ORGAN

DONATION
Course: Bioethics, Semester 02, 2020-2021
Instructor: Ph.D. Ha Thi Thanh Huong
Group members: Nguyen Dac Can_BEBEIU17056
Le Thi Hoang Uyen_BEBEIU17068
Nguyen Phuong Thanh_BEBEIU17035
 TABLE OF CONTENTS
!" !&
OVERVIEW LEGAL FRAMEWORK

!# !$ !%
VIEWPOINTS CASE STUDY CONCLUSION
 STATISTIC OF ORGAN DONATION

107,000+ people on the national transplant waiting list as of February 2021.

3/1000
Only people die in a way that allows for organ donation.

9
Every minutes another person is added
to the transplant waiting list. 20 people die each day waiting
for an organ transplant.

39,000 transplants were performed in 2020.

STATISTIC OF ORGAN DONATION IN VIETNAM

40,000+ organ donation registers

5,400+ transplantation have been done

2,500+ people signed up to wait for a transplant

WHAT DO YOU THINK ABOUT
ORGAN DONATION?

IS ORGANS DONATION ETHICAL?

 !"
OVERVIEW
 ORGAN DONATION

Definition: Organ donation is the

process when a person allows an organ
of their own to be removed and
transplanted to another person.
Donate → DONOR

Receive → RECIPIENT
 ORGAN TRANSPLANTATION

Definition: Organ transplantation is the

process of transferring a donated organ
to someone diagnosed with organ
failure.
§ Most commonly transplanted: kidneys
§ Most commonly transplanted tissue:
cornea
 ORGAN TRANSPLANTATION

The factors considered:

§ Blood type
§ Body size
§ Severity of medical condition
§ Distance
§ Waiting time
WHAT ORGANS AND TISSUES CAN BE DONATED?

ORGANS TISSUES
 TYPES OF DONOR
Living organ donation Deceased organ donation

§ Donor is still alive. § Donor is dead.

§ Increase availability for people § Declare brain death → becomes
waiting for a deceased donor. eligible for donation
§ Receive best quality organs. § Keep functioning of the body with
§ 3 types: directed, non-directed, the help of machines and drugs.
paired § 2 main types: Brain death or Cardiac
death
 WHO CAN DONATE?
❏ Anyone, at any age:
Over 18: register to be a donor for any organs, can change status
any time.
Under 18: need consent of parent or guardian.
❏ For deceased organ donation, a medical assessment will be done
❏ Exclude organs with HIV, actively spreading cancer, severe
infection.
 WHO CAN DONATE?

Fig: Hai An, 7 years old,

donated her cornea when
she passed away.
HOW TO REGISTER TO BE A DONOR IN VIETNAM?
In Ho Chi Minh City In Ha Noi Capital

Register with Cho Ray Hospital in Ho Chi Register with Viet Duc Hospital in Ha
Minh City: 2 forms Noi: 2 forms
§ Register directly at the hospital. § Register directly at the hospital.
§ Sign up via Email or Facebook § Download, print and fill out the form
Fanpage. at the link http://vnhot.com.vn, then
Phone: 0913677016 send it.
Email: dieuphoigheptangbvcr@gmail.com Phone: 0915060550
Fanpage:
https://www.facebook.com/dieuphoigheptangbvcr/
 HOW DOES PROCESS WORK?
Waiting for a transplant Becoming a donor
A person who has A person who has
organ fails. complete and irreversible
The patient is loss of brain function.
evaluated for a The patient is declared
potential transplant clinically and legally
and placed on the dead.
national organ Hospital checks the donor
transplant waiting registry.
list. → donation is an option.
 HOW DOES PROCESS WORK?
Waiting for Finding a match Becoming a
a transplant donor
Match donor with
suitable recipient.

Saving lives
Contact the recipient
Recover the organs and
send it to the hospital for
transplant.
 TRANSPLANT REJECTION

Definition: Transplant rejection is a process in which a recipient's

immune system attacks the transplanted organ or tissue.
Cause: The immune system detects foreign organs because the antigens
on the organ's cells are not “matched".
→ blood transfusion or rejection reaction.
 TYPES OF TRANSPLANT REJECTION
Hyperacute Minutes to hours
The antigens are completely unmatched.
→ Organ must be removed
Acute Days (one week) to months
T-cytotoxic lymphocytes attack to the transplanted organ.
Chronic Months to years
The body's constant immune response against the new
organ slowly damages the transplanted organ.

