This paper is an attempt to examine the traditional Yoruba beliefs about organ donation. Organ donation and transplantation remain a rare occurrence in African, this to a large extent can be as a result of the traditional African orientation on the one hand and the advancement in medical research that come with transplanting organ on the other. In this paper, we x-ray the problem of organ shortage in most African countries. We identified that apart (...) from lack of awareness on organ donation, Africans traditionally would not be willing to donate their organs after death. This paper critically examines beliefs in some African cultures and their relationship with organ donation. We analyze life after death in the Yoruba tradition and the belief in the continuation of the body after death. The paper concludes that the African belief in the continuation of the body in the afterlife contributes to the non-willingness of Africans to donate an organ after death. (shrink)

Lethal organ donation is a hypothetical procedure in which vital organs are removed from living donors, resulting in their death. An important objection to lethal organ donation is that it would infringe the prohibition on doctors intentionally causing the death of patients. I present a series of arguments intended to undermine this objection. In a case of lethal organ donation, the donor’s death is merely foreseen, and not intended.

This book provides the first systematic study on three types of incentives for organ donation. It covers extensive research conducted in four culturally different societies: Hong Kong, mainland China, Iran and the United States, and shows on the basis of the research that a new model of incentives can be constructed to enhance organ donation in contemporary societies. The book focuses on three types of incentives: honorary incentives, commonly adopted in the United States and other Western (...) countries by offering things such as a thank-you card and a memorial park for donors to encourage donations motivated by pure altruism; compensationalist incentives, adopted in the Islamic Republic of Iran to encourage donation by providing monetary compensation to unrelated living donors for appreciating their altruistic contribution of donation; and familist incentives, implemented in Israel and mainland China to provide priority to organ transplantation to donors and/or their family members. The book demonstrates that a new model of incentives must go beyond offering only one type of incentives and should rather include different types of incentives that are practically effective, politically legitimate and ethically justifiable for particular societies. This implies that suitable incentive measures may vary from society to society to optimize organ donation. This book provides a clear reference for both the scholars and practitioners in the field of organ transplantation, as well as for general readers interested in bioethics and health care policy. (shrink)

Because the number of organs available for transplantation does not meet the needs of potential recipients, some have proposed that a potentially effective way to increase registration is to offer a self‐benefit incentive that grants a 'preferred status' or some degree of prioritization to those who register as potential donors, in case they might need organs. This proposal has elicited an ethical debate on the appropriateness of such a benefit in the context of a life‐saving medical procedure. In this paper (...) we review arguments and ethical concerns raised by scholars, and studies of views of members of the public regarding the prioritization incentive system. We also report on our study of the views of those involved in organ transplant and of other medical professionals in Israel, as over half a decade ago Israel implemented a prioritization incentive system. Bioethicists propose that key stakeholders' views can provide additional arguments and perspectives on controversial issues. Proponents justify the prioritization incentive drawing mainly on arguments related to its potential effectiveness, reciprocity and fairness. Opponents point to the fact that registering is not binding and not an actual donation, and raise concerns regarding equity, autonomy and gaming the system. Ethical concerns raised by the practitioners in the study were examined in light of scholars' arguments and actual registration and donation data. Practitioners involved in transplantation raised ethical concerns corresponding to those raised by scholars as well as additional concerns. They also challenged proponents' assumptions regarding the utility of the incentive system from their own experience and argued that proponents obscure the meaning of reciprocity. (shrink)

