The U.S. Health Law: Organ Donation
Executive Summary
Organ donation establishes a tremendous difference in someone’s life; thus, people who donate organs to others do it with an aim of saving or improving someone’s life. Many countries have ratified laws which govern organ donation. The US, for instance, has devised laws such as; Uniform Anatomical Gift and National and organ Transplant Act among others. These laws have played a critical role in regulating how organ donation practice is conducted. Similarly, patients seeking organ transplants have increased overtime. Statistics indicate that, in the US alone, many patients are on the waiting list in need of organ donation. Though these patients are not certain when the organ will be available, to them, hope is the driving force. Unfortunately, some die long before the organ is secured, this owe to the fact that organ donors have decreased significantly.
Most religious groups support organ donation. The four main religious groups,that is; Islam, Christianity, Judaism and Hinduism views that organ donation is consistent with their beliefs. On the other hand, though organ donation is aimed at saving lives, significant concerns have risen in regard to this practice. Concerns such as; bioethics, organ shortfall and scandals among others have elicited major debates across the medical fraternity. Some of the organs donated includes; heart, lungs, kidneys and liver among others.
Introduction
Organ donation is a procedure which involves harvesting healthy tissues and organs from an individual. Healthcare experts highlight that organs donated can save many lives when accomplished on time. Some of the organs donated include; kidney, heart, liver, cornea, bone and bone marrow among others. Organ donation occurs after the donor has died. However, people can voluntarily donate their organs while they are alive. People from different age groups can be organ donors; thus, there is no age restriction in organ donation.
This paper explores US health law as it governs the practice of organ donation. The paper also evaluates recipients of organ donation on the waiting list and explores the religious viewpoint about the practice. Finally, the writer highlights common concerns connected to organ donation and outlines organs which can be donated.
US Health Law and Organ Donation
To regulate organ donation, the US government has devised guidelines which govern the practice. According to Berger et al (1993) the regulations are aimed at protecting the rights of donors, the living and the dead, and the recipients. Though people are allowed to donate organs to save lives of their loved ones, the US health law stipulates that people willing to donate their organs should adhere to rules which govern ethics and distribution concerns related to removal and sharing of organs.
Uniform Anatomical Gift Act, 1987
This act, which came into effect in 1987, revamped the Uniform Anatomical Act of 1968. Gift of Life Donor Program (2012) indicate that the UAGA has been successful in constructing a reliable yardstick for states to incorporate adjustment on their state based anatomical gift legislation. However, the law has beensilenton issues concerned with increasing the figure of donated and“transplantable” organs. The UAGA was created with an intention of improving the necessities and filling the gaps that existed in the UAGA of 1968. TheUniform Anatomical Gift Actoutlaws the sale of human organs. Also, it reinforces other Federal laws that hold similar opinion; however, itprovides exception on certain organs such as; human egg, sperm and blood. Similarly, the lawaddresses decedent fears that relate to dignity of the organ donated. Berger et al (1993) indicates the UAGA Act of 1987 simplifies the process of filling key documents to facilitate organ transplant (Berger et al., 1993). On the same note, it allows medical examiners to recommend “transplantable” organs from the autopsies under certain frameworks.
The National organ Transplant Act, 1984
This Act, abbreviated as NOTA was created in 1984. The act establishes detailed structure and policies governing organ donation and transplants. Arthur & Daniel (1999) demonstrate that this act mirrors the Congress recognition in the progress being undertaken in the field of transplant technology and procedures. NOTA support and disseminate grants to qualified Organ Procurement Organizations, OPOs, and the Organ Procurement and Transportation Network, OPTN (Berger & Praeger, 1993). Also, the Act outlaws the practice of selling human organs across the States. Consequently, Berger & Praeger, (1993) indicates that the Act has established a 25 member Task force on Organ Transplant. The task force is involved in the study of human transplant policies and challenges that encompass procurement and distribution of organs. In one of their proposal, the committee emphasized that more strategies should be implemented to encourage individuals to donate organs.
