Organ Donation And Transplantation III

8/8/2019 Organ Donation And Transplantation III

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ORGAN DONATIONORGAN DONATION AND AND

TRANSPLANTATIONTRANSPLANTATION



ORGANORGAN

TRANSPLANTATIONTRANSPLANTATIONInvolves the removal of an organInvolves the removal of an organfrom a cadaver or a living humanfrom a cadaver or a living humandonor and implanting it in adonor and implanting it in arecipient who is in need of it.recipient who is in need of it.Most commonly transplantedMost commonly transplantedorgans and tissues are the kidneys,organs and tissues are the kidneys,cornea, hearts, livers andcornea, hearts, livers andbonemarrow.bonemarrow.



Organ transplantation is aOrgan transplantation is anew way of sharing life. It isnew way of sharing life. It isa voluntary decision to offera voluntary decision to offer

without reward a part ofwithout reward a part ofone s body for the healthone s body for the healthand welland well- -being of another.being of another.

Pope John Paul IIPope John Paul II



ISSUES IN ORGANISSUES IN ORGANTRANSPLANTATIONTRANSPLANTATION1.1. Is it morally acceptable toIs it morally acceptable to

transplant an organ from one livingtransplant an organ from one livingperson to another?person to another?2.2. Manner in which the organ isManner in which the organ is

obtained from a donorobtained from a donor need ofneed ofgetting free and informed consentgetting free and informed consentfrom the donor.from the donor.

3.3. How will recipient be selected?How will recipient be selected?



MORAL ISSUESMORAL ISSUES

The transplantation of organs fromThe transplantation of organs fromliving donors is morallyliving donors is morallypermissible when the anticipatedpermissible when the anticipatedbenefit to the recipient isbenefit to the recipient isproportionate to the harm done toproportionate to the harm done to

the donor, provided that the lossthe donor, provided that the lossof such organs does not depriveof such organs does not deprivethe donor of life itself nor thethe donor of life itself nor thefunctional integrity of the body.functional integrity of the body.



Post mortem harvesting of organsPost mortem harvesting of organsdonated must not be started until deathdonated must not be started until deathis morally certain. Vital organs that isis morally certain. Vital organs that isorgans necessary to sustain life, mayorgans necessary to sustain life, maynot be removed until death has takennot be removed until death has takenplace. The determination of the time ofplace. The determination of the time ofdeath must be made in accordance withdeath must be made in accordance withresponsible and commonly acceptedresponsible and commonly acceptedscientific criteria. In accordance withscientific criteria. In accordance withcurrent medical practice, to prevent anycurrent medical practice, to prevent anyconflict of interest, the dying patient sconflict of interest, the dying patient s

doctor should ordinarily be distinct fromdoctor should ordinarily be distinct fromtransplant team.transplant team.



C RITERIA FOR ORGANC RITERIA FOR ORGANTRANSPLANTATION TO BETRANSPLANTATION TO BEETHI C ALLY A CC EPTABLE:ETHI C ALLY A CC EPTABLE:

1. There is a serious need on the1. There is a serious need on thepart of the recipient thatpart of the recipient thatcannot be fulfilled in anycannot be fulfilled in anyother way.other way.

2. Functional integrity of the2. Functional integrity of thedonor as a human person willdonor as a human person willnot be impaired, even thoughnot be impaired, even thoughanatomical integrity mayanatomical integrity may

suffer.suffer.



3. The risk taken by the donor as3. The risk taken by the donor as

an act of charity isan act of charity isproportionate to the goodproportionate to the goodresulting for the recipient.resulting for the recipient.

4. The donor s consent is free and4. The donor s consent is free andinformed.informed.5. The recipients for the scarce5. The recipients for the scarce

organs are selected justly.organs are selected justly.



ETHI C AL ISSUESETHI C AL ISSUESREGARDING THEREGARDING THEDONORDONOR

In case of a cadaver donor it is importantIn case of a cadaver donor it is important

that the individual really has died.that the individual really has died.Brain death must be certain.Brain death must be certain.If tissue or organs are taken from a humanIf tissue or organs are taken from a humanfetus while it is still alive which causes itsfetus while it is still alive which causes itsdeath, the procedure is tantamount todeath, the procedure is tantamount toabortion itself and therefore immoral.abortion itself and therefore immoral.



