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Week 8 Term Paper Final Draft

Dyana Gomez-Luna

West Coast University

PHIL 434: Medical Ethics and Issues

Professor D’Ascoli

December 20, 2024

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Week 4 Term Paper Final Draft

Organ donation and transplantation are among the most significant medical practices of

our time, offering life-saving opportunities for individuals with end-stage organ failure. The

ability to transfer viable organs from donors to recipients has not only saved countless lives.

However, it has also improved the quality of life for many patients suffering from chronic and

terminal illnesses. However, organ donation raises a complex array of ethical concerns,

particularly in the areas of autonomy, consent, and fairness. Ethical dilemmas surrounding organ

procurement, distribution, and emerging technologies add layers of moral complexity to the

practice. This paper explores the technical aspects of organ donation and transplantation, the

public policy debates surrounding it, and the ethical considerations involved, ultimately

reflecting on the validity of the pro and con arguments through a moral lens.

Organ donation is a multifaceted process involving several stages, each with its technical

challenges and ethical considerations. The first step is identifying a suitable donor, which can

either be a living individual or someone who has been declared brain-dead or deceased. Donors

must meet medical criteria to ensure that their organs are viable for transplantation, such as the

health status of the organs and their compatibility with potential recipients. Compatibility factors

include blood type, tissue type, and other immunological markers that determine the likelihood

of organ rejection after transplantation (Organ Procurement and Transplantation Network

[OPTN], 2023). Once a donor is identified, informed consent is paramount. For living donors,

this means ensuring that individuals understand the risks involved in donating an organ, such as

complications from surgery and the possibility of long-term health effects. For deceased donors,

consent can be obtained through donor registries, where individuals explicitly opt-in to donate

after death, or through a presumed consent system, where individuals are automatically
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considered donors unless they opt out (Glannon, 2021). The technical process of transplantation

involves removing the organ from the donor, preserving it, and transporting it to the recipient.

Organ transplantation requires highly skilled surgeons and medical professionals to ensure the

transplant is successful. Modern advancements in immunosuppressive medications have made

organ transplantation safer by preventing the recipient's immune system from rejecting the

foreign organ. However, challenges remain in terms of organ shortage, with demand far

outstripping the supply of available organs. This has led to ongoing efforts to improve organ

donation rates and expand the donor pool (Lambrecht & Waer, 2020).

Ethical considerations and societal values deeply influence public policy surrounding

organ donation. In some countries, policies like presumed consent or opt-out systems have been

implemented to increase the number of available organs. In these systems, individuals are

automatically considered organ donors upon death unless they explicitly decline during their

lifetime. Advocates argue that presumed consent can significantly increase donation rates and

address the shortage of available organs (Glannon, 2021). However, this system raises concerns

about autonomy, as individuals may be unaware of their status as donors or may feel coerced

into agreeing to donate, particularly in societies with limited public education about the issue.

Another debated policy is incentivized donation, where individuals or families receive

compensation for organ donation. This system is controversial, as proponents argue that financial

incentives could increase organ donations and address the shortage. However, critics warn that

incentivized donation risks exploiting vulnerable populations, particularly in low-income

communities, where individuals may feel pressured to donate organs for financial gain.

Furthermore, such policies could commodify human bodies, which raises ethical

concerns about the sanctity of human life (Lambrecht & Waer, 2020). Current organ donation
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systems focus on ensuring that organ allocation is fair and equitable. In the United States, for

example, the OPTN manages a national waiting list, prioritizing patients based on medical

urgency, compatibility, and waiting time. These systems aim to prevent discrimination and

ensure that organs are distributed in a manner that balances fairness with medical needs.

However, disparities still exist, with wealthier individuals often receiving quicker access to

transplantation services due to private insurance and other factors (OPTN, 2023).

The practice of organ donation offers profound life-saving benefits and is generally

viewed favorably in medical ethics, mainly through the lens of utilitarianism. This ethical theory

emphasizes actions that maximize the greatest good for the most significant number of people.

Organ transplantation undeniably saves lives, reducing suffering and improving the quality of

life for recipients. By participating in organ donation, individuals contribute to the collective

well-being of society, making it a morally good practice from a utilitarian perspective (Glannon,

2021). Additionally, the principle of autonomy supports organ donation as an expression of

individual choice. For living donors, the decision to donate an organ can be seen as an altruistic

act that aligns with the individual’s values and desire to help others. Even in the case of deceased

donors, organ donation can be framed as an expression of one’s values if consent is given

voluntarily (OPTN, 2023). From a rule utilitarian perspective, the establishment of clear policies

regarding organ donation, such as those that prioritize equitable distribution and ensure informed

consent, creates a system that benefits society by maximizing fairness and access to life-saving

resources (Lambrecht & Waer, 2020).

Despite the benefits of organ donation, several ethical concerns remain. One of the most

significant criticisms is the potential for exploitation in incentivized donation systems. Critics

argue that offering financial compensation for organ donation could coerce vulnerable
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populations, particularly those from low-income backgrounds, into donating organs against their

better judgment (Lambrecht & Waer, 2020). This raises ethical concerns about coercion and the

commodification of human bodies, which violates Kantian ethics. According to Kant, individuals

must always be treated as ends in themselves, never as means to an end. The exchange of organs

for financial gain risks reducing individuals to mere commodities, undermining their intrinsic

dignity and moral worth (Glannon, 2021).

Additionally, the issue of distributive justice in organ allocation remains contentious.

Critics argue that wealthier individuals often have better access to transplants due to private

healthcare systems and financial resources, creating an unjust disparity in who receives life-

saving care. The ethical principle of fairness suggests that access to healthcare resources,

including organ transplantation, should not be based on social or economic status, yet disparities

persist in many countries (OPTN, 2023).

After considering both the pro and con arguments surrounding organ donation, the

arguments in favor of donation are more compelling, particularly from the standpoint of

utilitarianism and autonomy. The life-saving potential of organ transplantation and the societal

benefits of increasing donation rates are significant, and individuals should have the right to

make informed decisions about their bodies, whether as living donors or through posthumous

consent. However, it is crucial to address the ethical concerns raised by critics, particularly

regarding the exploitation of vulnerable populations and the inequities in organ allocation.

I support the practice of organ donation but believe that policies must be designed to ensure that

it is conducted ethically and equitably. This includes transparent and informed consent processes,

as well as efforts to address the disparities in access to transplantation. By upholding these

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ethical standards, we can ensure that organ donation remains a compassionate and just practice

that benefits society.

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References

Glannon, W. (2021). Biomedical ethics: Organ transplantation and distributive justice. American

Journal of Bioethics, 21(3), 10–15. https://doi.org/10.1080/15265161.2021.1915879

Lambrechts, P., & Waer, M. (2020). The ethics of incentivized organ donation: A review of

potential risks and benefits. Journal of Medical Ethics, 46(4), 215–222.

https://doi.org/10.1136/medethics-2019-105861

Organ Procurement and Transplantation Network (OPTN). (2023). Annual data report: Trends in

organ allocation and equity. https://optn.transplant.hrsa.gov/

Pence, G. (2021). Medical ethics: Accounts of ground-breaking cases (9th ed.). McGraw Hill

Education.