organ donation (issue on morality)
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Organ Donation
ARANDIA, Gigi Aleckz N
THES004 Fundamentals of Moral Theology
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An introduction.
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Overview
Organ Transplant A surgical operation where a failing or damaged organ
in the human body is removed and replaced with a new
one.
Typically refers to transplants of the solid organs
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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Overview
Organ A mass of specialized cells and tissues that work
together to perform a function in the body.
Any part of the body that performs a specialized
function
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Overview
Graft The process of removing tissue from one part of a
persons body and surgically re-implanting it to replace
or compensate for damaged tissue.
Grafting is different from transplantation because itdoes not remove and replace an entire organ, but
rather only a portion.
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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The transplant process.
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Doctor checks the patients eligibility for a transplant Doctor refers the patient to a transplant center
Transplant center evaluates:
Health and mental status
Level of social support
If no readily available living donor or is ineligible for a
living donation, they are placed into the waiting list
for a cadaver organ donation
An organ procurement organization (OPO) takes the
organs into custody once the organs become available
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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A computer program determines, ranks and matchesorgan donations to possible recipients on the waiting
list
Blood type, organ size and type
Distance from the donor organ to the recipient Level of medical urgency
Time on the waiting list
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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If a match occurs, the organs are offered to thefirstpatients transplant center, fulfilling these questions:
Is the patient available and willing to be transplanted
immediately?
Is the patient healthy enough to be transplanted? If these are true, the OPO delivers the organs to the
transplant center for the transplant process
This entire process must occur very quickly as organs are
only transplantable for a short time period after theyve
been removed.
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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General procedure:1. Make an incision in the body near the failing organ
2. Cut the arteries and veins that run to the organ
3. Remove the organ through the incision
4. Take the new organ and insert it into the body throughthe incision
5. Connect the new organ to the arteries and veins
6. Close the incision
Long road to recovery Possible rejection
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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Moral, ethical and medical issues.
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Death medically defined
Irreversibly dead body Brain death irreversible cessation of all functions of
the brain, including the brainstem
Coma or unresponsiveness
Absence of brainstem reflexes Apnea suspension of external breathing
*higher-brain death
Non-heart beating irreversible cessation of
cardiopulmonary function
Ellen Bridget Linde, RN, BSN. Speaking up for organ donors. Issues in Nursing. January 2009
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Not an easy decision to make
Surrogate decision maker Substituted judgment standard
Best interest standard
Ellen Bridget Linde, RN, BSN. Speaking up for organ donors. Issues in Nursing. January 2009
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The organ shortage (2004)
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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The organ shortage (2015)
United Network for Organ Sharing. http://www.unos.org/index.php
http://www.unos.org/index.phphttp://www.unos.org/index.php -
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The organ shortage (2015)
Organ Procurement and Transplantation Network. http://optn.transplant.hrsa.gov/
http://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/ -
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The organ shortage
Distributive justice how to fairly divide resources Not one right way of distribution, but rather many
Criteria:
Equal access
Length of time waiting (i.e. first come, first served)
Age (i.e. youngest to oldest)
Maximum benefit
Medical need (i.e. the sickest people are given the first opportunity for
a transplantable organ)
Probable success of a transplant (i.e. giving organs to the person who
will be most likely to live the longest)
United Network for Organ Sharing (UNOS)
Maintains the list for the national waiting pool*
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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Donor organs
Donor organ sources: Cadaveric (dead) donors postmortem
Living donors inter vivos
Alternative organ source
Organ farming
Premature declarations of death in order to harvest organs
Ethics of Organ Transplantation. University of Minnesotas Center for Bioethics. February 2004.
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Will the doctors be anxious to hasten death in orderto transplant organs for a waiting recipient?
First and foremost, doctors primary concern is for the
patient in their care. In addition to steps outlined in this
brochure taken by Catholic hospitals, it should be notedthat the medical team working to save the life of an
individual is completely separate from the transplant team
that performs the organ transplants.
Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
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Organ Donation by Living Donors
Physicians must risk the life of a healthy person to saveor improve the life of a patient.
Directed donation loved one or friend
Pressure
Compulsion Non-directed donation general pool, top of waiting
list
Motivation
Directed donation to a chosen stranger Biased and unfair
Buying and selling
Robert D. Truog, M.D. Ethics of Organ Donation by Living Donors. The New England Journal of Medicine. 4 August 2005.
Massachusetts Medical Society.
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Requirements
Since the time of Pope Pius XII, , based upon theprinciple of fraternal charity, but only when certain
requirements are met:
The necessity of informed consent legitimately given by the
donor or one who speaks for him.
The physical and psychological risks incurred by the donor
must be proportionate to the good sought for the recipient.
The donor must be aware of these risks and the
proportionate good.
To destroy the healthy functioning or intrinsic beauty ofone's body, even to delay death of another, is morally wrong.
http://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.html
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What the Catholic Church says.
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http://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplants
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Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
How can I stay informed when makingimportant end of life decisions?
Catholics who are considering organ donation should
know that the Church has no official position on the
particular medical criteria that should be used fordetermining when death has occurred. The Church relies
on the expertise and judgment of scientists, clinicians, and
ethicists for such questions. Catholics should, however, be
informed about the ways in which death is determined inCanada and the distinct ethical issues for organ
transplantation that may arise with each method.
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Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
How do opinions differ on the definition of deathwithin the Catholic community?
