Organ Donation

Instructor: Ha Thi Thanh Huong, PhD

TA: Vinh Bao Phuc Hung
Vu Thuy Quynh Giao
 Our team

Đoàn Bảo Ngân Hứa Thành Đạt

Phạm Thị Hồng Ngọc
BEBEIU21243 BEBEIU21006
BEBEIU21091

Hồ Nguyễn Minh Nguyên Nguyễn Ngọc Khánh Thy

BEBEIU21247 BEBEIU21123
 Table of contents
01
Introduction 05

02 Engineering solutions

Bioethical questions
06
03
Case study
Scientific Background
07
04
Summary & Conclusions
Legal framework
 01
Introduction
 Organ donation

Organ donation, the act of giving one or

more organs (or parts thereof), for
transplantation into someone else, a very
personal complex decision
 Purposes
With the donors: With the recipients:
- Altruistic Satisfaction - It offers a second chance at
- Long-Term Health life
Impact (Living - A positive impact on the
Donors) psychological well-being of
- Increased Awareness recipients.
 Types of organ donation
Death Donor: Living Donor
- Giving an organ or a part - A person who is alive
of an organ, at the time of and willingly donates
the donor’s death, for the one of their organs,
purpose of transplantation such as a kidney or
to another person. part of their liver, to
- Includes organ, cornea another person in
and tissue donation. need of a transplant.
 The process of Organ donation

01 Waiting for a transplant

02 Become a donor

03 Finding a match

04 Saving lifes
 History
Perspective
 Stages

Ancient
Early 19th In recent
civilization century years

Middle Ages 20th century

In the ancient civilizations of Egypt, Greece, and
Rome, organ donation was practiced to some extent.
During the Middle
Ages, religious dogma
discouraged the practice
of organ donation.
The practice of organ donation reemerged in the early 19th century,
driven by the scientific advancements in anatomy and the emergence of
medical schools.
The development of
anesthesia and
immunosuppressive
medications in the 20th
century paved the way
for the modern practice of
organ donation and
transplantation.

In 1954 the surgeons transplanted a

kidney from Ronald Herrick into his
twin brother Richard.
In recent years, organ donation and transplantation have become a
fundamental part of modern medicine.
 Problems
statement
When do we think of an organ
transplant solution?
 When do we think of an organ
transplant solution?
You may need an organ transplant if one of your
organs is not working any more. An organ transplant is
usually only considered after all other treatments have
failed and your medical specialists believe you will
benefit from a transplant.
 Is there anyone who is not allowed
to donate organs?
Almost everyone is a potential
organ or tissue donor. There’s
no official age limit, and most
people have healthy parts left
even when disease has
affected other parts.
 02
Bioethical questions
 Principles to consider
Autonomy Beneficence
Individuals have the right to Medical professionals act in the best
make their own decisions about interest of the patient. This includes
organ donation, the right to identifying potential donors,
refuse or consent to organ conducting careful evaluations of
donation. potential recipients, that maximizes
the health benefits to the recipient.

Justice Respect for persons

Justice requires that organs are
distributed fairly and equitably among Respect for persons in organ
potential recipients, regardless of their donation and transplantation
age, race, gender, etc. practices is crucial and
preventing exploitation or
stigmatization of recipients.
How to solve organ
shortage?
 BIOETHICAL QUESTIONS
How to solve organ shortage?

Raise public awareness about the importance of organ donation

through educational campaigns and outreach programs to increase
organ donation rates.
 BIOETHICAL QUESTIONS
How to solve organ shortage?

Invest in research to develop new techniques for organ preservation,

transportation, and regeneration, which could extend the viability of
donated organs.

Improve the organ allocation system to ensure fairness, transparency,

and equitable distribution of available organs.
 BIOETHICAL QUESTIONS

Can brain dead patients donate organs?

Brain death is defined as the irreversible loss of all functions
of the brain and they will not ever regain consciousness or
start breathing on their own again. They have already died.

