Organ donation is the process of taking healthy tissues and organs from one person for transplantation into another. The organs are legally removed either by consent of donor while alive, or when dead with the permission of a kin. The organs and tissues that can be donated include kidneys pancreases, liver, lungs, intestines, bone and bone marrow, skin and cornea. People of all ages and from different backgrounds can give their organs. Speaking of the children less than eighteen years, a parent or a guardian has to give the consent first. Most organs donation and tissues occur after the demise of the donor.
The demand for organs has been on the rise in the United Kingdom as well as across the world. Due to this demand, the supply of the organs has become inadequate leading to some social-ethical issues. As of last year, approximately 7,000 people in the UK were in need of organ donation. In spite of having an impressive record of almost 3200 organ transplants last year up to July, approximately five hundred patients died before an appropriate donor was found. A research conducted in the UK shows that three out of four Britons are prepared to give their organs after demise, yet just around a quarter of them are enrolled donors and a less number of the register donors end up donating their organs (Barber et al 70). Statistics show that approximately thirteen donors died for each month. This partially mirrors the high protest rate among British donor relatives after their loved ones have passed on.
Organ Donation Model One
Ministers in Scotland have come up with plans to present a ‘soft opt-out’ scheme for organs donation. After implementation, the system will state that without an individual having actively opted-out when still alive, it is assumed that the individual has approved to donate his or her organs after death (Barber et al. 67). Humanists in the United Kingdom have for a long time supported an adjustment in strategy on tissue donation, for it is a vital means of saving lives through reducing the duration waiting for the people on a transplant list.
Lately, it has been discovered that England might soon take after Scotland's lead, as Downing Street reported the English would think about a difference in planning (Davis et al. 20). A representative at No.10 said the English would observe the progress of improvements in Scotland. The current choice of English system implies that individuals need to join the organ donation efficiently enlist. Support for a quit framework in England was previously proposed by The British Medical Association, which clarified that albeit 66% of individuals say they would give their organs, only 39% of individuals have marked the enlist.
If accepted, England will join Wales, a country that shifted to a soft opt-out plan in 2015 after an active crusade that was reinforced by the Humanists UK. In fact, Humanists UK provided verbal confirmation to Wales ‘Administration when it was scrutinizing the issue (Hodgson et al. 13). The Welsh administration made an announcement six months later after the introduction of new guidelines about organ donation. The announcement stated that out of the sixty tissues transplanted from the time when the rules were changed half of the tissues were received from individuals who had offered ‘presumed consent,' which means several deaths have been avoided through that amendment.
The Northern Irish administration has, additionally, proposed it might bolster up a comparative framework despite the fact that a private part's bill on the on the same issue was dismissed in the year 2016. Humanists UK Director of Public Affairs, as well as Policy Richy Thompson, remarked that Scotland had made a critical move to handle the significant issue of transplant holding up times and organ deficiencies (Ríos et al.20). It is trusted that Northern Ireland and England will follow the same course. Advancements in Wales since their crusade demonstrates the immediate positive effect an opt-out framework can have. Humanists UK reinforces crusades to urge the general population to examine desires for the finish of life for the sake of organ donation ahead of time. Ireland was among the only four European Union nations alongside Germany, England, and Holland, which did not have an opt-out framework (Hosgood et al. 22). The Welsh administration is sure of a 25% increment in the number of benefactors that will be attained in future due to the changes they have made in their organ donation policies.
