“I lay beneath the white sheets in anticipation for the potential surgery I am about to undergo. As the anesthetist wheels me to the prep room, I am swept behind the surgical room doors. ‘Am I doing the right thing? Will I be okay? ’ All of these questions and more bombard my mind as the darkness begins to slowly eat away at my vision. With the last visages of light I had found comfort ‘I am doing the right thing, I’m saving a life’. I become overwhelmed by the darkness and fall into a blissful, dreamless sleep soothed by the rhythmic beeps of the hospital equipment. (Ogilvie). These are the collective thoughts of the 100 or so people throughout the U. S. who will donate organs to a complete stranger. People such as John Cooper, who decided to donate a part of his liver to a stranger his wife, Deb Cooper, heard on the radio telling his tragic theory about having a liver disease and needing a liver transplant to live. John had made a decision he would donate a part of his liver to this complete stranger. The road to becoming a donor however, is not so simple as just to do it. John had endured various strenuous mental and physical tests.
He had to travel 8 times to Toronto to see experts in all fields relating to his donation. He saw a liver expert, a transplant coordinator, two transplant surgeons, a family physician, an anesthetist, a psychiatrist and a social worker. He completed innumerable forms, took a stress test, gave more than a dozen vials of blood and had his abdomen screened from every possible angle by CT scan and ultrasound. After all of these tests it was concluded that John was not an adequate match for the radio stranger though he was still elgible to be a donor.
He decided to proceed anyway, “After you get involved, how can you say yes to one person and no to another? ”(Ogilvie) His wife said. The Cooper’s were not strangers to being the victim of this type of situation. How would they fill if a possible donor of their situation refused to donate to them because the original intendee was not a match? So what motivated John Cooper to do this seemingly self-less act and what solidified his decision to do so? The Cooper’s had had experience with liver issues in the past. Four years earlier youngest daughter, Emily, suffered from an illness known as autoimmune hepatitis.
The condition results in the immune system attacking the liver. At one point in her illness a replacement liver was even an option. So obviously this tragic past had some influence in his decision to become a donor. When asked of why he did it John Cooper’s simple answer was simply, “There is no reason for me not to do this when there is someone who could be saved. ”(Ogilvie) Psycho- analysis theory would suggest that he unconsciously wanted to be there for his daughter. The helplessness he felt during his own daughter’s illness was in a way alleviated by helping someone else.
So while consciously he had no definite reasoning behind is actions other than the fact that, “There was no reason … not to do this. ” Unconsciously he was saving his little girl. John Cooper was not alone in his decision to become an organ donor. He sought the support of his family who graciously gave it to him, but unknown support came from his community. He was praised and even hugged by random people who had heard of his actions. The Cooper’s have in their home a hutch dedicated to holding the cards of those who wished him luck and a full recovery.
Another donor by the name of Kay Wolff had similar experiences to that of John Cooper, though her circumstances are a little more extraordinary. The strenuous appointments and tests were still a factor of her donation, she too sought the support of her husband, and she too had motives influencing her decision. What makes her experience extraordinary is that she is a 72 year old woman. Wolff had her own motives to donating an organ. 72 years of age without children, Wolff of course no longer had the possibility of bearing children of her own and circumstances resulted in her inability to adopt. ’It’s a little extreme to give an organ,’ Wolff admits, ‘but I felt extremely motivated to do it. I just felt this is a way to leave a legacy, and to really help someone in an important way. ’”(Goldberg). Sociologist theorist, Emile Durkheim, would suggest that Kay Wolff’s decision served a purpose. As a functionalist, he would suggest that children serve the purpose of giving our lives meaning. Kay Wolff, without any children of her own, felt the need to give her life purpose. We all want to leave our mark on the world and our children have that function.
For Kay Wolff, however, she left her mark by becoming an altruistic organ donor. As mentioned before altruistic organ donation is the act of donating an organ to a stranger. This is true, but the donor is allowed to place stipulations on the type of person the organ is donated too as long as the stipulations are not discriminatory in nature. Wolff herself placed such a stipulation on her kidney’s recipient. Wolff’s only request was that the person who received the organ did not have a killing vocation (hunter, fisher, exterminator, etc. ) of any kind. The recipient of the kidney was Zeny Pruna, a woman living six years on dialysis.
