Death In Organ Transplantation

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DEAD DONOR RULE
The first instance of heart transplantation not only startled the world, it once again posed the same ethical dilemma as kidney transplant. However, this time the uncertainty was stronger as removal of a kidney from a living donor was substantially justified by the fact that kidneys are paired organs. But removal of heart definitely ends the life of its source. So the discussion over the definition of death again came into picture: Is brain death sufficient to assert the death of an individual?
By the time of the Cuba Transplantation Conference in 1966, medical personnel had realized the significance of this question. Two years later, a major leap was taken by a report from Harvard Medical School which endeavored to redefine
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However, the limited available evidence suggests that a sizeable proportion of the public is less concerned about the timing of death in organ donation than about the process of decision making and assurances that the patient will not recover — concerns that are compatible with an ethical focus on autonomy and nonmaleficence.

Medical professionals engaged in organ transplantation in the United States and elsewhere are exceptionally cautious about promoting shifts in public policy that have ethical implications. Although many are impatient with the public’s reluctance to donate organs—a reluctance which is reflected in US consent rates from surviving family that are as low as 46% —they are also aware that the entire enterprise of transplantation is vulnerable to public opinion.
The caution is also related to the entire medical profession’s recognition that it is more susceptible than in the past to public scrutiny and censure. Sensational revelations of ethically questionable experimentation, the threat of alpractice suits, and increasing oversight by medical insurance managers, institutional review boards (IRBs), and ethics committees, have made serious inroads on a medical paternalism that once granted doctors wide latitude in medical decision

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