Josh is 14 years old, a bright and athletic child who has just been in a serious accident. His spine has been affected and he might never walk or even stand again. He might also not be able to procreate and his brain might be impaired. In the interim, he urgently needs a liver, creating the ethical issue of whether the next available viable liver should be given to him or someone with a better chance and a more fruitful life. This is a common predicament in the clinical practice of medicine not from a legal perspective but rather from an ethical one (Kamin et al, 2016). America suffers a massive organ deficit which creates an aspiration to have every available organ donated only to the most warranting recipient. The question of a warranting recipient is a complex one since most organ donations are a matter of life and death for the recipient with denying the organ being akin to a death sentence (Savulescu & Schuklenk, 2017). This complicates the decision kindred to the donation of organs to people with disabilities as shall be outlined in the instant research paper.
Background of the Problem
Organ transplant is one of the monumental medical feats established within the 20th century. It has created a possibility to save many lives which would have erstwhile been lost. What began with simple transplants such as skin transplants advanced to include transplants of major organs such as kidneys, lungs, heart, bones, and livers (Kamin et al, 2016). The skills keep on widening and more organs can now be transferred to a higher level of success. However, organ transfer is a complicated and expensive venture. It takes a lot of time for great experts to successfully carry out most transplants. Secondly, a lot of money is spent in the actual operation as well as for medication to be taken after the operation to curb any adverse effects. Finally, the organs themselves are few and far between. Thousands of Americans die in organ waiting lists as they await viable organs (Kamin et al, 2016). This has even buoyed illegal organ businesses through the black market even as some needy patients travel to other countries in search of a faster means to get organs.
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When an organ is finally available alongside the money and experts to carry out the transplant, the next question to be asked is who gets to benefit from it. A carefully developed criterion has been established to show who should get the organ. It is mainly based on the viability of the organ and the proximity of the patient to the organ. The instant research paper, however, relates to an important ethical issue that has not yet been worked into the aforementioned very well developed criterion (Kamin et al, 2016). This is whether or not the nature of the recipient should be a factor in the determining whether an organ transplant should be proceeded with. The hypothetical 14-year-old Josh is a good example of the ethical dilemma. If a liver becomes available and a decision should be made to either give it to Josh, who might remain in a vegetative state or Jane who is all well except for the liver problem, should Jane be given priority over John? If the answer is yes, the next fundamental question is where does the favoritism stop? What if Josh had no brain injury, just a spinal one, or his body is fine but the brain was affected so he will be slow all his life? What if Josh was born with Down Syndrome or became a cripple because of a bout of Polio, would Jane still get the priority?
Discussion
The available literature on the subject gives an indefinite answer to this crucial question. This answer is a combined yes and no, depending on the circumstances of each case. It is based on the fact that organ transplant is all about saving lives (Kamin et al, 2016). But the word life in this context can be qualified as the opposite of being alive in this aspect is not being dead but rather not being alive. From a descriptive perspective, a person in a vegetative state in a hospital is scientifically alive but philosophically not alive. The difference is based on the ability to enjoy life as well as the ability to share this life with others (Kamin et al, 2016). This, therefore, creates a distinction between a child in a vegetative state and a child with Down syndrome. The latter is capable of living a full life and enjoying it, albeit with limitations, and also share this life with family and friends (Savulescu & Schuklenk, 2017). A physically handicapped person can also live a full life and enjoy it fully as well as make a great impact in the world as Franklin Roosevelt did. A child with Down Syndrome, a Polio survivor, and a slightly impaired individual can, therefore, be given as much priority for organ transplants as anyone else (Savulescu & Schuklenk, 2017). But, the person in a vegetative state should not be prioritized over a person who stands a chance to live and enjoy life.
Conclusion
Should the hypothetical Josh be given the liver transplant even when the generally healthy Jane awaits it? The right answer from an ethical perspective is maybe. If the injuries that Josh has been assessed to have the kind of damage that will still allow for him to live an enjoyable life and share this joy with his loved ones, then Josh must be treated in a manner equal to Jane without discrimination. However, if Josh is seemed to be only able to live the rest of his life in a vegetative state, it is only fair and ethical to let Jane have the liver. This conclusion is not ideal, neither is it seemingly moral but it is ethically right. Organ transplants should be geared towards saving lives, not keeping human bodies alive.
References
Kamin, D. S., Freiberger, D., Daly, K. P., Oliva, M., Helfand, L., Haynes, K., ... & Kim, H. B. (2016). What is the role of developmental disability in patient selection for pediatric solid organ transplantation?. American Journal of Transplantation , 16 (3), 767-772
Savulescu, J., & Schuklenk, U. (2017). Doctors have no right to refuse medical assistance in dying, abortion or contraception. Bioethics , 31 (3), 162-170
