The Consequences Of An Opt-Out System

Organ transplantation is a term that most people are familiar with. When a person develops the need for a new organ either due to an accident or disease, they receive a transplant, right? No, that 's not always right. When a person needs a new organ, they usually face a long term struggle that they may never see the end of, at least while they are alive. The demand for transplant organs is a challenging problem that many people are working to solve. Countries all over the world face the organ shortage epidemic, and they all have different laws regarding what can be done to solve it. However, no country has been able to create a successful plan without causing moral and ethical dilemmas.

One of the areas that is currently affecting the United States is the ethical issue of organ transplant allocation. Since the first single lung transplant in 1983 and then the first double lung transplant in 1986 there have been thousands of people who have lived because of the surgery. One must examine, evaluate, and apply the four ethical principles to Organ transplant allocation to look at the ethical issues involved. Once must look at the fact that not every patient who would benefit from a transplant will receive one in time

Ontario, Manitoba, Saskatchewan, and Nova Scotia follow the opt-out model whereby all members of a class are part of the class action by default and must elect to opt-out if they do not wish to be a class member . This allows for the certification of mandatory national opt-out classes. Under Ontario’s Class Proceedings Act, section 9 provides that any class member involved in a class proceeding may opt out of the proceeding in the manner and within the time specified in the certification order, and subsections 27(2) and (3) provides that a judgment on common issues of a class binds every class member who has not opted out of the class proceeding and does not bind a person who has opted out of the class

In this society, organ transplant surgery has been perfected to where no risk is present. However, organs still have a high demand with low supply. In addition, the only people eligible to receive organs are those who came to their ailment at no fault of their own. In other words, they did not smoke, drink, or eat in manners that caused their diseased organs. The people who donate organs have to be perfectly healthy as well to eliminate unhealthy organs for donation.

The decision to determine who gets an organ is something that cannot be taken lightly. If proper protocol is not followed, issues such as biasness and judging people based on factors like socioeconomic status may be used to determine this dilemma. For this reason, organ transplantation is overseen by government regulators. The Division of Transplantation (DoT), which falls under the US Department of Health and Human Services, oversees this process. Organs are allocated according to strict rules that take into account physical matching, tissue and blood type matching, medical criteria, waiting time, severity of illness. The allocation system is blind to name, race, sex and wealth. The allocation rules have been developed over many years of deliberation by physicians and other transplant professionals, transplant candidates and recipients, donor families, and representatives of the federal government. (CITE ThIs) Removing these variables and following protocol causes the medical professional to make a decision on fairness rather than feelings, biasness, and possibly corruption such as bribery.

Deciding who receives an organ can be a tough decision, it can also be a controversial one. Being a living donor can be a great way to show autonomy; however, in some cases, a living donor can feel coerced into giving organs. According to Susan Lim, it is difficult to tell the difference between a voluntary autonomous donation and a coerced donation (Video). It is common for coerced living donations to come from a submissive spouse, inlaw, servant, slave, or an employee (Video). Furthermore, it is extremely common for a family member to give an organ due to the pressure from family dynamics (pg. 640). Some living donations can truly be voluntary and an autonomy decision, but more than likely living donations have some influence from pressure.

In most countries that use this system, families or a close friend would still be informed and their opinion would be taken into account, Spain being a good example of a country that uses the so called soft opt-out system, there system lets the family play a big part in decision making at the time of death and their views are taken into account, this seems to work well for them as they have the highest number of donors with 33 deceased organ donors per million population. Eurobarometer European and Organ donation (2007),

Innovative advances in the practice of medicine have increased the life span of the average American. This along with the growing population in the United States and has created a shortfall in the number of organs available for transplant today. The current system of allocation used to obtain organs for transplant faces difficulty because of two primary reasons according to Moon (2002). The two perceptions that stop potential organs donors are that the allocation criteria is unfair and favors certain members of society and/or that organs may be allocated to someone who has destroyed their organs by misuse (Moon, 2002). Many individuals decline to donate organs because anyone requiring an organ transplant is placed on a waiting list and it is possible that individuals who have destroyed their organs by their own actions or convicted criminals could receive donated organs before someone whose organs are failing through no fault of their own and positively contribute to society. When a celebrity or wealthy individual requires a transplant they are often viewed as "jumping" the waitlist but

