Organ markets and human dignity: on selling your body and soul.

This article addresses the ethics of selling transplantable organs. I examine and refute the claim that Catholic teaching would permit and even encourage an organ market. The acceptance of organ transplantation by the Church and even its praise of organ donors should not distract us from the quite explicit Church teaching that condemns an organ market. I offer some reasons why the Church should continue to disapprove of an organ market. The recent commercial turn in medicine can blind us to the problem of an organ market. In addition, the reliance on the gift image in organ transplantation raises difficulties of its own. What is needed is a fuller appreciation of the fact that the human person is essentially embodied with all its parts, and not merely an autonomous being that possesses organs as properties to sell. I support this vision of the embodied human person by appealing to the writings of Immanuel Kant.     

技术之后是法规和观念的更新--中国器官移植的重大进展

从我国器官移植的历史和现状出发,在器官移植的技术和基础研究有了理观念的更新.这种更新应建立在对器官移植的伦理思考和讨论的基础之上.2003年我国关于器官移植的法规和观念有了新的突破,有关的管理办法和条例也在草拟之中.中国政府和医学界对器官移植始终持积极和慎重的态度,所谓"中国移植和买卖死刑犯器官"完全是别有用心的捏造.     

《人体器官移植条例》颁布后面临的问题与对策

《人体器官移植条例》规范引导着我国器官移植健康发展,然而,随着《条例》对器官移植供、受者条件的严格限制,尸体供器官数量迅速下降,亲属活体移植逐步占据主导地位,由此引发一系列问题。结合《条例》,就器官来源短缺、保障活体供者安全、亲属活体供者选择和器官移植伦理委员会作用等问题做出较详细的分析,提出解决方法和对策。     

History of organ donation by patients with cardiac death

When successful solid organ transplantation was initiated almost 40 years ago, its current success rate was not anticipated. But continuous efforts were undertaken to overcome the two major obstacles to success: injury caused by interrupting nutrient supply to the organ and rejection of the implanted organ by normal host defense mechanisms. Solutions have resulted from technologic medical advances, but also from using organs from different sources. Each potential solution has raised ethical concerns and has variably resulted in societal acclaim, censure, and apathy. Transplant surgery is now well accepted, and the list of transplant candidates has grown far quicker than the availability of organs. More than 30,000 patients were awaiting organs for transplantation at the end of March 1993. While most organs came from donors declared dead by brain criteria, the increasing shortage of donated organs has prompted a reexamination of prior restrictions of donor groups. Recently, organ procurement from donors with cardiac death has been reintroduced in the United States. This practice has been mostly abandoned by the U.S. and some, though not all, other countries. Transplantation has been more successful using organs procured from heart-beating, "brain dead" cadavers than organs from non-heart-beating cadavers. However, recent advances have led to success rates with organs from non-heart-beating donors that may portend large increases in organ donation and procurement from this source.     

Why We Should Not Pay for Human Organs

The right to buy and sell human organs is challenged by the authors within the framework of a broad Christian perspective. Opposition to organ sales is argued in the light of the developing underclass of poor organ donors throughout the world who sell their organs to the rich. Very often neither the donors nor the recipients are fully informed about the medical risks involved in the procedure of organ transplantation.     

我国大陆、台湾地区《人体器官移植条例》的比较研究

采用条文比较与法理分析方法,对我国大陆和台湾地区的《人体器官移植条例》进行比较,主要就立法目的、立法调整范围、人体器官自愿捐献、禁止人体器官商业交易、医疗机构与人员的准入和退出、违反人体器官移植之规定的法律责任等问题作了探讨与分析。本研究将为我国大陆地区的具体立法探索一些有价值的意见与建议。     

开展活体器官移植的伦理学思考

活体器官移植起源于器官移植技术的最初阶段,目前已经成功开展了肾脏,肝脏,肺脏、小肠、脾脏等器官的活体移植手术,事实表明该技术不仅有其科学依据,而且有其伦理学依据,即以人类自身伟大的奉献精神来关爱他人。但开展这一技术时务必需要遵循知情自愿原则,生命价值原则,利益和风险并存原则。当然在积极肯定这一技术的同时,也应该看到这一技术也存在一些伦理学方面尚未解决的问题。     

Non-heart-beating organ donation: personal and institutional conflicts of interest

While procurement of organs from donors who are not "brain dead" does not appear to pose insurmountable moral obstacles, the social practice may raise questions of conflict of interest. Non-heart-beating organ donation opens the door for pressure on patients or families to forgo possibly beneficial treatment to provide organs to save others. The combined effects of non-heart-beating donation and organ shortages at major transplant centers brought about by the 1991 United Network for Organ Sharing (UNOS) local-use organ allocation policy created potential conflicts, including the fact that candidates for organs become potential donors far more frequently than previously. Hospitals with a major emphasis on transplantation have economic and academic interests that may have been hurt by the relative organ shortage. Some may view non-heart-beating organ donation as a way to restore weakened programs and thus unconsciously compromise recognition of problems associated with non-heart-beating donation.     

