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Organ Donation The Ignored Crisis


Max O’Connor was diagnosed with pulmonary fibrosis at age 7 and a half. For the next two years hopes and prayers went out for a new lung to save the young child’s life. Unfortunately, like so many other cases, a suitable lung could not be found in time, and Max died at the age of during the summer of 00. Lack of organ donation has become an upsetting statistic in the United States and is progressively becoming worse. Last year over 67,000 people died waiting for organ transplants, while the total number of fatal accidents figured more than 107,000 and suicide reached almost 7,000. Several proposals have been suggested to increase the number of participants for organ donation, including ‘presumed consent’ legislation, a mandate effect, accepting declared brain-dead patients, or using incentives in recognition for organ donation. Presumed consent and the mandate effect are the two most widely accepted proposals in the medical field and I strongly support putting either one into effect so to increase the number of lives that could be saved.


Many foreign countries today (not including America) have what is called ‘presumed consent’ the assumption that every person who dies is automatically an organ donor unless otherwise stated. In his essay “We Must Have Presumed Consent” Larry Kramer fervently advocates the idea of ‘Presumed Consent’ for the United States. “[N]ot enough Americans,” Kramer writes, “donate their organs to be used after they die. In many foreign countries, this extreme shortage does not exist because these countries (and they include Austria, Belgium, Denmark, Finland, France, Italy, Norway, Singapore, and Spain) have…presumed consent organ collection system” (par.). In America, you have to sign the back of your driver’s license if you wish to be an organ donor, and even then, most centers still require permission from a family member, which, believe it or not, may not be given. By allowing presumed consent, the gap between the need for organs and organs available would greatly diminish.


Presumed consent would automatically label a victim of unintentional misfortune an organ donor rather then having to look for their wallet or contact family members, which can become a lengthy task. Kramer analyzes the impact by stating “That means that when an accident occurs to a person who has not opted out…his or her organs can be taken immediately…” (par.). On average, about 80,000 people in the United States are on the waiting list for a new organ; about 0,000 receive their transplants in time. (And that is just those who are ill enough to be put on the list). The American public doesn’t realize that by not claiming themselves as an organ donator’s, their organs in no way will benefit a sick child waiting for a lung transplant or soon-to-be grandparent waiting for a kidney transfer. Presumed consent would shift the responsibility from people willing to donate their organs, to people not willing to donate their organs, a tremendous step towards better contribution of organs.


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A mandate effect is another proposal which is strongly favored, even more so then presumed consent, because it forces the subject of organ donning right in front of the American public faces, but does so in comfortable and unbiased way. In his essay “Mandated Choice For Organ Donation Time To Give It a Try” Aaron Spital makes logical and valid points as to why the American public should be authorized to choose whether or not to be an organ giver. Different from Presumed Consent, this proposal would not assume that every death of an undecided person is in fact a donor, but instead the mandate effect would simply ask each person to check off whether they are, aren’t or are undecided organ donor when reregistering for a driver’s license. Spital explains that “this plan would require all adults to record their wishes about posthumous organ donation…” (par.). Since no one knows when they might die, by asking the public to make a decision on organ giving in advance, many people who favor organ donation but never get around to saying so would be recorded as organ donors, and an innumerable about of desperate lives could be saved.


Much of the American public chooses to ‘look the other way’ when approached with the idea of organ donning, and the mandate effect would help force the decision on the issue. Death isn’t something many people like to think about, which is understandable. While helping another human in need is a wonderful act of kindness, at the expense of your death and organs makes many people uneasy. Spital explains “The American public has a tendency of dealing with uncomfortable issue by simply ignoring them. Mandate Choice, a proposal to stimulate the number of organs available for waiting patients, would force people to consider the issue” (par.5). It is important to understand that the mandate effect does not favor any one position over another, but simply forces the issue at hand whether they are an organ donor, whether they are not an organ donor, or, if they wish, they could check the third option which is ‘undecided’. “[T]he public generally approves of organ donation” states Spital, and would therefore greatly increase the number or transplants performed each year (par.). Organ donation consent from loved ones at the time of death is very difficult to obtain, usually because of the denial and deep grievance the family is undergoing. “By moving the decision-making process to a relaxed setting…” explains Spital, “mandated choice would hopefully take advantage of favorable public attitudes toward donation and thereby facilitate organ procurement” (par.6).


