Presumed Consent Organ Transplantation example essay topic

Organ transplantation is an operation that is lifesaving and the technology that supports it is continually expanding. It has saved thousands of lives worldwide and has given hope to many people, especially for those who suffer of terminal and life threatening illnesses. It has also created several arguments of moral and legal issues in most countries around the world. In finding the ways to increase the rates of organ transplantation the people who make the laws have to take into account the floor in which the issue lays.

Death and dieing are terms in which is difficult to get to agreements. This gets more complicated taking into account issues of consent, having to transplant organs quickly after death and the pressure of doing what is good for the community and not just the individual. In many places the regulatory systems require changes in order to increase the rates of transplantation but it is important to analyze if the presumed consent is the best way of achieving this goal. The greatest obstacle in organ transplantation is the scarcity of donors and organs. Generally patients can be expected to wait from one to three years for some organs and it is estimated that fifteen to thirty percent of the patients die before receiving the transplantation. The deaths do not result from the lack of potential donors but from the low rate of conversion from potential to actual donors.

Low rates of organ donation are bad for programs that otherwise would save many lives. It is very important to discuss the ways in which the regulatory systems can be changed so that organ transplantation increases without affecting the autonomy of people and the bodily integrity. In many places the legislation on organ transplantation indicates that organs may be transplanted only if the person over the limit of adult age has given prior consent, and if the person has not given such consent but has not expressed the contrary, a family member may give authorization for the removal of the organs. What is seen as an option to increase the rates of organ transplantation is the choice of a system that is known as presumed consent. Under presumed consent everyone is presumably willing to donate his or her organs unless they register an objection sometime during their life. Under presumed consent the pressure will not be on the potential donors but on the person who objects donating organs.

In some countries objection of the family to organ donation overrides the consent of the deceased. In other countries the opinion of the family is irrelevant and organs will be removed unless the person had objected. A common argument of the opponents of presumed consent is that it does not protect the autonomy of people to decide to donate or not. They say that increasing donation rates and saving some lives is not enough reason for not respecting the person's autonomy. If autonomy as a concept is vital to the legal system of some countries then any system regulating consent to organ donation will be unethical if the concept is not preserved. In the context of organ donation autonomy is very important because it is viewed as a protection against pressure from professional and community interests.

Under the regular system autonomy is protected by requiring expressed consent to the removal of organs after death by the donor or in some places by the family members. In some cases the autonomy is not well respected because even if the person had expressed the desire to donate organs if the family decide not to do it, it will not be done. Generally the law fails to protect the autonomy of certain individuals like Jehovah's witnesses or anorexic people who are given blood transfusions or fed without consent to save their lives. Another case where autonomy is presumably violated is in autopsies. Even though these are made to find causes of death and for the benefit of the community in many cases, some argue that these are made regardless of the will of the deceased or the family. Under presumed consent many say that the autonomy is not protected because the organs of someone who wishes not to donate but did not express it will be removed.

For this the solution is having a central register that records the person's desire not to donate his or her organs. The register is then made available to hospitals and must be consulted by physicians prior to removing organs from a patient. If a system is well implemented and adopted it is hard to see how an individuals autonomy will be violated taking into account that he or she had a lifetime to express his objection to donating organs, and under such a system everyone will be asked at some point. Presumed consent is also seen to protect the autonomy of those willing to donate because many people never express their willingness to donate simply because they think they have enough time or because they don't have strong feelings about it, while people who wish not to donate have strong feelings about it and will be very likely to express their objection. Presumed consent would eliminate the decision power of family members over the autonomy of the deceased and in this way increase the rate of donation.

Studies have showed that thirty five percent of the people in many countries would not donate the organs of their family members but would donate their own. Opponents to presumed consent legislation argue that the autonomy of specific groups in society may be particularly threatened by presumed consent legislation. They claim that the poor and uneducated may be incapable of exercising their autonomy because they are not in a political or educational position to ensure their objection to organ donation, or they may not have access to sufficient information to make an informed decision. While the potential exists for disadvantage groups to suffer, this potential is no grater in a system of presumed consent than under the other system.

Under the contracting-in system the individual willing to donate its organs is vey likely not to do so because he or she must have expressed its will. This is a return to the assumption that it is acceptable to violate the autonomy of a potential organ donor but it is unacceptable to ignore the wishes of an individual rejecting the use of their organs for transplantation. Rather than highlighting the disadvantaged position of certain groups in society as a reason not to adopt presumed consent in many places, it would be more beneficial to address social and educational inequality in society in general. It is impossible for a system of organ donation to address social inequality.

The autonomy of religious minorities may also be at risk. Since at the moment organ donation is not expected, objecting donation is perfectly legitimate. It is believed that making organ transplantation a routine procedure, the individuals objecting donation on a religious ground will be persecuted and their believes coerced. Under presumed consent organ transplantation and therefore donation becomes the common and supported practice. However any system of organ donation aiming to increase organ donor numbers will attempt to make organ donation upon death standard practice. Therefore any change and not just presumed consent will create the possibility of intimidation to donate organs.

Offering a real and effective way to express and respect objection should be the correct way to protect against intimidation to organ donation. This may not be as big a problem as anticipated because in reality the number of potential donors is very small. Most organ donations come from some traumatic events such as car accidents or head injuries where a typically young and healthy individual has died. Therefore not everyone is expected to donate organs and this may create an environment where there is support for those objecting donation on the grounds of religion for example. Given that the greatest difficulty that is faced in organ transplantation is the shortage of organs, a system that increases the number of donations is of great social benefit.

In many countries this extreme shortage does not exist. That is because these countries (and they include Austria, Belgium, Denmark, Finland, France, Italy, Norway, Singapore, and Spain) have what is called presumed consent organ collection system. Presumed consent should not be taken into account if it deters the autonomy of individuals. Objection registers can maintain autonomy under the system of presumed consent.

It has been proven that presumed consent would at least have the same effects on autonomy as the opting-in system. The great benefit that presumed consent has for society as it increases he rates of donation and therefore the number of transplantations, makes it a preferable method to adopt in places where it is not implemented still. Until such a system is not implemented in many countries thousands of people will still die not for lacking medical knowledge but for lacking resources. The technology that support transplantations keeps developing but many lives will not be saved if the legal and ethical issues are not treated in a way that supports donation without disrespecting the individual's autonomy.