Organ Donors Compensation

A considerable breakthrough in medical science, which took place in recent decades, has provided mankind with unique opportunities for overcoming once incurable diseases. The increasing progress made the society think about the limitations imposed on the introduction of medical technologies to widespread use. One of the achievements of science is transplantology, which allows the transplantation of vital human organs. In the United States, the idea of creating the market of human organs is unpopular because of moral and ethical considerations. The fact that in conditions of extreme shortage, only people who are able to pay the highest price for an organ get it explains this statement. Offering organ donors compensation is not an ethical solution to the organ shortage issue since it contributes to developing inequality between people who want to receive organs.

The Definition Of Death

The definition of death is a pivotal concept in the context of organ donations and organ transplantation. Historically, death was defined by the irreversible cessation of circulatory and respiratory functions. However, the establishment of brain criteria has led to the recognition of brain death as a legal definition of death. This paradigm shift is significant because it permits the procurement of donor organs from patients who have lost all brain function while their hearts may still be beating with the aid of medical technology.

This modern definition of brain death aligns with the principles of medical ethics, ensuring that the supply of organs is ethically sourced and that the dignity of the donors is upheld. It also facilitates a more efficient organ supply system, as organs can be preserved and transplanted with a higher chance of success, given the donor’s maintained physiological stability. Thus, the redefined understanding of death has profound implications for the practice of organ transplantation, enhancing the potential to save lives while adhering to ethical standards.

Problem of Organ Shortage

At the end of the 20th-the beginning of the 21st century, transplantology became the field of medicine that collected the latest achievements of anesthesiology, surgery, immunology, resuscitation, pharmacology, and other medical and biological sciences. One uses this sphere of high biomedical technologies in cases of such pathological changes in human organs and tissues, which inescapably lead to the death of a patient. Organ transplantation as a method of treating severe patients is of great social importance. It allows not only life prolongation but also ensuring its higher quality level. Due to transplantation, a significant number of people who suffer from a wide range of diseases received a chance for a new, healthy, and fulfilling life. Transplantology has been able to pass from demonstrating a surgical miracle to doing routine surgeries, which saved the lives of hundreds of thousands patients. However, the potentially broad capabilities of this area of medicine quickly reached a limit due to the restricted number of organs available for performing transplants (Rudge et al. 48). So far, no country in the world has managed to reach the zero waiting list that would fully satisfy people’s need for organ transplantation. Shaikh and Bruce emphasize the fact that “more than 122,000 people are waiting for a transplant in the United States, and 22 people on the waiting list die each day” (109). The problem of the development of organ donation is one of the most difficult moral and ethical concerns of modern medicine (Ravitsky 380). Being one of the most complex types of medical care that require high level of professional and material support, this area cannot develop without the help of society and active participation of the population. The discrepancy between the existing demand for this type of medical assistance and the number of available donors has raised the following issue: the society needs to develop social mechanisms of obtaining donor organs and increasing donor activity among the population. From the economic perspective, the optimal solution to this problem should be the introduction of free sale of human organs (Ravitsky 380). However, the application of market principle to the sphere of organ donation has caused a wave of criticism from not only bioethics specialists and sociologists but also the general public. As a result, from being strictly medical problems, the questions of the development of donation and organ transplantation have transformed into moral, ethical, and legal ones.

