FREE ESSAY ON ORGAN DONATION

ORGAN DONATION

Harry Wilson is one lucky man; even Harry's doctors cannot believe how lucky he is. You
see, Harry, at age 54, was dying. He had to have both of his kidneys removed, they were
failing and he had been on an organ donation list for the past two years without success.
Harry's children were tested for compatibility but without success. Harry's own brothers
and sisters were tested for compatibility but still no success. Now you may ask, how in
the world could anyone consider Harry Wilson lucky? Well Harry Wilson got married about
three years ago to Mary Smith. It was a second marriage for both and they obviously loved
each other very much. But that was only a small part of Harry's luck. The doctors decided
to test Mary for compatibility and it was a complete match. In fact, the doctors could
not believe that two people, who were related by marriage only, could have such a perfect
blood and tissue match. Consequently, the surgery was scheduled. Harry's two kidneys were
removed and replaced by one of Mary's kidneys. Now they both have one kidney apiece and
both are doing very well living together in Cadillac, Michigan. After the surgery, the
doctors told Harry that he would never have received an organ donation in time. Yes,
Harry Wilson is one very lucky guy. Organ failing deaths can decrease if more organ
donations are made.
Modern medicine has altered the definition of death and made the barrier between life and
death less clear. It used to be that one was pronounced dead when their heart stopped
beating and they had stopped breathing. Death today is defined not by heart beats and
respiration but rather by one's brain waves. Doctors measure these brain waves with
machines known as EEG machines. When an EEG shows a flat line, this means that the
patient's brain is dead. Brain death is when the brain has stopped maintaining controls
of all other bodily functions. Advances in technology have now made it possible to
maintain respiration and circulation artificially in persons who are considered dead so
that their organs can be removed and used to save someone else's life (Landau). This
technology is called artificial life support systems. Life support systems are used on
patients with brain function when the physician is actively treating the patient. They
are also used or continue to be used for organ donation when the patient has become brain
dead. Society struggles with the understanding that when someone is brain dead and being
maintained on life support systems that allow their heart's to beat and their breathing
to continue, that patient is never coming back. The conflict in the definition of death
arises when the opportunity of organ donation is presented. 
Throughout the nation, there are not enough transplantable organs to go around.
Statistics show that the majority of people in the United States are willing to donate
their organs upon death, and even more indicated their willingness to donate organs of a
loved one if they know that was their wish. More than half of the eligible donors refuse
to donate their recently decreased family member's organs because they don't know how the
decreased felt about organ donation (MacPherson). In June of 1998 there were fifty-nine
thousand nine hundred fifty-four patients across the nation waiting for an organ
transplant and last year nineteen thousand nine hundred sixteen patients actually
received transplants (Frei). Unfortunately less than one-fifth of the American people
actually sign donor cards (Fentiman). Every 18 minutes another person is added to the
waiting list. (Frei). In the four days a high school student is given to research organ
donation forty people died waiting for organs, but why? 
Many myths are associated with organ donation. Myths on organ donations are created due
to lack of knowledge. More and more evidence suggests that Americans are either unaware
of the organ shortage or are confused about the donating process (Perry). One myth is
that there are many people in the nation pledging their organs upon their death.
Unfortunately the truth of the matter is there are not enough organs donated annually to
supply the medical demand. Some five thousand Americans need new livers. Only half will
get them this year; close to ten percent will die before a match is found. Another three
thousand three hundred people are waiting for a heart. One third will get one; thirteen
percent are more likely to die before that happens. The rest continue to wait (Adato).
Another false belief is the idea that if one has a donor card then all resources to save
them will not be used. This myth suggests that donors will be taken off life-support in
order to reap their organs. In reality, the doctors giving medical treatment are unaware
whether one has a donor card or not. Medical care is unaffected by a patients willingness
to donate posthumously. It is common practice throughout the nation that no request is
made to the family to consider organ donation until after the doctor has signed a death
certificate; unlike what is shown in tv dramas. Possible donors have already been
declared legally brain dead because their brains have stopped functioning. Individuals of
sudden, traumatic deaths by gunshot, car accident, or stroke are the most probable organ
donors. Families traumatized by the news may believe they are being asked to decide about
terminating life support when they are really being asked if they want to organs to be
retrieved or the machines to be discontinued. It is also believed that celebrities get
preferential treatment. In fact, time is the number one factor, so matches are made in
the local area first. Mickey Mantle got his liver quickly because he was classified the
most critically needy patient in the Dallas area (Adato). Others believe that minority
candidates wait longer because of racial bias in the system. Only medical facts are taken
into consideration not ethnic backgrounds. It is true in many transplants that necessary
matching antigens have a higher occurance in people of similar race. Black are one of the
lowest groups to give to organ donation. All other organs can be shared between people of
different race, ethnicity or gender (Adato). The largest misconception is that religion
is a prohibiting factor in organ sharing. Only Orthodox Judaism opposes organ donation
and now viewpoints are changing within that community (Adato). Altrusim is considered by
Roman Catholics to be an act of charity or a matter of individual conscience. Judiasm
teaches that saving a human life takes precedence over maintaining the sanctity of the
human body. Baptists approve organ transplant when the transplantation offers real
medical hope for the recipient (Perry). Polls show that the majority of people of all
religions support the idea of donation. Myths created by misguided beliefs have a direct
impact on organ availability. During the course of the three-day time period given to
create the note cards including those on inaccurate myths and availability of organs,
thirty more people in the United States have died. 