The UK has some unique laws, as well as arrangements, for the tissue or organ donation procedure. For example, the assent of a guardian or a witness should be included in an organ donation agreement made by an individual. Regarding viable organ donations, in a few systems such as in Australia, which has approximately 15 contributors per million and 337 benefactors in the year 2011, the relatives are allowed to refuse, to give assent or might veto a possible recuperation regardless of whether the donor has agreed. A few number of the nation are have implemented a donor opt-out framework such as Spain, which has 36 successful donors for every million occupants and Austria, which has 21 givers in a million (Karim et al. 25). These nations have high benefactor rates, unlike other nations that are practicing donor opt-in frameworks such as Germany, which has sixteen donors per million, or Greece, which has six donors per million thus bringing down compelling organ donor rates. The leader of the SNTO (Spanish National Transplant Organization) has acknowledged that Spain's administrative approach is probably not the vital resolution behind the nation's achievement in growing the rate of donors in the commencement of 1990s. Focusing on the case of Spain, it has effectively received the assumed assent gift framework; ICUs (intensive care units) should be furnished with adequate specialists to augment the acknowledgment of potential organ donors as well as maintaining organs while relatives are counselled for giving an organ. The uniqueness that empowers the Spanish agreement model by making it effective is the availability of the organ transplant infrastructure. The infrastructure for organ transplant is available in almost all health centres giving thus boosting the donation and implementation of donor opt-out framework.
The Pros and Cons of Involuntary Organ Donation
Positives
More than six thousand five hundred individuals in the United Kingdom require a transplant. However, a lack of donors indicates that around three thousand five hundred operations are done annually.
Improvements in medical skills show that the amount of individuals whose lives can be saved through transplantation is increasing more quickly than people who are willing to donate.
The rules lead to many, some of the kids, to preventable demise, mostly on account of the deficiency of willing organ givers while, as the BMA states, 'bodies are incinerated or buried with all organs, some them that could be utilized to spare lives.
Surgeons and doctors may be trusted not to misuse their licenses. An alteration of the rule would give them that power.
Oppositions to an amendment in the rule are not logical. A corpse is a lifeless object, without feeling.
Arguments against Automatic Organ Donation
The proposed amendment that suggests that our bodies become state properties as soon an individual dies is offensive.
Removal of an organ without the spoken will of the dead could be disturbing for his or her relatives.
The proposed amendment to the rule can be abused, where deaths might be plat to get an organ wanted by some preferred patients.
The right not to accept the organ to be extracted after death is not inclusive. Critically sick patients or their relatives would feel left out when permission is withheld.
Organ Donation Model Two
Opt-Out System Implemented Within Wales
Wales has turned out to be the first nation of the United Kingdom to execute an opt-out framework about organ donation, implying that people beyond 18 years old will consequently be considered as donors upon their demise. The rest of the UK is still working under the opt-in system, and willing benefactors will at present convey an organ donation gift card. People who are not willing to donate can opt-out via telephone or online (Hodgson et al. 5). Various religious societies have condemned the new rule, however, by November 2015, only 8 percent of qualified adults had chosen to appeal entitlement to opt-out.
The formulation of this new law is because of the huge number of patients in hospitals that are in need of organs yet they are not able to receive them. Recent statistics show that about a thousand individuals die annually in the United Kingdom while waiting on the records. The Welsh administration has anticipated that the new structure could escalate the number of organs available by about 25% (Karim et al. 25). In spite of the fact that the law will just apply to grown-ups that have lived in Wales for over a year, organs that are donated will be accessible for anybody in the United Kingdom. The opt-out system follows in the strides of different nations like Belgium, Spain, as well as Croatia, where the rate of donating organs are up to about 40 percent higher. The challenge of waiting for a long duration is not experienced in Britain only but is a problem found all over Europe. According to the European Commission’s statistics, sixty-three thousand patients were waiting for organs towards the end of the year 2013 with about 4,100 having passed away over the span of the year when still hoping to get an organ. Nevertheless, donation of organs is increasing consistently crosswise over Europe. In the year 2004, about 8,414 transplants were received from living as well as dead donors and the number has been increased to about 9,912 in the year 2013 (Karim et al. 15). It might be shocking to note that 25% of transplants done worldwide in the year 2012 was done in the EU countries, in spite of the latter representing approximately 8 percent of the worldwide populace.
The opt-out system, which is another measure that has successfully increased the number of donors is the arrangement supported by transplant donor organizers in health facilities. The donor organizers are individuals in charge of recognizing potential contributors, and the formation of such posts in Greece and Spain has prompted an expansion in rates of donation of about 132% and 130% respectively (Hodgson et al. 10). The increment in organ donation in Greece is particularly surprising since it took only for years. Even though the creation of organ donation strategy remains a responsibility of individual countries, several EU states, including Croatia, Belgium, the Netherlands, and Germany have already formed their own. They have decided to delegate duties either wholly or partly to Euro-transplant, a group that works as an intermediary between recipients and donors to improve the use of available organs.
