Theme 3 - Organ Donation - Shedding Light on the Issue
Organ donation is the replacement of a diseased on non-functional organ with a healthier one. Organ transplantation and donation has become a new successful strategy to gift people in need a new life. One single deceased donor can present the gift of life to up to eight people. Although deceased donors never know who their organs may go to, the fact that they have the potential to change the lives of so many people is one of the greatest reasons people should take this step.
There is an increasing amount of awareness about this ideology with the growth of institutions supporting this practice. This has helped in escalating the rate of organ donation. However, one of the major issues with this strategy is the potential lack of enough donors and organs to meet the needs of a rising number of recipients. Statistics show that organ donation has increased by an average of 3.7% per year, while the recipient waiting list has grown by 19%. Almost 20 people die every single day due to lack of organ donors. This crisis exists in almost all countries all over the world, including the US and ought to be addressed. In US alone, there are over 100,000 patients waiting for the right donor.
Most organ donations are recovered from patients who are neurologically diagnosed as ‘brain-dead’. However, not all patients that are terminally ill fit this category, thus narrowing down the list of potential donors. In addition, organ donation is deeply attached to person’s will of life. Not all people make the decision to donate their organs, before they die. In the absence of deceased’s will, family consent is required to initiate the process after death. Sadly, consent of family has become one of the most vicious hurdles in organ donation. In the United States, the family consent rate is about 54% which means that just under half of the organ donors are able to save someone’s life. Some of these articles explore perspectives of families and address their concerns, in an attempt to understand how this potential block can be solved.
Another impediment in this practice is the question of moral and ethical values and religious conscience behind these actions. Different cultures exhibit different principles and these are all ultimately influential on a person’s decision to donate. It is therefore essential that such perspectives be understood and responded to. Some of these articles present important cultural and religious perspectives prevalent in the world, many of which are seen even in the United States.
Money is always a powerfully influential factor in so many of life’s decisions and this is the case even with organ donation. Research shows that people are reluctant to initiate the process due to the fear or ignorance of financial obligations in this process. This makes it imperative recognise and respond to this possible barrier and take significant efforts to raise awareness about the monetary requirements in this process. This concern is also addressed in these articles and suggestions to counteract this obstacle have also been included.
Organ donation is an important commitment to building lasting legacies for the seventh generation and passing on our inheritance. It is therefore imperative that this global issue be addressed before it is too late.
Resources
Thomas, Emily. (2019, Apr). Giving the Gift of Life. Retrieved from: https://www.youtube.com/watch?v=4Y1ZwHq7nKU
This video emphasises the significance of organ donation and encourages people to sign up for organ donation during their lifetime. High school kid, Emily Thomas, talks about how one organ donor can save eight lives and what it means to motivate others to be organ donors. Before we die, we can change the lives of so many people and contribute to the world in such a unique way. She talks about the enormous impact created on real-life cases by the power of organ donation. Thomas talks about the potential of both deceased and live organ donors and addresses concerns about bearing the costs of the process. She shares a story from her own life to leave a lasting impact on her audience.
Malhotra, Harsh Deep. (2018, November). Organ Donation: Life Beyond Life. Retrieved from: https://www.youtube.com/watch?v=4rSyFV6MEss
This video talks about the importance of organ donation and how other countries like Sri Lanka have successfully gotten rid of blindness though organ transplantation. Malhotra urges people to donate organs and gift life to those in need. He also ventures to explain how one donation can change the lives of not just a few but hundreds of others. Malhotra talks about whole body donation as a service to the medical field. Studying these cadavers enables medical students to refine their skills and save the lives of hundreds of patients. Whole body donation is also a larger extension of this process that has the capacity to make an impact even after death. He also addresses important religious perspectives in a country as diverse as India. Malhotra talks about how the National Organ Donor Week was started and why it is a global necessity to donate organs for the betterment of mankind. This video thus gives a better perception and awareness about the immense value of the practice of organ donation.
