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    Mateo Cuevas

    Writing 39C

    Erin McNellis

    April 15, 2014

    Medical Problem

    The world of medicine is constantly changing. There are new technological advances

    every year that make practices used a decade ago seem obsolete or impractical. One medical

    issue that needs a big improvement is organ donations. Organ donations are a big deal because,

    through the numbers gathered by the Organ Procurement and Transplantation Network, (OPTN)

    there are currently 112,220 candidates on the waiting list as of April 15, 2014; while the number

    of donors, starting this year January 2014 up to April 11, 2014, the number of donors has only

    been 1,209. (OPTN: Organ Procurement and Transplantation Network). These numbers clearly

    show that the number of donors here in the U.S. do not meet the demand of those in need of

    organs. The number of people who need organs will continuously rise and we cannot control that

    number; and the number of donors will not increase fast enough to keep up with those in need of

    organs. The U.S. has a problem trying to accommodate all the people who are in need of organ

    donations, and the people who are able to help are not doing all they can in order to solve this

    problem.

    Organ donations are vital to our society. More people are added to the organ waiting list

    every day and the chances of them living decrease every minute that they are not able to receive

    their transplant. One big issue that was very controversial in organ donation is LDOT (living-

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    organ donation transplantation). In the medical journal Organ Donation Is Not Mutilation: The

    History of an Erroneous Idea, Rev. Anthony Stoeppel and Rev. Pablo Requena, MD, argued

    that through history organ donation was seen as a mutilation because there was no medical

    reason to take a good organ from a healthy person. This idea was carried out for many years and

    few challenged it. Through research and though the succession of kidney transplants it began to

    be seen that not every mutilation is wrong (Requena, Steoppel 433). This problem has been

    around for a long time and trying to decide whether we think LDOT is moral or not over the

    years has cost people lives. People who were uneducated about organ donation were easily

    confused and did not know whether an organ donation was mutilation or not. Organ donation is a

    current problem and we are working to solve it but there are always more problems that arise

    from some type of solution. For example we have extended criteria donors or ECD. These

    donors have valuable organs that many people may use, however the standards that we have for

    organ transplantation exceed what doctors feel that these organs can offer and as a result, the

    US, for example, between 2001 and 2003, some 1200 ECD kidneys, 500 livers, and 250 hearts

    were discarded (Transplantation Proceedings 35). Although some may argue that the reason for

    not using these organs are for safety precautions, these are still organs that can be used and that

    are capable of helping someone else improve or save their lives. Having a chance to live from

    and ECD organ is much better than dying because a person was not given a chance. Organ

    donors must be healthy and their organs must meet the criteria in order for doctors to feel

    comfortable to transplant them into people. The organ donors must not be ill and preferable be

    young organ donors in order for doctors to decide that they are sufficient and worth risking for a

    patient.

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    Another main problem with organ donation shortage is caused by peoples decision to

    make the donation or not. They fear for complications or that something will go wrong and that

    they could possible die?. These fears are what contribute to peoples choice not to donate. This

    claim is also supported by Wojciech Baginski, who wrote an article in the American journal of

    Law & Medicine for the Boston University School of Law, where he discussed similar reasons

    and points out that through his research he found numerous people who did not donate for fears

    complications. They refused to consent to transplantation because of a chance that their lives

    would be in danger and as a result numerous donations were lost. (Baginski 563). Because of this

    reason and fears many possible organ donations were lost and several people who could have

    been saved did not receive a transplant from these potential donors. This is one of the largest

    negative influences towards organ donations. The decision to become an organ donor does not

    come so easily. There is a deeper level, which has been heavily studied, to support that there is a

    larger frame work on the decision to be an organ donor that lies at a physiological level. The

    research done at this level also proves that those who are more educated and think well of the

    process, in other words being well informed and knowing the possible outcomes, and the

    succession rate of the operations, contributes largely to their decision to become donors

    (Nijkamp et al 20). Studying how people make their choice to be an organ donor at this level is

    very important. Figuring out what causes people to think the way they do will help pin point the

    main problems when it comes to organ donors, and once those specific problems that lie in the

    physiological level are found a solution can begin to be found for this psychological problem.