The Significance of Defaults
Some scholar has developed the idea of “libertarian paternalism". The idea reflects both the need to guide individuals toward decisions that are to improve their situations while allowing them to their own selection. This approach can be used effectively in the case of organ donation (Karim et al. 28). The research by Karim et al. 28 included asking diverse individuals in an online interview if they would donate organs in some unique theoretical situations. In the interview, individuals were first asked to imagine being in a situation where they were not organ donor but a part of the assent. The interviewer was then asked to imagine being in a different situation where they were to be organ benefactors (yet they had the choice to opt-out). The research showed that at the point where members needed to opt-in, only 42% did it (Karim et al. 28). On the other hand, the research showed that when the interviewees were required to opt-out, 82% consented to donate. It is the best empirical proof to show the current case in practice.
In the year 2008, the United Kingdom administration started an autonomous survey of the accessible studies. Five different pieces of research were designed to investigate organ donation rates before and after the commissioning of the opt-out model in specific nations. Other eight different pieces of research were to investigate about donation rates between opt-in and opt-out framework in these specific nations. Before as well as after examinations, the survey indicated growth in organ donation rates after the presentation of the opt-out model. Furthermore, in the four among nation examination, referred as the most methodologically detailed, there were related increments in organ donation of about 25-30 %, 21-26 %, 2.7 more contributors for each million populace, and 6.14 more benefactors for every million populace. The survey clearly indicates that the implementation of the opt-out framework results in the increase in the number of organ donation (Hodgson et al. 7).
Moral Uncertainties
Approaches that result in greater number of deaths than the accessible options should be defendable. There could be good motivations to dismiss opt-out, yet we would be wise to speak out those options as they are. One reason that may have made a few individuals feel unequivocally restricted to the organs being utilized can be due to religious or other beliefs (Hodgson et al. 7). This problem is sorted out by making it easy to opt-out, thus enabling individuals to enrol complaints on the web, by post or by telephone. To improve the perception of people on organ donation, a nation dialog or a movement need to be established to enable more to understand the entire concept of organ transplant.
Also, some individuals would not like their organs to be utilized, yet they do not prefer to opt-out. The intentions of such individuals might not be clearly fathomed. Nevertheless, the public strategy is regularly about picking between minimum awful alternatives, and inclinations that cut both sides. Given that about 80 percent of Australian citizens show that given a dire situation, they might want to donate, shifting to an opt-out framework would likely prompt more individuals to participate in the donation. The next protest is that the opt-out framework might undermine the philanthropy that people normally connect with giving up organs. In the expressions of some Welsh church pioneers, organ donation should be "a blessing, a demonstration of affection and generosity." This is not a justifiable reason as to why more individuals should be left to die (Hodgson et al. 8).
Poor Strategy Costs Lives
Other than shifting to an opt-out framework, people ought to be urged to think about what they would like to happen to their bodies after they die. They may prefer to opt-out or might choose to donate. Nowadays, regardless of whether somebody has ended to the latter view, relatives might veto the choice after an individual has passed on. There is no lawful reason to relatives veto for an individual who has passed on, yet health experts regard families' desires in practice. Such actions should change if the society is serious about regarding individuals' self-rule (Karim et al. 30). Relative and friends should enable people to make advance care decision in terms of donating their property any way they find fit. Families and friends should not over-govern anyone’s desires in any case. A deceased's desire to give his or her organs must not be overturned.
After death, body organs are no longer useful to the deceased. Giving organs out can help save or significantly enhance the lives of up to ten other individuals. If research recommends that opt-out body organ donation system would save lives, we should embrace such a framework and consider trying it out in various jurisdictions (Karim et al. 30). It is a saddening to let such a large number of healthy organs be incinerated or to rot when they could be utilized to save the lives of individuals who so frantically require them. The assumed ethical complaints to opt-out are unconvincing.
