Ethical Issues in Healthcare Organ Harvesting

MORE Program MORE = Multiple Organ Retrieval & Exchange If you sign the consent card (used to be when you were mailed your drivers’ licence, now it’s done online) you authorize doctors to harvest any tissues or organs, or those specified by you, upon your death

Who Has the Final Say? Many doctors will not necessarily follow your wishes if the family objects to the procedure In 1999 only 617 transplant procedures were carried out in Ontario, at a time when 1720 Ontarians were waiting for organs About 100 of those people died

The Issues 1. Practical Issues 2. Ethical Issues Practical issues relate to grieving family members and how we define death The organs most likely to be used in transplants would come from relatively young, healthy people who die suddenly, usually because of an accident

Practical Issues Many young accident victims have intact bodies even though their brains have ceased functioning. – Doctors normally use the absence of brainwaves as evidence of death – Family members of such an accident victim are usually not prepared to cope with the sudden loss of this person whom they love – They are usually not willing or able to make rational decisions about harvesting their loved one’s organs, especially if the person’s heart is still beating

Dr. John Yun Dr. Yun, an oncologist from BC says, “If you ask why people are reluctant to donate organs, they will tell you that intuitively they feel if Mom’s heart is still beating and she’s still breathing, she’s still alive.”

Finding a New System Ethical issues – who owns the organs in question? As a living person, we clearly own all the organs and tissues in our bodies, but as a brain-dead accident victim, is this still the case? Spain’s 1979 organ donation law is regarded as the new way to go – Operates on the principle of presumed consent and that, after death, organs and tissues do not belong to any one person

New System Unless there is evidence that a person specifically resisted organ donation, Spain’s donation law requires doctors to pass details on to the Spanish central registry for organ donation and make arrangements for harvesting This raises the number of available organs because only people strongly opposed to organ donation (e.g. Religious beliefs) would go to the trouble of ensuring that their beliefs are well known

Organ Donation in Ontario 2002, Trillium Gift of Life (TGL) created in Ontario to coordinate and oversee all donations At one time, the province wanted TGL to follow Spain’s model and assume that unless otherwise indicated, all organs would be available for transplant without consent

Organ Donation Things to consider: – Is it ethical, for example, to forcibly take the kidneys from a brain-dead child whose parents are strongly opposed to this action? – Whose interests are paramount: those of the family of the accident victim, or those of the recipient?