Ralph, A., Chapman, J. R., Gillis, J., Craig, J. C., Butow, P., Howard, K., Irving, M., Sutanto, B., & Tong, A. (2014). Family perspectives on deceased organ donation: thematic synthesis of qualitative studies. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 14(4), 923–935. https://doi.org/10.1111/ajt.12660
This article delves into the specifics of experiences of families with regards to organ donation. Lack of family consent is a major hurdle in the organ shortage crisis. The study explores the concerns and anxieties of families surrounding death as well as organ donation. The research discovered that although the perception of a chance for the deceased to live on through organ donation to the recipient, was acknowledged by families; the time constraint to make such decisions in a period of grieving was greatly demotivating. Another important discovery was the realisation that closure after the transplantation in terms of knowing the success rate, was an important aspect to focus on. Families that received follow up were more satisfied and showed positive responses towards the donation. Nurturing confidence as well as determining anxieties that families may have is an important step towards promoting better consent rates.
Sanner MA. (2007). Two perspectives on organ donation: experiences of potential donor families and intensive care physicians of the same event. Journal of Critical Care, 22(4), 296–304.
This article analyses experiences of families of organ donors and physicians in charge of carrying out the transplantation in Sweden. According to Swedish laws, the consent of deceased is needed to execute donation. If the will is not known, the donor’s close family has the power to make a decision. A majority of people do not express their opinions about these aspects while living. Therefore after death, it becomes invariable to talk to the families about this procedure. However, approaching families of deceased ones immediately following their deaths with regards to organ donation is often observed to receive negative responses. The study recognised certain common experiences faced by both donor families and physicians that may be potential flaws in the health care system itself. The donor families had a greater understanding of the circumstances and were appreciative of the process. When the will of the deceased was unknown, many families were reluctant to initiate the procedure. The study advised that if dealt in a tactful manner, it may help families initiate a rational process of thought and perhaps enhance their positive response to the procedure.
Burroughs TE, Waterman AD, & Hong BA. (2003). One organ donation, three perspectives, experiences of donors, recipients, and third parties with living kidney donation. Progress in Transplantation, 13(2), 142–150.
This article analyses experiences of live kidney donors, recipients and other third parties associated with the donation. Past research has had encouraging responses from kidney donors and most donors would happily make the decision again. This observation was reinforced by this research. This study particularly compared and contrasted the simultaneous experiences of all three groups in an attempt to understand the communication and concerns at different steps and throughout the process. The participants were from across the country and thus offered a more national perspective on the procedure. There were some consistencies in all three groups but recipients and donors did not agree on certain aspects like recovery time and time taken to make the donation decision. The article thus highlighted issues and concerns at all three ends during this process and this information could be highly helpful in educating people about organ donation and generating greater awareness.
M.F. Kananeh, P.D. Brady, C.B. Mehta, et al., Factors that affect consent rate for organ donation after brain death: A 12-year registry, Journal of the Neurological Sciences (2020), https://doi.org/10.1016/j.jns.2020.117036
This article addresses concerns of family consent in brain-dead patients. One important observation made by this study was that the only parameter determining whether or not to approach the family to suggest organ donation, was the functional state of the organs. Thus, physicians were not discouraged by ethnic, racial, economic or other such differences when making the decision to approach the deceased’s family. However, racial and economic differences were observed in the responses of the family. Caucasians and people with higher socioeconomic status were more supportive of the cause than others. This information can be used to implement better systems to enhance the contributions of other communities.
Sharp, C., & Randhawa, G. (2014). Altruism, gift giving and reciprocity in organ donation: a review of cultural perspectives and challenges of the concepts. Transplantation Reviews (Orlando, Fla.), 28(4), 163–168. https://doi.org/10.1016/j.trre.2014.05.001
This article explores the perspective of organ donation as a form of altruism or the belief in self-less service of others. It views the organ donated as a “gift” to the recipient. The study recognised that registering as a donor is promoted by this feeling of altruism but the actual decision to donate is subjected to a number of social and cultural norms. This study views organ donation through the lens of Mauss’ gift exchange theory and attempts to analyse if this perspective could be a possible motivator for more people to take up this practice in their lives.
