The Ethics of Organ Transplantation

The Ethics of Organ Transplantation

Edited by Steven J. Jensen
Copyright Date: 2011
Pages: 368
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  • Book Info
    The Ethics of Organ Transplantation
    Book Description:

    These questions and others are thoughtfully probed in this collection of essays, which features articles from theologians, philosophers, physicians, biomedical ethicists, and an attorney.

    eISBN: 978-0-8132-1933-2
    Subjects: Philosophy

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-x)
  4. Introduction
    (pp. xi-xxviii)
    Steven J. Jensen

    I had already begun to trace the outline of what might be called the slippery slope of organ transplantation when in 2006 I first heard of the accusation, substantiated by the work of David Matas and David Kilgour, that the Chinese military was forcibly removing vital organs from members of the vilified religious group Falun Gong, so that these organs might be sold for profit.² The Chinese government had been openly selling the organs of condemned criminals—already a far way down the slope—but they denied the further slide of taking organs involuntarily from political pariahs. This denial, however,...

    • 1 Primum Non Nocere—A Contrarian Ethic?
      (pp. 3-20)
      Robert E. Hurley

      Primum non nocere freely translates to “first, do no harm,” and has been attributed to Hippocrates; the principle is clearly embodied in his original oath for physicians. It is noteworthy that Hippocrates, in the fifth century b.c., saw the importance of invoking the “gods,” which were all that he knew, in his oath. Significantly, modern revisions of the oath acknowledge no superior authority. These revisions, according to Paul McHugh, professor of psychiatry at Johns Hopkins University Medical Center, tend to be more self-centered than patient-centered, and are riddled with vague precept and abstraction. Nevertheless, original Hippocratic principles remain immensely important...

    • 2 Controversies surrounding Brain Death
      (pp. 21-42)
      D. Alan Shewmon

      Before discussing some of the current philosophical and ethical controversies surrounding so-called brain death (BD), let us begin with a basic overview of the medical phenomenon and its pathogenesis. BD is best understood as the endpoint of a vicious cycle of brain swelling and decreased blood flow to the brain in response to some injury (such as trauma, hemorrhage, meningitis, hypoxia-ischemia from cardiac arrest, and so on). Like any bodily tissue, the brain swells when injured. Unlike other organs and tissues, however, the brain is encased in a hard shell, the skull. As brain volume increases, other intracranial components (namely,...

    • 3 Ontological Status of Whole-Brain-Dead Individuals
      (pp. 43-71)
      Jason T. Eberl

      A great deal of literature has been penned by scholars in philosophy, theology, neurology, law, and public policy concerning how we ought to define and clinically determine when a human being has died. A good portion of the discussion focuses on whether we should move from the currently accepted “whole-brain” standard to a “higher-brain” standard, in which it is argued that a human person ceases to exist in her body when neocortical functions have been irreversibly lost.¹ A number of scholars, however, have argued in the other direction: that the whole-brain standard allows for individuals to be declared dead who...

    • 4 Consciousness and Aesthetics in Decisions concerning Organ Donation Using Anencephalic Neonates
      (pp. 72-92)
      A. A. Howsepian

      There is no disagreement of which I am aware concerning whether it is morally permissible, with parental consent, to harvest vital organs from live, healthy neonates and to transplant these organs into appropriate organ recipients. There is, on the other hand, substantial disagreement concerning the moral permissibility of using live anencephalic neonates as donors of vital organs.¹ I plan to explore in this essay precisely why this is so.

      There is a lesson to be learned in this domain from the related issue of embryology in the context of abortion. One of the most powerful ways to motivate the claim...

    • 5 Organ Donation following Cardiac Death: Conflicts of Interest, Ante Mortem Interventions, and Determinations of Death
      (pp. 95-113)
      Christopher Kaczor

      Organ donation after cardiac death (DCD), which has also been called non-heart-beating donation (NHBD), remains an issue of ethical as well as practical interest in part due to increasing demand for viable organs. “The greatly enhanced technical ability to transplant organs has also led to an ever-increasing need for transplantable organs. The explosive growth in the demand for and the marginal increase in the supply of transplantable organs have together been characterized as an ‘evolving national health care crisis.’”¹ In the United States, approximately 100,000 people are on organ transplant waiting lists, but each year only 10,000 to 20,000 receive...

    • 6 Ethical Concerns with Rapid Organ Recovery Ambulances
      (pp. 114-132)
      L. M. Whetstine

      The development of artificial life support in the modern era has made it clear that death is no longer a singular event where all vital functions fail at once. Rather, technology has caused death to be fragmented, the result of which can be the preservation of biological functioning absent a human subject to experience it. While it is accurate to say that death is a process, we attempt to quantify it as a specific event purely for pragmatic purposes: mourning, burial practices, transfer of legal rights and responsibilities, organ and tissue procurement, and so on.¹ However, in our attempts to...