Purpose: Organ donation and transplantation are practices that are supported by all of the world's major religions, including Sikhism, Christianity, Hinduism, and Judaism. Recent developments in the fields of organ donation and organ transplantation have sparked a renewed sense of optimism for the treatment of critical illnesses. The jurists permitted organ transplants on the basis of certain principles, including ownership and categories of property. On the other hand, moralists strive to deny the ownership of (...) human organs by using principles such as faith and Almighty Allah’s absolute authority. Then main objective of this research paper is on one hand to identify and emphasize arguments for and against organ donation and transplantation in the framework of scared provisions of Islam and its corresponding legal requirements and on the other hand to understand and teach the people that not only Islam allows organ donation but also encourage its followers to assist one another and make an effort to promote organ donations in society. Methodology: The doctrinal methodology. Explanatory and analytical research approaches are used in this work. It is worth mentioning that this research study is entirely based on library sources. Most of the sources are reputable and trustworthy textbooks, scholarly published and unpublished journal articles, law reports, and online websites related to the research area. Findings: According to the arguments as well as clear and explicit rulings, principles and authentic evidence from the Holy Quran, it is clear that the donation and transplantation of human body organs is permissible. The Holy religion of Islam persuades its followers to participate in charity, assist people, and donate organs to save the lives of those patients who are waiting for organ transplant. Recommendations: Theoretically, this work is very useful in contributing to the existing body of literature of knowledge. Practically, this work identifies the circumstances in which Muslim jurists not only allow but encourage its followers to assist one another and make an effort to promote organ donations in society in order to save people’s life. It is recommended that both the donor and the recipient of an organ must belong to the same nationality or legal jurisdiction in order to prevent the growth of an international organ trade, which would be far more difficult to regulate. Additionally, in order to protect the health of both the recipients and the donors, it is imperative that transplants from unknown sources be prohibited. (shrink)

This article discusses the practice and development of organ donation by capital prisoners in China. It analyzes the issue of informed consent regarding organ donation from capital prisoners in light of Confucian ethics and expounds the point that under the influence of Confucianism, China is a country that attaches great importance to the role of the family in practicing informed consent in various areas, the area of organ donation from capital prisoners included. It argues (...) that a proper form of organ donation from capital prisoners can be justified within the Confucian moral context in which the proper interests of capital prisoners and their families, the benefit of organ receptors, and a rightful order of society should all be appropriately considered. From the Confucian perspective, the act of donating organs from a capital prisoner must be decided by both the prisoner and his/her family (i.e., each side should hold a veto power), whereas such donation, in the proper circumstance protected by a rightful procedure, should be appreciated as a morally praiseworthy act of the prisoner who is willing to make the final effort to repent and correct his/her evil conduct and to leave something good to the world. (shrink)

The issue of directed donation of organs from deceased donors for transplantation has recently risen to the fore, given greater significance by the relatively stagnant rate of deceased donor donation in the UK. Although its status and legitimacy is explicitly recognized across the USA, elsewhere a more cautious, if not entirely negative, stance has been taken. In England, Wales and Northern Ireland, the Human Tissue Act 2004, and in Scotland the Human Tissue (Scotland) Act 2006, are both silent (...) in this regard. Although so-called conditional donation, donation to (or perhaps withheld from) a specific class, has been outlawed as a product of guidance issued by the Secretary of State for Health issued in the wake of the controversial incident occurring in the North of England in 1998, its intended application to ‘directed’ donation is less certain. Directed and conditional donations challenge the traditional construct of altruistic donation and impartial (equitable) allocation in a very immediate and striking fashion. They implicitly raise important questions as to whether the body or parts of the body are capable of being owned, and by whom. This paper attempts to explore the notion of donor ownership of body parts and its implications for both directed and conditional donation. (shrink)

I argue that valid informed consent is ethically required for organ donation from individuals declared dead using neurological criteria. Current policies in the U.S. do not require this and, not surprisingly, current practices inhibit the possibility of informed consent. Relevant information is withheld, opportunities to ensure understanding and appreciation are extremely limited, and the ability to make and communicate a free and voluntary decision is hindered by incomplete disclosure and other practices. Current practices should be revised to facilitate (...) valid informed consent for organ donation. (shrink)

