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Organ donation is so important as it can help make up to 8
people live and happy a full life via the donation of different organs, however
in the UK at the moment there is a big shortage of organs, in the essay I will
discuss which system would be the most moral to try and elevate the shortage of
organ donations. The current system in the UK is an opt-in system. This is
where every person who wishes to be on the organ donation list has to sign up
with full informed consent. This is usually the system considered least morally
controversial as most people agree that people who give consent for their
organs to be taken should have their organs taken. However, in practice it
doesn’t seem to getting as many organ as needed around 457 people died because
of a lack of an organ last year (https://www.theguardian.com/society/2017/sep/04/silence-transplants-deadly-organs-shortage-nhs)
. This clearly shows that the current system isn’t working and many people are
dying because of it. In this essay I will discuss why other systems like
presumed consent, buying and selling, anencephalic baby and a family dependent register
status.

Presumed consent/opt out is the next system adopted most countries.
At the moment Spain, Austria and Belgium all have this system. The number of
people dying in these places in much lower than places with opt in system. In Spain
in 2016, around 4818 (https://www.thelocal.es/20170915/how-spain-became-world-leader-at-organ-transplants)
organs were transplant this compare to the uk 3,519. (https://www.organdonation.nhs.uk/news-and-campaigns/news/highest-number-of-organ-transplants-ever-across-uk-but-many-families-still-say-no-to-donation/).
Spain also has a much higher rate per million with Spain at  34.4 in 2007 compared with 13.2 per million in
the UK.  However philosopher (INSERT NAME
HERE) says that the reason less people are dying in Spain is because there
whole organ donation system and register is much more advanced and better than
the British system. that there are many more people on the Spanish register so
regardless of whether they have a better system all together they still clearly
have a lot more organs available to donate. In Austria before presumed consent
about 10.1 million people were on the register the after presumed consent it
increased to about 27.2 million 4 years afterwards. Some people argue that it
shouldn’t even be called ‘presumed consent’ as that name by someone giving
consent is them actively saying yes to something after being fully informed,
however, presuming someone consent is completely against the whole idea of the
person giving their consent in the first place. In every other area in society,
presuming consent is considered immoral and not viable, for example, it is rape
if someone presumes someone else is presuming their consent. However it seems a
little inconsistent to allow the idea of presuming consent in organ donation. Some
people argue that this is the most moral way that British citizens should go by
as the public opinion SHOWS THAT AROUND 66%OF PEOPLE ARGREE WITH ORGAN DONATION
HOWEVER ONLY 39% HAVE ACTUALLY SIGNED (https://www.theguardian.com/society/2017/sep/04/silence-transplants-deadly-organs-shortage-nhs)
. Some people also argue that the presumed consent would be a good method to
use if we allowed it to be the ‘soft’ opt out system instead of the ‘hard’. The
soft opt out system means that when you die, your family are still allowed to
say no or yes to you donating your organs. Hard system means that regardless of
what your family say, what you signed up for is final, so if you didn’t take
your name of the list your organs are getting donated. Some people that the
soft opt out system is much more morally correct than the hard as it allows there
to be a bit of an informed consent decision made, however at the end of the day
you are not necessary giving your consent so it can be argued that the soft
system has the same moral implications as the hard system. Church of England is
also concerned about the issue of consent “How do we know it’s been done with appropriate
and informed consent? If it is opt-in, then consent is there automatically.” (Debbie
Hodge, Churches Together in England)  Catholic Church takes the view that we should
not move to a presumed consent system. Professor John Fabre of Kings College
London said that it would “degrade the ethical framework of our society… into
one of the state taking back what it thinks is it’s, while intruding on one of
the most personal and delicate moments of a family’s life”. The catholic church
is also concerned that it will lead to a slippery slope. They believe moving to
a premumed consent system allows the government to have too much power over our
body and could eventually lead to the government just taking the oragns when
needed. This is shown when David Jones a Catholic Bishop said “There is a
danger of people overreacting because they see it as becoming not human anymore.
This danger is not overstated.” (Catholic Bishops’ Conference of England and
Wales).

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The Catholic Church highlights the point that it may cause
even more stress for the family at such a sad time which isn’t good. This could
be easily rebottled by a utilitarian saying that although it puts the family
under a lot of pressure at such a sad time, it would create more happiness for
the person family receiving the organ rather than watching them die. The
Catholic Church’s written submission is co-authored with the Church in Wales
and the Wales Orthodox Mission. The submission states: “If organs may be taken
without consent, this is no longer ‘donation’. Believe it violates human right
to self-determination. This is the valid point that it takes the altruism out
of donating an organ which creates a less altruistic society.  However, it could be argued that society is
barely altruistic as it is and even then it is not altruistic enough, that’s
why people are dying because of a lack of an organ.

 

Kidneys are one of the most needed organs with about 2159
people on the register between 1/4/16 (https://nhsbtdbe.blob.core.windows.net/umbraco-assets/1343/annual_stats.pdf)
. That’s why it has been proposed to have a buying and selling market of
organs. This would be a single market run by the NHS in which it would buy the
organs and be distributed accordingly, wealth would not play a part in it so
the system would not just benefit the poor.

NHS is currently under extreme financial pressure and it is
thought that buying and selling could help alleviate that. The NHS spends about
£30,000 per year per patient, with over 2159 people on dialysis in 2013. This uses
millions of the NHS money which could be spent in other places to help people
with other illnesses. It has been shown that the surgery needed to transplant a
kidney would cost less than the surgery. The clearly shows that a buying and
selling would significantly improve the conditions of many people life. Most
organs currently transplanted come from cadavers, this means that the organs
are not often is as good a condition as living donors and will not last as long
in the body. This means that more money is wasted as the organs coming from the
cadaver won’t last as long. This therefore shows that a buying and selling
system could save money which could be better spent in other places improve
both the quality of life of the organ recipient. Some people argue against
buying and selling saying that it will exploit the poor. However, it would be
better to give the poor a way out of poverty than to carry on letting them
suffer when they have assets to sell. If we are not helping them get out of
poverty then surely we should let them use every asset that they have,
including selling there kidney. This will often be counter argued with the fact
that surgery has a risk to life involved, however the risk for short term and
long term is about the same as having your appendix out. This shows that the
risk is very small. We also let people do very dangerous jobs that could injure
them or kill them, yet these are said to be morally okay? Both of these points
have should how the risk to selling a kidney is an insignificant point.

Iran is an example of a country who use a buying and selling
system for kidneys. In Iran people get payed about 100,000 dollars for a kidney
in health insurance and money. This has not only improved the quality of life
for thousands of people and made it so there is no waiting list for kidneys but
also elevated many people from poverty. To go back to the argument that it
would just be exploiting the poor, in Iran it is a majority of kidneys come
from middle class people. This has proven that the buying and selling system is
an effective one for getting rid of the waiting list for kidneys. Sam Harris
make the argument that it is unfair to allow everyone else in the altruistic
donation process gets payed, the nurses and doctors, especially the recipient
who get payed the best with a new organ. Is it okay to say it is morally wrong for
the person who is giving by far the most should not get anything at all in
return? The Catholic Church says that allowing payment for organs will make
people less altruistic. However, we do not look at doctors any worse just
because they get payed for doing their job. In the same way, someone getting
payed for giving an organ shouldn’t be looked as any less altruistic. Also, the
Catholic Church states that it will create a less altruistic society, but
clearly the society we are living in isn’t altruistic enough with the 1000
people dying each year.

Another advantage to the buying and selling system is that
it would make the current black market for organs disappear. This is good as
the existing black market is unfair, unethical and inadequate. The black market
currently sells about 10,000 organs every year according to the United Nations
(http://www.who.int/bulletin/volumes/85/12/06-039370/en/)
. Many of the people on this were said they would get thousands for their
organs and only get a fraction of that. The middle man who took the organ then
go on to sell the organs for hundreds of thousands which they keep. By the
buying and selling system I propose, it would cut out the middle man allowing
the hundreds of people selling their organs to get a decent amount of money
that they deserve. Not only do they get ripped off and lied to, these are often
carried out under very unsafe conditions, this often results in further serious
health complications for the donor. The single market system I propose would be
run by the NHS and all operations would be under the normal standard currently
used for altruistic donations. It’s also argued against buying and selling by
saying that it goes against the doctors Hippocratic Oath, however going by that
logic, altruistic donations should be allowed either which are seen as
acceptable. This therefore means that they both are violating the Hippocratic
Oath. The pope has come out and said “the body can never be considered as a
mere object” this is because the Catholic Church believe human life is very
special as human life is a gift from and should never be commodified.

Although this seems like it is a morally acceptable way to
get organs, it would only help with kidneys which would not help with other
organ shortages.

 

Ancephalic babies are thought to be a potential source of
organs currently science is developed enough to allow adults to take these
organs however it is something that can be seen happening in the future. An anencephalic
baby is a babies born without the upper cortex of its brain, this in turn means
that it cannot think or feel anything. It however does still have a beating
heart and is still warm. Many people believe that these babies are good sources
of organs for young children. However it is argued against because a lot of
people say that it isn’t currently a reliable source of organs as most woman
will not carry out their pregnancy when they find out their child is
anencephalic. But for the ones that do, they say it is good their child being
used to bring so much happiness to another family and the baby does not lose
out on anything as it will never become intellectually developed enough to
experience pain/pleasure so there is not much point in using resources to keep
it alive. However, Dr Steve Kooley says “the capacity for thought- though it
may be the most singular characteristic of a human being cannot done define the
essence of a child” which does highlight that is does seem very demining to the
human status that if we don’t have intellect them we shouldn’t be allowed to
live, this then leads on to the slippery slope argument that if we allow organs
to be taken from a baby just because it doesn’t have the capacity for pain or
intellect, then this could eventually lead to organs being taken from people
who have mental problems and don’t function as within a critical role in
society. People have also highlighted that it might have very negative view on
medical staff and people will not trust them as much if they are taking their
baby away to take its organs. Although this does seem like a morally acceptable
to procure some organs it will not full manage to elevate the organ shortage in
the UK.

The last method  will
discuss is whether you should move higher up the list depending on whether you
are on the register or your family are on it. The more of your family the
higher up on the list to get the organs you are. This is a system they
introduced into Israel due to their extremely low rates of donation. Within
this system, people who have personally signed up are first priority, then its
people with first degree family members. Although this seems to be more organ
distribution it significantly brought up the number of people on the organ
register. In 2010 only 228 patients of the 1069 candidate listed for kidney,
lungs, and heart or liver transplants actually got one. This compared to 433
transplants from living and dead donors in 2015 almost doubling the number of
organs donated. (https://www.haaretz.com/israel-news/culture/health/.premium-1.699944).
This clearly shows that it has increased the donor rate. However many people
argue that this system would work as Israel had a major problem with people
signing up this is because many people rejected brain death as being actually
dead so didn’t want their organs being taken, this is not the same culture in
the UK and so may not have the same effect. It could also be argued against as
people with less family members have less priority over those with more, and
plus you should be responsible for your family members decisions. It also seems
to be unfair on those less educated and in a lower class as they would not know
what to do to receive a higher priority unlike the higher educated who are a
lot more likely to know how this system works. 

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