Brain death is essential to current practices of organ

retrieval because it legitimates organ removal from bodies.
 Does the family have the
right to a person's decision
to donate organs?
 BIOETHICAL QUESTIONS

Does the family have the right to a person's decision to

donate organs?

Families described choosing to donate as they found a sense of

meaning at the time of donation and creating a positive outcome or the
deceased expressed a wish to donate their organs during their lifetime.

The family does not agree to donate organs because of uncertainty

regarding the patient’s wishes, religious/cultural reasons, concerns over
delay in the funeral/burial process.
 BIOETHICAL QUESTIONS
Sources
[1] Yeung MY, Coates PT, Li PKT. Kidney Organ Allocation System: How
to Be Fair. Seminars in Nephrology. 2022;42(4).
doi:10.1016/j.semnephrol.2022.09.002

[2] Dalal AR. Philosophy of organ donation: Review of ethical facets.

World Journal of Transplantation. 2015;5(2):44. doi:10.5500/wjt.v5.i2.44

[3] Kumar L. Brain death and care of the organ donor. J Anaesthesiol
Clin Pharmacol. 2016;32(2):146-152. doi:10.4103/0970-9185.168266
 Scientific
background

03
 Scientific background
People who need organs often have serious
pre-existing conditions such as infections, hepatitis
and damage from chronic diseases such as diabetes
or genetic diseases.
 Scientific background

Advantages of organ donations

For donors: Create positive emotions and meaning for the
donor's life.

For recipients: Help people who need an organ transplant

have a normal life. Improves the quality of life, and increases
the recipient's lifespan.

For society: In some cases, donated organs are used for

research purposes to develop medical potential and save
future lives.
 Scientific background

Disadvantages of organ donations

For donors:

For living donors, it can lead to impaired function of some organs

or cases of infection and bleeding.

For recipients:

The recipient may face incompatibility and rejection of the

transplanted organ.

A process that costs a lot of money for the technology used, the
post-operative care, and the testing.
 Scientific background
Statistic for organ waiting list
 Scientific background

Sources
[1] Bunnik EM. Ethics of allocation of donor organs. Curr Opin Organ
Transplant. 2023;28(3):192-196. doi:10.1097/MOT.0000000000001058

[2] What are the Benefits of Organ Donation? Accessed October 30,
2023.
https://www.midamericatransplant.org/news/what-are-benefits-organ-
donation

[3] Bahador RS, Farokhzadian J, Mangolian P, Nouhi E. Concerns and

Challenges of Living Donors When Making Decisions on Organ Donation:
A Qualitative Study. Iran J Nurs Midwifery Res. 2022;27(2):149-156.
doi:10.4103/ijnmr.ijnmr_158_21
 04
Legal framework
 Legal Framework
Researching the legal regulations of some countries around the world, based on
the time of donation, it can be divided into two cases: donating tissues and
organs while alive and conditions for donating tissues, organs, and body after
death. Basically, every country has regulations on age, health and procedural
conditions.
 Legal Framework

In Dutch: Dutch law allows children from twelve to under

eighteen years old to donate. The right to register for
tissue and organ donation while alive as well as after
death and body donation.
 Legal Framework

In Russia: Russian law stipulates conditions for tissue,

organ and body donors to be adults. But minors still
have the right to register to donate and donation can
only be done when they are adults.
 Legal Framework

In Spain, Spanish Law stipulates: “The donor is of legal age”.

