Organ donation is ethically and morally acceptance compared to organ harvesting which is non ethic. donating an organs for saving a human life is ok, and acceptance but to donate your organs for economics is bad because you didn't have a grantee that your organs may save till you dying. the most expensive organ donation is ................

1. 5. Organ Donation
& Transplantation:
Dr. Ayub Abdulkadir (Dr. Alto)
Medical Ethics

2. • A transplant surgeon has five patients, each in need
of a different organ, who will each die without that
organ.
• Unfortunately, there are no organs available to
perform any of these five transplant operations.
• A healthy young traveler, just passing through the
city the doctor works in, comes in for a checkup.
During the checkup, the doctor discovers that his
organs are compatible with all five of his dying
patients.
• Suppose further that if the young man were to
disappear, no one would suspect the doctor.
• Do you support the morality of the doctor to kill
that tourist and provide his healthy organs to those
five dying persons and save their lives?

3. Introduction:
• An organ transplant is a surgical operation where a
failing or damaged organ in the human body is
removed and replaced with a new one.
• The term “organ transplant” typically refers to
transplants of the solid organs: heart, lungs,
kidneys, liver, pancreas and intestines.
•Animal and artificial organs may also
serve as transplantable organs.

4. History:
• 1954 living relating kidney transplant( Dr. Joseph
Murray and Dr. David Hume Boston)
• 1962 cadaveric kidney transplant by (Dr. Joseph
Murray and Dr. David Hume Boston)
• 1963 lung transplant (Dr. James Hardy Mississippi)
• 1967 liver transplant( Dr. Thomas Starzl Colorado)
and heart transplant(Dr. Christiaan Barnard South
Africa)
• 1981 heart/lung transplant(Dr. Norman Shumway
California)

5. • Today the transplantation of many organs between
well-matched human beings is quite successful,
with the majority of recipients living five or more
years.
• With current advances, even a human head
transplant (perhaps better referred to as a body
transplant) may be possible.
• Since many people can benefit greatly from organ
and tissue transplants, the demand usually
exceeds the supply.
• The costs related to some organ transplants are
very highas well.

6. • The ethical and legal issues related to organ and
tissue procurement and transplantation are:
1) Autonomy,
2) Benevolence,
3) Non-maleficence,
4) Free and informed consent,
5) Respecting the dignity, integrity and equality of
human beings, fairness, and the common good.

7. • Organ and tissue donation is a voluntary event
entirely at the discretion of the live donor,
• The principle of autonomy is fully in play here.
• For ex. a 35-year-old-man is dying of hepatic
failure. His brother is fully HLA matched and a
highly compatible donor. There are no other donors
at this time and the patient will likely not survive
long enough to find another donor. You are
screening the brother for the donation, but he is
not willing to undergo the surgery for the partial
donation. What should you do?

9. Types:
1. Autograft - A transplant of tissue from one
to oneself Skin grafts, vein extraction for
CABG, storing blood in advance of surgery.
2. Allograft - Transplanted organ or tissue
from a genetically non – identical member
of the same species.
• Most human tissue and organ transplant.

10. 3. Isograft -A subset of allografts in which organs or
tissues are transplanted from a donor to a
genetically identical recipient (e.g. identical twin).
Anatomically identical to allografts, closer to
autografts in terms of the recipient’s immune
response.
4. Xenograft -Replacement of an individual’s
defective organ with an organ harvested from
another species - Source of organs for human
use: primates (genetic similarities to humans)
and pigs (large availability).

12. Post-death donation:
• In the UK, 20 million people are on the register to
donate organs.
• Although half a million people die in the UK each
year, only approximately 5000 die in circumstances
suitable to donate organs.
• Organs degrade rapidly after death.
• Most donors are already in intensive care.

13. Suitability:
• It is about the quality of the organs and if an old
person takes care of themselves their organs can
still be used for donation
• There are only two health problems which means
people cannot donate – HIV or Mad Cow Disease.
• Smoking can make lungs unfit for transplant.

