Achievement Task

As a young adult you are making more and more important decisions. Decisions that will affect the rest of your life. The prospect of becoming an organ donor is another decision you will make if you haven’t already. When an Ontario resident receives a driver’s license an organ donor card is offered to you. You owe it to yourself and the people on the organ transplant waiting list to consider this important decision. There are many ethical considerations also to be pondered when developing criteria on who should receive donated organs, and how to deal with the organ donor shortage. This achievement task will hopefully get you thinking about organ donation and the process Canada has developed for this life-saving treatment.

1. In a report by David Baxter and Jim Smerdon "Donation matters: demographics and organ transplants in Canada 2000 - 2040" reveals some interesting findings. It appears Canada’s low rate of organ donation in comparison to other countries (for example Spain’s rate is 34) is not a result of a lack of generosity or altruism. What reasons do they provide for Canada’s apparent low standing?
2. What are five solutions transplant hospitals are using or could consider using to obtain more organs to fill their needs?
3. Choose one of the ethical issues listed below and research information on that topic using the internet. Write a synopsis of the ethical issue then provide your opinion on the issue.

   Ethical Issues

   1. Providing financial incentives to families of a person who donates their organs
   2. Allowing for animal to human organ donations (xenotransplants)
   3. Providing organ transplants for alcoholics and drug addicts (liver transplants), and smokers (lung transplants)

Listed below are a four cases dealing with organ donation. Read each case carefully then answer the question(s) at the end of each case.

1. Anissa is 17 years old when it is discovered she has leukemia. Her primary hope for survival rests on a bone marrow transplant, but there are no likely donors for her unusual genetic characteristics. Her parents decide to have another child in the hope that the infant will provide a tissue match (a 25% chance). Is it ethically right to conceive a child for the purpose of generating tissue for transplantation? If the infant is a tissue match, is it right for the parents to decide for the infant?(adapted from Garrett et al., 222)
   
2. Baby Fae was born with a severe heart defect which would cause her death within a few weeks. Her parents were poor and in a country without universal medical insurance. Loma Linda Hospital offered to cover the costs of transplanting a heart from a baboon. The parents signed an elaborate consent form which was never released. The doctors did not consider the possibility of a human donor, thinking the hopes of finding one were almost nonexistent. It seems that they also did not seriously consider a new form of corrective surgery for this type of heart defect with a 40 percent survival rate after several years. Baby Fae was reported in serious but stable condition for two weeks following the operation, but died a week later, apparently of complications related to rejecting the baboon heart. Did the doctors act in an ethical manner? Under what conditions, if any, would a transplant of this nature be acceptable?(cf. Ashley and O'Rourke 1986, 117; and Thomas and Waluchow, 119-24)
   
3. Sally was 15 years old and had been a practising Jehovah Witness for several years. She lived with her sister Jane, who was 18 years old and an atheist, and mother, who had been a Jehovah Witness but who renounced this following a legal separation with her husband. Sally had only seen her father, who was a devout Jehovah Witness, a few times since the separation. Sally was involved in a bad car accident and before lapsing into a coma was heard to say repeatedly, "I don't want to die. Please help me." The doctor said Sally would die without surgery which required a blood transfusion. The surgery had a 90% success rate, with a 5% chance of paraplegia and another 5% chance of death. Sally's mother insisted that the operation with a blood transfusion take place to save her life. Her father strongly objected that this would violate a sacred principle of Sally, an avowed Jehovah Witness. Jane pointed out that Sally was a minor and questioned whether her commitment to the blood transfusion principle could have been fully informed and voluntary. Her parents were her legal guardians. The doctor went before a judge to seek a resolution. If you were the judge, what would be your decision?(condensed from Thomas and Waluchow, 150-4)
   
4. Two men on the same service are awaiting a cornea transplant because of chemical burns on their eyes. One is an alcoholic street person with other serious health problems. The other is a prominent lawyer with a wife and three children. A donor's eye becomes available, and by coincidence both men's cornea match the donor's. The physician decides on the basis of "first come, first served" and transplants the cornea to the alcoholic. Is it ethical to do this when the alcoholic has more serious health problems? Is there a relevance to the patients' social positions? (adapted from Garrett et al., 221)