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Solving the Organ Crisis Ethically

Julian Savulescu and William Isdale

An editorial in the Lancet earlier this month report on the first fall in UK organ transplants in a decade.

Key statistics included that “the number of people who chose or were able to donate their organs in 2014 fell, and that 224 fewer people in the UK received an organ transplant than the year before”

Amongst the factors restricting donations is family consent: “no appreciable rise has occurred in the proportion of families who gave consent to organ retrieval following the death of a relative, which continues to hover “stubbornly below 60%”.

The Lancet also points to inefficiencies in the use of those organs that are donated.

Australia’s #DonateLife week has just been completed, a week dedicated to promoting organ donation, Australia is seeking to improve its own rates, which lag behind the UK, US and other comparable nations.  The government is already undertaking  a review into the current organ and tissue donation and transplantation programme.

One quote from the Lancet is perhaps timely:

As Rafael Matesanz, Director of Spain’s world-leading Organización Nacional de Trasplantes, recently reminded us, we should “…never blame the population. If people donate less, it must be something we have done wrong””

William  Isdale and I recently proposed Three Ethical Ways to Increase Organ Donation: no longer allowing a family veto where a patient has consented; financial incentives to consent; and non financial incentives to consent (such as higher priority as a recipient for those who are on the transplant list).

On August 25, Peter Singer, Neera Bhatia William Isdale, Julian Koplin, and myself will be participating in a public event in Melbourne, Solving the Organ Crisis Ethically, where we will critically discuss the ethics of a range of options available to increase the organ supply in Australia.

There are 1500 people waiting for an organ in Australia. Some of those will die, or become too ill to be an organ recipient, before an organ becomes available. How far should we go to address the organ shortage?

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3 Comment on this post

  1. Nicholas Shackel, Cardiff University

    Hi Julian
    For a start, we should have a free market in kidneys. Here are two of my earlier posts arguing for that, the first on the basis of a principle of the fair division of goods–, the second on the basis of best consequence– We should have a futures market in other organs. We should also be freeing ourselves from our dependence on human grown organs by growing organs in pigs. Research in this last has been blocked for many years by animal rights extremists and had it not been blocked we might already have them available.

  2. Strange that two professionals failed to see a major ethical issue here, namely that transplants and organ donation are organised on a national basis, by nation-state. So is blood donation. You don’t donate organs or blood to your fellow humans: you donate them to your fellow citizens. In some countries you can’t even get a transplant, if you are not legally resident. And that’s not the only ethical problem with donor and transplant procedures and organisations. We are not talking about altruism here, but about a commercialised and heavily politicised system, that conceals its true motives and procedures from the public. Does Julian Savulescu know, for instance, that the US military can claim all donated blood, in NATO member states? I doubt it. Any discussion on the ethics of donation, which ignores these realities, is inherently flawed.

  3. I think you should go very far to address this problem with organ shortage. I don’t understand why some people don’t donate organs of the dead to the ones who need them. I mean they probably want to keep their family members who recently died in once piece or maybe they dont know for sure what they wanted to do with their organs but what better way is there than to give it to someone who needs it

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