One other advantage to the mandate effect which is often overlooked but very important is that by checking ‘yes’, ‘no’ or ‘undecided’, it would be recorded as your choice and no one could change your belief after death. Spital reveals that “this plan would…. consider those wishes binding” (par.). Often, even if a person has claimed to be a donor, family of the deceased can override their wishes and not have any organs offered to the suffering and waiting. Mandate Choice would ensure the wishes of the deceased and not that of the family. Many times, out of grief and denial, the family denies the organs to be donated to waiting patients in need of organs. By declaring your position on organ donning with your organs, it would ensure your wishes to be respected and carried out, whether that might be donning or not donating. This is most conservative proposal so far towards increasing the donation of organs, but it could have tremendous and truly wonderful affect if put into effect.


Another proposal to increase the number or organ donations is accepting declared brain-dead patients as satisfactory donors, regardless if their heart’s are still beating through medical technology. Dr. Felix Rapaport, chair of surgery at the State University of New York and author of “Too Few Human Organs, Too many in Need… And the Gap Widens” is a fervent advocate of accepting brain-dead victims as organ donating candidates. To decrease the gap between donations available and people in need of transplants, Rapaport supports “the retrieval of organs from nonheart-beating, brain-dead cadaver donors, which differs from the usual recovery of organs from heart-beating, brain-dead cadaver donors on life support systems” (par ). Usually when possible, if a person is pronounced brain-dead they are still kept on a life support system until the family is contacted and able to come give their goodbyes. However, because their heart is still beating, it is often assumed they are still alive (which is true, but only because of technical material, not because of the victim’s body).


The proposal of using brain-dead victims “is not widely accepted by the transplant community, however, and evokes many ethical concerns involving the rights of deceased individuals and their families. The invasive procedure, though it does not disfigure the body, is solely for the gain of others and does not benefit the deceased” states Dr.Rapaport (par.1). On one hand, it is understandable where the transplant community is coming from; death should be respected and not used in business propositions or benefits. However, life is a cycle of both joy and sorrow, and when a tragedy does occur, it is irreversible- a difficult concept to accept for the family of the victim. Where there is death of a loved one, life for another can be given. Two heart beats are kept alive through technology the victim who is brain-dead and the patient in need of a transplant, who is fully alive with a completely functional brain. Dr. Rapaport ends his article by challenging readers to confront their thoughts on whether or not, if they were the victim of an accident, pronounced brain-dead once at the hospital, and kept alive only by technology, what they would do. Rapaport closes with “[I]ndividuals must confront their mortality, an uncomfortable prospect for most; they must explore their attitudes toward death, their own bodies, and their sense of self” (par.18).


The last proposal for organ donation is offering incentives in recognition for organ donation. In her essay essay “Incentives For Organ Donation?” Michele M. Hogan presents the positive idea of providing benefits/money to people willing to donate their organs after death to someone in need. Currently, the only incentive for organ donning is unselfishness and self-sacrifice. Stimulus may heighten the number or organ donors available, despite the selfish approach it takes. The various methods Hogan introduced should a person become an organ donor are “…given preferred status if they themselves ever need an organ. Funeral services…provided free for families who donate organs of the deceased. A low-cost life-insurance policy might even be made available to people which is payable only if organs are donated at the time of death” (87).


This proposal sends red flags flying, mainly because of corruption and deceit that lies with in this world, and if acted upon there could be possible frauds and tragic results. Some people are desperate for money and not above selling a family member or loved ones organs in return for money or other types of incentives. Also, there is some strong opposition to this proposal because of its overall effect it might have on the public in general and their willingness to become organ donors. Even Hogan admits that “these initiatives may cause a backlash of negative public opinion and thus undermine efforts to increase donations” (8). If someone read an article for example of a parent murdering their child in order to benefit from donating their organs, there is serious doubt that the article would motivate the public to become organ donors. There is much weariness of this proposal in fear of misuse and deception. A person’s body is still a loved one to many, and shouldn’t be a piece of meat to be salvaged in order for other people to prosper.


The system for organ donation is not satisfying the need of desperate patients waiting for a second chance at life. Kramer exposes the tragic truth in America of organ donation figures “Right now there are hundreds of thousands of people in this country waiting for organs. Most of them will die before they get them. Many of them will die after they have been put on a waiting list” (par.1). The American public is not taking enough initiative to help solve the ignored crisis of organ donation, and hopefully these proposals can open America’s eyes and see the tragic truth to lack of organ donations. Kramer bluntly puts it into perspective “No one wants to raise the American conscience to make people feel that it is their human obligation to pass along their body to the living when they die” (par.6). Organ donation can saves the hundred of thousands of lives, if only the public would be brave enough to find it inside of themselves to look at the gravity of the situation.


To become an organ donor, go to http//www.usatoday.com/life/hotlines/norg007.htm





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