Week 1

Organ donation is a significant health care issue in which ethical and legal concepts can be applied. Many people can benefit greatly from organ transplants in terms of extent and quality of life, but usually the demand exceeds the supply and this issue can leads to ethical dilemma with regard to who lives?, who dies? and who decides? (Pozgar, 2013). Therefore, for healthcare providers the ethical issue arise when they have to make decisions with regard to who lives and dies making for them the decision really hard even when there is guidelines to follow. On the other hand, another salient ethical and legal concerns associated with this issue can be the costs related to some organ transplants in which they are very expensive. Therefore, many questions raise regarding how best to provide more organs, how to reasonably distribute limited resources, and whether all transplants should be covered by public funds. Another questions that raised from this issue is; who gets priority? For instance, will be the priority based on the severity of a person's illness or their age? (Pozgar, 2013). In addition, will money and social status influence this decision? Therefore, a rich person would get a new organ and a poor person refused? For all these reasons, there are many issues arising from organ transplantation that have to be managed and solved considering the well being of the patients. In organ donations, the ethical and legal issues have to be addressed keeping in mind principles such as “autonomy, benevolence, non-maleficence, free and informed consent, respecting the dignity, integrity and equality of human beings, fairness, and the common good” (www.ualberta.ca/). Ethically and legally, a person should not be killed to provide organs for another, meaning that an organ retrieval can only be made when the donor had been declared dead. In addition, the process of organ transplantation should include a fully informed process where the interest of procuring organs should not interfere with optimal patients managements during dying process (http://cogprints.org/). Therefore, from the physician's point, where competent patients have the right to make informed choices regarding their bodies and their lives; they have the right to refuse medical therapy under most circumstances and to offer their organs for transplantation, irrespective of the circumstances of their death. Therefore, a competent adult can give free and informed consent to be or not to be a living donor, but an incompetent person cannot (http://cogprints.org/).

The field of organ and tissue donation and transplantation is one of the most regulated areas of health care. The different healthcare agencies have developed different laws to deal with the issues related to organ transplantation with the purpose of help healthcare administrators in the decision making, as well as, to regulate the process of transplantation and ensure the well being and protection of the patients. For instance, the National Organ Transplant Act is a federal law that addressees the severe shortage of organs available for transplant (www.organdonor.gov). Therefore, to address the nation's critical organ donation shortage and improve the organ matching and placement process, the U.S. Congress passed this law that in addition established the Organ Procurement and Transplantation Network (OPTN) to maintain a national registry for organ matching (www.organdonor.gov). On the other hand, the Health Resources and Services Administrations (HRSA) is the Federal agency with responsibility for oversight of the transplant system in the United States (www.organdonor.gov) Both state and federal legislation has been put in place to provide the safest and most equitable system for allocation, distribution, and transplantation of donated organs. On the other hand, the Uniform Determination of Death Act deals with the issue of determination of death. This Act states that an individual who has sustained either (1) irreversible cessation of circulatory or respiratory functions, or (2) irreversible cessation of all functions of the brain, including the brain stem, is dead (www.organdonor.gov).

Laws are developed to set boundaries for societal behavior, meaning that the people are enforced to follow an expected behavior. In addtion to laws, ethics is also necessary in guiding the actions of healthcare providers and organizations because the first one have explicit rules and penalties, as well as, officials who interpret the laws and apply penalties when the laws are broken, whereas, the second one, ethics, deals with values related to the human conduct (Pozgar, 2013). So, ethics is focused in the rightness and wrongness of actions and encompasses the decision making process of determining ultimate decision (what should I do, and is it the right thing to do?) (Pozgar, 2013). For all these reasons, ethics is necessary in guiding the actions of healthcare providers because it is based on universal moral principles of honesty, integrity, promise keeping, loyalty, fairness, caring and respect for others.

References:

Flaman, P. (1994). ORGAN AND TISSUE TRANSPLANTS: SOME ETHICAL ISSUES. Retrieved from: https://www.ualberta.ca/~pflaman/organtr.htm.

Pozgar, G. D. (2013). Legal and ethical issues for health professionals (3rd ed). Burlington, MA:Jones & Bartlett Learning.

Robinson, N. (2010). Organ transplants: ethical, social and religious issues in a multicultural society. Retrieved from: http://cogprints.org/8083/1/Organ%20transplants.pdf

1 US Department of Health and Human Services. (n.d.). Legislation and Policy. Retrieved from: http://www.organdonor.gov/legislation/.

Comment:

Hi Emad Aleid:

I liked your post because it is organized and explain easily the ethical issues around the HIV/AIDS. I agree with you that one of the main issues with regard to HIV/AIDS is the confidentiality. In addition, the ethical aspects which impact most directly on the relationship between patient and providers are duty to care, consent and confidentiality. Between all the principles in ethics that have to be accomplished for all patients, including the HIV patients, are respect, beneficence, and justice. Respect imply respect the decisions of autonomy and protect those persons who lack of decision making capacity and therefore are not autonomous. It also enforce an obligation to treat persons with respect by maintaining confidences and keeping promises. Beneficence enforce a positive obligation to act in the best interests of patients. Finally, justice requires that people be treated fairly.

References:

Pozgar, G. D. (2013). Legal and ethical issues for health professionals (3rd ed). Burlington, MA:Jones & Bartlett Learning.