The Unethical Procurement of Organs
Please note: this paper is not a representation of my personal view on this subject, however, it is meant to highlight many aspects of this issue from one extreme perspective.
The harvesting of organs from newly dead who have by no means given consent to organ donation is unethical and morally wrong. Humans have a moral duty to save as many people as possible so in regards to organ donation, it seems as though everyone would have an obligation to donate their organs when they die. This may seem like a sound argument however it does not take into account all of the factors of organ donation. There are multiple issues such as consent and the definition of death that ultimately make the desecration of someone’s loved one morally wrong and disrespectful.
The first moral issue needing to be articulated is the idea of whether a person is dead or not. The UDDA has defined death as “irreversible cessation of circulatory and respiratory functions; or irreversible cessation of all functions of the entire brain, including the brain stem.^(3)” If organs were to be harvested immediately postmortem (arguably when they are in the best condition), there is a real possibility that the brain could still be active even if the patient is completely unresponsive. This is where the Dead Donor Rule (DDR) comes in stating “Individuals must not be killed by organ retrieval.^(2)” It has been generally accepted that in the harvesting of organs, brain death must have occurred so that no harm is done to the patient. This presents a problem however because the standard tests and protocols for determining brain death take valuable time when harvesting organs. In patients who experience cardiac arrests, these protocols are usually substituted with a “clinical evaluation” that typically results in a ruling of “permanent” circulatory cessation.^(2) This allows physicians to be able to harvest a patient's heart only 75 seconds after cardiac arrest while multiple studies have shown that a human heart can be restarted 6 hours after extraction.^(2) This begs the questions of whether organs are being harvested before total brain death as well as what an accurate protocol for death should be. A main reason why the protocol for death has become so corrupt is because the terms “irreversible” and “permanent” have become synonyms. In fact, “permanent” is dependent on contextual factors such as available resources or an “existing moral agreement that resuscitative attempts in [patients] should not be performed.^(2)” This contrasts with “irreversible” in that even with the best equipment and physicians in the world, a patient cannot be resuscitated.
To try to alleviate this slippery slope, it is necessary to define when organs should be procured. Instead of trying to define when exactly a patient is dead, we should instead look at whether the patient is beyond harm and the situation is morally right to harvest their organs. This brings up the idea of using anesthesia while performing the organ retrieval.^(2) This would insure that, even if the brain were not entirely dead, there would be no harm done to the patient and the organs would still be in good condition. At this point, consent comes into play in determining whether it is morally right to harvest the organs. If the proper consent, by a proxy or the individual before death, has been given, then measures to insure no harm should be taken and the organs should be harvested.
Since the organ donor in question is dead (or at least unresponsive at this point), organs cannot be harvested unless consent has been given. Assuming the body is no longer a person (it cannot feel or think anything) and has organs that could save other lives, harvesting organs from every dead person seems like a perfect solution for organ shortage. This idea is only valid however if the dead body is looked at as having no value. The body that would be cut up to extract the organs is still seen as a symbol of the life that once was. Every reasonable human intrinsically finds value in the human body whether it is dead or alive. For example, Al-Qaeda dragging a dead soldier’s body around in the streets will immediately strike people around the world as quite disturbing since the body is being blatantly disrespected. If for instance a default organ donor system were set up such that organs of the dead were harvested immediately preceding death, the same concept would apply. The body and any thoughts of loved ones are being blatantly disrespected and thus strike people (especially family members) as disturbing. The disrespectful and selfish nature of cutting open a body and literally gutting it of most of its organs, shows the absolute necessity of acquiring consent in organ donation.
Unfortunately not everyone shares this view of consent being an absolute necessity. One of these people is named D. Micah Hester and in his essay “Why We Must Leave Our Organs to Others,” he outlines this default donor position. He starts out his argument with an assumption saying “we are obligated to do what we can to save seriously endangered lives when we can do so without risking anything of significant value to us.^(1)” For the rest of the essay he never clearly defines what he sees as “significant value to us” however he does imply it with a question of “what harm could be done to now-dead persons if organs are taken without direct consent?1” Based on this sentence alone it is clear to see that Hester views this situation only from the perspective of what could be done to the dead body. Obviously nothing can harm the dead body since it is no longer a person however whether or not the now dead person and family of said person want the organs extracted is a different story. If it is not specified that they want them extracted then a great disrespect and moral wrong has been committed no matter how big of a greater good it might be. Hester even inadvertently goes on to solidity my own point by saying “Respect and disrespect are paid to persons/moral agents, not to bodies per se.^(1)” By only focusing on whether the body is a person or not, Hester overlooks the fact of family members and loved ones being “person's/moral agents.”
The process of trying to define death and when a person’s organs can morally be harvested is complicated. Unfortunately, we have gotten so good at convincing ourselves of what constitutes a death that we have lost sight of ensuring the situation is morally right and no harm is done. Ultimately, protocols for declaring death need to be revised and a strict moral code needs to be enacted when harvesting organs. At the same time, respecting the body and acquiring consent is the only way organs should ever be harvested, no matter how much of a benefit the organs could be to others.
Work Cited
1. Hester, D. Micah. "Why We Must Leave Our Organs to Others." Contemporary Issues in Bioethics. Ed. Tom L. Beauchamp, LeRoy Walters, Jeffrey P. Kahn, and Anna C. Mastroianni. 8th ed. Boston: Wadsworth, 2014. 457-61. Print.
2. Rodriguez-Arias, David, Maxwell J. Smith, and Neil M. Lazar. "Donation After Circulatory Death: Burying the Dead Donor Rule." Contemporary Issues in Bioethics. Ed. Tom L. Beauchamp, LeRoy Walters, Jeffrey P. Kahn, and Anna C. Mastroianni. 8th ed. Boston: Wadsworth, 2014. 450-57. Print.
3. Uniform Determination of Death Act, Http://pntb.org/wordpress/wp-content/uploads/Uniform-Determination-of-Death-1980_5c.pdf (1980). Print.