98 FIDELITY Directive 30 The transplantation of organs from living donors is morally permissible if the donation does not sacrifice or seriously impair an essential bodily function and if the expected benefit to the recipient is proportional to the harm caused to the donor. In addition, the potential donor`s freedom must be respected and no economic benefit to the donor must be derived from this. Lozano, Ivan Lopez, John Michael 48 Transplants between living persons (adults, mentally handicapped, minors)Transplants between living persons raise the question of whether it can be ethically justifiable to mutilate one living person for the benefit of another. Many distinguish between parts of the body that can regenerate (for example, blood and bone marrow) and parts that do not. For the latter, some are matched (e.g. kidneys, corneas, and lungs), while others are unpaired (e.g., Heart). Before organ transplants such as kidneys were performed, many Catholic theologians considered it unethical between living individuals. They thought it violated the principle of totality, which allowed the sacrifice of a part or function of the body to maintain the health or life of the person (i.e. a part could be sacrificed for the whole body), but did not allow one person to be bound to another as a means to an end. Lozano, Ivan Lopez, John Michael ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL QUESTIONS Paul Flaman In India, despite the THO Act, trafficking has not stopped, and the number of deceased donors has not increased to address organ shortages. [3] The concept of brain death has never been promoted or widely promoted. Most independent transplants are currently performed under the legal authority of an authorization committee.
The few donations from deceased people that take place are due to the efforts of some non-governmental organizations (NGOs) or hospitals strongly committed to the cause. Recently, the government has been heavily criticized by the public and the media, adding some laws in the form of a gazette to curb illegal and independent fundraising activities and trying to close loopholes in the THO Act. [4] The failure of the THO law is largely due to the way it has been interpreted and implemented by authorities and hospitals. 97 FIDELITY Directive 65 The use of an infant`s tissues or organs may be authorised after death has been confirmed and with the informed consent of parents or guardians. Lozano, Ivan Lopez, John Michael 60 ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL QUESTIONSHUMAN FETUSES Some argue that fetal brain tissue transplantation would require the fetus to still be alive. That is, the tissue would not be good for transplantation purposes after the fetus suffered total brain death. (cf. Duncan, 16-22) Some say that other remedies can and should be developed to treat diseases such as Parkinson`s disease. (cf. Dailey) Another issue is consent. Anyone involved in an abortion would not be considered a guardian of the fetus because they have little interest in their well-being. The Catholic Health Association of Canada (CHAC) concludes that “transplants containing organs and tissues from intentionally aborted fetuses are ethically reprehensible.” (45; cf.
SCDF 1987, 16-18) Lozano, Ivan Lopez, John Michael ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL QUESTIONS Paul Flaman Understanding the ethics of organ donation is important if we are to address the moral and ethical challenges that arise with cutting-edge regenerative medicine such as stem cell transplants, cloning and tissue reengineering. The ethical principles of organ donation are a test of endurance that will help us develop and solve many of the future moral problems we are likely to encounter. 45 ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL QUESTIONSThe case of the deceased The case of the body of a pregnant woman in Germany, who had been declared brain dead and kept alive in the hope of the majority of the child, has recently attracted media attention. Some have criticized this as lacking the respect due to women. However, can`t this effort be somewhat similar to organ donation and therefore considered commendable? Before her fatal accident, the woman had at least implicitly offered her body for the sake of the child. His family also asked for it. (Associated Press) Cases like this also raise the question of “ordinary” and “extraordinary” ways to save lives Lozano, Ivan Lopez, John Michael ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL QUESTIONS Paul Flaman 42 ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL ISSUESF for the deceased Such a donation can greatly benefit others and cannot harm the deceased donor. Not offering such a gift can be a sign of indifference to the well-being of others.
However, a donation is not considered mandatory. Transplantation is against the conscience of some people for religious or other reasons. Considering survivors` sensitivity can also cause some people to be reluctant to sign their bodies. Lozano, Ivan Lopez, John Michael ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL QUESTIONS Paul Flaman 21 Theologians First justificationApplication of the totality principle A person cannot put his own life on the line to help another because of this principle. The body and its organs exist primarily for the benefit of the individual, so the power to donate organs to another living person is limited. The actual donor is mutilated Lim, Vanessa Marie T. Ethics of Health Care 3rd ed. by Ashley and O`Rourke 2001 81 Damage caused by the sale of kidneys Do the organs sold meet the needs? Exploitation of the poor by profitable intermediaries or clinics A real opportunity to improve the lives of poor sellers? Incentives based on organ prices (low supply/high demand created) The seller paid less than the right price (and the buyer pays more than the right price) A bad seller can hide high-risk exposure/behaviors Lozano, Ivan Lopez, John Michael The new living liver donation program has also been influenced by kidney donations, and unrelated living gifts have been reported in the media, including two deaths.
6] Although kidney donation is a relatively safe operation, the increasing incidence of diabetes and hypertension in India is causing young donors to risk their long-term health. In some studies, it was found that if the reason for donation was purely commercial, donors were more susceptible to the disease in the postoperative period. If the donation was purely altruistic, there was the feel-good factor and the psychological recovery was much better. In an interesting field study on the economic and health consequences of selling a kidney in India, it was found that 96% of participants (more than 300) sold their kidneys to repay their debts. The average amount received was $1070. Most of the money was spent on debt, food and clothing. Average family income decreased by one-third (P<001) after kidney removal, and the number of participants living below the poverty line increased. In total, three-quarters of participants were still in debt at the time of the survey. About 86% of participants reported a deterioration in their health after nephrectomy. Overall, 79% would not recommend others sell a kidney. The article concludes that among paid donors in India, selling a kidney does not result in long-term economic benefits and may be associated with deteriorating health.
Goyal et al. conclude: “In developing countries like India, potential donors must be protected from exploitation. This could at least mean educating them about the likely consequences of selling a kidney. [7] After a major kidney rush in Tamil Nadu, the Ministry of Health issued a notice in the form of a “government order” attempting to absolve any responsibility for proving a business relationship or opportunity with AC. She stated categorically that the burden of proving such a relationship lay solely with the hospital doctors, who had signed the document requesting an interview. However, this contradicted what the THO Act itself states and the role it defines for the licensing committee. When the legal status of the order was questioned, it was withdrawn. The new Gazette now requires a video recording of the entire interview process.
In addition, there are also guidelines for the Board and clearly states that there should be no conduit or intermediary where the donor must provide an explanation of why he wants to make a donation, with documentary evidence of cohabitation (old photos) and information about his vocation with financial statements of the last 3 years. Removing the ambiguity of the term affection and giving it the seriousness it deserves can help prevent the sale of kidneys.