We argued in a recent issue of this journal that if abortion is restricted,1 then there are parallel obligations for parents to donate body parts to their children. The strength of this obligation to donate is proportional to the strength of the abortion restrictions. If abortion is never permissible, then a parent must always donate any organ if they are a match. If abortion is sometimes permissible and sometimes not, then organ donation is sometimes obligatory and sometimes (...) not. Our argument was based on the following ideas: (a) that a fetus has full moral status, (b) that parents have special obligations to their offspring, fetus or not, and (c) that this special obligation is to protect them. The result is the conclusion that abortion restrictivists cannot also consistently deny that organ donation should be compulsory. (shrink)

BackgroundA patient who fulfils the due diligence requirements for euthanasia, and is medically suitable, is able to donate his organs after euthanasia in Belgium, the Netherlands and Canada. Since 2012, more than 70 patients have undergone this combined procedure in the Netherlands. Even though all patients who undergo euthanasia are suffering hopelessly and unbearably, some of these patients are nevertheless willing to help others in need of an organ. Organ donation after euthanasia is a so-called donation (...) after circulatory death (DCD), Maastricht category III procedure, which takes place following cardiac arrest, comparable to donation after withdrawal of life sustaining therapy in critically ill patients. To minimize the period of organ ischemia, the patient is transported to the operating room immediately after the legally mandated no-touch period of 5 min following circulatory arrest. This means that the organ donation procedure following euthanasia must take place in the hospital, which appears to be insurmountable to many patients who are willing to donate, since they already spent a lot of time in the hospital. Case presentationThis article describes the procedure of organ donation after euthanasia starting at home (ODAEH) following anesthesia in a former health care professional suffering from multiple system atrophy. This case is unique for at least two reasons. He spent his last conscious hours surrounded by his family at home, after which he underwent general anaesthesia and was intubated, before being transported to the hospital for euthanasia and organ donation. In addition, the patient explicitly requested the euthanasia to be performed in the preparation room, next to the operating room, in order to limit the period of organ ischemia due to transport time from the intensive care unit to the operating room. The medical, legal and ethical considerations related to this illustrative case are subsequently discussed.ConclusionsOrgan donation after euthanasia is a pure act of altruism. This combined procedure can also be performed after the patient has been anesthetized at home and during transportation to the hospital. (shrink)

Who should decide about organ donation after death, the individual or the family? This paper examines why this practical question can be difficult to resolve. A comparison is made between standard decision‐making in medicine and decision‐making about organ donation. The questions are raised of the connection of the dead body to the person, and of who properly has autonomous control over the dead body. To understand the issues, an exploration of autonomy is needed, but at the (...) same time this shows that a resolution depends on addressing complex spiritual and cultural issues, and questions about the autonomy of the individual versus that of the group. (shrink)

This article responds to the four pieces in this special symposium of the Journal of Law, Medicine & Ethics on uncontrolled organ donation following circulatory death . The response will focus on lessons and debates about the kinds of consent necessary and sufficient for temporary organ preservation in the context of DCD and for organ donation itself; on conflicts of obligation, loyalty, and interest in DCD and ways to address those conflicts; and on benefit, cost, (...) risk assessments of uDCD programs, including measures to achieve a more favorable balance of benefits, costs, and risks. (shrink)

The several articles in this special issue on organ donation after circulatory determination of death or, as it is often put, donation after cardiac death, draw lessons from different kinds of experience in order to guide efforts in the U.S. to develop or refine policies for DCD. One lesson comes from a major and, by many measures, successful experimental DCD program in Washington, D.C. in the 1990s. Another lesson comes from European countries that have adopted presumed-consent legislation, (...) a form of “opt out” that facilitates DCD as well as donation after neurological determination of death. Another lesson, from the perspective of critical care medicine in Canada, attends to the implications of viewing a dying patient, undergoing resuscitative procedures, as a potential organ donor. A final lesson sketches implications of legislation and court cases in the U.S., often involving DND, for initiating temporary organ preservation in DCD programs before consent has been obtained for organ donation. Some of these lessons are optimistic about the prospects for DCD, especially if certain steps are taken, while others are more cautious, particularly because of the costs and risks involved in DCD. (shrink)

