Organ Donations and Blood Donations: Increasing Numbers, Increasing Challenges - Research Proposal

Introduction

Over the past years and recent times, the rate of organ donations and blood donations has constantly been increasing. However, despite the growth in the numbers of donors, this itself is a challenge due to the emotions involved in donations, either voluntary or through other means. The increase in donations might be due to technological advancements and so awareness through the internet. Through technology growth, there are healthcare innovations that improve healthcare systems and also accessibility to information as wide as across the whole world. However, the increase in the number of donors might also be due to the growth of the world's population and so the United States'. It can also be due to increased diseases among the communities. This is a marketing plan that aims at analyzing a broad aspect concerned with organ, blood, and blood product donations in the general world and the United States specifically. It starts with a statistical overview of organ donation and transplantations; then describes various topics related to donations and procurement with the efforts of increasing organ and blood donation rates. However, there is still work to be done on the enormous numbers of patients on the waiting list for transplantations.

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Rules and Regulations Related to Organ Donation and Procurement

Organ donation as a field is among the most restricted and regulated sectors in health care in modern life. For this reason, a collective effort of both the federal and state has been implemented with the ultimate goal of establishing a safe and reliable system to deal with distributions, transportations, and allocation of donated organs.

A model was formed to govern the laws related to organ donation. The model is known as the Uniform Anatomical Gift Act (UAGA) based in the United States (US) (National Academies of Sciences et al., 2020). The UAGA is 'opt-in' model legislation that is drafted then passed into law state by state. This is done by Uniform Commissioners, who are experts in laws and policies ("View Data Reports - OPTN", 2020). Appointment of the Uniform Commissioners is done by governors of every state in the identification of areas that are likely to benefit from nationwide uniformity and that; they cannot be regulated through federal means since they are under reserved state authority ("View Data Reports - OPTN", 2020).

Policies and regulations governing organ donation should, however, be consistent regardless of the state a person lives in because it is a public health issue that is regulated by the state ("View Data Reports - OPTN", 2020). Thus, each state is reserved with powers to regulate public health matters, estate, and giftings or contracts ("View Data Reports - OPTN", 2020). Organ donation consists of all the components of the state regulatory. Therefore, UAGA is implemented in each state to provide a consistent approach to organ donation across the US (National Academies of Sciences et al., 2020).

Through UAGA, a gift law is established as the primary principle using an opt-in model of organ donation (National Academies of Sciences et al., 2020). The gift law enables medical providers to be trained through the central health law doctrine as per the informed consent, as they realize how unique organ donation laws are as they do not adhere to the same legal procedure ("View Data Reports - OPTN", 2020). Informed consent involves granting permissions by a patient for a specified treatment, especially when risks are involved and so benefits are stated for an alternative treatment. However, the deceased donation does not include risks and benefits to the donor since the gift only takes place after death ("View Data Reports - OPTN", 2020). Also, the persons involved give permissions for donation before their deaths regardless of when they provided the consent; this makes it unknown about the organ or tissue that will be suitable to donate when the death of the individual involved occurs ("View Data Reports - OPTN", 2020). Therefore, the gift law requires the voluntary donor to recipient organ transfer without making payments ("View Data Reports - OPTN", 2020).

The federal law provides that there should be no purchasing or selling of organs. Contrary, the contract law involves considerations in the contract made which necessitates monetary exchange and therefore, it will not be an appropriate law for organ donation; individuals have to make a promise in terms of payment or compensation for the transfer of something from another person when entering a contract ("View Data Reports - OPTN", 2020). Moreover, the professionals involved in donations and transplantations are usually paid for their services since it is not restricted by federal law. In this case, as per the UAGA, the recipient of the transplant is the anatomic gift recipient, and that payment made to the professionals are not legally regulated in organ donation (gift) ("View Data Reports - OPTN", 2020). Therefore, the transfer of organs or tissues from a donor to a recipient is a legal-bound process and so taken as a matter of policy that the system is dependent on ("View Data Reports - OPTN", 2020). The gift law gives a legal guideline that deals with the reality of organ donation for the deceased individuals as opposed to decisions that would otherwise be made by typical health care ("View Data Reports - OPTN", 2020).

Three major elements act as a requirement for the gift law, that is, donative intent, transfer, and acceptance, which can be fulfilled to enable legal gift transfer ("View Data Reports - OPTN", 2020). Donative intent can be met when an adult person issues permission in advance to death or in the case of the next-of-kin at the death of the donor. However, UAGA does not provide informed consent standards which lead to the professionals involved in donations utilizing the term authorization against consent; even though the terms are all legally binding, where anatomic gift authority is made by a professional while the patient provides informed consent under medical treatment ("View Data Reports - OPTN", 2020).

