Human Organ Transplant: Everything You Need to Know

Introduction 

A child lies dying from cancer that has eaten away both kidneys and three options are available to the parent. The first is prolonging the life and pain of the child as long as possible using medical means but eventually, lose the child to the ailment. The second and third are seek for a cadaver from which to harvest a kidney or get a donation from another human being respectively. Whereas there are several primary factors kindred to which decision the family of the child ought to make, among the most important secondary decisions is the ethical one (Citerio et al, 2016) . This relates to whether or not it is right to either harvest an organ from a cadaver or get a donated organ from another to save a life. Further, the family will also need to compare between the ethical implications of the two organ transplant options so as to realize which one is more applicable from an ethical perspective. Both harvesting organs from a cadaver and getting them from a living donor come with a massive pro et contra but none can be considered ethically worse than allowing a life that could have been saved, to be lost. 

Brief History of Organ Transplantation and the Kindred Problems Thereof 

Organ transplantation has been a historical subject and reflects attempts to perform transplants going back over a millennium ago. However, most of these efforts were met with failure. It is only in the 20 th century that transplants began to be undertaken with a level of success. This began with outer organs such as the skin and the limbs. By mid-20 th century, transplants involving major organs which could not be undertaken when the donor was alive began (Citerio et al, 2016) . This included heart transplant, which albeit began with almost absolute failure, began to pick up high success rates towards the end of the 20 th century. By the advent of the 21 st century, organ transplants were common place globally and an acceptable mainstream means of clinical intervention. Millions of different organ transplants from hearts, uterus, lungs, kidneys, livers and many others are carried out on an annual basis across the globe (Citerio et al, 2016) . Ethical issues have been closely associated with the subject of organ transplant. There are several broad ethical issues with the subject being too wide to be canvassed within the ambit of the instant essay. To narrow down the subject, this essay will focus on whether or not organ transplants should be carried out at all and if they do, whether the organ ought to come from a living donor or a dead one. The approach to the same will be the juxtaposition of the pros and cons for the two options. 

Ethics is a complicated subject since it is based on various varying theories and concepts, some of which do not agree with one another. For example, under consequentialism, a decision is determined to be right or wrong ethically, based on the outcome thereof. Currently, organ transplants have been proven to be a very successful way of saving lives that would have been lost without the procedures being carried out (Veatch & Ross, 2014) . Further, modern science, more so with regard to prevention of infection and agglutination and organ rejection has made organ transplants extremely safe. From this perspective, therefore, organ transplants should be considered as right. However, under Kantian ethics, each and every human being must be considered as an end and not a means to an end. An organ transplant can, therefore, be considered as being in breach of human dignity. Further, the desire to live creates desperation for most humans. Many are willing to give their lives savings and also borrow massive amounts while pursuing impossible transplants or some with very low chances of success (Veatch & Ross, 2014) . The availability of this high amount of money has spurned a criminal underworld specializing in arm-twisting potential donors and even killing them for their organs. The billions of dollars spent on researching organ donation for a few could also instead be used to save millions of lives currently being lost to curable diseases. However, on a balance of probabilities, however, a procedure that saves lives without placing other lives in danger can seldom be considered as being wrong from any perspective. This tilts the balance towards performing transplants as and when necessary to save lives. 

The Pros and Cons of Taking Organs from a Cadaver 

For thousands of years and across different civilizations, elaborate procedures, festivals and ceremonies have been undertaken upon death. This creates a major distinction between the body and an animal and the cadaver of a human being. Indeed, every individual has an ability to choose what will happen with their bodies with this forming part of the instructions placed in wills. The first ethical issue of harvesting organs from cadavers lies on the issue of consent (Truog et al, 2013) . This relates to what level of consent is necessary for organs to be harvested from a cadaver as well as what influence family members and pecuniary interests play in the subject. A dying person is seldom in a state to rationally understand subjects as complex as what is to be done with their bodies. Further, many theories abound as to what happens after death with the belief that actions of earth can bring about vindication in the afterlife being common around the globe. A dying person may, therefore, feel pressured to give organs in a bid to secure a better afterlife (Truog et al, 2013) . There is also the issue of pecuniary gain to the family, with the dying person feeling that it would be selfish not to provide in death, the kind of pecuniary support that may have been impossible in life. 

The greatest advantage of getting organs from a cadaver lies in the fact that the cadaver suffers no risk of infection or after effects of the operation (Truog et al, 2013) . The medical team need only worry about the viability of the organs themselves and the health of the recipient. This makes removal of organs from a cadaver the much safer option. Unfortunately, preference for cadaver organs and the absence of legal complications has led to an underground black market where viable donors are killed and the organs marked as having come from cadavers. Another advantageous way of looking at this from an ethical perspective is the literal approach. Dead people have no use for organs while the same can make the difference between life and death for the living (Truog et al, 2013) . Therefore, the right decision would be to allow for the living to benefit from this organs as a means for saving their lives. This brings it utilitarian ethics which would favor the issue of using the parts of the already departed to aid the living. 