In Aotearoa/new Zealand, organ donation and transplantation rates for Māori and non-Māori differ. This article outlines why this is so, and why some groups may be reticent about or object to organ donation and transplantation. In order to do this, I draw on the conceptual and methodological lens of phenomenology and apply what Van Manen calls the existential themes of lived body (corporeality), lived space (spatiality), lived time (temporality) and lived other (relationality and communality) to a (...) discussion of the cultural values and spiritual beliefs of Māori around tissue donation. Specifically, the aim of the article is to encourage non-Māori, who will already be aware that diverse cultural traditions transmit different beliefs about organ donation and transplantation, to recognize the existence of a deeper understanding of what this difference may mean for people on a felt level and how it might impact on lived experience. (shrink)

: Recently, various suggestions have been made to respond to the increasingly great shortage of organs by paying for them. Because of the undesirable side effects of such approaches (commodification, injustice, and costs), a communitarian approach should be tried first. A communitarian approach to the problem of organ shortage entails changing the moral culture so that members of society will recognize that donating one's organs, once they are no longer of use to the donor, is the moral (right) thing (...) to do. This approach requires much greater and deeper efforts than sharing information and making public service announcements. It entails a moral dialogue, in which the public is engaged, leading to a change in what people expect from one another. Among the devices that could help to change the moral culture are a public statement, endorsed by community members and leaders, that expresses the community sense that donation "is what a good person does" and a community-specific web page that lists those who have made the commitment. A change in law so that a person's wishes in the matter are recognized as final and binding is also desired. This position paper deals only with cadaver organs and not living donors. (shrink)

abstract Numerous measures have been proposed to change the collection procedure in order to increase the supply of organ donations. One such proposal is to give the candidate donors the right to direct their organs to groups of recipients characterised by specific features like sex, age, disease and geographic location. Four possible justifications for directed donation of organs are considered: the utilitarian benefit, the egalitarian principle of justice, the maximin principle of justice and the autonomy principle. It is (...) concluded that none of these principles justifies the acceptance of designated donations. When potentially life‐saving resources are distributed, only a pure egalitarian distribution is in agreement with the principle of justice.s. (shrink)

Public appeals for organ donation to an identified individual raise serious ethical questions about the role of the media, the physician, the prospective recipient, and the donor in the procurement process.

In the following interview, philosophers Leonard Fleck and Arthur Ward discuss the latter’s recent experience of being a nondirected kidney donor. The interview took place in the Center for Bioethics and Social Justice at Michigan State University.

In August 2000, Arthur Matas and his colleagues de scribed a protocol in which their institution began to accept as potential donors, individuals who came to the University of Minnesota hospital offering to donate a kidney to any patient on the waiting list. Matas and his colleagues refer to these donors as nondirected donors by which is meant that the donors are altruistic and that they give their organs to an unspecified pool of recipients with whom they have no emotional (...) relationship. This paper represents an ethical and policy critique of the nondirected donation protocol that was implemented at the University of Minnesota in August 1999. Specifically, I address the ethical questions: Whether altruistic living solid organ donations by strangers should be permitted? And if so, What are appropriate ethical guidelines for such donations? (shrink)

In August 2000, Arthur Matas and his colleagues de scribed a protocol in which their institution began to accept as potential donors, individuals who came to the University of Minnesota hospital offering to donate a kidney to any patient on the waiting list. Matas and his colleagues refer to these donors as nondirected donors by which is meant that the donors are altruistic and that they give their organs to an unspecified pool of recipients with whom they have no emotional (...) relationship. This paper represents an ethical and policy critique of the nondirected donation protocol that was implemented at the University of Minnesota in August 1999. Specifically, I address the ethical questions: Whether altruistic living solid organ donations by strangers should be permitted? And if so, What are appropriate ethical guidelines for such donations? (shrink)

