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Organ Donation Teaching Resource Pack

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Organ Donation
Teaching Resource Pack

Ethical Dilemmas

Organ transplantation is not just a part of medical history. Today it has become a moral and major ethical challenge: to whom shall we give these organs when there are so few available?

Patients are waiting longer than ever to receive organ transplants in Scotland because of a lack of donors. A decade ago a large proportion of donated organs came from car crash victims. However, this source of organs has lowered considerably for the following good reasons:

  • better road safety programmes;
  • effective drink-driving campaigns;
  • traffic calming measures eg, speed bumps;
  • compulsory use of seat belts;
  • advances in medical treatment and care.

As a result, the number of organs had been falling by about 3% every year. Though this trend has now been halted, the number of people in need of a transplant is increasing by the same level. This discrepancy in supply and demand gives rise to many ethical dilemmas about recipients.

Here are some of the issues people discuss and that the medical world faces.

Discuss in class these situations:

1. Robert has died and he carries a donor card and has signed the NHS Organ Donor Register. The transplant co-ordinator approaches Robert's wife, and she says 'no'.

What is the right thing to do?
Do you follow Robert's wishes or his wife's?

2. Michael is suffering from chronic liver disease, caused by alcohol- related problems. Without a transplant he will die. Michael is known to be a very heavy drinker.

Should Michael be given a liver transplant? Should he be given another chance? Would there be any conditions?

3. Kate is 17 years old. Her mum has a serious kidney disease and has been on dialysis for over 2 years. Kate, distressed by her mum's suffering, offers to donate her kidney to her mum. They approach the transplant co-ordinator and surgeons to discuss this possibility.

What do you think the professionals' response to this offer would/should be?

4. What if in Scotland there was an 'opt-out' system rather than 'opt-in'.

Should a person who has 'opted-out', and clearly indicated his refusal to donate organs, be entitled to receive an organ in order to save his or her life?

5. What about smokers?

Should they have as equal a chance as others to receive a life-saving organ?

6. A convicted killer imprisoned in Scotland requires a heart transplant and after several months on the list, he receives a heart transplant.

How do you feel about this? How do you think the donor would have felt?

7. America is moving closer to allowing payment for organ donation. Presently this is illegal, both in America and here in the UK.

However, in the face of such a shortage of organs, do you think financial rewards and incentives should be offered?
What concerns might be raised about financial reward for organs?

8. Luisa lives in a shanty town in Brazil. She has 7 children, and struggles every day to provide food for them. She decides to sell one of her kidneys to a wealthy family in Brazil whose 11-year-old son is seriously ill awaiting a kidney.

What are Luisa's motives in offering her kidney? Do you think this arrangement should proceed? Think of the obvious advantages and less obvious disadvantages.

9. 'NEED A KIDNEY TRANSPLANT? I CAN DONATE A KIDNEY TO YOU FOR FREE.'

This advert appeared in newspapers from Patricia. She believes that to offer her kidney to save another's life is a good thing to do.
At present it is illegal for a stranger to donate to a stranger.
Do you think Patricia should be allowed to carry out her wishes in giving one of her kidneys to a stranger?

10. Jim sends off his form to the NHS Organ Donor Register but writes on it 'I do not want my organs to go to anyone who is not Scottish'.

Will his wishes be respected?