Policies that guide the distribution or allocation of organs have always been controversial. Please read the articles below and discuss how organs should be allocated in the US and why?
Ethics of Organ Transplants (About.com summary)
The Waiting Game (PBS)
Distributing Donor Organs (PBS)
United Network for Organ Sharing (UNOS)
About Organ Allocation (Transplant Living)
Organ Allocation Issues (Miracosta College)
Controversies in Organ Donation (Nephrology, Dialysis, Transplantation Journal)
Infant Heart Transplant Controversy (US News)
Human Organs for Sale (New Internationalist)
Do US Hospitals Push Organ Black Market (CBS News)
So What About Mickey Mantle (Wordpress Donate Life Blog)
Natalie Cole Kidney came From Deceased Fan (CNN)
Jobs Travel to Transplant Mecca Shows System Flaws (Bloomberg)
Britain to Outlaw Most Private Organ Donations (Yahoo! News)
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If we are to decide how to allocate organs, we must first decide whose decision it is to send what organs where if at all they are to be sent. I think it is easy to agree that no one should have the power to mandate that somebody give up an organ without their consent. With that can we not assume organs are the property of the person who’s body they are in (regarding organs grown from stem cells, I would assume the possession be given to the person whose DNA the organs were grown from…in the case of animal stem cells…of the ear grown on the rat, I would assume possession to go to the sentient being most responsible for that organ’s growth…assuming the rat won’t miss the human ear on its back)? It has been accepted that a person’s property is to be distributed as they please after death. If no will exists then it’s likely the next of kin or spouse or parent etc, will have the right to distribute said property. Ultimately it is entirely up to each individual whether or not to donate their organs. I do feel that they should also have some rights as to the allocation of those organs. Although this does open the door to a proper recipient being denied an organ due to donor bias, we must remember that the possibility of anybody receiving the organs would not exist without the donor consent in the first place.
If a person decides whether or not to donate organs and to whom, the next question is when, a rather easy question for those organs not essential to life, such as kidneys. The living donor would obviously dictate when they wanted to donate a kidney and to whom, whenever they were ready, willing and able. Some people see the heart as the machine that keeps the body alive and therefore will define death as the moment the heart stops beating. Others will say brain death, whether that be the death of tissue responsible for higher brain functions or the total death of the brain including the stem and other areas responsible for lower level function. In my own personal opinion I believe that it is the higher functions of the brain that make this life worth living, take those away and the emotions and reasoning skills and capacity to love and enjoy life will go with it and leave life unsatisfying, empty and in my eyes no longer worth the effort as I will become a drain on those around me and will be in need of constant care. For others, so long as their hearts beat and lung exchange air then life must continue. This could be due to philosophical reasoning or religious upbringing, but the end result is a large gap in ideology that will not be easily bridged and compromised. In the meantime, people will die while we argue. If my desire to do the most good for the most amount of people means that life support will be unplugged a few days before another in the same circumstance, then that is my right to choose.
The allocation of organs is a very controversial subject that brings up many ethical issues. I have a couple ideas in the way organs should be allocated. The first is involving the wealthy. The wealthy are able to “jump” ahead on the list and place their names on any other state list. This I do not agree with. I believe the list should follow an order and if ten people are ahead of you on that list, then you must wait. Most people are not able to travel regularly and place their names on a large amount of organ recipient lists. In order to do this, the wealthy will only be allowed to be placed on one list. This list should be in their current place of residence. This would stop the social status advantage the rich have over the poor. Also benefiting the wealthy is the cost of transplants. If you are poor and need a liver, you are more likely not to receive the organ and/ or die from the attempted surgery. I don’t know how they would do it, but I believe if you are unable to pay for a transplant, then there is some kind of financial aid to pay or help pay for you to receive the treatment you need. The rich will not like this however because it can also be seen as a social status advantage. Because they are not poor and/or unable to pay, they cannot receive any financial help. This idea is something the government would need to “clean up” in order to avoid loopholes or an uproar from the rich population. It is my belief that organs should be taken from a donor when they are considered brain dead. It is my belief that most if not all people would not like to live in a vegetative state unless the donor states other wise. In this case, with the donor being in a vegetative state, the organs are still working and the window in order to get the organ(s) to the recipient has not been shortened unlike if they had wished to wait till the heart had stopped; then that window of time would have been shortened and the organs might not be able to be used again to help save a life. One of the main issues is who should get the organs? Should it be someone that lives close so they can get the organs faster and have a larger window, a child, that with it, will live a longer life, or someone who is going to die without it? How are all these situations taken into account? This is one part that I cannot determine how they should be allocated. All have very good arguments. It’s sad to think that two people on a list who both have a case which is medically urgent, and only one of them can be saved because of the order on the list. Basically, I believe organs should be allocated by, medical urgency, and time spent on the waiting list. However, there may be some exceptions to this. Some of the articles also talked about miss users such as alcoholics needing a liver. If they are trying to get back on the right track and are doing better, than I believe they should be allowed to be on the list. If they are still abusing while on the list, then I believe they should be denied. Why waste another liver when someone who is need could use it? When it comes to the allocation of organs, there are always situations and rules that change your point of view.
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