Patient Self-Determination Act of1991
Abbreviated as PSDA; this law was created to encourage the practice of using advanced directives in healthcare provision. The law embraces the living wills and the powers of the attorney in enhancing healthcare. However, in MEDICAID and Federal Medicare laws, it alters some critical provisions. Berger and Praeger (1993) indicate that, in these facilities, it dictates to hospitals and healthcare providers on how to maintain elaborate procedures and policies. It requires hospitals and healthcare facilities to indicate in the patient’s medical form whether a patient has fulfilled an advance directive. Also, PSDA forbids hospitals and health care facilities against patient discrimination in relation to his/her decision on an advance directive, and lastly, hospitals and healthcare facilities should conform to state laws in regard to advance directives.
Advance Care Directives
The US health law stipulates essential documents that may be used as evidence for a person wishing to donate his/her organs. These documents are critical in unlikely events such as a person’s certain death. Arthur and Daniel (1999) points out that the Living will is one of these documents. Living wills spells out instructions on how the person’s organ or tissue may be donated if deemed medically fit. However, the law obliges people making the commitment inform their family members and their physician. Also, durable power of the physician is an essential document. It allows an individual or his/her agents to make a firm decision in regard to someone’s healthcare should the person become debilitated. The final document is advanced care medical directive. This document conglomerates some elements of the powers of attorney for healthcare and the living will. It permits a person to provide instructions in regard to the healthcare he/she wants or do not want in a variety of medical scenarios.
Waiting List
Huertas (2008) indicate that in the US, patients seeking organ transplant has increased steadily reaching about 97,670 in 2007. This figure is based on the statistics collected in December 2007. Similarly, based on statistics collected in December 2002, about 80,790 were on waiting list in 2002 (Huertas, 2008). Further, Huertas (2008) indicate that in 1997, patients on the waiting list were about 53,167 as confirmed by December 1997 statistics. Consequently, US Department of Health & Human Services (2012) shows that about 6,000 patients died while on the waiting list, and further 26,000 received organ transplants. Arthur and Daniel (1999) cite that majority of patients on the waiting list needs kidney donation.
US Department of Health & Human Services (2012) gives a trend of US organ transplant. They point out that children, women and men numbering over 100,000 thousand are in dire need of life saving organ transplants. Similarly, new names are being added to the country’s national waiting list daily. Moreover, US Department of Health & Human Services (2012) notes that, in a day, about 18 people die while on the waiting list. Similarly, though 90 percent of Americans supports organ donation, only 30 percent understands the procedures followed in making organ donation.
US Department of Health & Human Services (2012) recognize that to encourage organ donation, the US government in partnership with non -governmental organizations have devised strategies which are aimed at promoting organ donation. People are encouraged to make their donation’s sign up at the State level. This method is straightforward. Hence, most states have developed methods such as designating organ donation on state identification cards or driver’s licenses (Huertas, 2008). Similarly, the government has developed donor registries. The donor registries gives an opportunity to make donation decisions whether give the procurement agencies the authority to use their organs and tissues after people die (Huertas, 2008).
Religious Views on organ Donation
The major world religious organization support organ donation, they consider organ donation is a sign of love and giving. A brief overview on the four main religions of the world affirms this view.
Judaism
Judaism encourages organ donation. The religion contends that people should be willing to donate their organs to enrich other people’s lives. This is because organ donation is a noble privilege. Similarly, the Jewish medical ethics accepts organ donations as an act of charity (Organ Donation, 2012).
Islam
Islam religious leaders and their adherents’ accepts organ donation during one’s existence and after death. They consider the practice as an act of kindness aimed at saving a life. However, they view organ donated should not cause harm to the donor (Organ Donation, 2012). Besides, they view this cause as a means of achieving a noble end.
Hinduism
Hindus are not barred by law from donating their organs; thus, they regard it as a benefit in donating one’s organ for the sake of the “neighbor”. However, Organ Donation (2012) opines that the choice for donating an organ has to be made by the donor himself.
Christianity
Christians recognize organ donation as a sign of fraternal love, compassion and self- sacrifice. Christians contends that Jesus Christ came on earth to give life in abundance. Hence; donations and transplants allow a person to live this life in richness, eliminate suffering and pain, and as an expression of love in times of need. In Catholicism, organ donation and transplants is morally and ethically acceptable (Organ Donation, 2012).