Zusammenfassung Personen, die nicht bereits sind, als postmortale Organspender zur Verfügung zu stehen, sollten nachrangig versorgt werden, falls sie selbst einmal ein Organ benötigen, so wird in diesem Aufsatz argumentiert. Postmortale Organspenden sollten demnach grundsätzlich gerichtete Spenden zugunsten von anderen Spendewilligen sein. Diesem Ansatz zufolge sollten Organe nicht als öffentliche Ressource betrachtet werden und der Staat sollte respektieren, dass die Entscheidung darüber, was nach dem Tod mit dem Körper geschehen soll, bei der betreffenden Person selbst liegt. Während einige Formen (...) der gerichteten Spende moralisch problematisch sein können, ist ein allgemeines System von gerichteten Spende an andere Spendewillige diesem Vorschlag zu folge moralisch erlaubt, weil es die Grundsätze der Autonomie- Achtung, der Reziprozität sowie der Solidarität wahrt und niemanden unangemessenen Schwierigkeiten aussetzt, der im Notfall keine schlechteren Aussichten auf ein Spenderorgan haben möchte. (shrink)

Five arguments are presented in favour of the proposal that people who opt in as organ donors should receive a tax break. These arguments appeal to welfare, autonomy, fairness, distributive justice and self-ownership, respectively. Eight worries about the proposal are considered in this paper. These objections focus upon no-effect and counter-productiveness, the Titmuss concern about social meaning, exploitation of the poor, commodification, inequality and unequal status, the notion that there are better alternatives, unacceptable expense, and concerns about the veto (...) of relatives. The paper argues that none of the objections to the proposal is very telling. (shrink)

In their recent article, Glannon and Ross remind us that family members have obligations to help each other that strangers do not have. They argue, I believe correctly, that what creates moral obligations within families is not genetic relationship but rather a sharing of intimacy. For no one are these obligations stronger than they are for parents of young children. This observation leads the authors to the logical conclusion that organ donation by a parent to her child is (...) not optional but rather a prima facie duty. However, Glannon and Ross go a step further by suggesting that because parent-to-child organ donation is a duty, it cannot be altruistic. They assert that “altruistic acts are optional, nonobligatory…supererogatory…. Given that altruism consists in purely optional actions presupposing no duty to aid others, any parental act that counts as meeting a child's needs cannot be altruistic.” Here I think the authors go too far. (shrink)

About 6,000 individuals participate in the U.S. transplant system as a living organ donor each year. Organ donation by living individuals is a unique procedure, where healthy patients undergo a major surgical operation without any direct functional benefit to themselves. In this article, the authors explore how the ideal of informed consent guides education and evaluation for living organ donation. The authors posit that informed consent for living organ donation is a process. Though (...) the steps in this process are partially standardized through national health policy, they can be improved through institutional structures at the local, transplant center-level. Effective structures and practices aimed at supporting and promoting comprehensive informed consent provide more opportunities for candidates to ask questions about the risks and benefits of living donation and to opt out voluntarily Additionally, these practices could enable new ways of measuring knowledge and improving the consent process. (shrink)

Emotionally-related live organ donation is different from almost all other medical treatments in that a family member or, in some countries, a friend contributes with an organ or parts of an organ to the recipient. Furthermore, there is a long-acknowledged but not well-understood gender-imbalance in emotionally-related live kidney donation. This article argues for the benefit of the concept of just love as an analytic tool in the analysis of emotionally-related live organ donation where (...) the potential donor(s) and the recipient are engaged in a love relation. The concept of just love is helpful in the analysis of these live organ donations even if no statistical gender-imbalance prevails. It is particularly helpful, however, in the analysis of the gender-imbalance in live kidney donations if these donations are seen as a specific kind of care-work, if care-work is experienced as a labour one should perform out of love and if women still experience stronger pressures to engage in care-work than do men. The aim of the article is to present arguments for the need of just love as an analytic tool in the analysis of emotionally-related live organ donation where the potential donor(s) and the recipient are engaged in a love relation. The aim is also to elaborate two criteria that need to be met in order for love to qualify as just and to highlight certain clinical implications. (shrink)

McGovern, Kevin After a brief account of the process, this article considers three significant ethical issues about Donation after Cardiac Death.

