The successful transplantation of an organ and tissue from one person to another is certainly one of the greatest achievements in modern medicine. However, the practicing of organ donation and transplantation has given rise to the series of serious emotional, psychological, legal, medical and ethical issues. There are dangers and benefits to both the organ beneficiary and donor. Commercialization of body organs has made the availability of organs in the world-wide market possible; they have become the products of money trade (Munson, 2007). As a result, the practice leads the potential donor to the risk of being exploited by the recipient through the assistance of medical personnel. This paper provides a review and analysis of two current issues in the field of organ transplant, using the utilitarianism as a theoretical framework.
Organ Transplantation Demand Rise in Future
The supply of organs for transplantation is currently less than the demand, and the demand is anticipated to increase in future. This is due to an anticipated increase in longevity, due to the improvement of nutrition, medical care and public health (Munson, 2007). Hence, a large segment of the population will be subjected to aging diseases, such as kidney failure, heart failure and diabetes. This will ultimately escalate the prevalence of organ failure among the ageing population and the demand for organ transplantation.
The number of persons in need of organ transplant has increased, being at a rate five times as fast as the number of conducted transplant operations. There has been an increasing acute need for three vital organs: liver, heart and kidney. Reports by the United Network for Organ Sharing (UNOS) show that there have been dawdling demands for organs from the deceased donors, whilst the number of living organ donors has essentially doubled over the last decade (Munson, 2007). The network also noted an increasing number of living organ donors that have no family relations with an organ recipient. However, as more hospitals continue improving the organ transplant technique, the number of people on the transplant waiting list remains more than the number of available organs.
The increasing in future demand for organ transplantation is attributed to the increasing in the organ availability from living donors. The recent study shows that the recipient of organs from living donors is more likely to survive than those from deceased donors. This is because living donors are normally subjected to careful and detailed screening. In addition, the surgeries are conducted in controlled environments (Winters, 2009). However, the number of living organ givers is less than the number of those, requiring organ transplant. In 2005, the number of organ transplant in United States of America was approximately 21,715. This represented 44 percent increase, since 1999. However, there were approximately 72,310 persons on the national organ transplant waiting list by the end of 2005; this was twice as many as in 1999. The trend has increased since then (Winters, 2009).
The Health and Human services have promised to launch a national wide campaign to increase the organ donation to meet the current and future demand. However, the department of Human Services is still uncertain about the possibility of meeting both current and future organ transplant needs, which are projected to increase (Winters, 2009). Currently, a lot of efforts are revolving around public education to encourage families in leading the discussion organ donation issue before the need arises. Other efforts have been directed toward improving the relationship between organ banks and hospitals to identify more potential organ donors. A lot of resources have been invested in finding the most appropriate ways of approaching the grieving family about donation.
As a result of the projected increase in organ transplant demand, several methods have been employed to seek authorization of harvesting of an organ from a deceased person in an effort to increase the supply from the important sources. This has been done through public education on merit and need of organ donation as a ‘gift of life’ to save fellow human being. This is on the basis of utilitarianism ethics principle, which explains morality in terms of maximization of happiness and reduction of suffering (Tong, 2007). Therefore, when a physician faces a dilemma on making critical decision, regarding organ transplant, he has to resort to the action that will promote the greatest good and benefit. The utilitarian actions are considered to be right with regard to the proportion, in which they are going to promote happiness and wrong, when tending to produce the reverse of happiness (Tong, 2007).
It has been established that 3 out of 10 Americans have indicated their wishes of donating an organ. Where the wishes of a deceased person for organ donation are unknown, the family normally tends to reject organ donation request, in order to avoid making erroneous decisions. This has been a key factor of organ transplant shortage in the organ bank. Furthermore, there have been myths that surround the organ donation. Doctors have been accused of not exhausting of all available option for saving potential donors. It has also been claimed that rich people and celebrities generally have better chances of getting organs as compared with other patients. This myth has made families resist organ donation request. It has raised ethical issues, regarding the availability of organs for transplant to all persons in need, regardless of their social-economic status (Morrison, 2009).
All medical personnel are normally guided by the principle of utilitarian thinking in their operations. Therefore, it is usually considered to be morally right for family members of the deceased person or critically ill person to grant the doctor the permission to harvest the organ of their loved one, in order to save the life of four different people in need of a transplant (Morrison, 2009). The utilitarianism principle requires personal sacrifices, in which the total pleasure outweighs the cost of pain, even when the individual making of such choices is of no benefit.
Overview of Commercialization Organs
From the begging of 1962’s, when the first successful organ transplant of unrelated persons was done and become fruitful, the demand for human organs has continued to rise (Tong, 2007). These great breakthroughs in the field of medicine have led to development of effective immunosuppressive drugs, which enabled human organs to be transplanted. The advancement in medicine also facilitated a critical shortage of body organs (Tong, 2007). This has made many nations around the world to seek alternative means of human organs’ acquiring. One of these methods is commercialization of organs.
