Thursday, April 4, 2013

The ethics of organ donation

The Journal reports that the number of organ donations in Ireland fell by 17 per cent in 2012, to levels below the usual annual average – with 78 people donating their organs upon death last year.

The Irish Kidney Association said the shortage was not down to a lack of willingness from the Irish public to donate an organ, but rather to management issues such as the absence of an organ donor registry.

Meanwhile, there is still no progress on longstanding calls to change the Irish system from ‘opt-in’ – where a person has to explicitly declare their desire to donate their organs after death – to ‘opt-out’ where the person, or their surviving relatives, must intervene to stop the process.

The Irish Government requested submissions by March 14th 2009 in respect of alternative options as follows

Option A – Opt-out: sometimes called presumed consent
(The person is presumed to have consented to donate his or her organs after death unless he or she has specified otherwise.)

Option B – Opt-in: sometimes called explicit consent
(The person can decide in advance to consent to donate his or her organs, or to nominate someone to make the decision on his/her behalf after death. Where the deceased has not made a decision his or her family may do so.)

Option C – Mandated choice and required request
(A person would be required by law to specify whether or not he/she wishes to donate their organs after death.)

The ethics of organ donation
An article published in the New England Journal of Medicine in 2008 re-opened the debate about the ethics of organ donation. The article warns that organs can be - and are being - harvested from the bodies of patients who cannot be convincingly termed 'dead'. The authors do not oppose organ harvesting on these grounds, stating:
    The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead.