What Is Transplant Ethics?

Mary McMahon

Transplant ethics is an area of medical ethics that discusses organ transplantation and the myriad concerns that can come up in the process of organ allocation, preparation for transplant, and interactions with donors and their families. This is a topic of academic study as well as practical application. In facilities where transplants take place, personnel usually have training in transplant ethics and the hospital has a precise protocol to follow in transplant situations that includes ethical considerations.

When taking an organ from a cadaver for transplant, it's important to make sure the donor is already dead.
When taking an organ from a cadaver for transplant, it's important to make sure the donor is already dead.

The ability to transplant organs and tissue was a tremendous development in the field of medicine. Patients with failing organs could receive a new lease on life through donation, but the rise of transplantation procedures also created ethical concerns. A hospital must decide who should receive transplants and how they should be prioritized on a list of patients waiting for organs. This may involve a consideration of medical history, risk factors, and the ability to care for the donor organ.

This area of ethics also includes concerns about donors. Organ donation can involve patients who appear to be alive; in beating heart organ donation, for example, the organ transplant team takes organs from a patient with a beating heart. This may be traumatic for care providers and family members. Part of transplant ethics involves determining when a patient is actually dead with means like tests to check for brain activity, to avoid a situation where organs are taken from a living patient. Counselors who work with donors and their families must also consider how to approach families with requests for organ donation, and need to be able to educate families about the process so they can make an informed decision.

Some tangled issues can arise in transplant ethics. Members of some religious faiths may have concerns about religious bans on donation, and ethics education must include a discussion of major religious faiths and their stance on organ donation. It must also consider social issues like the fact that some patients may not be able to afford the cost of a transplant, or might not have the support system in place to recover from a transplant. Transplants are grueling and the new organs are often fragile. If a patient does not have the capacity to care for a donor organ, he is a poor candidate for transplant.

Specialists in transplant ethics sit on the transplant committees that make decisions about organ donation for hospitals and other institutions. These committees must review patient cases to determine who to allow on a waiting list for organs, and where to place people on that list. A patient might move up the list because of critical need, for example, but the ethicists have to consider whether this is fair to patients who have been waiting for a long time. There is also a risk of death while waiting for organ transplant that must be considered.

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