    There are several other issuesthat influence the relatively small number of organ

    donations, compared to the number of patients who need one. There is a large argument that is a

    clear issue today, and that argument consists of morals. Is taking the organ of a person who is

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    dead morally acceptable? Deciding whether a person is capable to make a decision for

    themselves to become an organ donor on their own is debatable depending on the condition of

    the patient. What becomes even more controversial is leaving an organ donation choice of a

    person who is incapable to deciding for themselves, to someone else. The border line that

    decides whether a person is capable to decide organ donation for themselves or that it should be

    left to someone else is very thin. The current American system of cadaveric organ procurement

    includes the default assumption that individuals prefer notto donate their organs for

    transplantation after their death (Gill 37). The decision of whether to donate someone elses

    organs should not be left to just anybody. The consent of the possible organ donor is clearly

    important and this quote helps explain why so many organs are lost. The people who can

    contribute them did not choose whether to donate or not, so the default is that doctors assume

    they did not want to donate. Doctors cannot simply hand over a decision like this to anyone, it

    should have been the patients choice to donate or not. However if the patientnever got the

    chance to decide for themselves the automatic decision is that they did not want to donate and

    therefore the opportunity to save the lives of many people is lost instantly.

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    Works Cited DID NOT USE ALL THE SOURCES!!!!!!! CHECK THEM

    Abouna, George M. Transplantation Proceedings. Organ Shortage Crisis: Problems and

    Possible Solutions.Volume 40, issue 1, January-February 2008.

    http://dx.doi.org/10.1016/j.transproceed.2007.11.067.Pages 34-38. Web. April 3, 2014.

    George M. Abouna from Drexel University, College of Medicine in Pennsylvania argues

    the relevance that organ shortages we have today and also offers possible solutions to

    help obtain more donors and minimize the number of those on the waiting list. Abouna

    published his text on this topic in a popular magazine hoping to get his information out.

    George M. Abouna utilizes statistics over several years, as well as research which he used

    to break down the problem in a simpler form that would make it easier to follow. It is

    relates to my topic because it shows the true numbers and history of this organ shortage

    problem that have been around for a while. Not only that but it also shows a problem that

    contributed to the small number of organ donors.

    Gill, Michael B. Journal of Medicine and Philosophy. Presumed Consent, Autonomy, and

    Organ Donation. 2004 Vol. 29, No. 1. Page 37-59.

    http://jmp.oxfordjournals.org/content/29/1/37.full.pdf.Web. April 16, 2014

    Nijkamp, Marjan D, et al. Health Psychology Review. To be(come) or not to be(come) and

    organ donor, thats the question: a meta-analysis of determinant and intervention studies.

    Vol. 2, No 1. 1, March 2008, 20-40.

    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-

    9e94577e9af3%40sessionmgr111&vid=5&hid=123.Web. April 16, 2014

    http://dx.doi.org/10.1016/j.transproceed.2007.11.067http://dx.doi.org/10.1016/j.transproceed.2007.11.067http://jmp.oxfordjournals.org/content/29/1/37.full.pdfhttp://jmp.oxfordjournals.org/content/29/1/37.full.pdfhttp://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-%099e94577e9af3%40sessionmgr111&vid=5&hid=123http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-%099e94577e9af3%40sessionmgr111&vid=5&hid=123http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-%099e94577e9af3%40sessionmgr111&vid=5&hid=123http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-%099e94577e9af3%40sessionmgr111&vid=5&hid=123http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-%099e94577e9af3%40sessionmgr111&vid=5&hid=123http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=77f0ea86-babb-43d6-be64-%099e94577e9af3%40sessionmgr111&vid=5&hid=123http://jmp.oxfordjournals.org/content/29/1/37.full.pdfhttp://dx.doi.org/10.1016/j.transproceed.2007.11.067
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    Requena, Pablo, and Stoeppel, Anthony. Organ Donation Is Not Mutilation. The History of an

    Erroneous Idea. September 1, 2013.

    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e39f03bb-7b75-4dad-a2e6-

    8337444eae87%40sessionmgr198&vid=7&hid=125.Web. Pages 427-436 March 2,

    2014.

    Rev. Anthony Stoeppel, and Rev. Pablo Requena, Md, explain the view of Living-organ

    donor transplantation and its history going from unacceptable mutilation, to a life-saving

    process. They present their argument in a medical journal format from which this

    particular article was taken from and use a formal tone. They use extensive research that

    was conducted by various experts as well as their own research and observations that

    extended over dozens of years before they come to their conclusion. They want to inform

    an academic audience of the problems with organ donations that once existed in the past.

    Although it seemed like this issue was resolved there was not an extreme increase in the

    number of donors of organs. This meant that there are other things apart from this

    problem that also contributed and continue to contribute to the shortage problem.

    "Transplant Rejection: MedlinePlus Medical Encyclopedia." U.S National Library of Medicine.