Most of the commercialized human organs include heart valves, skin, kidneys, bones, liver and corneas. As a result of the increased demand for organs, citizens from poor nations or regions are at times tempted to sell some of their organs (Fisanick, 2010). In the recent research, selling and buying of human organs is on the rise. It either happens among both the deceased or living donors. In many countries, Commercialization of human organs is something that many governments closely monitor. Most governments prohibit the selling and buying of organs (Monagle & Morrison, 2009). By means of that they ensure some level of impartiality in the access to organ transfer. Many people including surgeons have insisted on the importance of having some kind of compensation or even direct payment for organ donors. This has become an emerging issue, where human organs are being traded now just like any other commodity in the market.
This issue has brought about many ethical questions (Fisanick, 2010). Many people wonder, whether human organs are supposed to be viewed as spare parts that can be traded by people at their own will. In today’s organ transplantation practice, there exists a wide gap between the number of organs needed for transplantation and the number of donated ones (Taylor, 2005). There are more people, waiting for tissue or organ transplant in hospitals, than donors for these organs. This leads to a widespread shortage of organs. According to the reports released by the United States Department of Health and Human Services, it is estimated that each year only about 5,500 deaths of an estimated 8,000 – 15,000 deaths of appropriate donors’ candidates lead to organ donation (Taylor, 2005). Temporarily, the total number of people, who normally wait for organ transplant in hospital beds, grows every day. It is thus estimated that more than 4,000 will die each year, while waiting for organ or tissue transplant (Morrison & Monagle, 2009).
Commercialization has brought about many moral questions. The major belief that the state is supposed to facilitate organ donation, in order to prevent the wastage of such a valuable resource has generated debates among many nations (Wilkinson, 2011). Some people have argued that humans are born in families and in communities and thus their bodies should be seen as community resources. If it is assumed that the refusal of a dead person’s family to permit organs to be taken for transplantation is ethically wrong, then it is reasonable to override it. This could be accomplished by letting medical professionals to regularly remove cadaver organs from dying patients without any family permission (Wilkinson, 2011).
Utilitarianism and Commercialization of Organs
In the western world, commercialization of human organs is unaccepted, and thus programs are organized around cadaveric living and emotionally involved donors. However, this does not mean that organ commercialization does not exist (Wilkinson, 2001). In Utilitarianism theoretical model, commercialization of organs is done because of various reasons. Despite criticism of this act, the utilitarian go ahead in buying and selling of human organs. All they care about is the results of their actions (Mill, 1957). They propose that commercialization of organs is right in proportion, as it promotes good health to the recipient of these organs. Any other factor that can be typically considered when making any moral judgment about an action is not considered by the utilitarians (Mill, 1957).
What is more important in the utilitarianism theoretical model is that this commercialization is intended for individual happiness. When making any decision in life, this model emphasizes that people should make their moral choices in ways that maximize happiness, while at the same time minimizing pain (Wilkinson, 2011). When commercializing human organs the utilitarian are aiming to reduce the recipients suffering and promote his or her happiness by reducing any agony he may be undergoing. According to this model, the process of commercialization does not matter. All that matters is the pleasure that will be gained, when a patient, lying on a hospital bed, gets a full recovery after receiving the transplant. In this model the fact, whether the transplant organ was bought or donated does not matter.
In utilitarianism, commercialization of organs become ethically acceptable, if in the course of accounting the pain and pleasure, associated with organ commercialization, the sum of total pleasure overshadows the sum of pain (Wilkinson, 2011). According to utilitarianism, government acts of making organ commercialization illegal only increase suffering to organ recipients. It is thus unacceptable to allow these patients to continue suffering, while somebody elsewhere is willing to sell his or her organ (Mill, 1957).
Governments from different countries may restrict the sale and buying of human organs because poor people become vulnerable. According to utilitarianism theoretical model, this is wrong because such people could earn money from the sale of their organs and improve the conditions of their lives. This has the capacity to increase their happiness, unlike when they have their organs. Utilitarianism would thus encourage such poor people to sell their organs to bring happiness to the lives of the recipient while at the same time improving their lives (Mill, 1957).
From the above discussions, it is evident that an increased future demand for human organs is expected to rise. It can thus be expected that commercialization of organs is something that governments world over should legalize (Wilkinson, 2011). This is so because despite the strict measure that the governments put, selling and buying organs still takes place. Procedures to govern the sale and buying of human organs can be strategized. Alternatively, such governments and world organizations as United Nations, should device mechanisms that will cater for the acute shortage of organs.