Organ availability is a significant factor in organ transplants. Organs are available for
transplant only after a person has been declared brain dead. Determining brain death is
based on strictly medical and legal guidelines. First, the brain must have stopped
functioning, indicated by flat brain waves on an EEG test. In addition, artificial means
must be necessary to maintain heartbeat and breathing. Only at the point where all bodily
functions would cease if artificial life-support systems were removed, does organ
donation become an option. For these transplants to be successful, however, time is a
critical factor. Organs must be immediately transferred to the hospitals, or the odds of
successful transplantation dwindle. The window of opportunity varies for different
organs: the kidneys are viable for forty-eight to seventy-two hours, the heart and lungs
for only four to six hours after recovery (Perry). Because this window of opportunity is
so slim and the availability of organs drops with time, knowing the steps of organ
donation becomes critical.
When an individual has come to the decision that he/she wants to donate their organs
there are a few simple, but necessary steps to do so. First sign a donor card; they are
available at almost all hospitals or can be obtained from local organ procurement
agencies. The second thing to do is to discuss the decision with one's family. Time and
time again many would be donors fail to share their decision with immediate family
members. Then as a result, without knowing their intent, many family members decide
against donation in time of trauma. Statistics show that most family members will respect
a loved one's wishes and grant permission to donate organs if prior conversation on the
topic has taken place. For the donor card to mean anything six standards must be met: an
absence of coercion and undue influence must exist; clients must be capable of providing
consent; clients must consent to specific procedures; the forms of consent must be valid;
clients must have the right to refuse or withdraw consent, and client decisions must be
based on adequate information (Landue). Following pre-donor steps can greatly lighten the
families stress when a loved one dies. (Two days lapsed in organizing and rearranging
ideas for this research paper. Twenty more people lost their lives due to the shortage of
organs donated.)
There is a lot to overcome in organ donation. Death for one thing; signing documents for
another. This makes the necessary donation process both emotional and difficult. Equal
difficulty arises however, when politics gets involved in who shall be the recipient. 
In today's society political influences are universal. One of the ways that politics gets
involved in the organ donating system is how it determines who receives an organ and who
doesn't. Politicians are made geographical location an important role in organ donation.
As of right now donated organs are treated as community resources. The law states a
preference that organs be offered first to a recipient from the donors geographical
community. Although organ allocation should be made in accordance to medical, not social
criteria, it is important to recognize that the line between medical and social criteria
is often blurred. 
The difference between life and death are less clear, it used to be that one was
pronounced dead when their heart stopped beating and they had stopped breathing. Now
however, technology makes it possible to maintain respiration and circulation
artificially in persons who are considered dead so that their organs can be removed and
used to save someone else's life (Landau). This is why organ donating is so important.
Lives need to be saved. Everyday there is about ten people who die in the United States
while waiting for an organ donation (Currently). It's quite obvious that there are not
enough transplantable organs to go around (MacPherson). More than half of all eligible
donors refuse to donate their recently deceased family member's organs because they don't
know how the deceased felt about organ donation (MacPherson). This is where the problem
lies because so many more lives would be saved if people really took the time to think
about organ donation. In June of 1998 there were 59,954 patients across the nation
waiting for an organ transplant and last year 19,916 patients actually received
transplants. Every 18 minutes another person is added to the waiting list and 10 people
on the list will die each day without an organ (Frei). Statistics show that the majority
of people in the U.S. are willing to donate their organs upon death, and even more
indicated their willingness to donate organs for a loved one if they know that was their
wish. Unfortunately less than one-fifth of these people actually sign donor cards. 
Some of the reasons why people choose not to donate are because of their lack of
knowledge on the subject. The reason for this is because it is not often talked about in
society. More and more evidence suggests that Americans are either unaware of the organ
shortage or are confused about the donating process (Perry). So just like anything else
that people are unaware of, myths get created. The first myth is that plenty of people
pledge to donate organs; the truth is our willingness to donate lags far behind medical
technology (Adato). Some five thousand 
Americans need new livers. Only half will get them this year; close to ten percent will
die before a match is found. Another 3,300 are waiting for a heart. One third will get
one; thirteen percent are more likely to die before that happens. The rest continue to
wait.
