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Organ donation and transplant involves a number of ethical considerations.
Medical ethicists address these issues with a great deal of care and consideration
so that donation and transplant are used in the best interest of our society.
All ethical issues are extremely complex and involve many aspects, influences
and ramifications. The following list gives a very brief, simplistic overview
of common ethical considerations and prominent views from each side. It is not
intended to be a complete synopsis or endorsement of any particular perspective.
Ability to pay for transplant -- Should transplant centers be able to
reject
some patients due to the patients' inability to pay?
Yes -- transplants are very expensive and providing expensive treatments
at no cost can drain the resources of healthcare providers, potentially leading
to cutbacks and inability to provide treatment to additional patients.
No -- everyone should be afforded basic healthcare and shouldn't be allowed
to suffer or die due to lack of funds.
Allocation -- Is the allocation process fair and ethical? Should organs
be given to prisoners, and people with self-inflicted medical
conditions, such as alcoholism and drug addiction?
Yes -- "Worthiness" should not be considered, only medical necessity.
Trying to determine who is the most worthy of an organ transplant by evaluating
character, morality and societal role is not only impossible, it creates a competitive
"caste" medical system in which people vie for transplants by proving
their social value.
No -- A precious resource like organs, of which there are not enough to
satisfy the need, shouldn't be wasted on people who put themselves in their situations
due to illegal or immoral behavior while other, law-abiding people wait.
Cloning -- Should cloning technology be used to increase the availability
of transplantable organs?
Yes -- It's a potentially huge development in transplant technology that
could save thousands and thousands of human lives, possibly erasing the transplant
waiting list.
No -- It manipulates nature, may lead to unknown, unforeseen medical complications,
and is unethical or immoral based on when the definition of "when life begins"
and what constitutes the creation of life.
First-person consent -- Should a family be able to "over-rule"
what an individual expressed regarding organ donation on his/her driver's license
or uniform donor card?
Yes -- The welfare of a living family is more important than a deceased
individual and nothing should be done that would traumatize a hurting, grieving
family even more.
No -- The deceased person legally expressed his/her wishes regarding donation
and those wishes should be honored.
For-profit vs. not-for-profit tissue banking -- Should for-profit tissue
banking be allowed?
Yes -- These organizations are able to direct more money into research
and development and find more uses for tissue, resulting in being able to help
more people.
No -- Companies that profit financially from tissue donations "commodify"
the human body and the notion of people profiting from others' death and tissue
donation is offensive.
Living donation -- Should transplant centers perform living organ donation for transplants, especially riskier procedures such as living liver and lung donations?
Yes -- These are low-risk, live-saving surgeries and transplant centers
are obligated to help families who desperately want to save their loved ones'
lives.
No -- There is too much risk to donors -- perfectly healthy individuals
who do not need the surgery, especially for liver donations, and contradicts doctors'
basic tenet of "due no harm."
Payment for donor families -- Should donor families (or living donors)
receive payment for organ donations?
Yes -- It would serve as an incentive to increase donation and donor families
are the only ones in the transplant process who don't benefit from their organ
donation.
No -- It's illegal, would not serve as an incentive to increase donation
and is offensive to donor families.
Presumed consent -- Should our system be that everyone is "presumed"
to be a donor, unless he/she has "opted out," unlike the system of "opting
in," in which people have to express their desire to be donors?
Yes -- It would greatly increase the number of organs available for transplant
and still give people the same option of whether or not they want to be donors.
No -- It would give the medical system too much authority over organ donations
and violate our civil liberties as citizens.
Xenotransplant -- Should genetically engineered animals be raised for
the purpose of supplying transplantable organs to people?
Yes -- Animals are already raised for human consumption and it's a potentially
huge development in transplant technology that could save thousands and thousands
of human lives, possibly erasing the transplant waiting list.
No -- It manipulates nature, may lead to unknown, unforeseen medical complications,
and is cruel to animals.
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