The UAGA gives provision for a two-case scenario where it allows the case when a person provides a gift in advance to their death and the case when a next-of-kin (surrogate) can give authority for a gift at the time of death of the donor ("View Data Reports - OPTN", 2020). It is of the essence, especially when making decisions on donations as it provides two legally-accepted distinct avenues ("View Data Reports - OPTN", 2020). Usually, when individuals give permission or authority for their anatomic gift prior to death, it is referred to as first-person authorization ("View Data Reports - OPTN", 2020). It is possible using a donor registry that contains anatomic gifts. Usually, an adult person can volunteer to register as a donor, thus providing a donation.

The UAGA provides for three stands that are legally recognized, that is, authorized gift, no decision, and refusal to give a gift where a person can decide on either of them before death ("View Data Reports - OPTN", 2020). Based on the three positions, authorized gift involves a registered donor, no-decision means a revoked registration, whereas refusal involves no registration at all. However, when an individual decides not to provide a gift (be a donor), the UAGA considers such as refusal. Moreover, refusal can be in the form of a signed document and should be a legal-bound one ("View Data Reports - OPTN", 2020). Therefore, a surrogate is usually approached in the case when the donor neither provided a gift or refused to make a gift.

Historical Data

In the United States (US), operates under Uniform Anatomical Gift Act (UAGA), which is an opt-in model giving guidelines and procedures to organ donations where an individual makes a gift (organ donation) before death or a surrogate authorizes donation of an organ (National Academies of Sciences et al., 2020). However, a number of European countries such as Belgium, Spain, France, and Austria, as well as South American countries, including Colombia and Argentina, use an opt-out model system (National Academies of Sciences et al., 2020). The system provides for participation and authorization of the donor in the case of no real objections.

The first-ever human organ to be successfully transplanted is the kidney, and this was carried out in the year 1954 ("History - UNOS", 2020). Moreover, other organs such as the pancreas, the heart, and the liver were carried out with success in the 1960s, whereas, the intestine and the lung were first performed in the 1980s ("History - UNOS", 2020). However, transplant procedures were minimized and reduced in the 1980s due to the realization of some organs being rejected and unsuitable for donation ("History - UNOS", 2020). Due to this, there was a need for medical advancements, which boosted and reduced rejections leading to more transplants being carried out successfully and so increased demand ("History - UNOS", 2020).

Organ donation and procurement laws in the US were first enacted in the 1960s, the period during which organ transplant was considered as a viable medical procedure. Promulgation of the UAGA was done in the year 1968 by the National Conference of Commissioners to establish uniformity within and across all the states and also simplify the organ transfer process from the deceased individuals, thus achieve Uniform State Laws. The UAGA was formulated not as a federal law but as a guideline for states to come up with their laws relating to organ donations (anatomical gifts). Thereafter, the District of Columbia and the rest of the states of the US adopted the UAGA as formed in 1968.

There is an increasing rate of organ donation. It is a challenge itself as it is defined by complexity and the emotional perspective accompanied by it, especially in decision making for family members or relatives to sacrifice their organs. According to history, organ donors have been increasing each year as from the year 1988, approximately from around 6,000 donors in 1988 to about 14,500 total donors in 2005 (OPTN, 2006). With an annual increase in the previous year, that is, 26 more donors from 1988 to 1989, raising to additional 1057 donors from 1999 to 2000 (OPTN, 2006). Moreover, there has also been an increase in the figures for recovered organs, that is, around 1100 new organs recovered each year than the preceding year. For example, in 2004, there were 2416 more recovered organs in comparison to the year 2003, making it the largest ever increase before that period (OPTN, 2006).

In terms of the waiting list, there has been growth with about 5,000 additional candidates needing transplant each year than the previous year. The gap has since been widening, that is, between the supply of organs to be transplanted and the number of recipients (patients) waiting, which necessitates the need for the organs to be donated.

The United States, in this case, listed around 16,026 people on the waiting list in 1988. Since then, the figure grew surprisingly to over 90,000 individuals needing transplant in 2006 (IOM, 1999; OPTN, 2006). Kidney transplant is the highly required and demanded organ that makes up the majority of the candidates on the waiting list with up to 72% of the total candidates as per March 2006. The list grows every year as new candidates are registered, and those who have been successfully transplanted are removed from the list. For instance, in 2005, there were 44, 619 additional individuals needing transplant added to the waiting list with 48, 922 more regis...