The second myth is the belief that if one has a donor card, every effort to save their
life won't be made. The fact is medical care is unaffected by a patients willingness to
donate posthumously. In fact no request is made to the family to consider organ donation
until after the doctor signs a death certificate. 
The third myth is the belief that donors are taken off life-support in order to reap
their organs. In fact, potential donors are brain-dead having already been declared
legally dead because their brains have stopped functioning. These are often victims of
sudden, traumatic deaths by gunshot, car accident, or stroke. Families unprepared for the
news may be confused when they learn that organ functions are being artificially
maintained. When a request for donation is made they may believe, mistakenly, that they
are being asked to decide about terminating life support, when they are really being
asked if they want the machines to be discontinued or if they want to recover the organs
(Adato). 
The fourth myth is that celebrities get preferential treatment. In fact, time is a
factor, so matches are made locally first. Mickey Mantle got his liver quickly because he
was classified the most critically needy patient in the Dallas area (Adato). 
The fifth myth is the minority candidates wait longer owing to bias in the system. In
fact, no consideration is given to race, only to medical facts. In many transplants the
necessary matching antigens are more likely to occur between people of similar race or
ethnicity. Blacks are one of the lowest groups to give to organ donation. All other
organs can be shared between people of different race, ethnicity or gender (Adato). 
The sixth myth is that religion prohibits organ sharing. In fact, only Orthodox Judaism
opposed organ donation; and now attitudes in that community are changing. As a matter of
fact the religion misconception is probably the largest one. It's a fact that all major
organized religions support donation. Like the Roman Catholics, some consider it an act
of charity, others a matter of individual conscience. Judaism teaches that saving a human
life takes precedence over maintaining the sanctity of the human body. Baptists approve
organ transplant when the transplantation offers real medical hope for the recipient
(Perry). There really aren't too many people who make up their mind because of those
myths. The fact is that in the polls the majority of people support the idea of donation.
It's because death is just an unpleasant topic to talk about and that's why so few people
register to donate (Perry).
In organ transplants another issue is availability. Organs are available for transplant
only after a person has been declared brain dead. Determining brain death is based on
strictly medical and legal guidelines. First, the brain must have stopped functioning,
indicated by flat brain waves on an EEG test. In addition, artificial means must be
necessary to maintain heartbeat and breathing. If artificial life-support systems were
removed, all bodily functions would cease. Only at this point does organ donation become
a possibility (Perry). For transplants to be successful, however, time is a critical
factor. Organs must be immediately transferred to the hospitals, or the odds of
successful transplantation dwindle. The window of opportunity varies for different
organs: the kidneys are viable for forty-eight to seventy-two hours, the heart and lungs
for only four to six hours after recovery (Perry). 
When an individual has come to the decision that he/she wants to donate their organs
there is a few simple, but necessary steps to do so. First sign a donor card: they are
available at almost all hospitals or can be obtained from local organ procurement
agencies. The second thing to do is share the decision with your family. Unfortunately,
many would-be donors fail to discuss their decision to donate with immediate family
members. Without knowing their intent, many family members decide against donation. If
you have discussed organ donation with your family most will respect your wishes and
grant permission to donate (Perry). For the donor card to mean anything though six
standards must be met: an absence of coercion and undue influence must exist; clients
must be capable of providing consent; clients must consent to specific procedures; the
forms of consent must be valid; clients must consent to specific procedures; the forms of
consent must be valid; clients must have the right to refuse or withdraw consent, and
client decisions must be based on adequate information (Landue).
It doesn't really matter what subject is at hand, the fact that politics influences it is
universal. When it comes to politics involving organ transplants many issues crop up. One
of the ways that politics get involved in the organ donating system is how it gets
determined who receives an organ and who doesn't? Geographical location plays an
important role in organ donation. As of right now donated organs are treated as community
resources. The statute articulates a preference that organs be offered first to a
recipient from the donors geographical community. Although allocation of scarce resources
such as organs should gerneraly be made in accordance to medical, not social criteria, it
is important to recognize that the line between medical and social criteria is often
blurred. Giving preference to members of the donor's community accomplishes two goals. It
prevents organs from being funneled to the most prestigious regional centers, and it
helps to redress the racial imbalance in allocation of organs. Organ donation is an
appropriate community response to a community tragedy - the death of those whose lives
could have been saved through the donation of organs from a person no longer living. The
model statute recognizes organ donation as a powerful act of virtue. Yet by relying on
presumed consent and compensated donation and by giving a preference for local organ
recipients, the statute makes it easier for persons to undertake this act of virtue and
save more lives through organ donation (Fentiman). 