Organ Donation Model 3
Organ Harvesting In China from Prisoners (Falun Gong Practitioners)
Reports from Falun Gong practitioners about organ harvesting and other political detainees in China have raised concerns in some international community groups. A report by human rights lawyer David Matas, a former Canadian legislator David Kilgour and a journalist Ethan Gutmann collates statistics gathered from clinics within China to demonstrate what they assert as a big difference between the number of transplant carried out in China and the official figures of the number of Chinese organ transplants that have been released in the public (Matas et al. 45). As per the report, political detainees are executed "on request" so that their organs can be harvested and donated to recipients. The killing of political detainees to harvest their organs is purported to take place as a way of Chinese Communist Party oppressing Falun Gong besides the financial incentives available to the people and institution engaged in this clandestine and inhuman activity.
The report blames the Communist Party, the Chinese government, hospitals and the health system for being complicit. The numbers or transplants given by the Communist Party provides an approximate number of legitimate transplants, which is around ten thousand every year. However, these figures are less the official Chinese figures released. By taking a look at some of the biggest hospitals in China, one gets to understand the astronomical number of transplants being done annually. The estimates given by a report shows that the number ranges between sixty thousand to one hundred thousand organs are donated every year in Chinese hospitals (Camero et al. 728). Further, the report indicates, that difference between the official figures and the actual figures is due to the number of executed detainees. A considerable number of the prisoners who are detained because of their political or religious convictions are being killed and their organs harvested. To make a good cover-up, the Chinese government does not release the number of executions they carry out.
The systematic organ harvesting report from Falun Gong detainees first came in public in 2006. However, this practice of killing detainees is estimated to have started about six years before the release of the report. Some researchers such as the prominent Canadian former parliamentarian David Kilgour, investigative journalist Ethan Guttmann and human rights legal counsellor David Matas approximate that a big number of Falun Gong detainees have been executed to supply a lucrative exchange cadavers and human organs. The researchers believe that these inhumane practices might be still ongoing (Matas et al. 734). These allegations are based on a series of interviews with former detainees, medicinal professions, and public security agents from these prisons.
As indicated above much of China's organ donation framework is kept as a mystery, while the official figures show approximately two thousand and eight hundred volunteers gave organs in 2015, with seven thousand and eight hundred huge organs acquired (Matas et al. 734). Essentially, by adding up a small number of the clinics that have been listed in the report, it will be easier to come up with a higher number of transplant carried out annually comparing with the official figure given of ten thousand. According to official figures, there are more than a hundred health care centres in China endorsed to carry out organ donation operations. Nonetheless, the report expresses that the researchers have verified and affirmed seven hundred and twelve hospitals, which carry out kidney and liver harvesting, and claim the actual figures of transplants could get much bigger than China reports. The discoveries by the report stand in the difference to Beijing's assertion that, since the start of 2015, China has changed from totally depending on organs from detainees to the Asia largest organ donation system.
Execution Buses
Known as a mobile execution unit, the execution van was adopted by the administration of the PRC (People Republic of China) and was first used in 1997. Jinguan Auto are the manufactures of these buses. It is, also, the maker of bulletproof executive limousines for the rich in China with a population of 1.3 billion people. The buses seem unremarkable (Matas et al. 738). They have been claims by critics that the vans aid the government to harvest organs secretly, and sell them to the west, as there is a doctor stand by to oversee the harvesting process and they never exhibit the bodies between execution and incineration.
Human rights' undercover investigative groups have revealed that the doctors, judiciary, and police are altogether linked in making money from millions of China's huge exchange of human body parts. An examination conducted on the executed victims shows the medicinal team on board first remove the eyes of their victims. Afterwards, wearing masks and medical gowns, they remove the pancreas, lungs liver and the kidney. The organs are dispatched in refrigerators to clinics in the sprawling cities of Guangzhou, Bejing, and Shangai, which have built up another authority exchange selling the harvested body parts. In hospitals across China, the body parts are transplanted into the sickly bodies of the wealthy Chinese people and other individuals who come as organ tourists from neighbouring nations such as South Korea, Taiwan Japan, and Singapore. Chinese clinics perform up to twenty thousand organ transplants every year. The costs of a kidney transplant are £5,000; however, the price fluctuates up to about £30,000 if the patient is willing to pay a higher price to acquire a quick organ transplant.