Even the taking of tissues or organsEven the taking of tissues or organsfrom dead human fetuses meritsfrom dead human fetuses meritsserious moral objection if theseserious moral objection if thesefetuses have been intentionallyfetuses have been intentionallykilled by abortion.killed by abortion.In case of morally acceptable organIn case of morally acceptable organdonation it is necessary and ideal todonation it is necessary and ideal tohave obtained prior release from thehave obtained prior release from thedonor if a signed statementdonor if a signed statementindicating that the donor is willingindicating that the donor is willingto give his organs after death.to give his organs after death.



C RITERIA FORC RITERIA FORC ESSATION OFC ESSATION OFBRAIN FUN C TIONBRAIN FUN C TION

1.1. Irreversible comaIrreversible coma2.2. No spontaneous respirationNo spontaneous respiration3.3. No response to apnea test for sixNo response to apnea test for six

(6) minutes.(6) minutes.4.4. Absent pupillary, corneal and gag Absent pupillary, corneal and gag

reflex and negative caloric testreflex and negative caloric test



C RITERIA FORC RITERIA FOR

IRREVERSIBILITYIRREVERSIBILITY1.1. C ause of coma is established andC ause of coma is established and

sufficient to account for loss ofsufficient to account for loss ofbrain function.brain function.

2.2. Possibility for recovery isPossibility for recovery isexcluded.excluded.

3.3. Persistent for at least 24 hours ofPersistent for at least 24 hours ofobservation and therapy.observation and therapy.



ETHI C AL ISSUESETHI C AL ISSUESREGARDING LIVINGREGARDING LIVINGDONORSDONORS

Properly informed consent must beProperly informed consent must beobtained.obtained.Functional integrity is maintained even ifFunctional integrity is maintained even ifthere is loss of anatomic integrity.there is loss of anatomic integrity.If the donor individual is married, theIf the donor individual is married, thespouse has to give the consent also.spouse has to give the consent also.

Undue pressure is not placed on theUndue pressure is not placed on thepotential donor.potential donor.Proxy consent may not be given for theProxy consent may not be given for thebenefit of another individual if there isbenefit of another individual if there isany more than a truly minimal risk or lossany more than a truly minimal risk or lossto the donor.to the donor.



MORAL ISSUES REGARDINGMORAL ISSUES REGARDING

THE RE C IPIENTTHE RE C IPIENT

Does the intendedDoes the intended

transplantation truly offerstransplantation truly offerssome benefit to thesome benefit to therecipient?recipient?Benefits and risks must beBenefits and risks must be

weighed.weighed.Proper informed consentProper informed consentneeds to be obtained.needs to be obtained.



In case of multiple recipients for aIn case of multiple recipients for asingle organ, medical facts mustsingle organ, medical facts mustbe determined which potentialbe determined which potentialrecipient has the greatest chancerecipient has the greatest chanceof accepting the organ by theof accepting the organ by the

basis of tissue compatibility.basis of tissue compatibility.Should social criteria be a factor?Should social criteria be a factor?Should age, need be involved inShould age, need be involved indetermining which recipient getsdetermining which recipient getsthe organ?the organ?Lottery method.Lottery method.



C RITERIA FOR SELE C TION OFC RITERIA FOR SELE C TION OF

REC IPIENTSREC IPIENTS1.1. One who needs most andOne who needs most and

who benefits most.who benefits most.2.2. Person s contribution toPerson s contribution to

society.society.3.3. Queuing or first come firstQueuing or first come first

serve basis.serve basis.4.4. LotteryLottery



W HY W E SHOULD NOTW HY W E SHOULD NOT

PAY FOR HUMAN ORGANSPAY FOR HUMAN ORGANSOrgan donation is an act of fraternalOrgan donation is an act of fraternallove and charity.love and charity.

W e have no absolute dominion overW e have no absolute dominion overour body.our body.There will be an open market placeThere will be an open market placewhere brokers will exploit the poorwhere brokers will exploit the poor

living donors or even prisoners.living donors or even prisoners.The poor will be used to serve theThe poor will be used to serve thewealthy so much so that only thosewealthy so much so that only thosewho can afford can avail of suchwho can afford can avail of such

technology.technology.

Organ Donation And Transplantation III

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