Spanish law also stipulates: “Minors can be tissue donors of

hematopoietic organs and bone marrow. In this case, the
donor and recipient must be genetically related and always
have prior permission from their parents or guardians.”
 Legal Framework

The Uniform Anatomical Git Act (UAGA) of the United

States stipulates that all citizens fifteen years of age
and older have the right to donate tissues and organs
for transplantation, therapy, research science or
teaching and this right is decided entirely by the
individual, regardless of whether family members agree
or not.
 Legal Framework

In VietNam, regarding the age to donate tissues,

organs, and body parts, in Article 5 of the Law on
Donation, Removal, and Transplantation of Human
Tissue and Organs and Donation and Removal of
Corpses in 2006, it is stipulated: People aged 18 years or
older, with Full civil capacity has the right to donate
tissues and organs while alive, after death and to
donate body.
Organ donation process in Vietnam
According to Decision No. 07/2008/QD-BYT

1. Go to the nearest medical facility to express your wish to register

for organ donation after death.
2. The medical facility notifies the National Coordination Center for
Human Organ Transplantation.
3. The center notifies the medical facility to conduct registration
procedures for the donor.
4. Medical facilities meet directly with people in need to advise and
guide donor registration, check the donor's health, and issue
donation registration cards.
Organ donation process in Vietnam
According to Decision No. 07/2008/QD-BYT

1. Go to the nearest medical facility to express your wish to register

for organ donation after death.
2. The medical facility notifies the National Coordination Center for
Human Organ Transplantation.
3. The center notifies the medical facility to conduct registration
procedures for the donor.
4. Medical facilities meet directly with people in need to advise and
guide donor registration, check the donor's health, and issue
donation registration cards.
 Legal Framework

Source:
[1] Khung Pháp Lý thể hiện quyền con người về hiến, nhận mô, Bộ phận
cơ thể người của một số nước Trên Thế giới - Kinh Nghiệm Cho Việt
Nam. Nghiên cứu trao đổi - Phổ biến giáo dục pháp luật - Cổng thông
tin điện tử Bộ Tư pháp. (n.d.).

[2] NHS. (n.d.-a). Organ Donation Laws In UK. NHS choices..

 05
Engineering
solutions
Engineering Solutions
 Risks to the donor
Can include pain, infection,
blood loss, blood clots, allergic
reactions to anesthesia,
pneumonia, injury to organs and
even death.

As transplant surgeries are

becoming more common and
techniques are advancing, risks
involved with organ donations
continue to decrease.
 Engineering Solutions

Is buying and selling organs legal?

Direct payment for organs from recipient to donor or donor's family
or estate is not allowed in the United States. Officially no one is
allowed to buy an organ and laws ban trafficking in organs, but some
people think there have been cases of illegal compensation occurring.

● “Organ Markets”, “Presumed Consent” and “Pair Organ

Donation” are not popular in Vietnam due to ethical concerns,
health law and policy.
 What is the best choice
between “Living Donation” and
“Deceased Donation”?
 Engineering Solutions
Both living and deceased organ donations play critical roles in addressing the shortage of
organs for transplantation. The choice between them often depends on the specific organ
needed, the recipient's condition, and the availability of willing donors.

Advantages Disadvantages

Living Donation Immediate availability of Limited to specific organs

organs (kidney, liver,...)
High success rates Risks to the donor

Deceased Donation Potential for a wider range Timing and organ quality
of organs (heart, eyes,...) Waiting lists
Multiple organ donations
 Engineering Solutions
Sources
[4] Organ-and-Tissue-Donation-Following-brain-death.pdf. Accessed
October 30, 2023.
https://bynder.uwhealth.org/m/8a070e5266012ee9/original/Organ-an
d-Tissue-Donation-Following-brain-death.pdf

[5] Yousefi H, Roshani A, Nazari F. Experiences of the families

concerning organ donation of a family member with brain death. Iran J
Nurs Midwifery Res. 2014;19(3):323-330.

[6] Chapman J. Should we pay donors to increase the supply of organs

for transplantation? No. BMJ. 2008;336(7657):1343. doi:10.1136/bmj.a179
Case Study

06
Case 1: The Ethics of Organ Donation
from Condemned Prisoners

China has denounced a former military doctor who

says he removed skin and organs from executed
Chinese prisoners that were then sold, sometimes
to foreigners.