The surgery was a success and she lives a wonderful life with her family. She says her anonymous donor (who she did not know at the time), Wolff, is truly a life saver and expresses her gratitude. Kay Wolff has since stated that she want to do more for others but don’t know how, “’I don’t know, but I’ve been thinking about bone marrow,’ says Wolff, ‘And I understand that that’s a piece of cake after a kidney. ’” (Goldberg). As mentioned before we all want to leave our mark on the world, and the number of children we produce directly correlates to the size of the mark we leave.
By donating various tissues and organs, Kay Wolff is leaving a bigger legacy. She is saving various lives and giving ‘birth’ to more children. Altruistic organ donation is still a mystery to most people. Why would you sacrifice so much for someone without compensation? Why should you have to? Perhaps through a better understanding of organ donation we can answer these questions. The first successful organ transplant in the U. S. took place on December 23, 1954. On this date a kidney was transplanted between two identical twins. The surgery took countless hours and was done with little knowledge of the subject.
Today, one-year patient survival rates have reached between 76 and 94 percent for heart, liver, pancreas, and kidney transplant recipients. (Kaserman pp. 1) This statistic is true both for living and cadaveric donors. Because of the deficit in cadaveric donors, living donors are increasingly being relied on. Altruistic organ donation is a practice frowned down upon by some and praised by others. The communities are those who generally praise the act. On the other hand doctors and surgeons are generally those who frown down on the act.
They argue that to perform an altruistic organ donation is against their Hippocratic Oath. “’You know this person is a perfect human being, and now you do something to that person that can change that,’” says Dr. Martin Hertl to “The Star” magazine. (Ogilvie). When another physician was asked of his opinion he also stated that, “If Hippocrates was here, he would say you have violated my first tenet of ‘do no harm,’ ” says Dr. Gary Levy, medical director of Toronto General’s multi-organ transplant program (Ogilvie). This could be because to deny anyone the possibility of getting better is to indirectly oppose the oath.
While if interpreted directly is would suggest that to put a altruistic donor in a possibly harmful situation is to still oppose the oath to do no harm. So while performing the act is unpopular in the medical community the act itself is respected. But the question remains. Why do we allow and even depend on altruistic organ donators such as John Cooper and Kay Wolff. One reason is the increasing demand. The Human Resources and Services Administration (HRSA) found that on average a person is added to the organ waiting list every 11 minutes.
At the rate we are currently moving 75 people a day are getting transplants. About 100 people a day need a transplant, so while 75 people live, 25 people die every day because of the lack of cadaveric organ donors suitable for transplant? As mentioned before the one- year survival rates are similar. As time progresses however, these rates change drastically. Studies by HRSA also suggest that while for the recipients of living donor’s organs maintain consistent survival rates, those recipients of cadaveric organs drop significantly.
The five- year survival rates of particular organ transplant are as followed: kidney 69%, heart 75%, liver 74%, Lung 54%. The procurement of human organs is difficult in its own ways. Because of the National Organ Transplant Act of 1984, which states no one can be compensated for the donation of an organ, less people want to become donors (Kaserman pp. 8) Money is known to be the single greatest motive of everyone. The task is strenuous whether living or dead. Cooper and Wolff both endured the living aspects of donating a organ, the physical and mental tests. “It as been estimated that only about 1 percent of all deaths in the United States occur under circumstance that would allow the organs of the deceased to be used in transplantation. ”(Kaserman Pp. 9-10)
From the 1 percent of acceptable deaths only those who have signed an organ donor card (approximately 38% of the U. S. ) may be used for donation. In addition the families consent is usually sought. This however, is unnecessary due to the Uniform Anatomical Gift Act of 1987 which states, “such permission is not required in cases where the decedent has signed an organ donor card. (Kaserman 9-10). This Act was established because of various families denying releasing a dead loved one’s organs and tissues into the hospital’s custody. The World Health Organization found that even with signed donor cards they were losing thousands of potential donors because of the family’s denial. They therefore took the matter to Congress who passed this act to assure that those who wish to donate their bodies after death are allowed to do so. Doctor’s still however do still recognize a family’s grief and therefore seek consent before extracting.
