Proposal to Reduce Organ Shortage and Curb the Organ Black Market

Introduction

Organ donation is a noble, yet a controversial topic in most of our societies, organ donation is the activity of giving up a body organ to another human being whose organ could have malfunctioned (Wiseman, 2018). Organ transplant is a lifesaving procedure that allows people with dysfunctional organs to replace them with donor organs. However, many issues and myths affect the safety and quality of organ donation. There is inadequacy in the regulation and policy on organ donation, which makes most organ donations illegal raising the cost of acquiring an organ due to the increased cost of organ brokerage (Wiseman, 2018). This paper will establish a policy proposal to regulate organ donation and sales which will be instrumental in curbing the irregularities and the black market which has led to unethical and criminal acts in regard to the harvesting, donations, and selling of human organs.

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Identification of the Problem: Organ Black Market and Shortage

Organs Shortage Problem and Increase in Number of Patients in Need of Organs

Modern-day organ transplantation is a complex and sensitive process that involves many parties, not just the donor and recipient. Continued advances in immunology, hematology, xenotransplantation, stem cell discovery, and tissue engineering offer alternatives and somewhat effective procedures to outright transplantation (Wiseman, 2018). There remains a huge difference between the number of organ recipients waiting to receive the donated organs and the donated organs. This has resulted in extremely high demand for organs as compared to the low supply of donated organs. Even with the organs, one last issue of how to distribute the organs will still arise. There is an ethical concern in the criteria that can be used to distribute the available organs and also the source of new organs (Henderson, 2018). All these issues have caused a lot of controversy in the organ donation field, and there is a need to address them in a bid to come up with the most favorable courses of action.

Organ Donation Under the Law

Organ donation should be made legal to increase the safety of organ donation and halt the exploitation of poor donors in the black market. Organ donation is priceless and cannot be quoted at a particular price; organ donation should be as a result of mutual understanding between the donor and the recipient (Wiseman, 2018). Currently, the federal law prohibits the sale of organs which has led to the growth of a black market. The primary legal framework that regulates the donation of organs is the Uniform Anatomical Gift Act (UAGA), which was drafted by the Uniform Commissioners and passed state by state into law (McIntosh, 1990). The law has been enacted in every state in the bid of creating a uniform organ donation policy. The UAGA operates under the donative intent, which is fulfilled by an adult before death or the next of kin after death (McIntosh, 1990). The lack of awareness of UAGA and religious beliefs have significantly limited the number of people willing and able to donate their organs which has led to the shortage of organ donations voluntarily within the legal framework and substantially contributes to the rise of the black market to meet the existing organ supply gap.

Justification of the Problem

Organ harvesting is like any other routine procedure that can be carried out while the donor is alive unless the donation of vital life support organs likes the heart which can only be from a willing donor who will eventually die probably from a chronic disease or execution.

Organ transplant is a personal decision or a decision from a surrogate who will only decide on the best interest of the patient (Wiseman, 2018). Organ donors who are below decision-making

age can have their guardians make their decision to donate. Organ donation is a procedure that is carried out after a health assessment to assess the ability of the donor to give up a particular organ. Organ donation is restricted to individuals who are fit to donate; disease might not affect some organs which can be given to benefit other people with organ problems (Henderson, 2018). Organ giving is a personal decision, and the decision can only be made on behalf of a donor if it could be in their best interest or had wished to donate an organ upon their death. Organ donation should be a show of humanity and kindness; it is an extension of being human in life and death through sharing and sacrifice (Wiseman, 2018). Organ donation saves a life, and it is a right and moral thing to do towards humanity. Therefore, organ donation is not limited by age, race, or ethnicity, and there is an instrumental need to regulate and control how organs are donated.

Organ donation is acknowledged as being one of the most successful medical advances achieved in the twentieth century. An organ transplant is the surgical transfer of an organ from a donor to a recipient who in most cases, is ailing or has damaged organs (Henderson, 2018). Organ donation is the act by which an individual allows an organ or their organs to be removed. The removal must be legal; legalized either by donor's consent while they are alive or after through the assent of the next of kin in case the donor is dead (McIntosh, 1990). Some of these organs are the liver, heart, kidney, small bowels, pancreas, and lungs. Rules and regulations have been set up to control the harvesting of these organs. With the dynamism in organ donation and transplant, medical ethics and laws have continually evolved to accommodate new developments in the sector. This assignment focuses on the ethical implications resulting from the advances in

organ donation; it addresses the scarcity of organs. It also points out the gaps existing in the system that lead to these shortages, mainly structure used in harvesting and consent (Wiseman, 2018). The entirety of the process of organ donation is more ethically complicated than most people perceive it to be. Before the invention of organ transplant in the twentieth century, damage or failure of vital organs resulted in severe pain and suffering that eventually lead to death (Abouna, 2001). According to Watson and Dark, (2011), the history of transplantation dates back to 1905 when the first cornea transplant was recorded.