Involuntary organ donation is illegal under

Chinese law, but critics say Beijing does not
enforce the policy.
 Case 1: The Ethics of Organ Donation
from Condemned Prisoners

Dr Wang Guoqi told that he had removed skin and corneas

from nearly 100 executed prisoners.

It is said that recipients pay $15,000 for organs. Dr Wang,

said the sale of organs netted huge profits. He said prisoners
selected to be donors were tested before execution for
suitability and then shot in the back of the head so as not to
damage their heart, liver, kidneys or skin.
 Case 1: The Ethics of Organ Donation
from Condemned Prisoners
(Discuss in 5 minutes)

Q1: Could the use of organs from prisoners create

pressure to increase the use of the death penalty to
provide a steady supply of organs?

Q2: Is it ethical to take organs from condemned

prisoners, who may be more vulnerable to coercion and
pressure to donate due to their vulnerable position?
 Case 1: The Ethics of Organ Donation
from Condemned Prisoners
ANSWERS

Q1:The use of organs from prisoners could indeed create pressure to increase the use of the death
penalty to provide a steady supply of organs. This would be unethical and would violate
international human rights principles that prohibit the use of capital punishment.

Q2: It is not ethical to take organs from condemned prisoners, as they may be more vulnerable to
coercion and pressure to donate due to their vulnerable position. This violates their right to autonomy
and self-determination, and creates a situation of exploitation where their bodies are used as a
commodity rather than being treated with dignity and respect.
 Case 2: Lessons from the
German Organ Donation Scandal

Doctors at four German hospitals have been suspended from their posts following
internal investigations which alleged that they had been manipulating the organ
transplant allocation system in order to help their patients get donor livers more
quickly.

It is alleged that doctors exaggerated the severity of their patients’ conditions so

that they would be accorded higher priority for receiving organs, but there may also
have been manipulation of medical records, deception of patients and potential
harm to patients both within Germany and across the EU.
 Case 2: Lessons from the
German Organ Donation Scandal
(Discuss in 5 minutes)

Q1: Do these doctors in Germany do it

ethically or unethically? Explain about
your answer.

Q2: What're the consequences for

patients who are unable to receive
donated organs when the waiting list
is impacted by these doctors?
 Case 2: Lessons from the
German Organ Donation Scandal
Q1: Do these doctors in Germany do it ethically or unethically? Explain about your answer.

● Manipulating organ transplant allocation for personal or professional gain is

unethical and a violation of medical ethics. Doctors should prioritize patient care,
medical facts, and ethical principles over personal interests. Exaggerating patient
conditions, manipulating medical records, and deceiving patients compromise public
trust in the medical profession.
 Case 2: Lessons from the
German Organ Donation Scandal
Q2: What're the consequences for patients who are unable to receive donated organs when
the waiting list is impacted by these doctors?

● Doctors manipulating organ allocation systems may cause patients to experience

extended waiting times, potentially leading to health deterioration and death. This
affects the fair distribution of organs based on medical need and ethical
considerations, potentially eroding trust in the healthcare system and donation
programs.
 Case 3: Was Sarah
Murnaghan treated
justly?
In 2005, the United Network for Organ Sharing
developed a scoring system to prioritize patients
for transplantation. However, due to the limited
number of pediatric lung transplants, the Lung
Allocation Score system was excluded. In 2013, a
10-year-old's family challenged this system,
claiming it was unjust to children. A mother who
went before a federal judge to fight for the life of
her child.
 Case 3: Was Sarah
Murnaghan treated
justly?
United Network for Organ Sharing that would later
become known as the "Under 12 rule," was pushing
their dying daughter to the bottom of the adult
lung transplant waiting list.

The Under 12 Rule said that although Sarah would

be given priority to a child's lungs, adult lungs would
have to be offered to adult matches in her region
before they could be offered to her. It was solely
based on the patient's age, instead of medical
need.
Case 3: Was Sarah
Murnaghan
treated justly?
Q1: Should children like Sarah
Murnaghan be given priority over adult
patients for organ transplantation?