Ethical and Moral Issues

The problem of the marketization of organ donation is associated with the commodification of human life, which means giving it certain characteristics of a product. The financial incentives include income tax credit, contribution to retirement fund, global health insurance, and tuition voucher. Even in cases when cash is not exchanged, such incentives possess the monetary value. However, in the society, sacred values that do not concern monetary relations exist. Using market logic in areas that do not relate to trade or sale carries the danger of devaluation of their social and cultural significance. The dissemination of market principles in the sphere of organ donation can lead to the violation of the social order. It is associated with the transformation of a person into a commodity; due to it, the exploitation of a human body becomes possible. The introduction of monetary mechanisms can result into the situation where the possession of capital will put in the subordinate position those who have smaller reserve of resources (Ravitsky 380). Therefore, trafficking in human organs can lead to the state, in which the bodies of poor people are of great value after their death. In other words, the value of life of low-income group representatives becomes lower than the value of their bodies, which can be used for prolonging the lives of the rich and privileged people. The prohibitive principle towards the commercial relations in organ donation is in accordance with the basic law of moral relations between people, which claims that a person cannot be regarded as a means of achieving the goal of another individual. “The commodification critique holds that the human body has inestimable intrinsic value and allowing someone to sell the body, or part of it, degrades that person’s dignity” (Allen and Reese 2031). The ethical understanding of a human as an individual who possesses dignity, will, and freedom opposes the offer of compensation to organ donors. Giving compensation to donors leads to financial exploitation of a person who do not want to become a donor. It is difficult to understand why donation of organs for money is inherently incompetent especially if one uses this money for education or medical care for a close relative. The main elements of altruism, among which are motive, care, and attention to others, play the key role here (Shaikh & Bruce 109). In this case, the sale of organs serves as the transfer of money from those who have them to those who do not. Nevertheless, this argumentation will hardly convince anyone. It far from simple ethical issues especially in the world where inequality in wealth and access to healthcare exists. Allen and Reese state that the introduction of payment for donation of organs will destroy the principles of altruism since every donor will start demanding money (2031). At the same time, it is not possible to harvest all potential donor organs from corpses. One of the factors in this dispute, which are not acceptable from the ethical point of view, is exploitation. It can be emotional exploitation by family members, financial exploitation by relatives or persuasion of someone who does not want to be a donor (Shaikh and Bruce 110). Allen and Reese argue that people of low socioeconomic status are particularly vulnerable to such coercion and have no choice but to sell their organs (2031). This danger exists in any form of commercial intermediation especially if the monetary rates are high. Therefore, it is not surprising that financial transactions on the sale of organs almost inevitably mean that it is money, not medical necessity, decides which patient will receive a particular organ. The issue of the legal status of transplants closely relates to these ethical provisions. The ban on buying and selling a person expands to his/her tissues and organs. Turning into biological materials and representing a means of transplantation, individual’s organs should not become a tool of commercialization of life due to their belonging to human body (Delmonico et al. 1188). Since the organs and tissues of a person are the parts of the human body, they do not correspond with the concept of things. Consequently, person’s organs should not have a market equivalent or become the subject of a sale-purchase transaction. The given situation concerning the organs and tissues of a person has its inevitable consequences. It leads to the recognition of the possibility of their purchase and sale as well as erases the differences between the material and personal sides of human existence (Ravitsky 380).

It is not difficult to determine the existing degree of danger of ignoring the fundamental medical ethics and ethical foundations for the society. The application of market rules to the sphere of organ donation contributes to spreading criminal organ trade. In the world, a person, his/her life, health, and honor must be the main social values. According to Shaikh and Bruce, “the purchase or sale of human organs is not allowed, according to the National Organ Transplant Act (NOTA) and the Uniform Anatomical Gift Act” (109). Unfortunately, recent events showed that illegal human trafficking began to demonstrate rapid development around the globe. It is possible to obtain organs from defenseless people due to fraudulent or even criminal means as well as organize organ trade, which are acts that deeply contravene medical ethics.

Today, buying and selling of organs are gaining popularity. To prevent illegal trade of organs, laws should prohibit trafficking in organs and other human anatomical materials. Provision of compensation to donors has negative moral consequences not only for donors but also for buyers. The sale of person’s organs for transplantation is a quick way to get a significant sum of money. People who urgently need a donor for a dying relative are ready to give everything they have in return for a chance to extend life of a loved one. Swindlers use this fact to take the last money from these individuals and then simply disappear. A certain guarantee of fairness in the distribution of donor organs is the inclusion of recipients to the transplant program, which forms on the basis of a waiting list at the regional or interregional level. The question of price does not play any role here. Recipients gain equal rights to meet their appropriate donors within the frameworks of these programs. The latter also provides the exchange of donor transplants between transplantation associations. The provision of equal rights is realized through a mechanism of choice where purely medical reasons, severity of the condition of a patient-recipient, and parameters of the immunological or genotypic characteristics of a donor matter. In this system of distribution of organs, which must be a guarantee of eliminating all possible abuses, the recommendation to create a tool for the procurement of donor organs at the regional or national levels becomes one of the common ethical rules. Therefore, there is a need for the comprehensive solution of transplant issues through improving and compiling an adequate legal framework that is consistent with international legal acts as well as creating favorable moral and political climate in the society.