Because the families consent is preferred most potential donors go on to not do donate after death. James Childress, a professor and author of ethics and medical education at Hollingsworth University, even proposes there are ethics to organs procurement including: “1. Respect for persons, including their autonomous choices and actions; 2. Beneficence, including the obligation to benefit others and maximize good consequences 3. Nonmalfeasance, the obligation not to inflict harm; and 4. Justice, the principle of fair and equitable distribution of benefits and burdens” (Childress Pp. 7- 113) These ethnics were widely accepted but not everyone agreed with them. Another author and bioethics engineer by the name of Abert Jonsen contradicts Childress by suggesting that people should be required, after death, to donate their organs. This is known as conscription.
Childress concludes that conscription is not ethically acceptable. It violates the principles autonomy and respect for persons, as mentioned in ethic one. Jonsen, however, takes a contrary position, arguing that, while moral autonomy of persons would seem to render conscription ethically unacceptable, this issue is “no longer relevant to the cadaver hich, has no autonomy and cannot be harmed. ” (Jonsen Pp. 215-19) But as Childress points out, Jonsen fails to recognize that people “can be wronged even when they are not harmed. ” (Childress Pp. 87-113) This basically means that refusing someone’s wishes after death deprives them of autonomy. Also conscription may violate the autonomy of surviving family members. Steps have been taken so that only the mentally capable may sign a donor card. From 1987-1991, the World Health Organization (WHO) released numerous guidelines regarding human organ transplantation.
Though admittedly the book was published while altruistic organ donation was in its infancy it provides insight to the then recent guidelines of organ transplantation. Guiding Principle 3 for example states the requirement of living organ donation as, “The donor should be free of any undue influence and pressure and sufficiently informed to be able to understand and weigh the risks, benefits, and consequences of consent. ”(WHO Pp. 8). This Principle emphasizes the necessity for complete and objective information to be given to the donor.
It also takes into account issues relating to people who are legally incompetent to fulfill the requirements for “free consent” or the other conditions specified. Another principle concerning mental stability suggests, “No organ should be removed from the body of a living minor for the purpose of transplantation. ”(WHO Pp. 8). In contradiction to this guideline, just a few years after its publication it was found that, “in 1998 twenty- seven living donors under ten years old were reported to be donors, including nine of which were under one year of age. ”(Kaserman Pp. 8) This does suggest that a recent change of guidelines have become apparent since the publication of WHO’s Human Organ Transplantation. Kaserman developed a couple theories about the future of organ donation. The most popular theory was his theory that their would eventually become a organ donation market system. Donors would be paid while alive for their organs upon their death. The amount paid would depend on the demand. John Cooper and Kay Wolff chose to be altruistic organ donors even apparently out of the kindness of their hearts. There are arguments against this idea though.
The main argument against altruistic organ donation includes the unnecessary safety risks it poses to the donor. As a donor anything can happen during a surgery and it not being necessary makes the risk worse. Even the donor’s family must come to terms with the fact that the donor may not come back from surgery. The surgery team must be prepared to take responsibility for the potential loss of a donor who was perfectly healthy. Luckily the surgery is free to all who wish to donate, though separate medical advice outside of those that are designated are the responsibility of the donor to compensate.
