Nick Moder
Writing 1150
Literature Review
10/24/11
Introduction: Organ transplantation is the process of removing and replacing a failing or
damaged organ with a new one. The most common organs that are transplanted are the heart,
lungs, liver, pancreas, and intestines but other procedures allow eyes, nerves, and bone marrow
to be transplanted to a necessary recipient. Of course, in order to receive a new organ one has to
be able to have correct compensation and their bodies have to be compatible to insure that the
organ isn’t rejected.
The Transplant Process
There are two processes in which a person can receive a new organ. The first source of organs is
from the recently deceased in which these organs are categorized as cadaveric organs. In order to
be able to harvest these organs, the deceased must have proof that he or she is on fact an organ
donor, whether it is written on their death certificate or is clarified on a driver’s license. If organ
donation is not indicated, doctors must then ask the family of the deceased if it is all right. In
some states, hospital policies require family consent of organ donation regardless of whether or
not donation is requested. The second source of organs is directly from a living person. Usually
these living donors are related but transplants have been done by close friends or complete
strangers. There are two ways a living donor can have an organ transplanted, the first is donating
one-half of a paired organ set, like the kidneys. The second way is by donating a portion of an
organ that can still function without it such as a segment of the liver or the lobe of a lung.
Procurement and Distribution
There will always be fewer donors than potential recipients. According to the O.P.T.N. (Organ
Procurement and Transplantation Network), the number of transplants that were performed,
starting in January and ending in July 2011, totaled 16,416 with nearly 13,000 of them being
from deceased or cadaveric donors and nearly 3,500 being from living donors. Unfortunately, a
total of 8,132 recipients had recovered after the transplant procedure. Procurement also causes
the problem of determining whether or not it is safe to declare a person dead based on heart or
lung failure, brain function, or recognizing the signs of complete loss of higher functions. “This
brings forth the issue of not taking organs from someone who is still alive but also wastes time
by waiting for complete death which may cause organs to become unsuitable for use,” (Caplan,
1999). Distribution of organs in the United States must abide by certain methods and the UNOS
(United Network for Organ Sharing) hopes transplant centers will be able to correctly and
efficiently distribute under the criteria of medical need or urgency, probability of success, and
the amount of time spent on the waiting list. “The distributive justice concept states that there is
no one “right” way to distribute organs, but helps patients justify giving an organ to an individual
over someone else,” (Veatch, 2002). A distributive justice criteria known as equal access helps to
limit unfair bias based on a patients objective factors including the length of time on the waitlist,
(first come, first served) and age of the patient, youngest to oldest. The equal access theory also
encourages that no patient be denied treatment based on sex, race, income level and geographic
distance from the organ being donated.
Compensation for Organ Donors: Should they be paid?
On July 23, 2009, a businessman was accused of buying and selling kidneys due to a growing
organ shortage across the country. The National Organ Transplant Act states that human organs
can’t be exchanged for something of monetary value. Some people believe that the supply-anddemand problem of organs could have a financial solution. The largest debate comes from the
discussion of financial incentives for kidney donation, since the need for this particular organ is
the greatest and is one of the few organs that can come from a living donor. “The idea of
eliminating financial woes from live organ donation is an obstacle since some people lose more
money than they make when donating,” (Rettner, 2009). For example, a donor experiencing
complications during the transplant process could mean the potential for lifelong medical
treatment afterwards. The National Kidney Foundation supports the idea of compensating
donation-related expenses since the living donor is supporting state and federal legislations that
in return create tax credits in order to reimburse expenses that may have been out-of-pocket
costs. Of course the biggest fear of paying donors is the possibility of an organ market in which
the more economically secure could exploit the poor for organs. “Once monetary gain is in the
equation, you have a market,” says Dr. Francis L. Delmonico, a transplant surgeon of the New
England Organ Bank. “Once a market is established, it isn’t something that can be easily
controlled or regulated,” (Delmonico). However, some people believe that this system could
work with supervision of transplant professionals who would screen potential donors in order to
decide whether or not they would be able to donate. Unfortunately the poor could be excluded
from this system. If a donor were living in poverty stricken conditions the risk of kidney disease
is much higher. However, exploiting people shouldn’t be a reason for the poor to be a part of this
possible system. The government would pay the incentives, regardless of what they are. It is
within the best interest of the government to pay for the transplant and incentives compared to a
situation where a kidney transplant goes through complications and the recipient or donor must
be supported by dialysis, which can rack up a total expense of around $65,000 to $75,000 per
year.
Conclusion
The future of organ transplants is still in development, from new procedures to new surgical
techniques. How accessible and affordable these operations are is still undergoing some legal
requirements and hopefully it leads to organ transplants being available to anyone and everyone
free of complication and denial. However, unforeseen complications such as organ rejection by
the body and conserving suitable organs for transplant may still need some further research and
development.
Works Cited
Caplan, Arthur (1999). The Ethics of Organ Transplants: The Current Debate.
Prometheus Books.
Veatch, Robert (2002). Transplantation Ethics. Georgetown University Press; Reprint
Edition.
Rettner, Rachael (2009). “Great Debate: Should Organ Donors Be Paid?” Live Science,
August 10.
Munson, Ronald. (nd) Ethics of Organ Transplants “Raising the Dead: Organ
Transplants, Ethics, and Society” About.com