Concerns in Organ Donation
Though organ donation has been critical in saving a life, it has elicited various concerns in the society. These concerns range from bioethical ethics to organ shortfall and scandal.
Bioethical issues
Organ donation has received much applause in some quarters in the society. For example, the gypsies have opposed all attempts regarding organ donation based on their faith propensity (Moazam, 2006). They view organ donation goes against the living will, patient autonomy and guardianship of a person. Similarly, on the viewpoint of deontological ethics, the basic question engulfing morality of an organ donation is perceived as semantical in nature; thus, the definition of human, death, life and body has infiltrated every aspect of human society. For instance, Arthur & Daniel(1999) points out that a challenge exists whether or not a brain dead person should be conserved artificially in view of preserving his/her organs for procurement. This is a significant concern in clinical bioethics (Allen, 2012).
Organ donation has created what Arthur & Daniel (1999) refer to as black market donation or organ tourism, this aspect on a teleological perspective has established ethical or moral dilemma. In a black market donation, those who have the means such as money are assured of the donation. However, the targets are left in devastating state. Moreover, the black market has elicited weighty concerns as innocent people are killed as the culprits search for organs to sell.
Organ shortfall
Arthur & Daniel (1999) cite that the world is witnessing a significant demand for organs, but the number of donors is shrinking every day. Thus, the number of recipients is more than that of the donors.
Scandals
Scandals have also hit organ donation schemes. McKinley (2008) indicates that a Californian surgeon, HootanRoozrokh, was charged in 2008. The surgeon was found guilty of prescribing what juries observed as an excessive administration of tranquilizers and morphine doses. The surgeon intention was to accelerate the death of the patient. The surgeon was performing this actin order to harvest the organs for sale.
Organs Donated
McKinley (2008) indicates that some organs can be donated. However, appropriate test should be carried out to determine their compatibility with the recipient in need. The organs which can be donated includes; kidney, liver, lung, heart, pancreas and small bowel.
Conclusion
Organ donation is a fundamental practice which can help save or improve a life. Various governments and non-governmental organizations have risen to the occasion by formulating strategies, which encourage more donors to do so. In the US, for instance, legislation such as; the Uniform Anatomical Gift and National Organ Transplant Act among others has given a guiding framework which ensures organ donation is achieved in accordance with the law. This implies that the donors and the recipient are assured of their protection. Similarly, legislation’s drafted have enabled the hospitals and other healthcare providers to perform organ donation and transplant within the guideline of the law.
Despite many patients being on the waiting list, the organ donors continues to decline. This suggests that more patients will need to wait a little longer; however, this will not guarantee them an automatic benefit. Thus, more will continue to die while still on the waiting list.
The stand on organ donation by religious groups is encouraging. This commitment has been critical in influencing their adherents to willingly donate their organs. Despite organ donation being a noble cause in saving someone’s life, it has elicited serious concerns in the society. The concerns range from bioethics to organ shortfall and scandals. These concerns are on the increase. Thus, effective strategies by relevant stakeholders to avert them will be vital.
Reference List
Allen, J. F. (2012). Health Law & Medical Ethics for Healthcare Professionals. Boston, MA: Pearson.
Arthur L., & Daniel, H. (1999).The Ethics of Organ Transplants: The Current Debate. Amherst: Prometheus Books.
Berger, A.S., and Praeger, A. S. (1993).Dying & Death in Law & Medicine: a Forensic Primer forHealth and Legal Professionals.California:ABC-CLIO.
Gift of Life Donor Program (2012).Giving Life a Second Chance through Organ and Tissue Donation. Web.
Huertas, A. (2008). Organ Transplant Waiting List Reaches High in US. Web.
McKinley, J. (2008). “Surgeon Accused of Speeding a Death to Get Organs. Web.
Moazam, F. (2006).Bioethics and Organ Transplantation in a Muslim Society: A Study in Culture, Ethnography, and Religion. Indiana: Indiana University Press
Organ Donation (2012).Religious Views on Organ Donation and Transplantation. Web.
US Department of Health & Human Services (2012).Organ Donation Data/Statistics. Web.