Another argument includes motivation and in extension mental stability. It has been repeatedly argued that anyone who would take such risks must be seeking something in return, whether it is infamy or compensation. If the donor doe not seek either of these, they may be posted as mentally unstable. The motivation of the surgery team would of course be the chance to save a life while being compensated heavily for it. A recent study claims that even a rookie surgeon gets paid a median $150,000 a year. If the surgeon has over 5 years of experience they get an average of $450,000 a year. Charlie S. ) The motivation of a donor could be simply to save a life but that is considered for the most part crazy. The recipient and recipient’s family rarely ever meets the donor so even their gratitude is unapparent. The final argument would be commercialism. Critics claim altruistic organ donation will lead to commercialism of organs. The only people who would be the recipients of organs under this system would be the wealthy. This is because organs would be auctioned off to the highest bidder, thus leaving the lower and even a majority of middle class from obtaining a suitable organ.
Organ donation is an important decision to all of those who are concerned with the organs donation, the family of a deceased relative, the recently deceased decision to be a donor, and even the living donor. The family is often looked to for the potential donation of a recently deceased relative. What factors play into the decision of the relatives of the deceased? A study suggested that when making a decision, the family typically decide to donate based on three questions: wish of the deceased, behavior of the deceased, and plans for the organs. The family will typically adhere to wishes of the deceased.
If they signed a donor card they will typically allow it. The behavior oddly enough also plays a factor. If the deceased had a good character: caring and loving, the relatives will allow the donation, vice versa is also true however so that people won’t allow the donation. Finally most families wish for donated organs to be used for donation rather than research. (Shanteau Pp. 19-20) Motivation of a dead donor is simple. When asked about why they decided to sign a donor card some approached the question with serious answers and others more humorous. Where I’d be heading I wouldn’t need them” joked one man about the use of his organs “might as well put them to good use while I’m gone. ” (Bonnet) Others of course felt more serious about the matter. Like Kay Wolff some people thought it was just another way to leave a legacy in this world when they pass on. “Some people give money, and some people give their time,” Wolff points out, “but I thought this is something that I thought was significant and important, and I think it’s a time to think about donating an organ. ” (Goldberg).
This statement serves the purpose of further detailing the idea of leaving a legacy behind. Also she mentions giving time and money. Kay Wolff has limited mobility despite being in great health. She is not rich by any means and therefore has little excess money. Donation was the best way to leave a legacy given her situation. The motivation of a living donor is similar to that of a dead donor. Similarities in wanting to leave a legacy on the world are found. The motivation of living donors can actually still be an incentive such as acknowledgement.
While the donor and recipient never meet, community members learn of the donation and the donor usually gains a lot of positive acknowledgement. (Gohh) The final motivation of a living donor could be their religion. Mostly all major religions suggest that organ donation is positive, though every religion looks at it in a different way. Religion is currently the single most widely accepted motivator throughout the world. Religion can influence us to do things that we otherwise wouldn’t consider.
John Cooper and Kay Wolff as well as many other donors who have been interviewed have admitted to their religion playing a role in their decisions to become organ donors. The use of religion as an acceptable motivator for altruistic organ donation is controversial at best. Ethics of organ donation has established the rule that religion cannot be the only motive for donating an organ. Of course the screening process eliminates those who would do so purely for religious reasons because it would be thought that they are not “free of any undue influence and pressure” (WHO Pp. ) as stated by the World Health Organization in their ethics book Human Organ Transplantation. This, however, does not bare those who wish to be donors who considered religion as one of the influences of their decision. A 50- year-old woman recently donated her kidney and when asked why she would want to do so she mentioned that she was a Buddhist, who was accustomed to experiencing the emotional pain that the family of the ill was going through. (Gohh) So while religion did play an important role in her decision to donate it was not the only motivator.
As mentioned before almost every major religion condones altruistic organ donation, though they have different views on the act. Christians and Catholics share the same views on altruistic organ donation. They both decide to accept the decisions of the medical experts. If the doctor accepts the act the church will follow. An important exception to that statement in concerns with Catholics includes the idea that the pope’s body may never be used for organ donation. The majority of Muslim religious leaders accept organ donation during life (provided it does not harm the donor) and after death in order to save life.