    U.S. National Library of Medicine, n.d. Web. 12 Apr. 2014.

    http://www.nlm.nih.gov/medlineplus/ency/article/000815.htm.

    Uniting People and Information to Help save Lives." OPTN:Organ Procurement and Transplantation

    Network. http://optn.transplant.hrsa.gov/ . Web. 13 Apr. 2014

    Sims, Sterling. Penn Bioethics Journal. A Brief History of Organ Tranplantation.

    October 1, 2010. Volume IV, Issue ii.

    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e39f03bb-7b75-4dad-a2e6-%098337444eae87%40sessionmgr198&vid=7&hid=125http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e39f03bb-7b75-4dad-a2e6-%098337444eae87%40sessionmgr198&vid=7&hid=125http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e39f03bb-7b75-4dad-a2e6-%098337444eae87%40sessionmgr198&vid=7&hid=125http://www.nlm.nih.gov/medlineplus/ency/article/000815.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/000815.htmhttp://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/http://www.nlm.nih.gov/medlineplus/ency/article/000815.htmhttp://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e39f03bb-7b75-4dad-a2e6-%098337444eae87%40sessionmgr198&vid=7&hid=125http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=e39f03bb-7b75-4dad-a2e6-%098337444eae87%40sessionmgr198&vid=7&hid=125
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    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=85b91674-77ce-4fbc-bb34-

    e949637987c9%40sessionmgr112&vid=2&hid=103.Web. April 23, 2014.

    Bagneski, Wojciech. American Journal of Law and Medicine. Hasting Death: Dying

    Dignity and the Organ Shortage Gap. December 1, 2009. Issue 35 Pages 562-584.

    http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=0237dc16-7884-4c78-b025-

    da2d3c6e20ee%40sessionmgr4003&vid=9&hid=4209.Web. April 22, 2014

    "Ethical Controversies in Organ Donation After Circulatory Death."Pediatrics.

    http://pediatrics.aappublications.org/content/131/5/1021.full#ref-19.Web. April 21,

    2014.

    Saving More lives: Organ Donation After Cardiac Death. Life Gift.

    http://www.lifegift.org/resources/files/DonationAfterCardiacDeathBrochure.pdf.Pdf. April 21,

    2014

    Health System Joins HAPs Donate Life Hospital Campaign. Penn Medicine. August 6,

    2013.http://www.cchosp.com/cchpage.asp?p=2029.Web. April 21, 2014

    Cenevivas, Nick. "The Shortage of Donor Organs." Nick Cenevivas Technical Writing Blog.

    http://sites.psu.edu/nickceneviva202cblog/2013/09/18/the-shortage-of-donor-organs/.Web.

    April 22 2014.

    Cutleer, J.A, Englesbe. M.J, et al. Improving Organ Procurement Travel Practices in the United

    States: Proceedings from the Michigan Donor Travel Forum. The American Journal of

    Tranplantation. March 1, 2010. Volume 10. Issue 3, Pages 458-463.

    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=85b91674-77ce-4fbc-bb34-e949637987c9%40sessionmgr112&vid=2&hid=103http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=85b91674-77ce-4fbc-bb34-e949637987c9%40sessionmgr112&vid=2&hid=103http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=85b91674-77ce-4fbc-bb34-e949637987c9%40sessionmgr112&vid=2&hid=103http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=0237dc16-7884-4c78-b025-da2d3c6e20ee%40sessionmgr4003&vid=9&hid=4209http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=0237dc16-7884-4c78-b025-da2d3c6e20ee%40sessionmgr4003&vid=9&hid=4209http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=0237dc16-7884-4c78-b025-da2d3c6e20ee%40sessionmgr4003&vid=9&hid=4209http://pediatrics.aappublications.org/content/131/5/1021.full#ref-19http://pediatrics.aappublications.org/content/131/5/1021.full#ref-19http://www.lifegift.org/resources/files/DonationAfterCardiacDeathBrochure.pdfhttp://www.lifegift.org/resources/files/DonationAfterCardiacDeathBrochure.pdfhttp://www.cchosp.com/cchpage.asp?p=2029http://www.cchosp.com/cchpage.asp?p=2029http://www.cchosp.com/cchpage.asp?p=2029http://sites.psu.edu/nickceneviva202cblog/2013/09/18/the-shortage-of-donor-organs/http://sites.psu.edu/nickceneviva202cblog/2013/09/18/the-shortage-of-donor-organs/http://sites.psu.edu/nickceneviva202cblog/2013/09/18/the-shortage-of-donor-organs/http://www.cchosp.com/cchpage.asp?p=2029http://www.lifegift.org/resources/files/DonationAfterCardiacDeathBrochure.pdfhttp://pediatrics.aappublications.org/content/131/5/1021.full#ref-19http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=0237dc16-7884-4c78-b025-da2d3c6e20ee%40sessionmgr4003&vid=9&hid=4209http://web.a.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=0237dc16-7884-4c78-b025-da2d3c6e20ee%40sessionmgr4003&vid=9&hid=4209http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=85b91674-77ce-4fbc-bb34-e949637987c9%40sessionmgr112&vid=2&hid=103http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=85b91674-77ce-4fbc-bb34-e949637987c9%40sessionmgr112&vid=2&hid=103
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    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eaaa5b8e-6d97-409a-a5b1-