Ethical Issues
Most of major organ transplant nations utilized the body parts from executed detainees during the historical backdrop of the improvement of organ transplantation services. Nevertheless, with the social advancement being experienced globally, the unethical practice of harvesting organs from detainees was scrapped out. This was accompanied by the creation of national donation frameworks that set the requirement for transplant organs. At this point, the detainees that are awaiting their execution cannot be denied the right state whether they would like to give body organs or not. Conducting an organ transplant from bodies of detainees who have been executed and they did not consent to that while they were alive is not ethical. Currently, there is an accord among China's transplant group that there is need to have another framework that will relinquish their dependency on body parts from executed convicts. The execution of the new national framework is expected to be in operation soon. This will mark the commencement of eliminating the old practice. Despite the fact that it took a long time to establish a modern national organ donation framework in western countries, it has been a long time since the law passed, and now it is being re-examined to address the difficulties of setting up another national framework such as defining the role of national accountable institutions and their duties by WHO (world health organization) rules. Because of the law, the establishment of procedures for the new framework remains a big challenge for China.
Similarities between the UK and China
The similarity that the two countries have is the commercialization of organ donation. Commercialization of organ donation is a sensitive subject in the transplant group. Most counties including the UK believe that donation of organs is more like giving out gifts rather than selling them. The difference between a commodity and a gift is comprehended and applies the same to living and deceased organ donation. The enactment of the Human Tissue act 2004 Northern Ireland and England 1 and 2006 Scotland, 2 in the United Kingdom prohibits business dealings in human body parts for transplantation. Likewise, in China, the organ donation has been trading with government institution and state agencies. This operation has made the organ donation in China to be seen as an inhumane rising the ethical issues about organ transplant.
In the UK, the first case of the commercialization of organ donation was in 1998 in Bristol when it turned out to be certain that staff at the hospitals was keeping hearts following surgery at their theatres. Alder Hey scandal emerged accidentally when Professor Robert Anderson, who was a cardiologist, revealed that a different official investigation into heart surgery at Bristol with a store where kids' hearts were kept. Similar to China, the organ harvesting was surrounded by secrecy. Similar to China, the UK scandal ended up plainly obvious that organ harvesting at Alder Hey had been a well-established practice to the point that even parents whose kids died decades earlier discovered that organs had been removed before the bodies were discharged to the families.
Funerals Homes Harvesting Organs to Sell
Traditionally, after death, bodies are taken to be the property of the relatives of the deceased as well as the properties that were owned by the deceased. The other significant thing that the relatives of a deceased have is their right bury their dead. Inheriting this conventional approach is the idea of proprietorship. However, such an approach cannot be the means by which most government handles issue pertaining to the rights of relatives over the body of their deceased (Troug et al. 444). The assumed consent is considered as a possible solution to the shortage of organ donation. Presumed consent is no assent by any stretch of the imagination and cannot be used in making decisions for the deceased. If people can make their opposing wishes known while still alive, the legislatures around the globe will claim their organs and utilize them as they see fit. It appears to be somewhat undemocratic for the legislature to assume anything in regards to one's wishes, not to mention the idea that the governments have the authority to consider what one needs to do with their body either when dead or alive.
The publicity of cases, for instance, the Mastromarino reveals to the general population the unethical of the practice of selling the organs of the deceased. The bodies, which the relatives believe have been legitimately and respectfully discarded as dead body or waste, have turned out to be cruel trade objects. These bodies have been stripped of humanity as far as ethics and morals are concerned. The bodies are then chopped and worked on to make helpful materials which are then used for entrepreneurial activities by some individuals. The treatment of bodies and body parts as unimportant assets is unethical and leaves an unpleasant permanent image to the public of the health professional same as the maintenance of organs without assent with a profit-driven motive (Troug et al. 445). The Alder Hey and Bristol hospital cases in the UK stunned member of the public when these facts became known. These inhumane incidences influence individuals' decision concerning the donation of body parts, and support preconception regarding the significance of some organs as inalienable and sacrosanct. Sociological investigations conducted previously shown individuals having trouble in donating the heart of their deceased, as it is frequently imbued with extraordinary emotional symbolic significance.
