMPROVEMENT TO THIS FEEDBACK THREAD

Friday, February 25, 2005

Organ Donation: Who, How,Why and also What are the Ethics? (5)

There is a source of organs for transplant that represents one of the highest forms of humanistic altruism and that is an organ donation from a living donor. But there are real ethical and psychologic concerns about this action and it is on this topic that I would like to conclude my series on organ donation.
You first need to read the article in Virtual Mentor in which reporter Chris Fusco wrote about his series of articles in the Chicago Sun-Times where he describes his experiences as a living donor of part of his liver. In Virtual Mentor there is a link to the Sun-Times where you can access these articles. The following is a brief excerpt from the start of the Virtual Mentor article which sets the beginning of his journalistic endeavor.


When journalists have opportunities to escape their newsrooms and report stories first hand—to spend days, weeks, or even months with their subjects—they usually chomp at the bit to take them. In most cases, I would, too. But this story was personal. It was August 17, 2000, when my childhood friend Mark Mucha told me that he had liver cancer and might need a living-donor transplant to save his life. Four of my friends and I ended up on the short list to be Mark’s liver donor, and, after nearly 4 months of waiting, I was selected. Adding to the drama was that Mark was a new dad, and that my wife Jennifer was 8 months pregnant with our first child when Mark and I went into surgery on December 12, 2000. We were both 28. … The problem was that this story did not have a happy ending. Mark died on March 25, 2001, after a series of complications that included my liver failing him and a second transplant not working, either


The problem with living donors compared with dead donors is that both parties are alive and aware of the gift and the donor and the recipient may each have their own good feelings of what has happened but each may also have their own uncertainties about it too. If both parties remain separated and anonymous to each other some of the psychologic issues of the transplant will be moot but even if they had not met, there may be a drive in both to finally meet and express their feelings to each other. Some of the feelings that have been discussed by those studying living donor transplants have to do with a feeling of duty by the recipient to, in some way, pay back the sacrifice of the donor. Remember, no money has changed hands or is legal as part of the transplant. Even, though initially the donation represented an altruistic gesture, the donor may eventually expect something back from the recipient. But what is the “something”? This may lead to an unhealthy relationship developing between these two individuals and even their families unless these hidden feelings are brought out. Would it be ethically more beneficent to both parties if the transaction was handled as a sale of a commodity? Yet this idea of selling organs brings up a host of other ethical issues regarding issues as simple as whether the human body parts can be considered commodities. Also what impact selling organs would have on from where the organs would be coming? For example, would this lead to those people who were financially poor to be the more likely population to take the physical risks of surgery and loss of an organ or tissue rather than those financially well off? And would this be just? Would selling organs stimulate a “black market” of organs and be associated with criminal behavior?

What about the situation as described in the story by Chris? The liver tissue that Chris donated “failed” Mark. Think of what a donor might consider if this should happen. Was it the donor’s failure or was the recipient not compliant in some way and caused this to happen? And what about a perhaps unrealistic guilt a recipient might have about this failure.

Another issue about living donors is the greater possibility that the donor will be aware of the specific recipient and that the chances for a directed donation would be more likely depriving those in need on a waiting list for that organ.

These are just some of the issues along with those in my previous posts that have been of concern regarding organ donation. And now for the "Why" regarding the continued dependence on organ donation. At present there is no simple and more permanent way to substitute organ function. Ideally, the answer to the problem of providing life supportive treatment to those whose vital organs have failed them is to eliminate organ transplantation entirely. After all this procedure is only available to a small fraction of those in need. The preservation of a transplanted organ may require a lifetime of compliant complex medical management. What would be best if we can’t prevent even premature organ failure by specific approaches would be to study and try to develop organ repair and regrowth with the use of human stem cells based on their suspected potential value. If this was possible, organ donation along with its limitations and ethical concerns would become an extinct procedure. ..Maurice.

3 Comments:

At Saturday, September 02, 2006 10:36:00 PM, Anonymous Anonymous said...

One of the largest religions that welcomes organ donation are the United Methodists. This church is aware of the meaning behind donating your organs and knows that this will at some point save someone else’s life.

 
At Sunday, September 03, 2006 9:21:00 PM, Blogger Maurice Bernstein, M.D. said...

Thanks for the encouraging information. ..Maurice.

 
At Monday, July 20, 2009 10:01:00 PM, Blogger Maurice Bernstein, M.D. said...

Here is a comment on the subject of organ donation and receiving an organ by my visitor Leemac. ..Maurice.

I have had to rethink about organ donation.. I still have no desire at al to be a recipient.... I don't even want blood transfusions..., But I have had occasion to be exposed to some who have needed one.. at first I had to admit to myself..that I would not care if bone or skin tissue were needed by someone and I wasn't going to be needing them anymore that it would be ok if they got mine... (I saw some heatbreaking stories...) and could no longer feel ok about taking them to the furnace or grave with me.. (If I die away from home, I will be cremated.. If I die at my old home and I can be buried within 24 hours, I will be buried without embalming in my family cemetery.) After thinking about it some more, I could not distinguish why skin or bone would be ok, but liver, kidneys or heart wouldn't (mine are ok for a 57 year old).
So, although ( I mean no disrespect Dr. Bernstein) I am a bit nervous about dieing by having my heart vessels clamped off.. I have little faith in brain death diagnosis.., it will be ok with me to take what parts can be used.
leemac

 

Post a Comment

<< Home