This essay is a comparative analysis of results reported in this volume from studies in mainland China, the United States, Iran, and Hong Kong regarding organ donation incentives. They reveal widespread (but not unanimous) support for honorary incentives (such as notes or ceremonies of gratitude) and significant support for familist incentives (offering a donor’s family members priority should they need an organ transplant in the future). Opinions on financial incentives were much more mixed, with significant worries expressed (...) regarding potential exploitation and unfairness. These interviews also reinforce the importance of culturally appropriate constructions of any steps to increase organ donation rates. And, in addition to their comments on various types of incentive, interviewees in these chapters also offer insight into other measures that could be taken to increase organ donation. (shrink)

BackgroundUndocumented immigrants can donate their organs, but lack access to organ transplantation. This challenges foundational principles of organ donation: fairness and informed consent. Little is known about undocumented immigrants’ knowledge of barriers to their access to organ transplantation or how this might affect their decision to donate their organs.MethodsThe study was performed in an urban, university-affiliated, safety-net hospital. We interviewed hospitalized patients who selfidentified as undocumented immigrants and were unaware of having any contraindication to organ (...) donation (for example, cancer). We first recorded their demographic characteristics and knowledge and attitudes regarding organ donation. We then assessed the effects of informing participants about limits to their access to organ transplants on their willingness to donate.ResultsThis group of 59 uninsured Hispanic immigrants had adequate knowledge about organ donation. Participants were suspicious about inequality within the medical system, but most were willing to donate their organs (74 percent). Most participants (74 percent) were aware that they would have to pay to receive an organ, but they dramatically underestimated the out-of-pocket expenses. Yet willingness to donate their organs was unaffected by participants being explicitly informed of the low likelihood that they would be able to afford to receive an organ transplant.ConclusionsDespite being well informed about the organ donation system, undocumented Hispanic immigrants underestimate the costs and overestimate their likelihood of receiving an organ. Even when they are given this information, they remain willing to donate their own organs. (shrink)

This chapter provides conceptual and ethical comments on Hong Kong’s interview findings and survey results regarding the three types of incentive for organ donation. It focuses on three particular conceptual and ethical issues. First, it shows that there is not always a clear-cut distinction between an honorary and a compensationalist incentive measure for organ donation. Instead, a measure such as offering a public columbarium niche to a deceased donor in Hong Kong carries both honorary and compensationalist (...) elements and can, as a mixed type of incentive measure, be ethically justified for adoption in that society, even if purely monetary incentives cannot be similarly ethically justified. Moreover, in relation to the proposal to offer a familist incentive in Hong Kong (namely, to give patients with a first-degree family member who was a cadaveric donor, or who have themselves previously been live donors, a priority right for a transplant over other medically similar patients), it is argued that no proposed opposing reason is ethically convincing. Finally, the chapter demonstrates that there are legitimate considerations to support maintaining Hong Kong’s familist decision-making model regarding organ donation. (shrink)

This chapter gives an outline of the development of the human organ transplant system in Hong Kong, whose key features are a soft opt-in system and strict prohibitions on commercial dealings in human organs for transplant. It is argued that under such a system, there is a lack of incentives for either cadaveric or living organ donations and for family members to endorse deceased donation. This argument is followed by an investigation of the shortage of organ (...) donations in Hong Kong, the limited success of the government promotion to improve the number of donations, and a discussion of new alternatives for improvement that have been initiated or proposed. It is argued that the feasibility and effectiveness of these alternatives are limited and uncertain. More radical reform of the existing system in terms of honorary, compensationalist, and familist incentives is needed and they all need to be taken into consideration. (shrink)