    • 7 Allow the Dying to Donate: Replace the Dead Donor Rule
      (pp. 135-154)
      Thomas I. Cochrane

      The dead donor rule states that vital organs may be taken only from dead patients, and that living patients must not be killed by organ retrieval.¹ The rule has been a fundamental principle guiding organ transplantation since it was first performed.² If we were to replace it with alternative principles, every policy, regulation, and law governing organ transplantation would have to be rewritten.

      We should do just this—replace the dead donor rule with alternative principles. We should do it because, from the perspective of a dying patient who wishes to donate his vital organs, the rule serves no purpose...

    • 8 A Catholic View on the Dead Donor Rule
      (pp. 155-169)
      Witold Kania

      Thomas Cochrane, in unison with Robert Troug and Franklin Miller, has proposed that we set aside the dead donor rule in order to have organs that are more functional and of better quality for transplant than those now available.¹ When I read their proposal, however, I feel that the authors and I speak different moral languages, because we hold different philosophical visions about the nature of the human being and about what is moral. The vision about human beings in the proposal about the dead donor rule is not explicit but implicit. In order to show the Catholic position on...

    • 9 Killing and Letting Die
      (pp. 170-192)
      Steven J. Jensen

      I do not particularly care for my title. First, because it is inaccurate. The terminology of “letting die” implies that by failing to treat someone we are thereby aiming at their death. In fact, we need not be. By failing to treat we are doing precisely that: not providing life-sustaining aid or assistance. Typically, we think it likely that the person will soon die without our assistance, but we are not always correct in this assumption, as is evidenced by the case of Karen Quinlan, who lived for ten years after her ventilator was removed. Even when we happen to...

    • 10 Organ Donation and the Beatific Vision: Thomist Moral Theology Confronts the Tide of Relativism
      (pp. 195-216)
      Romanus Cessario

      “As for the scientific utopia looming ahead, we have caught a glimpse of that, too, in the broiler houses, the factory farms, and lately the transplant operations, with still-warm bodies providing the spare parts for patching up others, and so ad infinitum.” Thus Malcolm Muggeridge (1903–1990) in a sermon originally delivered on January 14, 1968, at the University of Edinburgh service in the High Kirk of St. Giles.¹ At that point in his life, Muggeridge had embraced a generic brand of Christianity. Although he and his wife, Kitty, would come into full communion with the Catholic Church only some...

    • 11 The Meaning of Gift in Organ Transplantation
      (pp. 217-231)
      Thomas Hurley

      When we speak of organ transplantation, particularly in its most widely accepted forms, we routinely do so in terms of gift: organ donation and organ donors. In particular, this aspect of giftedness is often seen as an important criterion for ethical issues involving organ transplant. It is therefore important to reflect on the meaning of, and the basis for, thinking about organ transplantation in terms of gift, and some of the implications of thinking in this way. Such reflections will necessarily involve some understanding of the broader relevance of giftedness to what it means to be human.

      What does it...

    • 12 Ethics of Contact with China on Transplants
      (pp. 232-248)
      David Matas

      Falun Gong is a set of exercises with a spiritual foundation. The practice of Falun Gong began in 1992, inspired by the writings and teachings of Li Hongzhi. It was initially encouraged by the government of China as beneficial to health, but was banned in 1999. Those who did the exercises after 1999 were arrested and asked to denounce the practice. Those who did so were released. Those who did not were tortured. Those who still refused to recant after torture disappeared.

      What happened to those who disappeared? Research that David Kilgour and I did indicates that many were killed...

    • 13 Gestational Surrogacy and Live Organ Donation: A Contrast
      (pp. 251-271)
      Thomas L. Cook

      In this chapter I intend to draw several lines of contrast between two startling technologies. The first is no less startling for being fifty years old: the donation of organs from one live person to another. The second is gestational surrogacy, or the use of one woman’s womb to carry another woman’s child. I hope to show the intellectual consistency of the Catholic Church in its acceptance of the former and rejection of the latter. I also hope the contrast will provide some useful thinking on the implications of organ sharing, and bodily sharing in general.

      For the sake of...

    • 14 Organ Transplants: A Study on Bioethics and the Ordinary Magisterium
      (pp. 272-304)
      Janet E. Smith

      Currently, bioethicists otherwise known for their fidelity to the Magisterium find themselves disagreeing with each other and even occasionally with some magisterial pronouncements about such issues as brain death, condoms and HIV, the withdrawal of artificial nutrition and hydration from those in a debilitating state, and embryo adoption. Disagreement about some of these issues would likely dissipate quickly with more definitive scientific information; for instance, were reliable studies to show that emergency contraception does not prevent implantation, opponents of emergency contraception for post-rape treatment would likely abandon their opposition.

      Other issues cannot be decided on the basis of scientific fact....

  10. Bibliography
    (pp. 305-330)
  11. Contributors
    (pp. 331-334)
  12. Index
    (pp. 335-339)
  13. Back Matter
    (pp. 340-340)