Conclusion
Due to valid reasons, the advancement of organ donation framework in China tremendously improved. Recently, directions have been set up to guarantee decency, unprejudiced nature, straightforwardness, and regard for life all through the procedure of donating an organ. In a brief timeframe, the quantity of organ donations in China has increased to over a thousand cases. Donations from censured detainees are never the principal sources of tissues as well as organs for transplantation again. It has likewise been revealed that the current practice of donating organs still faces some challenges in several regions. The administration is taking necessary measures to determine issues, for example, an absence of significant resistance and motivation. Future work ought to be centred on the change of OPOs’ skill, enactment of brain deaths, as well as the proclamation of lawfully legitimate rules of organ donation when circulatory death occur.
There should be no age restriction when becoming a tissue as well as an organ donor. However, a couple of medical issues should be set in place to can prevent an individual from donating organs. A person, who is legally competent, can join the National Health Service ODR (Organ Donor Register). Joining the list gives a person legitimate approval to donate tissues or organs after death. Children can also join the organ donor register but their guardians or parents should give consent after the death of a child, or the children can give consent themselves after they attain the age of 16-18 years. Healthcare specialists should be given the duty to decide which tissue and organs are fit for donation. However, one should not be above 80 years in case of cornea donation, above 60 years for tendons and heart valves donations. Skin and bone donation does not have any age limit. Therefore, regarding age, it depends on the organ to be donated and the age of the donor. Individuals from a similar ethnic group are most likely to match their organs. However, effective transplants with individuals from various ethnic groups have been successfully done.
Proper screening should be done before the organ is transplanted from the donor to the recipient. Blood should be tested for communicable diseases as well as viruses such as hepatitis and HIV. One can still donate organs even with a certain medical condition if a healthcare professional decides it is still safe to do so. The doctor is the one who can decide whether one’s organs or tissues are suitable for transplant considering one’s therapeutic history. HIV positive person can be able to donate an organ to someone who has HIV. Organs from Donors who die out of cancer might safely be used after they have been confirmed to be cancer-free. However, a person with Creutzfeldt-Jakob disease or cancer that has spread in the last 12 months should not be able to donate organs.
The approach that has been used by the Chinese system previously has demonstrated a high level of inhumanity. Such actions should not be emulated. The process of executing prisoners for the sake of harvesting their organs for some few rich people is not a moral practice and should never be condoned. Everyone is an eligible donor and the list of donors should not be reduced to a particular group of individuals based on their history. The Chinese system had selected political detainees to be their donors. Such an approach is highly unethical and inhumane. Despite the health condition of an individual or their criminality, one has to give his or her consent for his or her organs to be donated. A solution to the deficiency of organs can be solved by transplant tourism. Some countries could have more organs than recipients, thus outsiders can be assisted. In addition, the opt-out system is essential in policy that can help in giving donors more space as far as choice of donating organs is concerned. If an individual who is in the list of donors does not want his or her organs to be harvested, he or she should have an option to do so. Just like in a normal market, the process should follow a willing seller-willing buyer approach.
Setting limitation of the organ donors is not a proper way of addressing the issue of organ donation. Patients who require organs are facing either facing imminent death or life-threatening survival. In such a situation, the available organs should be used to save these people’s lives. Prisoners facing death row are also humans and they have same organs as any other human. Some of these prisoners have very healthy organs. They should be allowed to donate their organs to save lives of civilians in need. By allowing prisoners facing death sentence to donate their organs, the shortage of organs in the hospital can also be addressed. However, due to the massive investments in different firms on the development of organs, artificial organs will soon be available. Having the artificial organs will eliminate the problem of seeking organ donors.
Works Cited
Barber, Kerri, et al. "Potential for organ donation in the United Kingdom: audit of intensive care records." Bmj 332.7550 (2006): 1124
