Organ Donation

Ethics of Transplants
In organ Transplants ,there should be ethical decisions involve like
determination of Death
An Individual who has sustained either :
1. Irreversible cessation of circulatory and respiratory functions
2. Irreversible cessation of all functions of the entire brain stem ,is dead.
A determination of death must be made in accordance with accepted
medical standards.
Organ donation
Organ donation is the process when a person allows an organ of their own to be
removed and transplanted to another person, legally, either by consent while
the donor is alive or dead with the assent of the next of kin.

Republic Act No. 7170, otherwise known as the Organ Donation Act of 1991, as amended by

Republic Act No. 7885, organ and tissue donations from donors who have been declared brain
dead has been allowed.
Authored by Senator Richard Gordon, the “Organ Donor Act of 2018” states that
the internal organs of 'brain dead' patients will automatically be harvested for
transplant to patients in need. ... “We have to educate all the Filipinos that there
is such a thing as deceased organ donation

The Ethics of Organ Donation from the Patients perspective

The ethics of human donor are influenced by the question of whether the
donation involves a renewable resource such as blood or bone marrow or paired
nonrenewable organs such as the corneas ,kidneys or non paired non renewable
organs such as the liver and the heart.

The donation of the organs inter vivos between living persons would be unethical
except in rare cases unless approves of altruistic suicide like when a living donor
gives his heart as the donor simultaneously about to receive the heart or lungs
from the third party
Donor must have inform consent
Surrogate decision making is more complex whether for an incompetent adult or
a child
Examples : Parents conceiving a child in the hope if providing bone marrow
donor for older sibling.Parents here are surrogate and must give permission for
such blood a donation and must operate in the best interest of the donor.

ETHICAL CONSIDERATIONS
1. Informed Consent
Ethically justifiable living organ donation presupposes the competent donor’s voluntary
informed consent. Competence or capacity in this context refers to the prospective
donor’s ability to understand the relevant information in relation to his or her personal
values and interests and, on that basis, to make a thoughtful decision about donation.
When the individual being evaluated for living donation lacks the capacity to make such
a decision, he or she cannot, strictly speaking, be a “donor,” that is, one who
competently decides to donate

2. Voluntary Consent
General ethical concerns focus on a potential donor’s competence, level of
understanding, and voluntary choice, whatever the relationship between the donor
and the recipient. When the prospective donor is related to the recipient, which
usually involves close affective ties as well as the genetic relationship, specific
concerns focus on the dangers of undue influence, pressure, and coercion, even if he
or she is competent, has received adequate information, and appears to understand
that information.
3. Donations, Not Sales
An ethical concern about living unrelated donation that frequently arises is that the
organ is actually being sold or, at least, that financial incentives partially motivate
the donation. For example, such concerns have arisen with regard to solicitations on
the Internet (Steinbrook, 2005). Money may be a factor in living related donations
too. Whatever the context, compensation for organs is illegal under Section 301 of
the National Organ Transplant Act: “It shall be unlawful for any person to knowingly
acquire, receive, or otherwise transfer any human organ for valuable consideration”
(Public Law 98-507). Compensating living donors opens up the possibility of
exploiting poor and underprivileged people and also increases the risk that
potential donors will withhold relevant medical information.
4. Independent Donor Advocate Team
In determining which potential living donors will be accepted, transplantation
teams serve as ethical gatekeepers, with less societal oversight than occurs in much
of transplantation. Additionally, they may have an inherent conflict of interest
because they seek to obtain an organ for patients on the waiting list while assuming
major responsibilities to potential and actual donors.
5. Living Donor Follow-Up
living donation developed on an ad hoc basis in various transplant centers and has
never had the central oversight and supervision that has marked practices of
donation by deceased individuals. As a result there is no national infrastructure for
gathering information and for ensuring accountability as there is for donation by
deceased individuals.
The Ethics of Cadaver Organ Donation
When dealing with the cadaver donation the harvest and transplant the organ as
quickly as possible .
The philosophical ambiguity regarding the nature of death is clearly seen as
disputes about whether death is the end of all existence, a reentry into another life
on earth. Even as generalized definition of death as the irreversible loss of functions
essentially significant to it or death as irreversible loss of capacity or social
interaction does not solve the problem.
The Uniform Definition of Death Act (UDDA) has been adopted by many and
provides as follows:
An individual who has sustained either
1. irreversible cessation of circulatory and respiratory functions
2. irreversible cessation of all functions of the entire brain including the brain stem
is dead.
The Harvard Criterion of Irreversible Coma ( Beuchamp and Perlin 1978 ) is an
example of one set of medical standards .These Criteria call first to the elimination
of the possibility of hypothermia and coma induced by barbiturates and then the
application of the following four tests
1. unreceptivity and unresponsitivity even to intensely painful stimuli
2. no movement or breathing during an hour long period of observation
3. no reflexes
4. a flat electroencephalogram
Cardiac death
The United Network for organ sharing (UNOS ) http.//.unos .org/)lists a daily
update of waiting list candidates which on March 9, 2012 was 122,950 .Seventy five
percent comes from a deceased patient and the most rapid rise was is those who
had a medical situation that did not result in brain death but left the patient
terminal and usually supported by a ventilator without hope of recovery .Many had
injuries or illnesses that did not affect other organs leaving these ideal for
transplantation .These procedure involves withdrawing life support using all
comfort measures and there has been total arrest of circulation for 5 minutes ,the
organs are procured.
REFERENCES
Abecassis M, Adams M, Adams P, Arnold RM, Atkins CR, Barr ML, Bennett WM, Bia M,
Briscoe DM, Burdick J, Corry RJ, Davis J, Delmonico FL, Gaston RS, Harmon W, Jacobs CL,
Kahn J, Leichtman A, Miller C, Moss D, Newmann JM, Rosen LS, Siminoff L, Spital A,
Starnes VA, Thomas C, Tyler LS, Williams L, Wright FH, Youngner S. 2000. Consensus
statement on the live organ donor. Journal of the American
Medical Association 284(22):2919–2926.
ACOT (Advisory Committee on Organ Transplantation), U.S. Department of Health and Human
Services. 2005. Recommendations. [Online].
Available: http://www.organdonor.gov/acotrecs.html [accessed February 23, 2006].