Ethical Rules for Living Organ Donors

The ethical landscape surrounding living organ donors is complex, with ethical problems manifesting in various forms:

• Ethical problems: The primary concern is ensuring the autonomy and well-being of the donor. Organ donations from living individuals must be voluntary and free from coercion or undue influence.
• Organ trafficking: This illegal trade not only exploits donors but also compromises the supply of organs by introducing unsafe practices that can affect organ quality.
• Transplant system: A robust ethical framework is essential to maintain trust in the very system, ensuring that organs are allocated fairly and transparently.
• Transplant hospitals: These institutions bear the responsibility of upholding ethical standards, providing thorough counseling to potential donors about risks and benefits.
• Supply of organs: Ethical guidelines help in increasing public trust, which can positively influence the supply of organs and support the broader goals of organ transplantation.

In summary, the ethical rules for living donors are crucial for safeguarding the interests of donors, maintaining the integrity of the transplant system, and ensuring the success of organ transplantation as a life-saving medical procedure.

The Matter of Organ Preservation

The integrity of the transplant system heavily relies on the efficacy of organ preservation methods. These advancements are crucial in extending the viability of donor organs beyond extraction, which directly influences the organ supply. Enhanced preservation techniques ensure that the organ quality is maintained until transplantation, significantly improving the success rates for recipients.

Moreover, effective preservation methods can mitigate the impact of fluctuating organ donation rates and combat the challenges posed by organ trafficking. By improving the longevity and usability of donated organs, transplant hospitals can perform more transplants, thereby saving more lives. Ultimately, the evolution of organ preservation practices is a key factor in the optimization of organ donation processes, ensuring that each donation has the best chance of helping those in need.

Navigating the Challenges of Chronic Rejection in Transplant Medicine

Chronic rejection in organ transplantation represents a significant and ongoing challenge within the field. It is a condition where the recipient’s immune system continuously attacks the transplanted organ, leading to a gradual loss of function and a decline in organ quality over time. This issue is not only perplexing but also deeply concerning, as it can occur months or years after the transplant, often without clear warning signs.
The success of organ donation and transplantation hinges on the ability to effectively manage or prevent chronic rejection. Strategies to combat this include the development of better immunosuppressive drugs and closer monitoring of recipients for early signs of rejection. Additionally, there is a growing interest in stem cell transplantation as a potential solution. Stem cells have the unique ability to modulate the immune response and promote tissue repair, which could be key in preventing chronic rejection.

Moreover, increasing the pool of organ donations from deceased donors can help address the issue by improving the match between donor and recipient, which is thought to reduce the risk of rejection. As the field advances, it is hoped that a deeper understanding of chronic rejection will emerge, leading to more effective treatments and improved outcomes for patients undergoing organ transplantation.

Prospects and Advancements in Transplant Medicine

The horizon of organ transplantation is witnessing a transformative phase, addressing the pressing ethical problems and the donor organ shortage that have long challenged the field. The transplant system is poised for a paradigm shift, propelled by groundbreaking advancements such as stem cell transplantation. This innovative approach holds the promise of creating lab-grown organs, potentially alleviating the scarcity and ethical dilemmas associated with the donation of organs.

Organ donation rates need to be bolstered, and this can be achieved through public awareness and education about the importance of becoming deceased donors. Transplant hospitals play a pivotal role in this endeavor, ensuring that the organ supply meets the growing demand. Moreover, the definition of brain death has been refined, aligning with the brain criteria established by medical ethics, thus expanding the pool of eligible donors.

However, challenges such as organ trafficking must be addressed to preserve the integrity of the organ donation process. As we look to the future, the transplant system must continue to evolve, embracing both technological innovations and ethical considerations to enhance the efficacy of organ transplantation and offer hope to those in need.

Conclusion

Transplantology had brought crucial changes into medicine through contributing to the possibilities of prolonging people’s lives. However, there is significant organ shortage that leads to the formation of ethical question of whether offering compensation to organ donors is a moral solution to the problem. Ethical problems that are associated with the commercialization of transplantology exist due to the fact that human organs become commodities. What is more, in the conditions of universal deficiency of donor organs, they transform into very expensive commodities. It leads to unlawful removal of human organs for the purpose of enrichment. Therefore, paying compensation to donors cannot become a moral solution to the organ shortage problem because it opposes human rights and principle of equality.