14. Discussion points:
• Ethical Issues Regarding:
1) The Donor.
2) The Recipient.
3) Allocation of Limited Resources.
4) Procurement of Organs and Tissues.
5) Informed consent.

15. … Ethical Issues Regarding the
Donor:
• From the Deceased; the recently dead person.
• From Living Persons (Adults, Mentally Disabled,
Minors).
• From Anencephalic Infants.
• From Human Fetuses.

16. … Ethical Issues Regarding the
Recipient:
• Should individuals who have abused their bodies
through smoking, drinking, or diet receive new
organs, or should organs only be given to those
whose organs were damaged by illness?
• The recipients for the scarce organs are selected
justly.

17. … Ethical Issues Regarding
Allocation of Limited Resources:
1) Criteria for Selection Allocation rules, defined by
appropriately constituted committees, should be
equitable, externally justified, and transparent.
2) Using Animals.
3) Artificial Substitutes for Tissues and Organs.
4) Distributive justice – How to fairly divide
resources.
5) Equal access.
6) Maximum benefit.

18. Presumed consent debate:
• In England in order to be an organ donor you have
to sign up to the organ donor register. This is called
opt-in
• In Spain the system is opt-out
• http://www.bbc.com/news/uk-wales- 34964386.
• http://www.bbc.com/news/uk-wales- 34932958.

22. Organ donor network asks
for consent for donation:

23. • For example, a 30-year-old woman is your patient
in the intensive care unit for respiratory failure. The
patient has had a motor vehicle accident and has
sustained a massive intracranial hemorrhage. The
patient is brain dead and will be removed from the
ventilator. You know that there are numerous
patients in your hospital waiting for organs. The
family of the patient is with you. You have an
excellent relationship with the family and they trust
you. What should you do about the donation?

24. • Only the organ donor network or uniform network for
organ sharing should obtain consent for an organ
donation. The medical team taking care of the patient
should not ask for the donation. Even if your
relationship with the family is excellent, the organ
donor network has an enormously greater success rate
in obtaining consent.
• Physicians that ask for consent for organ donation are
far more likely to be refused. Because a greater number
of refusals would lead to a loss of potential organs for
donation when the shortage statute of available organs
is critical it is against the law for doctors to obtain this
consent.
• By legal statute, only those specifically trained to obtain
consent for organ donation should approach the family
for this consent.

25. PAYMENT FOR DONATIONS:
• With the exception of renewable tissues such as
sperms, unfertilized eggs, and blood, payment for
organs is considered ethically unacceptable. People
must not be in the business of selling organs.
• The economic aspects of organ donation must be
minimized so that people believe that the patients who
need organs the most will get them, not that the
wealthy will get preferential treatment.
• It is, however acceptable to cover the cost to the donor
of donation. There is a difference between reimbursing
the donor for the cost of donation and creating a
financial incentive for people to “sell” organs.

26. ORGAN DONOR CARDS:
• Although an organ donor card gives an indication of
a patient's wish is for donation, family consent is
still necessary for donation.
• Family objection can over rule the organ donor
card.

29. Organ trafficking:
• The term organ trafficking is commonly used to refer to
a range of criminal activities, including illegal organ
harvesting from a living or dead individual and the
illegal sale and transplantation of human organs.
• Organ trafficking may be considered part of a broader
market that includes tissues, cells, or other human
body parts or products, referred to by some as the
“red market.”
• Prominent international legal frameworks, and many
national frameworks, including in the United States,
prohibit any sale of human organs.

30. • The nongovernmental organization (NGO) Global
Financial Integrity (GFI) estimates that the annual
value of organ trafficking globally ranges from
$840 million to upwards of $1.7
billion.

31. • Causes of organ trafficking:
1. Poverty.
2. High demand low supply.
3. Illiteracy.
4. War.
5. Developing regions.
6. Lack of strict laws.