Most Catholic ethicist and clinicians accept brain death as
a valid way of determining when death has occurred. Pope
John Paul II in 2000 stated that the complete andirreversible cessation of all brain activity (in the
cerebrum, cerebellum and brain stem), if rigorously
applied, does not seem to conflict with the essential
elements of anthropology.(Address to the 18th International Conference
of Organ Transplant Specialists, August 2000)
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Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
Transplants are a great step forward in sciencesservice of man, and not a few people today owe their
lives to an organ transplant. Increasingly, the
technique of transplants has proven to be a valid
means of attaining the primary goal of all medicine
the service of human life There is a need to instill in
peoples hearts, especially in the hearts of the young, a
genuine and deep appreciation of the need of
brotherly love, a love that can find expression in the
decision to become an organ donor.
- Pope John Paul II to attendees at the International
Congress on Transplant in Rome, August 2000
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Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
Organ donation is a peculiar form of witness to charity. Ina period like ours, often marked by various forms of
selfishness, it is ever more urgent to understand how the
logic of free giving is vital to a correct conception of life.
Indeed, a responsibility of love and charity exists that
commits one to make of their own life a gift to others, if
one truly wishes to fulfill oneself. As the Lord Jesus has
taught us, only whoever gives his one life can save it (cf.
Luke 9:24).
- Pope Benedict XVI,
November 2008 Address at a Conference entitled,
A Gift for Life. Considerations of Organ Donation.
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Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
The act of love, which is expressed with the gift of onesown vital organs, is a genuine testament of charity that
knows how to look beyond death so that life always wins.
The recipient should be aware of the value of this gesture
that one receives, of a gift that goes beyond the
therapeutic benefit. What they receive is a testament of
love, and it should give rise to a response equally generous,
and in this way grows the culture of gift and gratitude.
- Pope Benedict XVI,
November 2008 Address at a Conference entitled,
A Gift for Life. Considerations of Organ Donation.
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Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics Institute.
By donating your organs so that others may have life, youare in keeping with the Catholic Churchs teaching on
respect for life and the dignity of a human person.
The transplant of organs is morally acceptable with theconsent of the donor and without excessive risks to
him/her. Before allowing the noble act of organ donation
after death, one must verify that the donor is truly dead.
(Compendium of the Catechism of the Catholic ChurchSec. 2296, Compendium Sec. 476)
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[T]he Gospel of life is to be celebrated above all in daily
living, which should be filled with self-giving love for
others. . . . Over and above such outstanding moments,
there is an everyday heroism, made up of gestures of
sharing, big or small, which build up an authentic culture
of life. A particularly praiseworthy example of such
gestures is the donation of organs, performed in an
ethically acceptable manner, with a view to offering a
chance of health and even of life itself to the sick who
sometimes have no other hope.
(Evangelium Vitae, no. 86, original emphasis)
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Organ transplants are not morally acceptable if the donor
or those who legitimately speak for him have not given
their informed consent. Organ transplants conform with
the moral law and can be meritorious if the physical and
psychological dangers and risk incurred by the donor are
proportionate to the good sought for the recipient. It is
morally inadmissible directly to bring about the disabling
mutilation or death of a human being, even in order to
delay the death of the other persons (no. 2296).
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Human organ transplantation gives new hope, particularly to
patients with end stage diseases, to recover and regain an
acceptable and decent lifestyle. It provides a better quality of
life compared with alternative expensive and exorbitant
medical interventions (e.g., renal dialysis). Human organ
transplantation, however, cannot be separated from thehuman act of donation. John Paul II states that,
It is a decision to offer, without reward, a part of ones own
body for the health and well-being of another person. In this
sense, the medical action of transplantation makes possible thedonors act of self-giving, that sincere gift of self which
expresses our constitutive calling to love and communion. (20June 1991, no. 3)
CBCP Statement on Organ Donation Against Organ Sale. http://cbcponline.net/v2/?p=551
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We understand the poor and they should not be blamed.
There are other ways to help them but not through organ
sale. They are human beings and cannot be treated as
commodities. We encourage voluntary organ donation
from cadavers and also from living donors. We condemn
any form of organ sale and organ trade.
CBCP Statement on Organ Donation Against Organ Sale
CBCP Statement on Organ Donation Against Organ Sale. http://cbcponline.net/v2/?p=551
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References Ethics of Organ Transplantation. University of Minnesotas Center for
Bioethics. February 2004. PDF. Organ Donation: A Catholic Perspective. Canadian Catholic Bioethics
Institute. PDF.
http://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplants.
Robert D. Truog, M.D. Ethics of Organ Donation by Living Donors. The New
England Journal of Medicine. 4 August 2005. Massachusetts Medical Society.PDF.
Ellen Bridget Linde, RN, BSN. Speaking up for organ donors. Issues inNursing. January 2009. PDF.
http://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.html
CBCP Statement on Organ Donation Against Organ Sale.http://cbcponline.net/v2/?p=551
United Network for Organ Sharing. http://www.unos.org/index.php
Organ Procurement and Transplantation Network.http://optn.transplant.hrsa.gov/
http://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplantshttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://cbcponline.net/v2/?p=551http://cbcponline.net/v2/?p=551http://www.unos.org/index.phphttp://www.unos.org/index.phphttp://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/http://optn.transplant.hrsa.gov/http://www.unos.org/index.phphttp://cbcponline.net/v2/?p=551http://www.catholiceducation.org/en/science/ethical-issues/play-it-again-organ-donation.htmlhttp://www.catholic.com/quickquestions/what-is-the-churchs-view-on-organ-transplants