The Taskforce consider opting out information to be more sensitive in nature than information provided by opting in Organ Donation Register ( Organ Donation Taskforce , 20). The current is based on an open access website with an electronic register that is available to all hospital staff. In an opt-out system, not registering in this register may mean that someone’s organs may be taken when they have had a serious objection to this. Theoretically, it is possible for someone to re-enter someone’s name on the register without them knowing, although there is no evidence to suggest that this will happen on a wide scale. This is why some may argue that an opt-out system would require far greater security due to the sensitive nature of the information. This information could be accommodated on the Personal Demographics Service ( Organ Donation Taskforce , 2008) but entering all this data would be a drain on the NHS resources especially at the start of an opt-out system which would involve entering the data of several million people. People may also choose to be increasingly specific about which organs or tissues they choose to donate as medicine advances so the framework required for would be rather complex. This would also take a large toll on the funds provided to the NHS with the costs of for the setup of IT and communications approximating to £45 million. An additional £5 million per year is needed to refresh public messages and an estimated £10

The general allocation policies of organ transplants starts with the waiting list process. The donor recipient must do a series of tests required for the transplant of an organ, the results will be entered into the UNOS computer system. The UNOS computer system will match the deceased donors to the recipients by comparing the HLA (human leukocyte antigen) and the computer will show a “match list” that will be based on the number of antigens matching and the antibody levels of the recipient. The length of time the recipient has been on the waiting list is also taken into

Every day, 20 people die because they are unable to receive a vital organ transplant that they need to survive. Some of these people are on organ donation lists and some of them are not. The poor and minorities are disproportionately represented among those who do not receive the organs they need. In the United States alone, nearly 116,000 people are on waiting lists for vital organ transplants. Another name is added to this list every 10 minutes. This paper will argue that organ donation should not be optional. Every person who dies, or enters an irreversible vegetative state with little or no brain function, should have his or her organs-more specifically, those among the organs that are suitable for donation-harvested. A single healthy donor who has died can save up to eight lives (American Transplant Foundation).

In February 2003, 17-year-old Jesica Santillan received a heart-lung transplant at Duke University Hospital that went badly awry because, by mistake, doctors used donor organs from a patient with a different blood type. The botched operation and subsequent unsuccessful retransplant opened a discussion in the media, in internet chat rooms, and in ethicists' circles regarding how we, in the United States, allocate the scarce commodity of organs for transplant. How do we go about allocating a future for people who will die without a transplant? How do we go about denying it? When so many are waiting for their shot at a life worth living, is it fair to grant multiple organs or multiple

Organ donation can be a lifesaving transaction that can save people from all walks of life. The justice-based ethics theory ensures that these transactions are without bias. That a person who receives an organ will not be discriminated against based on their life. This theory is supposed to give everyone an equal chance at receiving the medical help they may require. This is very important when trying to distribute vital, lifesaving organs. Unfortunately, this theory does not always get put into practice.

The most controversial issue with receiving organ donations is that the donor cannot legally choose who the recipient will be in most cases. Of course in a situation where one’s parent is dying, one is allowed to give up an organ if it is a good match, but if one decides to donate a kidney to his or her best

When medical professionals create organ allocation policies, their main decision comes down to a simple question: should their policies place a higher emphasis on equity or efficiency? Policies emphasizing efficiency primarily aim to avoid wasting organs. Although the definition of “waste” varies, efficiency advocates discourage allocation to those estimated to die soon, such as the elderly, or those who have caused their own disease. Pro-equity advocates tend to consider such judgments of value biased and unfair. Policies emphasizing equity are concerned with fairness in the allocation process: assuring the criteria remain unbiased towards any one group (e.g. race, sex, age, sexual orientation, etc.). Opening up the use of “worth” as a criterion leaves room for human bias. Fortunately, the United Network for Organ Sharing continuously reviews and modifies organ allocation policies within the United States.