Symptoms: Organ’s function decrease, pain at the site of the transplant, feeling ill, fever, flu,…
HOW TO PREVENT TRANSPLANT REJECTION
Before transplantation occurs:
§ Ensure have compatible blood types
§ Perform genetic testing
§ For living donors, prefer organs from relatives.
After transplantation occurs:
§ Lab results in first year.
§ Anti-rejection medications
§ Organ recipients should also educated of the possible signs
 '()*'+,)-+.)*/0*/123.*3.4*'+556)*'13.57-3.'5
Joseph Murray and J. Hartwell Harrison
"8%$ performed first successful kidney transplant
First successful kidney transplant performed performed between identical twins – 8 years.
between siblings who were not twins – 2 years. "89!
"899 First successful liver transplant – over 1 year.

First successful heart transplant – 18 days. "89;

"8:" First combined heart/lung transplant performed
– 5 years.
First successful hand transplant performed in
France.
"88:
First successful partial face transplant
&!!% performed in France.
 !&
LEGAL FRAMEWORK
 Country Policy Year implemented
SYSTEM: Argentina opt-out 2005

Brazil opt-in
§ Opt-in (explicit consent):
Chile opt-out 2010
actively register
Colombia opt-out 2017

§ Opt-out (presumed consent): Spain opt-out 1979

Austria opt-out
automatically register
Belgium opt-out

VIETNAM OPT-IN United Kingdom opt-out 2020

Israel opt-in

United States opt-in

 WORLD POLICIES
Transplantation of Human Organ Act (2017)
Guidelines for deceased donors:
q Require brain-death declaration, include certification from:

+ Doctor

+ Neurosurgeon or neurologist

+ Physician, anesthetist, intensivist (THOA-2014).

 WORLD POLICIES
Guidelines for living donors:

q First relative donors:

+ Require to provide proof (genetic testing or legal documents)

+ Competent authority/Authorization Committee

q Near relative donors:

+ Only require Authorization Committee

 WORLD POLICIES

q Unknown donors:

+ Require a license from Appropriate Authority

+ Only be given to hospitals after verifying their capacity and

infrastructure.
 VIETNAM POLICIES
Prohibit:

§ Buying and selling organ.

§ Taking tissue and organs of people under 18 years old.

§ Transplanting human sperm and ovule in consanguinity.

§ Revealing information about the donor and recipient.

 VIETNAM POLICIES

Donor benefits:

§ Free health care, health check-up.

§ Free health insurance.

§ Priority transplant tissue and organs.

 !#
VIEWPOINTS
MYTHS ABOUT ORGAN DONATION

§ Have medical condition = cannot be a donor

§ Against religion

§ Recipients pay for donation

§ Distrust organ donation system and process

 SUPPORTING
Argument 1: Organ donation satisfies autonomy.
 SUPPORTING
Argument 1: Organ donation satisfies autonomy.

Based on opt-in and opt-out system

→ Respect the dignity and value of
individual choice.

RESPECT FOR PERSON

 SUPPORTING
Argument 2: Donated organ, the miracle that can save one's life.

MAXIMINE THE BENIFITS

 SUPPORTING
Argument 3: Justification of organ donation for
donors and recipients
 SUPPORTING
Argument 3: Justification of organ donation for
donors and recipients
vAllocation/Waiting list
vMoral criteria:
§ Base on medical criteria and need not on the
social, financial or political status.
§ Willing to donation.
§ Regardless of the race, religion or ethnic origin.
 SUPPORTING
Argument 3: Justification of organ donation for
donors and recipients
The method of allocation:
§ Geographical location: local → state or region → nation
§ The blood group compatibility and histocompatibility matching
§ Waiting list variables: (a) the time of waiting, (b) immunological
matching, (c) medical urgency, (d) the age of the patient

FAIRNESS
 OPPOSING
Argument 1: While autonomy is a fundamental value, it
does not justify organ donation.

Baby Fae is the first transplant from a

baboon to a newborn infant with heart
failure, who survived for 20 days.