Concejero, A. M., & Chen, C.-L. (2009). Ethical perspectives on living donor organ transplantation in Asia. Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 15(12), 1658–1661. https://doi.org/10.1002/lt.21930
This article explored the ethics of organ donation, especially in economically backward countries of Asia. Religion is a vital aspect of Asian culture and is therefore an essential influence even on these decisions. While certain religions like Hinduism and Buddhism leave the verdict to the individual’s conscience, others like Shintoism and Islam have a definitive say in what is right and wrong when it comes to organ donation. Apart from religion, laws in certain Asian countries are still under debatable circumstances surrounding what can be defined as death with respect to donation of organs. Such circumstances raise a number of moral and ethical questions that demand to be addressed. After a defined research in this field, the study concluded that ultimately medical needs and surgical advancement are what make the final decision. Although religious opinions ought to be respected, yet sometimes the significance of human life and scientific knowledge override such opinions and judge the circumstances in a more rational way. Thus, this article spreads light on how ethical concerns must be addressed pragmatically but must also respond to the needs of the recipient audience.
Cuesta-Briand, B., Wray, N., & Boudville, N. (2015). The Cost of Organ Donation: Potential Living Kidney Donors’ Perspectives. Health & Social Work, 40(4), 307–315. https://doi.org/10.1093/hsw/hlv068
This article focuses on the financial concerns raised by organ donation. Many people, particularly donors are unaware of the costs associated with organ transplantation which makes them hesitant to embark on this process. Results from the study advised that a walkthrough of the economic commitments might encourage more people to donate and give them a better sense of understanding of what exactly they are committing to. There are several direct and indirect costs that have to be borne by donors including travel, accommodation, certain medical expenses, loss of income, dependent care etc. Reimbursement of expenses may be available in some countries and donors should be educated about this process. This research also highlighted the fact that minority groups or economically disadvantaged communities do not engage in organ donation, perhaps due to financial limitations. In addition, certain communal drawbacks such as lack of leave from job for organ donation, are considerations that the system and concerned authorities should take care of, in order to encourage this practice. This article thus recommends individualized financial advice to donors to ensure they are aware of their monetary obligations and are better educated about the process as a whole.
Yang, Luhan. (2018, Oct). How to create a world where no one dies waiting for a transplant Retrieved from: https://www.youtube.com/watch?v=xgBnYr0_FRk
This video gives insight into a newer possibility to solve the organ supply issue – xenotransplantation –a process in which human organs are genetically engineered to be carried in pigs and then transplanted to the requested recipients. However, one of the major issues preventing the implementation of this knowledge, is the presence of benign PERV virus in pigs which is extremely dangerous to humans. Luhan Yang and her team have come up with a revolutionary solution to this decade-old problem. Yang and her group have developed genetic scissors called CRISPR which are directed by a guide RNA. This revolutionary technology genetically engineers organs in pigs to develop without this virus, making them safer for transplantation. This is a new breakthrough in the world of organ donation and can be used to solve the organ shortage crisis.
Mohanka, Ravi. (2018, Sept)The Past, Present & Future of Organ Transplantation. Retrieved from: https://www.youtube.com/watch?v=tJavx_SwWr4
This video explores the journey of organ transplantation starting from documented episodes as early as 2000 BC in Hindu mythology to more recent advancements in this technology. Mohanka talks about immunity barriers to organ donation and how they were overcome with time and further scientific investigation. He shares stories from the past, about heart-touching organ donation anecdotes. He explains how brain death is a key milestone for organ donation to be possible. As science progressed, preservation of organs became possible, which was another breakthrough in this journey. Mohanka emphasises the organ supply crisis and urges his audience to sign up for organ donation and make this difference in their and their receipients lives. Understanding how organ donation has developed over the years provides a greater understanding of what
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