The Pros and Cons of Taking Organs from a Living Donor 

One of the most common forms of organ donations happens when one living individual offers an organ to another living individual, mainly a close relative. In some third world countries, however, this has become a commercial venture where for pecuniary incentives, people offer body parts for sale to prospective donors, mainly through agencies (Salomon et al, 2015) . This brings in the issue of consent for organ donation and the factors behind it. From the perspective of it being an advantage, a living donor has a higher say on what will happen to their body parts than a cadaver. It is possible for the will of a departed person to be overlooked or even overturned but unless by criminal elements, this cannot happen for a living donor. However, an underlying disadvantage lies in the fact that there exist many ways of luring the living to offer their organs in spite of the fact that it would not have been their will to do so. For example, a relative who is a viable donor will be under intense pressure to save the life of an ailing relative. It is unfair to state that a sibling to offers an organ to save a brother or a sister did the same out of a free will (Salomon et al, 2015) . Declining would seem to be selfish with the death of the sibling being blamed on the donor who declined. The very existence of organ transplant, therefore, seemingly takes away free will, when a close relative is a victim . Further, on the same subject of consent comes the complex ethical issue of donors who happen to be of a minority age. These children lack the legal ability and capacity for making the decision for themselves making the obligation fall upon a guardian ad litem. Yet this decision will affect the child for the remainder of its life, making it critical enough for the child to have a say in the decision. In many cases, however, more so when a sibling is at risk, the decision is made for and on behalf of the child with adverse ramifications (Salomon et al, 2015) . 

The second vital ethical issue kindred to the donation of organ plants from the living is the issue of impact on the donors themselves. The removal of a body part such as a kidney, one of the most common forms of transplant between two living beings can come with major ramifications for the donor (Salomon et al, 2015) . First, the removal of the organ is done through incisive surgery which creates a propensity for complications. Modern science has reduced this propensity exponentially in the recent past but the same cannot be overruled. If the remaining organ fails, due to unexpected circumstances such as an accident, the donor will be highly inconvenienced and may even require a donation. Further, another disadvantage of organ transplant from a living donor lies in the limitation thereof. Only a very limited number of organs can be harvested viably from a living donor (Salomon et al, 2015) . Among the commonly needed organs such as the liver. 

Juxtaposition and Summary 

From a practical perspective, it is difficult to compare between cadaver donations and living donor donations because living donor donations are extremely limited. On the other hand, cadaver donations are extremely limited from a time perspective as they become available upon death, which may be sudden and will not remain viable for long. With a living donor, there is available a lot of time as long as the receiver remains alive. From an ethical perspective, however, none of the two options seem to be superior to the other. Consent for the living and the dead can both be influenced, coerced or even taken away. When money is part of the arrangement, a dying person will be as hard pressed as the living to sell a body part so as to meet the needs of loved ones. Yet, selling organ parts is ethically wrong. From the perspective of effect in the donor, cadaver donations clearly carry the advantage over those from living donors. This is because the cadaver neither needs the organs nor gets adversely affected by the kindred surgical procedure. The subject of illegalities and the black market affects both transplants from cadavers and from living donors. However, the impact of the illegalities will also tilt the ethical debate in favor of the cadaver, rather than the living donor. Dishonor and indignity that happens when a cadaver is violated cannot take precedence over pain and suffering undergone by living donors. On a balance of probabilities, ethical implications clearly favor the living over the dead. 

Personal Reflection and Conclusion 

The analysis, summary, and juxtaposition outlined above are based on a careful analysis of the theories and concepts developed in existent in today’s world. From a personal perspective, however, bioethics is a subject that is flaunt with hypocrisy. Many researchers and opinion leaders will take a firm position on against procedures such as organ transplant with or without exchange of monies. They will make rosy ethical, practical and medical arguments to support their contentions. However, when they finally fall ill, or more importantly when their loved ones require organ transplants , the ethical theories will be lost in the wind. They will do anything necessary to save the lives of their loved ones, including flying them to India and buying organs in the black market. Similarly, killing another human being is ethically wrong from all perspectives. Yet, almost every criminal law system allows for self-defense as an absolute defense for murder. The right for self-preservation is also an absolute fundamental right under international law. Therefore, anyone who does not stand need of a donated organ, or has not had a loved one being in need of one lacks a fundamental qualification to develop an argument on whether or not a donation of an organ is ethical. This regard, therefore, organ transplantation from both cadavers and living donors must be considered as ethical. However, carefully set out and well-implemented rules and regulations must be put in place to ensure that this important clinical intervention is not abused or used to further illegalities. 

References 

Citerio, G., Cypel, M., Dobb, G. J., Dominguez-Gil, B., Frontera, J. A., Greer, D. M., ... & Wijdicks, E. F. (2016). Organ donation in adults: a critical care perspective.  Intensive Care Medicine ,  42 (3), 305-315 

Salomon, D. R., Langnas, A. N., Reed, A. I., Bloom, R. D., Magee, J. C., & Gaston, R. S. (2015). AST/ASTS workshop on increasing organ donation in the United States: creating an “arc of change” from removing disincentives to testing incentives.  American Journal of Transplantation ,  15 (5), 1173-1179 

Truog, R. D., Miller, F. G., & Halpern, S. D. (2013). The dead-donor rule and the future of organ donation.  New England Journal of Medicine ,  369 (14), 1287-1289 

Veatch, R. M., & Ross, L. F. (2014).  Transplantation ethics . Washington, D.C.: Georgetown University Press