In April, the country recognized National Organ Donation week at the request of President Clinton. Considering how recently organ transplants became available, their use has grown dramatically in the world. However, with the establishment of Organ Donation week comes the need to assess the process's problems and the possible solutions.
While most acknowledge that the shortage of organ donors is a problem now and for the future, the drastic solution proposed will certainly undermine the present system. Rather than resorting to drastic measures, we should recognize the role of the media and education in combating apathy on the part of potential organ donors.
The single largest problem facing this country is the lack of organs for the number of people who need them. Many potential recipients die while on the waiting list. UNOS (United Network for Organ Sharing) estimates that of 21,982 patients on the waiting list in 1990, 2,200 of them died before receiving a transplant.
Many have become fed up with the lack of organ donors in this country and want to institute changes to increase their number. Up to now, education has been the preferred method of increasing donations in the United States. Although many Americans understand the need for organ donors, they have not acted according to those beliefs.
Discounting those fundamentally opposed to organ donation, a large number of Americans seems to suffer from apathy. In a survey done by UNOS in 1991, 79 percent of the respondents did not object to organ donation, but only 39 percent said they were actually listed as potential organ donors. In elections, apathy can result in skewed outcomes; in the case of organ donations, apathy can result in hundreds of lives lost that might otherwise have been saved.
To combat this problem, people have tried to jump the gun and introduce many ways of promoting organ donation. Several of these solutions are quite drastic and far-reaching, even to the point of changing the Constitution. Three methods include compensation for donations, non-monetary compensation for donation and presumed consent. Unfortunately, these methods have not been shown to work. There are problems with each, should they ever come to be implemented.
Monetary compensation for donation is ethically wrong. It asks people to sell their body parts for money. The idea of setting a price for as invaluable a gift as an organ is morally reprehensible. It leads to fears about the wealthy procuring organs much faster and leaving the poor at an incredible disadvantage. Also, this method has been tried in Third World nations. The chaos it has created in Egypt with a black market for organs should steer other countries away from trying it.
Should the U.S. ever implement this program, it would first have to change present laws by which paying for organs is illegal. If monetary compensation not only tarnishes the practice of organ donations but also is unsuccessful where it has been employed, it should have no place in the U.S.
Non-monetary compensation includes placing a potential donor higher on a list of organ recipients should he or she ever need a transplant, or providing services such as grief counseling to the families of organ donors. Although it seems a much better plan than monetary compensation, it still bears some flaws.
Most importantly, preferential treatment for organ donors is unfair to those morally opposed to organ donation. Their thoughts must be taken into account as well. Hospital cannot treat them with any less respect by denying certain services provided to the families of organ donors. Non-monetary compensation also tarnishes the image of organ donation--organ donors make a gift to society; society does not have a right to those organs. By marring the public's view of organ donation, we may see a decrease in potential donors. We cannot ignore the individual's rights in trying to provide an aid to society as a whole.
Presumed consent has its own ethical dilemmas, stemming from using people's apathy to its advantage. Presumed consent assumes that people had wished to donate their organs unless they had previously registered their objection to their organs being transplanted after their deaths. The plan counters the apathy of the many who would have become donors but had never gotten around to signing the forms. The method has been tried in Belgium and substantially increased the number of donors.
But that increase may have come at the expense of some opposed to donation. Organ donations is a moral gift to society because of the way it is now administered. We now treat the donation as an act of pure benevolence. Should this image be tainted in any way, organ donation will lose respectability in the eyes of the public--the same public which supplies the gift. In the long run, the plan could precipitate a marked decrease in donations.
All these methods and extremes can be avoided with less apathy and more activity from the public. The only way to increase donations--and keep them morally pure-- is to exhort the public to fight their apathy and consent to donate.
There is always a marked increase after a public appeal is made on the behalf of an individual by the media. Donations increase as a whole, not just for the individual. Also, once request for organ donation became required by law on the part of physicians, donations also went up. Many families feel that they can take some good from an incredible tragedy. To force these same people to donate is to underestimate the generosity of the public in a grave way. Should the media make a greater effort, organ donation will increase to a level sufficient to stave off drastic changes in law and morality.
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