Honestly, I cannot hope to address the full range of ethical issues associated with organ transplantation. What I do offer is to raise the subject, provide you with links to some helpful articles, and invite you to look within yourself to see whether becoming a living organ donor is right for you.
The first successful organ transplant involved a kidney transplant between identical twins in 1954. It can be said, then, that organ transplantation as a medical therapy began within living memory. Ethical discernment regarding organ transplantation, therefore, does not have thousands, or even hundreds of years of history behind it, compared to, for example, questions about slavery or appropriate punishment for violations of the law.
There are a variety of online sources I went to in investigating this topic. I’ll start with the World Health Organization (WHO), which encourages donations from deceased persons to their maximum potential, as there are inherent risks in living donations. Nevertheless, they recognize the necessity of donations from living donors due to the limited supply from the deceased. The WHO has adopted the following slogan with respect to organ transplantation: If we are prepared to receive a transplant should we need one, then we should be ready to give.
Wikipedia has a helpful article regarding the ethics of organ transplantation. The article mentions “transplantation tourism” which has the potential to violate human rights, exploit the poor, and provide unequal access to services. For these reasons, the WHO, among other organizations, calls for a ban on compensated organ donation. On the other side, some hold to the view that trade in organs, if adequately regulated to make sure that the seller is fully informed of the consequences, is a mutually beneficial transaction between two consenting adults. To be clear, in Canada, before a live donor is accepted, a detailed interview is held to rule out monetary compensation as a factor in the donor’s offer.
In a 2005 article in the New England Journal of Medicine, Dr. Robert Truog discussed “The Ethics of Organ Donation by Living Donors.” Living donations often come from relatives or friends of the person needing the organ. The ethical dilemma here has to do with the intense pressure that can be put on people to donate, leading to a feeling of coercion for those who are reluctant.
The altruistic donor raises a different set of ethical concerns. An example I mentioned in an earlier post would be Carol Penner, who wrote about her experience as An Undesignated Donor. Truog cites the example of a potential donor who was pathologically obsessed with giving away everything, to the point of openly musing about giving away all his organs in a dramatic suicide. A psychosocial assessment is therefore part of every potential donor’s evaluation process.
In my next post, I want to look at the religious and cultural dimensions of organ donation. As these perspectives involve certain convictions as to the nature of the human body, death, the beliefs underlying funerals and life beyond death, deceased donations are also impacted by such concerns.