Jewish medical ethics takes a unique approach. It accepts organ donation as a meritorious charitable act, but with two conditions: that the donor be deceased before removal of the organ and that the organ be treated respectfully (and not, for instance, merely discarded if it for some reason becomes unusable). According to Buddhism it is a great merit to donate one’s own flesh for the sake of another. It is so great because it is believed that Buddha in his past life, as a rabbit, sacrificed himself by jumping into a fire to feed a lost and starved villager.
Finally like all the other major religions, Indian religions condone organ donation. Life after death is a strong belief of Hinduism and is an ongoing process of rebirth. So, the physical body is insignificant. This could be seen as reflecting positively on the concept of organ donation and transplantation in Hinduism. (NMDS) When looking at John Cooper and Kay Wolff we see some similarities in culture and sociological facts that may have also served as motivators in their decisions to become altruistic organ donors.
They both are white Americans so perhaps that played as an unconscious motivator in both their minds. Studies by HRSA have reported that discrepancies in the race and gender of donators are significantly different. It was determined in 2008 that 67% of all donators in the U. S. are white, 16% were black, 14% Hispanic and 2. 5% Asian. This correlates with the national waiting list which consist of 45% white, 29% black, 18% Hispanic, and 6% Asian. It was also found that 60% of all donators in America were female.
So while Kay Wolff was the most ideal of organ donors by being a white female American, John Cooper was also a likely choice being a white male American. As Americans perhaps our culture helped to motivate Wolff and Cooper moreso than it would in a different continent. Further studies by the HRSA also suggest that the percent of consent in American is actually less than that of Europe. 38% of all Americans choose to donate an organ, whether it is in life or death. In Europe 42% of all Europeans choose to be donors.
Through these studies it can be determined that race and gender have served as an unconscious motivator for Wolff and Cooper. Culture played a large role in their decisions. In some cultures organ donation is frowned upon and in others it is the ultimate form of selflessness. John Cooper, Kay Wolff and all other organ donors have made sacrifices so that others may live a more care-free and happy life. But why should they have to? What possible consequences can an organ shortage present? How can the situation be worse without their individual contributions?
One such consequence would include the length of waiting times that a person would have to wait to obtain an organ. Studies have shown that in a 7 year span, between the years of 1988 to 1995, there has been a 141% increase in the waiting time for kidneys. This rate of increase is still increasing exponentially. There are even consequences of the longer wait times that people are forced to endure. The expense of keeping someone alive on a dialysis machine makes life increasingly harder. Also deteriorating health because of longer wait times lead to less successful organ transplantation surgeries.
Finally the most obvious consequence of the waiting time is the death of those who cannot hold on long enough to get their transplantation. Another consequence of the organ shortage would be the increasing use of dialysis. In 2002 alone, 185,000 people were using dialysis. Only 45,000 (24%) of those people were on an official organ transplantation waiting list, whereas, at least half of them were elgible. The increasing dependence of dialysis leads to a higher expense than the transplantation of the organ. Approximately $2. 4 Billion more over a 5 year span.
Also an abundant amount of their life is spent on a machine limiting their mobility. Finally it was found that those who go without dialysis face fewer complications during their organ transplantation. The final most apparent consequence of the shortage of organs is the reliance of the ill on more living donors. This in itself poses a risk to not only the ill but also the healthy. Society may also be forced to develop a marking system for human organs which as discussed before would be regulated by the need of supply. This can lead to high expenses by the government.
This in extension means higher taxes for everyone including those who will receive the organ as well as the donator. (Kaserman Pp. 33) Everyday on average 20 people die from the lack of organ transplantation and while over a third of the country are willing organ donators through death only 1% of those deaths meet the criteria to become donors. This has led to an increasing demand of living donors like John Cooper and Kay Wolff who choose to donate an organ out of the kindness of their heart to a complete stranger for no compensation. We as a society need to become more informative of the option of cadaveric organ donation.
I believe that altruistic organ donation is important and I would even consider doing it myself in time. I think however, that we should not to have a need to do it, but a want. We have been to through their experiences, motives, and the reason why they must donate. Throughout this entire project while a better understanding of the subject may have been obtained there are still questions of why these people choose to be altruistic organ donors.
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