Online research in philosophy

Living organ donation has developed into an important therapeutic option in transplantation medicine. However, there are some medico-ethical problems that come along with the increasing reliance on this organ source. One of these concerns is based on the observation that many more women than men function as living organ donors. Whereas discrimination and differential access have been extensively discussed in the context of cadaveric transplantation and other areas of health care, the issue of gender imbalance in living organ donation has received less attention. This paper presents relevant data from the Eurotransplant and UNOS transplantation systems and discusses possible explanations for the documented gender discrepancies. The conclusion calls for are view of existing practice guidelines in order to secure effective protection of particularly vulnerable potential donors and an equitable donor-recipient-ratio in living organ donation.

Most organized religions have indicated a level of support for organ donation including the diagnosis of death by the brain criterion. Organ donation is seen as a gift of love and fits within a communitarian ethos that most religions embrace. The acceptance of the determination of death by the brain criterion, where it has been explained, is reconciled with religious views of soul and body by using a notion of integration. Because the soul may be seen as that which integrates the human body, in the absence of any other signs of human functioning, loss of integration is considered to be an indication that soul and body have separated. To some extent this view would seem to be informed by an Aristotelian notion of the soul, but it fits well enough with religious notions of the person continuing after death.There have been several developments internationally that indicate that the acceptance of so-called ‘brain death’ by organized religions has been challenged by new developments including the acceptance of a lesser standard than loss of all brain function and a rejection by the US President's Council on Bioethics of the notion of loss of integration as an explanation of death by the brain criterion.

: Presently more than 80,000 Americans await an organ transplant, while 10 to12 people die each day because of the lack of organs. The program proposed here would allow federal inmates additional "time off" for agreeing to become living donors or to provide organs or their bodies upon death. Such a program could add 100 to 170 thousand new organ donors to the pool, with another 10 to 12 thousand added annually. If the program were applied to all state inmates, up to 4 million new donors might be added, with another 10 to 13 thousand added annually. Given the extreme need for more organ donors and the need for more living donors, the current National Transplant Act of 1984 and the Uniform Anatomical Gift Act must be amended, while still retaining control of donation procedures.

Anticipating the reevaluation of the Dutch organ procurement system, in late 2003 the Rathenau Institute published a study entitled ‘Gift or Contribution?’ In this study, the author, Govert den Hartogh, carries out a thorough moral analysis of the problem of organ shortage and fair allocation of organs. He suggests there should be a change in mentality whereby organ donation is no longer viewed in terms of charity and the volunteer spirit, but rather in terms of duty and reciprocity. The procurement and allocation of donor organs should be seen as a system of mutually assured help. Fair allocation would imply to give priority to those who recognize and comply with their duty: the registered donors. The idea of viewing organ donation as an undertaking involving mutual benefit rather than as a matter of charity, however, is not new. Notwithstanding the fact that reference to charity and altruism is not required in order for the organ donation to be of moral significance, we will argue against the reciprocity-based scenario. Steering organ allocation towards those who are themselves willing to donate organs is both an ineffective and morally questionable means of attempting to counter the organ shortage.

Scientific developments of the last 20 years have made the transplantation of cadaveric solid organs a viable and expected treatment alternative for patients suffering from various forms of End Stage Organ Disease. Of the number of organs that could be utilized for this, only a small percentage of them are actually made available. North American legislation explicitly categorizes the transfer of cadaveric organs as an anatomical or tissue "gift". The concept of the gift is mediated by transculturally consistent unwritten, but powerfully felt, rules of conduct. Among the most profound elements of the concept is the obligatory gift-exchange which is central to the gift-relationship . Obviously, neither of these are permitted by the organ transplant scenario. As a result, dissonance is created within the thought process of the individual which cannot be easily resolved, paralyzing many into inaction. We maintain that the present legal framework, designed to facilitate the transfer of organs, clashes with the human phenomenon of giving , and may actually prevent organs from being made available. In a search for a solution to this gift-relationship dilemma, giving organs is contrasted with taking organs as a basis upon which to ground ethically sound public policy. Liberty-limiting principles and the concept of harm are considered within this context. Keywords: ethics, organ transplantation, procurement, gift, public policy CiteULike Connotea Del.icio.us What's this?

Feminist analysis of cultural mythology surrounding organ donation offers a critical perspective on current U.S. transplant policy. My argument is three-pronged. First, I argue that organ donation is appropriately understood as a sacrifice. Structurally, donation accords both to general and to specifically Christian archetypes of sacrifice. The characterization of donation as sacrifice resonates in the cultural psyche even though it is absent in public rhetoric. Second, I characterize widespread feminist concerns about the over-glorification of sacrifice. These concerns provide a helpful framework for considering whether the sacrifice of organ donation is over-glorified in our culture. Third, I consider several specific aspects of organ recruitment and organ allocation. Each demonstrates an over-glorification of sacrifice that leads to a dangerous "routinization" of sacrifice. None of these excesses are addressable without due attention to the symbolic import of organ donation and transplantation. I close by suggesting lessons my analysis offers to Christian churches who support donation, to the discourse of bioethics, and to the general public.

In the study of organ and tissue transplantation, the focus tends to be on donation. But where there is giving, there is also getting: receiving help. Altruism, helping behavior, and the exchange of benefits have received extensive attention from social psychological researchers. The gift exchange described by anthropologist Marcel Mauss provides a framework for reviewing this social psychological research on altruism and exchange and applying it to transplantation. An overall conclusion is that altruistic donation is not so ethically or clinically problematic, while receiving help has a complex psychosocial context that needs to be acknowledged and given more attention.

This paper examines the meaning of what Karol Wojtyła/John Paul II calls “The Law of the Gift,” namely, “Man, who is the only creature on earth which God willed for itself, can fully find himself only through a sincere gift of himself.” After explaining what it means to be “willed for itself,” I consider how “finding oneself only through a gift of self ” is justified. I then argue that in his theory of self-gift,Wojtyła/John Paul II espouses an “embodied” altruism. Two objections to Wojtyła/John Paul II’s account are also addressed: (1) the idea that finding fulfillment (moral goodness) through self-giving is incompatible with altruism and (2) that reciprocal self-giving is incompatible with altruism. I defend Wojtyła/John Paul II’s notion of self-giving against these objections in several ways, but focus on evidence for the compatibility of subjective enrichment and altruism.