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Organ donation is the process when a person allows an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive or dead with the assent of the next of kin.
A do-not-resuscitate order (DNR), also known as Do Not Attempt Resuscitation (DNAR), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR), no code or allow natural death, is a medical order, written or oral depending on country, indicating that a person should not receive cardiopulmonary resuscitation (CPR) if that person's heart stops beating. Sometimes these decisions and the relevant documents also encompass decisions around other critical or life-prolonging medical interventions. The legal status and processes surrounding DNR orders vary from country to country. Most commonly, the order is placed by a physician based on a combination of medical judgement and patient involvement.
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.
Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some autonomic functions remain. It is also distinct from comas as long as some brain and bodily activity and function remain, and it is also not the same as the condition locked-in syndrome. A differential diagnosis can medically distinguish these differing conditions.
The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the Uniform Acts drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), also known as the Uniform Law Commission (ULC), in the United States with the intention of harmonizing state laws between the states.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. It is important to note that these four values are not ranked in order of importance or relevance and that they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).
Body donation, anatomical donation, or body bequest is the donation of a whole body after death for research and education. Donated bodies are mostly used for medical education and research. They are used for gross anatomy, surgical anatomy and for furthering medical education. For years, only medical schools accepted bodies for donation, but now private programs also accept donors. Depending on the program's need for body donation, some programs accept donors with different specifications.
The Australian Organ Donor Register (AODR) is a government register, recording individuals who have agreed to donate organs and tissues in the event of their death. The register is operated by the Organ and Tissue Authority (OTA) and Services Australia through Medicare.
Libertarian paternalism is the idea that it is both possible and legitimate for private and public institutions to affect behavior while also respecting freedom of choice, as well as the implementation of that idea. The term was coined by behavioral economist Richard Thaler and legal scholar Cass Sunstein in a 2003 article in the American Economic Review. The authors further elaborated upon their ideas in a more in-depth article published in the University of Chicago Law Review that same year. They propose that libertarian paternalism is paternalism in the sense that "it tries to influence choices in a way that will make choosers better off, as judged by themselves" ; note and consider, the concept paternalism specifically requires a restriction of choice. It is libertarian in the sense that it aims to ensure that "people should be free to opt out of specified arrangements if they choose to do so". The possibility to opt out is said to "preserve freedom of choice". Thaler and Sunstein published Nudge, a book-length defense of this political doctrine, in 2008.
Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.
Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.
The Center for Ethical Solutions (CES), founded by Sigrid Fry-Revere, is a 501(c)(3) non-profit bioethics think tank based in Lovettsville, Virginia whose mission is to find practical solutions to controversial problems in the field of medical ethics. CES supports research and public education, seeking to achieve its goals through research and developing products including books and documentary films to educate the public. Lobbying and participation in political campaigns are specifically excluded from its activities.
Many different major religious groups and denominations have varying views on organ donation of a deceased and live bodies, depending on their ideologies. Differing opinions can arise depending on if the death is categorized as brain death or cease of the heartbeat. It is important for doctors and health care providers to be knowledgeable about differentiating theological and cultural views on death and organ donations as nations are becoming more multicultural.
The Human Tissue Act 2004 is an act of the UK parliament applying to England, Northern Ireland and Wales. It consolidates previous legislation and created the Human Tissue Authority to "regulate the removal, storage, use and disposal of human bodies, organs and tissue."
The Human Transplantation (Wales) Act 2013 is an act of the National Assembly for Wales, passed in July 2013. It permits an opt-out system of organ donation, known as presumed consent, or deemed concent. The act allows hospitals to presume that people aged 18 or over, who have been resident in Wales for over 12 months, want to donate their organs at their death, unless they have objected specifically. The act varies the Law of England and Wales in Wales, which relied on an opt-in system; whereby only those who have signed the NHS organ donation register, or whose families agreed, were considered to have consented to be organ donors.
The HIV Organ Policy Equity Act is a law that modifies rules regarding organ donation between HIV-positive individuals. The law authorizes clinical research and the revision of rules about organ donation and transportation as a result of the research. Organs from HIV donors would only be going to individuals who are already HIV positive, but could lead to 600 additional organ transplants a year. The use of HIV-positive organs was previously a federal crime. This bill passed the United States Senate during the 113th United States Congress, and also passed the United States House of Representatives. It was signed into law as PL 113-51 by President Barack Obama on November 21, 2013.
The current law in Ireland requires the potential donor to opt in to becoming an organ donor. However, it is ultimately up to their family to make the decision whether or not the person is allowed to donate their organs after they die.
The Organ Donation Act 2019 is an Act of the Parliament of the United Kingdom. The Act changed the law regarding organ donation so that unless someone expressly opted out, they would be deemed as having given consent. It was a private member's bill introduced by Geoffrey Robinson and Lord Hunt of Kings Heath.
Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.
References
- ↑ Remedying donor organ complications
- ↑ Herz, Susan. Two Steps to Three Choices: A New Approach to Mandated Choice, Cambridge Quarterly of Healthcare Ethics (1999), 8 : 340-347 Cambridge University Press
- 1 2 Appel, Jacob M. The Ultimate Prescription: Make Us Decide How We Want To Die, July 30, 2009.
- ↑ Organ donated 'nudge' for drivers in new DVLA process, BBC, July 31, 2011 accessed July 31, 2011.
- ↑ Taking organs without asking, Chicago Tribune, July 18, 2005.
- ↑ Chouhan P and H Draper. Modified Mandated Choice for Organ Procurement J Med Ethics. 2003;29(3):157-162, at p. 158.
- ↑ Spital, Aaron. Mandated Choice: The Preferred Solution to the Organ Shortage? Arch Intern Med. 1992;152(12):2421-2424.
- ↑ Kolata, Gina. Families Are Barriers to Many Organ Donations, Study Finds. The New York Times, July 7, 1995
- ↑ Chouhan P and H Draper. Modified Mandated Choice for Organ Procurement J Med Ethics. 2003;29(3):157-162, at p. 161.