    69847cdd5e74%40sessionmgr115&vid=10&hid=122.Web. April 24, 2014.

    This source contributes insights on the subject of organ transportation practices, as well

    as care of the organs while they are being handled. Several experts and well qualified

    individuals who are from the department of surgery from various universities, a few

    including: The University of Michigan and The University of Massachusetts. Along with

    the research conducted on the transportation methods of varies hospitals this source also

    includes a large graph that shows, in a simplified version, the findings for transportation

    failures and therefore why they are important. This is relevant to my research because it

    adds to the reason why there are people who are not receiving their transplants, and so

    this issue is just adding to the shortage of organs.

    Organ Donor Crises WPTZ NewsChannel 5. Nov 13, 2013.

    http://www.youtube.com/watch?v=1ZRy3LoNPns.Video. April 19, 2014.

    This source is a video from YouTube. Even though this video is from YouTube, it was uploaded

    by a local newstation, WPTZ Newschannel 5. In the video a mother and her young boy are

    shown in a hopstial. The boy is in need of a lung transplant. He is lucky, after a long period of

    wait, to receive a transplant. The transplant fails after a few years and he goes back on the waitin

    list. This short video is a good example of what it is like to be in need of a transplant. It shows

    the options that are available and also the realities that cannot be changed. Because of the

    shortage of donors the boy did not make it the second time he needed a transplant. It is very

    relevant to this paper because is also just happened last year. This organ shortage problem is very

    current and is not slowing down.

    http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eaaa5b8e-6d97-409a-a5b1-%0969847cdd5e74%40sessionmgr115&vid=10&hid=122http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eaaa5b8e-6d97-409a-a5b1-%0969847cdd5e74%40sessionmgr115&vid=10&hid=122http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eaaa5b8e-6d97-409a-a5b1-%0969847cdd5e74%40sessionmgr115&vid=10&hid=122http://www.youtube.com/watch?v=1ZRy3LoNPnshttp://www.youtube.com/watch?v=1ZRy3LoNPnshttp://www.youtube.com/watch?v=1ZRy3LoNPnshttp://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eaaa5b8e-6d97-409a-a5b1-%0969847cdd5e74%40sessionmgr115&vid=10&hid=122http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=eaaa5b8e-6d97-409a-a5b1-%0969847cdd5e74%40sessionmgr115&vid=10&hid=122
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    ) Underneath the MLA Works Cited entry for your two most promising sources, write source evaluations of

    the type described in AGWR 77 - 79. These should be, at minimum, a substantial paragraph for each,

    explaining why you feel you can trust the source, what kinds of information the source provides, and why

    the source is relevant to your argument.

    Gastaca, M. Extended Criteria Donors in Liver Transplantation: Adapting Donor Quality and

    Recipient. Transplant Proceedings. Volume 41. Issue 2, April 2009. Pages 975-979.

    http://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+P

    roceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver

    +Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h

    &pid=. Web. April 25 2014.

    Gatascas article was published in a credible medical journal. It is a source that is known and has

    been around for a long time. This article discusses the problems that currently exist with ECD

    donors. It talks about the much higher risks these donors have for other patients as donors. It is

    relevant to my paper, because it falls into place as a social problem. The people that are donating

    organs are older people who, according to the standards of doctors, do not meet the criteria to be

    good donors. They want to help and are part of a small number of people who are willing to

    donate, but not allowing the chance to be taken with the organs from these donors keeps the

    number of people on the waiting list for a transplant the same.

    http://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pidhttp://ucelinks.cdlib.org:8888/sfx_local?genre=article&issn=00411345&title=Transplantation+Proceedings&volume=41&issue=3&date=20090401&atitle=Extended+Criteria+Donors+in+Liver+Transplantation%3a+Adapting+Donor+Quality+and+Recipient.&spage=975&sid=EBSCO:a9h&pid