Capella University
PHI-FPX3200: Ethics in Health Care
Dr. Ginger Raya
December 22, 2023
Robbing the Dead: Is Organ Conscription Ethical?
The demand for transplantable organs exceeds supply. With the increasing risk of more people dying while waiting for an organ, the government has to consider alternatives for making organs available for transplantation. Organ conscription is among the interventions that improves organ availability. The option allows organ procurement organizations to respond to the needs of thousands of people on the waiting lists across the country. Exploring ethical issues such as respect for autonomy and non-maleficence is necessary to ascertain the implications of organ conscription on individuals.
Moral Aspects of Organ Conscription
Conscription is among efficient and effective ways of increasing transplantable organs. The policy gives hope to thousands of patients on long waiting lists. In this case, every person who dies in situations enabling organ transplantation must automatically donate their organs. The primary consideration is addressing organ shortages through one of the quickest ways of obtaining organs. Similarly, the policy creates options for states to harvest all usable organs (Cherry, 2019).
However, moral concerns raise questions about viability and sustainability of organ conscription. Firstly, it is morally inappropriate to ignore strategies that could help address organ shortages. Deceased individuals with organs suitable for transplantation help address the needs and expectations of the thousands of people on the waiting list (Cherry, 2019). Organ conscription meets the provisions of Kantian ethics and utilitarianism that remind the care team to fulfil their duty of care and maximize benefits for a larger population (Iserson, 2020). The process also enhances adherence to beneficence principle, which requires the care team to meet patients’ best interests. Autonomy is another vital consideration that given patients the right to refuse unwanted medical procedures. The refusal includes rejecting intentions to remove vital organs without consent.
Fairness and Justness of Organ Conscription
Mandatory cadaveric organ donation triggers discussions about the level of fairness and justice. The society supports posthumous wishes such that foregoing individuals’ wishes is subversive to dignity. Fair and just organ donations should acknowledge the need to respect voluntary decisions to donate or avoid donating organs, even after death. Respecting freedom of choice allows people to act according to their values and preferences (Cherry, 2019). Organ conscription responds to the needs of patients from underserved and under-resourced communities with limited funds to access organs from illegal markets and other donors. The policy promotes equal distribution of incentives available to ensure more people access organs and prolong lives (Lewis et al., 2021). However, health disparities may expose low-income familiar from unfair compensation (Park et al., 2022). Similarly, failure to request or require informed consent may also limit individuals from sharing their values and preferences beyond religious considerations.
Consent and Organ Conscription
Organ conscription ignores the principle of informed consent. Organ procurement organizations proceed to access usable organs without requiring or requesting consent from patients and families. This way, the policy overrides the principle of self-determination on opting-out options. Presumed consent is an important consideration to capture patients’ preferences to donate their organs for transplantation after death (Cherry, 2019). In consented scenarios, patients register their desires and preferences not to have their organs for transplantation. Organ conscription undermines the principle of presumed consent such that the relevant agencies end up removing organs from people who did not want their organs removed. The decision is morally unacceptable since it jeopardizes the principle of respect for autonomy.
Interventions for Increasing Donor Organs
Increasing donor organs is a vital step for the country to respond to the needs of thousands of patients on the waiting list. Nudging patients is a necessary consideration to encourage them to make objective decisions that match society’s interests (Robitaille et al., 2021). The aim is to respect the principle of autonomy, which allows individuals to act according to their preferences. Nudge incentives will reduce organ scarcity by empowering patients and their families to help others in need of vital organs.
Organ procurement also raises questions about the risk of violating non-maleficence principle. Allowing patients to die in a manner of their choosing empowers them to save lives through organ donation (Robitaille et al., 2021). In this case, it is crucial to assure patients that organ procurement will not be the cause of their death. Terminally-ill patients will appreciate the need to donate organs immediately following medical procedures such as placement on life support. Further, it may be necessary to allow patients not infected with HIV or hepatitis C to receive organs that carry the virus. The move aligns with improvements in treatment of diseases that previously jeopardized efforts to increase supply of transplantable organs.
Conclusion
The need for transplantable organs continue to exceed supply. Delays in identifying alternatives for sourcing organs could expose terminally-ill patients to severe complications and premature deaths. Ethically justified strategies for improving organ availability should accommodate a patient’s autonomy. The interventions should also assure patients about adherence to non-maleficence principles that protect individuals from psychological, physical, and emotional harm.
References
Cherry, M. (2019). Contested organ harvesting from the newly deceased: First person assent, presumed consent, and familial authority get access arrow. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 44(5), 603-620. https://academic.oup.com/jmp/article-abstract/44/5/603/5570662
Iserson, K. (2020). Healthcare ethics during a pandemic. Western Journal of Emergency Medicine, 21(3), 477-483. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234717/pdf/wjem-21-477.pdf
Lewis, A., Koukoura, A., Tsianos, G., Gargavanis, A., Nielsen, A., & Vassiliadis, E. (2021). Organ donation in the US and Europe: The supply vs demand imbalance. Transplantation Reviews, 35(2), 1-8. https://www.sciencedirect.com/science/article/pii/S0955470X20300586
Park, C., Jones, M., Kaplan, S., Koller, F., Wilder, J., Boulware, E., & McElroy, L. (2022). A scoping review of inequities in access to organ transplant in the United States. International Journal for Equity in Health, 21(22), 1-16. https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01616-x
Robitaille, N., Mazar, N., Tsai, C., Haviv, A., & Hardy, E. (2021). Increasing organ donor registrations with behavioral interventions: A field experiment. Journal of Marketing, 85(3), 168-183. https://journals.sagepub.com/doi/epub/10.1177/0022242921990070