Currently, allocation of scarce organs is based on accidents of geography, not in common
medical criteria. The Department of Health and Human Services has established a new
regulation to decrease geographic fatalities. The new rule calls on the Organ Procurement
and Transplantation Network, the private sector system created by the National Organ
Transplant Act of 1984, to develop revised organ allocation policies that will reduce the
current geographic disparities in the amount of time patients wait for an organ. The rule
also calls on the OPTN to develop uniform criteria for determining a patient's medical
status and eligibility for placement on a waiting list (Currently).
Another way that politics seems to have a sway in the donation decision is on how the
people on the inside in a way advertise the use of donations. Organ donations are made
through nonprofit organizations, (that's why they're called donations) with members who
are not getting paid to get more organs. These people use exhortation to get available
organs. What tends to happen is that these people aren't really trying to get too many
organs after all. Perhaps the participants of these organizations are ignorant of the
production in which they are engaged. Or, possibly the production system relying on
exhorting donors is inherently problematic. Or, perhaps the shortage is due to the
well-known limitations of the nonprofit organizations that are the key actors in the
production system (Thorne). A fifty percent increase in the aggregate real spending on
acquiring organs between 1988 and 1990 was associated with the thirteen percent rise in
the total number of kidneys procured. This finding is consistent with the notion that
more effort yields more organs (Thorne). So the reason why there are shortages in organs
may be due not to inadequate altruism but rather to failure to exploit the donation
systems potential efficiencies (Thorne). This gives an example of how organs can't go to
needy patients because of how people work on those organizations. The only problem with
this argument is that at least these people are doing it. It is a fact that they are not
getting paid for doing such a deed. It's all volunteer work and if we didn't have them,
then organ donations would be a much smaller amount, and more people still would be dying
from organ problems. 
There are so many people who need donations but the bottom line is there just isn't
enough donations. Now that doesn't mean patients need to give up hope, all it means some
things need to be done to get more donations in circulation. One thing that definitely
needs to take place is getting more families to talk about it. The National Coalition on
Donation - whose members include the American Hospital Association and the American Heart
Association - believes that getting families to talk about organ donation before tragedy
stikes will increase donations (MacPherson). A problem that arises when one decides to
donate his/her organs is they don't let anyone else in the family know, so when an
accident occurs the family members decline the opportunity to donate because they were
not aware of their deceased family members opinion. The main element is the discussion,
which will ensure that families know their kin wanted to donated his/her organs
(MacPherson).
Getting families to discuss donations is a very important element in making more people
donate. Now the next step is actually getting the families to talk about it. Right now
people don't walk down the street and say Hi Joe, what are you doing with your organs?
What needs to happen, though is have the subject brought up more frequently so it can be
discussed and everyone will know the other family member's opinion. So when a tragedy
does arise, the wrong decision won't be made. Although the loss of the family member will
be a misfortune, it will be because of his or her decision that someone else might live.
So the goal of the National Coalition on Donation is to advertise organs. Advertising,
not in the sense of purchasing, like most advertising, but rather on the supply end of
the scale. Television ads, now being broadcasted, seek to spur families to talk about
their wishes regarding organ donation (MacPherson). These TV ads are among the most
emotional charged public service ads ever aired. The ads feature five real people who had
a choice to make: Four of them agreed to donate a loved one's organs, the fifth said no.
These commercials are not scripted and there are no actors. What the commercials mainly
focus on is how hard it is to make the choice without ever before discussing the subject
if their spouse died. However these ads probably won't have a large effect because they
are aired during unsold time, when no one is watching television (MacPherson). The thing
that needs to be done is more people need to get involved and more money raised so the
commercials are aired at a time when families are sitting in front of their television.
This would cause a much stronger impact. 
Other ways to obtaining more organs is using the federal government. Over seventy million
Americans received an unexpected, but lifesaving, message with their 1996 tax refund
checks - Become an Organ Donor. What this is trying to do is to get families to not only
discuss how to spend their money, but also how to save lives. For the first time,
Congress is wagging a massive federal campaign to educate the public about the importance
of organ and tissue donation (Perry).
Another route the federal government might go is compensated donations. Right now this is
just a hypothetical idea that would have the federal government providing one-thousand
dollars for the donation of one's corneas, five-thousand dollars for one's kidneys, and
so forth, up to a maximum of ten-thousand dollars for the donation on all of one's major
organs. Alternative benefits might include the payment of burial expenses, reimbursement
of related medical expenses, a college tuition voucher for dependents, or a
tax-deductible gift to a favorite charity. 
Thesis: If organ failing deaths are going to decrease more organ donations need to be
made.
Introduction
I Why organ donations need to be made.
A. How many donate in the nation
B. How many need donations
1. How people get on a list.
2. How long it takes to get an organ.
C. Myths of organ donation.
D. Organ consent requirements and when organs become available
II. Politics involved in donations.
A. The use of exhortation 
B. Geography and organ allocation policy
III. Methods to get more donations
Works Cited
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Donating Dilemma
Joffre Martin
11/24/98