Week 11: Organ Donation PDF

Week 11: Organ Donation What you need to know for the exam: - Ethical theory and organ transplantations - Medical risks for the donor - Benefiting the sick while endangering health - Utilitarian - hedonic calculus (for) - Kantian - autonomy, and no...

Week 11: Organ Donation What you need to know for the exam: - Ethical theory and organ transplantations - Medical risks for the donor - Benefiting the sick while endangering health - Utilitarian - hedonic calculus (for) - Kantian - autonomy, and no harm (against) - Moral obligation perspective on organ donation - Ensures individuals do not “fast tract” death to donate their organs to their loved ones which provides patients w more autonomy - Black market of organs - Intrinsic value of the body and instrumental /use value - Utilitarian perspective on organ donation - Hedonic calculus, we just need to weigh the potential benefits and risks to the involved parties - Kantian perspective (v strong on autonomy) - Breach of autonomy, violation of harm principle, treating individual as a means to an end - Ethical challenges: issues include resource allocation, fairness in organ distribution, and the ethical implcicaitons of experimental procedures - Pros and cons of xenotransplantation - Xenotransplantation: the transplantation of organs from animals to humans - Ethical issues - Human animal identity - Public health risks: possibility of zoonotic diseases - Animal rights - Commercialization of human tissue - ProS: - Offers a potential solution to organ shortages by using animal organs - Can save lives by providing organs for patients w limited options - Cons: - High risk of organ rejection and transmission of zoonotic disease - Ethical concerns about animal rights and welfare - Experimental nature raises questions about patient safety  - Who faces a risk of xenotransplantation? - Animals, humans, society - Link between death and organ donations - Brain dead definition: facilitate organ donation, brain death is defined as the irreversible cessation of all brain function - This death definition serves organ transplantation needs rather than objective criteria - Supply and demand issues - Ethical issues in organ transplantation - Changing definition of death “whole brain” complicate organ transplantation - Harvesting organs when people are not technically dead (still connected to a ventilator) is an ethical issue - Push for reformation of death definition was pushed along by the emergence of donation - When should we retrieve organs from a dying person? - Case of denmark - Claims that the moment at which we can harvest organs should be called an irreversible process of dying - gives green light for organ harvesting for 48 hours, but still keep them on the ventilator - Anencephalic infants (an - no, enchephalic - brain) - sources of organs - Babies born only wbrain stem, no brain - Organs for babies are v difficult to find - Putting these babies on ventilators adn cultivating the organs within for other babies - Would kantians approve of this? - Hell no, keeping babies alive to use as a means and not as ends - Are cadaveric organ donations a viable option? Why or why not - Not always, we are now living longer lives, so dead individuals likely lived a long time and no longer have good organs anymore - The definition of death is based upon the need for organs - Increasing the supply - Small number of deaths for organ harvesting - Educational campaigns = no increase in supply - Informed consent and donor cards  - Even if individual signs donor cards, families often override their wishes - Ethical debates about respecting autonomy vs familial consent - “Required request” - laws mandate hospitals to ask families about organ donation but nearly half decline - Mandated choice - mandated “have to” choice (make a choice) - Everyone is required to make a choice and sign some sort of document, there will be no ambiguity by ignoring the question, resulting in more people responding and more people saying yes - Presumed consent (pre-assumed consent) - If not declined, presumed as donor - We assume from the get go that everyone is an organ donor, and you must explicitly say no to opt out - All usable organs will be taken for donations - Organ donation consent systems in canada - All provinces and territories have an opt-in system, except nova scotia which as presumed consent (opt out) - Policy of conscription of organs - all usable organs will be removed and no consent is required - Logic behind this relates to john harris’ perspective on medical research, unethical for us to keep the organs to ourselves given the high need and scarcity - Organ donations: gift or moral obligation? - Financial incentives - Ideas include offering payments, tax discounts, or funeral expense coverage to encourage donations - Commodify human body, deterring altruistic donations and disproportionately affecting the poor - If informed consent is given, can we harvest organs from dying patients? Assisted suicide patients? - Less than 25% of canadians are registed organ donors - Allocation issues - Allocation: distributive justice - Caplan and Coelho’s two major points w organ donation - Maximizing the chances of success of the transplant  - Should you take into consideration the current status or lifestyle of patients to determine who should get it? - Responding to the most urgent need - the sickest should get it frist bc they are in more dire need - Criteria for allocation: - Ethical frameworks often prioritize factors like urgency, age and likelihood of success - Supportive family environment - Organ transplantation vs other medical needs - Key points from the videos that you watched - Historical context - First kidney transplant - many tries - 1954 - Boston, identical twins - 1960s - early heart transplants - Early attempts were mostly experimental - Most common and successful type of organ transplant - Kidney (90% for 5 years) > heart and liver (75% for 4 years) > lung pancreas - Kidney has most transplants and time waiting for transplants - Very costly and highly technical procedures, can take up a lot of resources - Experimentation w face, womb and other transplants - 5 major ethical issues with organ transplantation (people are selling it) (CASCD) - Cost - Allocation - Supply - Changing definition of - Demand - Consent - Countries with highest rates of organ donation - Spain - US - Croatia - Portugal - France - Transplant tourism: patients travelling abroad to purchase organs, often exploiting vulnerable populations… illegal