Here I consider some of the ethical and philosophical issues at the intersection of medical assistance in dying (MAiD) and deceased organ donation (DOD). Three possible objections about inherent aspects of the practice of DOD after MAiD are considered, and rejected. The bulk of the chapter examines recent calls to keep decisions about DOD and MAiD separate, and to clarifying the nature of the ethical concerns underlying effort to protect patients from undue pressure and coercion. Several insights are (...) revealed as a result of this analysis, including that there is good reason to think that sometimes it may be morally justifiable to allow an eligible patient to pursue MAiD because they wish to donate their organs after death. Noting that more research is needed, I close with several recommendations for policy and practice. (shrink)

Prolonged survival after the declaration of death by neurologic criteria creates ambiguity regarding the validity of this methodology. This ambiguity has perpetuated the debate among secular and nondissenting Catholic authors who question whether the neurologic standards are sufficient for the declaration of death of organ donors. Cardiopulmonary criteria are being increasingly used for organ donors who do not meet brain death standards. However, cardiopulmonary criteria are plagued by conflict of interest issues, arbitrary standards for candidacy, and the lack (...) of standardized protocols for organ procurement. Combining the neurological and cardiopulmonary standards into a single protocol would mitigate the weaknesses of both and provide greater biologic and moral certainty that a donor of unpaired vital organs is indeed dead. (shrink)

Should we remove whole organs from living donors only in the case where they are genetically related to the intended recipients of such organs? The practice in a majority of European nations is to apply such a restriction. Yet this restriction obviously limits the availability of already scarce donor organs, and curtails the opportunities for altruistic action on the part of those who, in any given case, are not genetically related to the recipient. The author argues that we have a (...) duty to maximise procurement of organs, and that we should respect the 'genetic relative' restriction only in response to compelling moral reasons. The author considers the principal objections to non-related donation and shows them to be misdirected. He concludes that non-related donation should be welcomed where clinically appropriate and truly voluntary. (shrink)

Living organ donation has developed into an important therapeutic option in transplantation medicine. However, there are some medico-ethical problems that come along with the increasing reliance on this organ source. One of these concerns is based on the observation that many more women than men function as living organ donors. Whereas discrimination and differential access have been extensively discussed in the context of cadaveric transplantation and other areas of health care, the issue of gender imbalance in (...) living organ donation has received less attention. This paper presents relevant data from the Eurotransplant and UNOS transplantation systems and discusses possible explanations for the documented gender discrepancies. The conclusion calls for are view of existing practice guidelines in order to secure effective protection of particularly vulnerable potential donors and an equitable donor-recipient-ratio in living organ donation. (shrink)

This symposium explores the boldest recommendation of the Institute of Medicine’s Committee on Increasing Rates of Organ Donation, namely, the recommendation that the U.S. consider a new population of potential donors. In its 2006 report, Organ Donation: Opportunities for Action, the committee recommended pilot programs in socalled “uncontrolled” donation after a circulatory determination of death. Potential uDCD donors have died from an unexpected loss of circulation, either due to sudden cardiac arrest or excessive blood loss (...) following traumatic injury. Because circulation is lost before death is determined and long before organ procurement could begin, potentially transplantable organs will die from oxygen starvation unless they are quickly preserved by cooling or other means. (shrink)

This symposium explores the boldest recommendation of the Institute of Medicine’s Committee on Increasing Rates of Organ Donation, namely, the recommendation that the U.S. consider a new population of potential donors. In its 2006 report, Organ Donation: Opportunities for Action, the committee recommended pilot programs in socalled “uncontrolled” donation after a circulatory determination of death. Potential uDCD donors have died from an unexpected loss of circulation, either due to sudden cardiac arrest or excessive blood loss (...) following traumatic injury. Because circulation is lost before death is determined and long before organ procurement could begin, potentially transplantable organs will die from oxygen starvation unless they are quickly preserved by cooling or other means. (shrink)