NEGATE AUTONOMY
 OPPOSING
Argument 1: While autonomy is a fundamental value, it
does not justify organ donation.
Organ Trafficking
&
Transplant Tourism

AGAINST THE PATIENT’S

Chinese child had his eyes cut out
RIGHT FOR AUTONOMY
 OPPOSING
Argument 2: Many risks of organ donation.

MORE HARM THAN GOOD

Risks from zoonotic infections Medical and surgical conditions are not
(xenotransplantation) guaranteed in black market
 OPPOSING
Argument 3: Injustice in organ donation

Executed Chinese prisoners

 OPPOSING
Argument 3: Injustice in organ donation

§ Corruption in the judicial process.

§ The lack of informed consent (presumed consent).
§ Death row inmate: use of harvested organs for profit.

UNFAIRNESS
DO YOU SUPPORT OR OPPOSE
ORGAN DONATION?
 !$
CASE STUDY
CASE STUDY 1
 CASE STUDY 1

Inmate Nguyen Hai Duong, the

perpetrator of the terrible massacre in
Binh Phuoc province, has his last wish to
donate his body to medicine.
 CASE STUDY 1
Question 1:
If you are a state authority, do you agree to accept Nguyen Hai Duong's
will?

Question 2:
If you are an organ donor patient, will you receive organs from a death
row inmate?

Question 3:
Is it ethical to take organs from executed prisoners ?
CASE STUDY 2
 CASE STUDY 2

In this movie, a couple with the

intention of curing their son's
congenital disease and adopting a
baby girl, then waiting for the girl to
reach maturity using her love for her
brother to persuade her to donate
organs to her brother.
 CASE STUDY 2

Question 1:
In your opinion, was this couple's actions legal and ethical?

Question 2:
If you are the son of this couple, and unknowingly you know
their intentions, will you accept a transplant ?
 CASE STUDY 3

Falun Gong practitioners expose the Chinese Communist Party's

crimes outside of the United Nations building in New York
 CASE STUDY 3

The number of organ transplant

surgeries in China every year is huge,
and at the same time hospitals find
organs very quickly, but there are some
scandalous informations about the
Falun Gong case has been uncovered in
the past few years.
 CASE STUDY 3
Question 1:
In your opinion, whether the Chinese government figures and
information are reliable. Is it possible that China can reach such a
large number and miraculous speed just by the supply of volunteer
donors?

Question 2:
If you or a family member needs an organ transplant, would you like
to go to China to increase your percentage success ?
 !%
CONCLUSION
ENGINEER SOLUTION
3D printing human tissue
 ENGINEER SOLUTION
Stem cell therapy
All stem cells can self-renew (make copies
of themselves) and differentiate (develop
into more specialized cells)

→ Stem cells derived from the recipient

may repair damaged endothelial cells of
arteries in transplant organs,reduce the
immune response that causes transplanted
cells to be rejected by the recipient.
 REFERENCES
1. Abouna, George M. Debate: Medical Ethics Series 1 Ethical Issues in Organ Transplantation. 2003,
doi:10.1159/000068158.
2. Caplan, Arthur. “Bioethics of Organ Transplantation.” Cold Spring Harbor Perspectives in Medicine, vol. 4, no. 3,
Cold Spring Harbor Laboratory Press, 2014, doi:10.1101/cshperspect.a015685.
3. Deuse, Tobias, et al. “SCNT-Derived ESCs with Mismatched Mitochondria Trigger an Immune Response in
Allogeneic Hosts.” Cell Stem Cell, vol. 16, no. 1, Cell Press, Jan. 2015, pp. 33–38, doi:10.1016/j.stem.2014.11.003.
4. Heid, Susanne, and Aldo R. Boccaccini. “Advancing Bioinks for 3D Bioprinting Using Reactive Fillers: A Review.”
Acta Biomaterialia, vol. 113, Acta Materialia Inc, 1 Sept. 2020, pp. 1–22, doi:10.1016/j.actbio.2020.06.040.
5. How Organ Donation Works | Organ Donor. https://www.organdonor.gov/about/process.html. Accessed 19 Apr.
2021.
6. Shroff, Sunil. “Legal and Ethical Aspects of Organ Donation and Transplantation.” Indian Journal of Urology, vol.
25, no. 3, Wolters Kluwer -- Medknow Publications, 2009, pp. 348–55, doi:10.4103/0970-1591.56203.