Policy Solution: Creating a Federal Organ Donation Education Commission

The current organ donation shortage and black market sales is a significant public health problem that can be resolved by creating a public commission which will be tasked by creating awareness and educating the public on the existing policies that regulate organ donation in the United States (Wiseman, 2018). The policy initiative will be instrumental in creating awareness of the current gift policy involved in organ donation and the right channels that people with organ problems can meet their organ needs within the existing legal framework.

Commission Roles and Responsibilities

Creating Awareness of the Importance of Organ Donation: Lack of awareness on the importance of organ donation has been detrimental in the number of people under the Uniform Anatomical Gift Act framework to donate their organs upon their death (McIntosh, 1990). Most people are not motivated to donate organs because they are limited by the law and also religious beliefs. Creating an organization that educates the public on organ donation can significantly improve the supply of organs which could save many people with failing or failed organs and give them a second chance in life (Wiseman, 2018). The education of the public through the

creation of a Federal Organ Donation Education Commission will significantly reduce the number of people going to get their organ solutions in the dark market. Educating the public on the existing legal framework and the importance of organ donation will be instrumental in overcoming the existing criminal cartels involved in organ sales, which is against the federal law, which prohibits organ sales.

Increased Emphasis of Secure Organ Donation and Transplant: The Federal Organs Donation Education Commission will be instrumental in creating awareness and education to the public on the existing policy framework that regulates organ donation which is based on a gift and cannot be given a monetary value. Most of the people are deceived into donating their organs in the black market due to lack of awareness and knowledge on the dangers involved in going against the law to sell organs. The policy will improve the number of people willing to donate their organs in accordance with the law and end the menace of the black market where most people go to buy organs.

Creation of Clear Policies and Guidelines to Regulate Organ Donation: The commission will engage the public and professionals on approaches of improving organ donation to meet the contemporary needs of organs. The creation of new policies will be instrumental in creating a transparent system to support organ donation in the country. There is a significant consideration of legalizing the sales of organs which will necessitate the need for existing law amendment to allow a contractual framework where people can exchange their organs for body parts. Besides, the commission should create more transparent procedures for the patients to get organs, which will reduce the panic and confusion, which forces patients to go for the black market organs.

Conclusion

Organ donation is vital to the recipient and the meets the dying wish and will of the donor. However, there is a need to regulate and educate people on organ donation as well as create a safe environment for people to donate and receive organs. Organ donation is an individual choice, and although providing monetary benefits could increase the number of donors and increase the number of lives saved, it is still a personal decision that is beyond monetary value. The scarcity of donors consequently makes it difficult to distribute organs that have been donated for transplant to patients because they are very many, and there are only a few donated organs. Therefore, ideally, the criteria applied in the process of organ distribution should incorporate distributive justice, where patients enjoy an equal share that depends on their merits with no discrimination. The organ donation procedure should be dependent on the waiting list which follows a chronological order, but other factors such as the match levels, age, the expected quality of life, the urgency of the service, and the level of usefulness in society also matter. Some of these factors violate the ethical principle that requires all people to have equal access to organ transplantation.

References

Abouna, G. (2001). The Humanitarian Aspects of Organ Transplantation. Transplant International, 14(2), pp.117-123. Retrieved from https://www.ncbi.nlm.gov/pubmed/11270166.

Henderson, M. L. (2018). Social media in the identification of living kidney donors: platforms, tools, and strategies. Current transplantation reports, 5(1), 19-26.Retrieved from https://link.springer.com/article/10.1007/s40472-018-0179-8

McIntosh, A. (1990). Regulating the Gift of Life--The 1987 Uniform Anatomical Gift Act. Wash. L. Rev., 65, 171. Retrieved from https://heinonline.org/hol-cgi-bin/get_pdf.cgi?handle=hein.journals/washlr65&section=13

Watson, C. J. E., & Dark, J. H. (2012). Organ transplantation: historical perspective and current practice. British journal of anaesthesia, 108(suppl_1), i29-i42. Retrieved from https://academic.oup.com/bja/article-abstract/108/suppl_1/i29/237577

Wiseman, A. C. (2018). Protecting Donors and Safeguarding Altruism in the United States: The Living Dono...