Belgian physicians recently reported on organ donation after euthanasia. In patients suffering mainly from a neurodegenerative disorder, the organ donation procedure starts after cardiac death due to euthanasia. The Church condemns the act of euthanasia. The act of procuring organs after euthanasia cannot be approved either, since those who procure the organs must cooperate closely with those who perform the euthanasia. Although the act of organ donation itself can be an act of charity, participation (...) in organ donation after euthanasia suggests approval of euthanasia. A patient may, because of a difficult medical situation, choose to accept an organ obtained after euthanasia but should dissociate himself explicitly from the act of euthanasia itself. National Catholic Bioethics Quarterly 12.3 (Autumn 2012): 431–437. (shrink)

The need for organs for donation is far greater than organ availability. In the last decade this has led to restructuring and investment in the organ donation programme with political and public support. The majority of transplanted organs are retrieved from patients dying on an intensive care unit, and the wish to consider organ donation as a normal part of end-of-life care has led to considerable pressure on clinicians to adhere to the large amount (...) of practical and ethical guidance being published to achieve this. There has not been universal acceptance of the guidance by critical care clinicians, and this paper explores some of the concerns related to the practicalities of the evolving changes in management of potential organ donation patients within intensive care. (shrink)

A recent joint study by the Council of Europe and the United Nations focused on the criminality surrounding organ donations. Published in October 2009, it points out the various violations of the international prohibition on the trafficking of organs. This paper will first analyze this study and then contextualize it in the current discourse about organ donation in the Philippines. Finally, the issue of organ donation will be put in the wider discourse of justice in (...) organ transplantation.Organ donation and trafficking are much debated issues in medical ethics. This paper will discuss this problematic in three specific dimensions. After an explanation of the general lines of the debate on organ transplantation , it will analyze the recently published joint report of the Council of Europe and the United Nation on the trafficking of organs . The discussion afterwards will be situated in the concrete cultural, ethical and legal framework of the Philippines as a test case for the validity and applicability of the reports recommendation . Lastly, it will conclude with some ethical considerations on the horizon of an elaborate concept of justice. (shrink)

Next SectionFive arguments are presented in favour of the proposal that people who opt in as organ donors should receive a tax break. These arguments appeal to welfare, autonomy, fairness, distributive justice and self-ownership, respectively. Eight worries about the proposal are considered in this paper. These objections focus upon no-effect and counter-productiveness, the Titmuss concern about social meaning, exploitation of the poor, commodification, inequality and unequal status, the notion that there are better alternatives, unacceptable expense, and concerns about the (...) veto of relatives. The paper argues that none of the objections to the proposal is very telling. (shrink)

New protocols have been developed for donors after circulatory death involving early assessment of donor status and premortem supporting treatment in appropriate cases where there is evidence that the patient wished to be an organ donor. These donors are now making an increasingly marked impact on overall deceased donor numbers in the UK. Donors after brainstem death, on the other hand, are much less buoyant yet require the same flexibility in approach in order to improve rates of donation (...) and to realize the wishes of potential deceased organ donors to the proper requisite extent. (shrink)

This chapter makes further ethical commentaries in response to the findings as described in Chaps. 2 and 3. We contend that it is not the case that only one type of incentive can be justified to motivate organ donation in mainland China. In particular, we argue that while each of the three types of incentive (honorary, compensationalist, and familist) can work, some particular incentive measures can be ethically justified and be the most motivating in the context of mainland (...) China. Based on our findings and arguments, we revisit the orientation of China’s organ donation reform and attempt to provide some recommendations for future policy considerations. (shrink)

This chapter discusses some legal implications of Hong Kong’s three types of organ donation incentive and presents further thoughts about their ethical and policy implications. It aims to transform the useful findings presented in previous chapters into legal solutions and policy innovations in practice. We argue that the Hong Kong law is able to incorporate mixed incentive measures and further suggest detailed legal rules regarding organ incentives for the government to consider. In terms of ethical and policy (...) implications in a wider context, we suggest a paradigm shift in incentive structure and the adoption of mixed incentive measures for the promotion of organ donation and procurement. However, we agree that the exact choice or combination of organ incentive measures ultimately depends on how each country or jurisdiction will assess their practical effectiveness, political legitimacy, and ethical justification. (shrink)

(No abstract is available for this citation).