Q2: Was it ethical for Sarah's parents to

advocate for her to receive an adult
lung transplant, considering the
potential risks and complications?
Case 3: Was Sarah
Murnaghan Q1: Should children like Sarah
treated justly? Murnaghan be given priority over adult
patients for organ transplantation?

The decision to prioritize children over

adults for organ transplantation is a
complex issue involving medical,
ethical, and legal considerations.
Children have specific medical needs
and are at high risk of mortality. On
the other hand, organ allocation
policies must be fair and based on
medical need, not age. Therefore, the
decision should be made based on
medical necessity and not solely on age.
Case 3: Was Sarah
Murnaghan
treated justly?
Q2: Was it ethical for Sarah's parents to
advocate for her to receive an adult
lung transplant, considering the
potential risks and complications?

Sarah's parents had the right to advocate

for their daughter to receive a lung
transplant, regardless of her age and the
potential risks involved. However, this
decision should have been made based on
medical criteria and not personal
preferences or beliefs.
 References

1/ BBC. (2001, June 28). Asia-Pacific | china fury at organ snatching “lies.” BBC News.
http://news.bbc.co.uk/2/hi/asia-pacific/1411389.stm

2/ Welle, D. (2013, August 19). Transplant trouble. dw.com.

https://www.dw.com/en/organ-donation-in-germany-hindered-by-transplant-scandal/a-17027343

3/ deSante, J., Caplan, A. L., Hippen, B., Testa, G., & Lantos, J. D. (2014). Was Sarah Murnaghan treated
justly? Pediatrics, 134(1), 155–162. https://doi.org/10.1542/peds.2013-4189
 07
Summary &
Conclusion
 Summary
- Definition of organ donation and bioethics questions about this
controversial topic
- The legal framework of organ donation has proved that legal
regulations in some countries cover age, health, and procedural
conditions, ensuring fair treatment for all involved.
- The organ donation field is experiencing a surge in engineering
solutions. Key areas include improving preservation techniques,
improving organ matching algorithms and etc.
- The case study use real-life examples, making them more relatable
and relevant to the field of organ donation. From that, students can
explore and opt for the best and suitable solutions, which is difficult
to conduct.
CONCLUSIONS
Organ donation raises a number of bioethical issues, including
informed consent and fairness in distribution, autonomy. For example,
some may argue that not all potential donors truly understand the
risks and benefits of donating organs, or that organ allocation
systems may favor those with more resources rather than those most
in need. These bioethical concerns must be carefully considered and
addressed in order to ensure that organ donation is conducted in a
way that is both safe and ethical.

While organ donation has undoubtedly revolutionized the field of

medicine, challenges such as increasing the number of potential
donors, improving public awareness and education, and addressing
ethical and legal concerns must be addressed to ensure the
sustainability and success of organ donation and transplantation.
Thank you for
listening!
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 BIOETHICAL QUESTIONS
What should matter more in the process of allocation in organ donation:
gauging the best match for the organ, or factors of justice, such as time
spent on a waiting list?

Gauging the best match for the organ Factors of justice

The element of fairness should be the most emphasized factor in the allocation process.

Allocation decisions should not be based on ethically irrelevant factors such as gender,
ethnicity, social status, etc. Evidence for that is the principle of prioritizing the worst-case
scenario, which implies patients with a higher mortality rate should be treated first.
 ENGINEERING SOLUTIONS

What ethical concerns are most important in the retrieval of

organs for donation?

This alternative is based not on brain death and the dead-donor rule, but on the
ethical principles of nonmaleficence (the duty not to harm, or primum non
nocere) and respect for persons.

The core ethical norm of the medical profession is the principle “do no harm”.

The only morally defensible way to remove an organ from someone is if the
donor chooses to undergo the harm of surgery solely to help another, and if
there is sufficient medical benefit to the recipient.
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