关于器官移植非优因素的哲学思考

目前器官移植是拯救器官功能衰竭患者较有效的措施,但同种及异种器官移植术中存在的大量非优因素决定了器官移植的局限性和过渡性。本文根据系统自组织理论,从哲学的角度指出：发掘人类器官组织的自组织能力必将是恢复患者衰竭器官功能最优化和最有前途的途径     

Marketing human organs: The autonomy paradox

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a “gift of life” and a “commodity exchange.” The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources.     

Why we must leave our organs to others

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, obligatory for most people. Each of us is pressed by the growing demand for our organs should we die "rightly," and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong.     

Class and Ethnicity in the Global Market for Organs: The Case of Korean Cinema

While organ transplantation has been established in the medical imagination since the 1960s, this technology is currently undergoing a popular re-imagination in the era of global capitalism. As transplantation procedures have become routine in medical centers in non-Western and developing nations and as organ sales and transplant tourism become increasingly common, organs that function as a material resource increasingly derive from subaltern bodies. This essay explores this development as represented in Korean filmmaker Park Chan-wook's 2002 Sympathy for Mr. Vengeance, focusing on the ethnic and class characteristics of the global market in organs and possible modes of counter-logic to transplant technologies and related ethical discourses.     

Transplantation: Biomedical and Ethical Concerns Raised by the Cloning and Stem-Cell Debate

Transplantation is becoming an increasingly more common approach to treatment of diseases of organ failure, making organ donation an important means of saving lives. Most world religions find organ donation for the purpose of transplantation to be acceptable, and some even encourage members to donate their organs as a gift of love to others. Recent developments, including artificial organs, transplants from nonhuman species, use of stem cells, and cloning, are impacting the field of transplantation. These new approaches should be discussed with bioethical considerations in mind, particularly the notion of human beings as a unity of body and spirit.     

Some Must Die

The transplantation and procurement of human organs has become almost routine in American society. Yet, organ transplantation raises difficult ethical and psychosocial issues in the context of “controlled” death, including the blurring of boundaries between life and death, self and other, healing and harming, and killing and letting die. These issues are explored in the context of the actual experiences of organ donors and recipients, brain death, the introduction of non‐heartbeating donor protocols, and the increasing reliance on living donors. The author draws on a thematic analysis of the way that organ transplantation is presented in the media, films, and science fiction and on his clinical experience as a psychiatrist working with transplant patients, their families, and the nurses and physicians who care for them.     

Knowledge and attitudes of Polish university students toward organ donation and transplantation

Although the number of patients needing organ transplantation systematically increases, recent years have seen a considerable shortage of donors. The level of knowledge and attitudes toward donation are critical factors in achieving the required balance between supply and demand. This pilot study assessed the knowledge, opinions, and behaviors related to organ donation and transplantation among 625 students representing eight different fields of study from the University of Rzeszow in south-eastern Poland. Although the participants provided evidence of knowledge about human organ donation and transplantation, they were aware of the main organs of the human body for potential transplants, and generally showed positive attitudes; only 24% of the subjects indicated their willingness to register as a donor; only 3% stated that they had already registered and had a donor card. The findings suggest that good intentions do not translate into action and that Poland needs to develop a nation-wide, up-to-date, and youth-oriented health education program that builds on favorable attitudes toward organ donation and transplantation.     

Why We Must Leave Our Organs to Others

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, obligatory for most people. Each of us is pressed by the growing demand for our organs should we die “rightly,” and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong.     

Religion and Organ Donation: The Views of UK Faith Leaders

This article reports the findings from the one-to-one interviews with the main UK faith and belief leaders which were commissioned by the Organ Donation Taskforce as part of its evidence gathering. Interviews were arranged with the main faith and belief organisations within the UK. Interviews covered a range of issues related to organ donation. Although some faith groups had some reservations regarding organ donation, interviews with these leaders demonstrated that none of these faith groups have reached a consensus against organ donation. The interviewees stated that the majority opinion in their faith or belief group is to permit organ donation, with some actively supporting it. Interviewees were keen to stress that there is a broad spectrum of opinion on organ transplantation within each faith and belief group and that consequently it is difficult to speak on behalf of an entire group. One complication mentioned by interviewees is that as organ transplantation is a relatively new medical procedure, there is no explicit reference to it in many original religious texts. Consequently, positions on the receipt and donation of organs are based on interpretation. It was felt that a much greater level of engagement is needed, as organ donation is currently not a priority for many faith and belief groups.     

Procuring organs from a non-heart-beating cadaver: a case report

Organ transplantation is an accepted therapy for major organ failure, but it depends on the availability of viable organs. Most organs transplanted in the U.S. come from either "brain-dead" or living related donors. Recently organ procurement from patients pronounced dead using cardiopulmonary criteria, so-called "non-heart-beating cadaver donors" (NHBCDs), has been reconsidered. In May 1992, the University of Pittsburgh Medical Center (UPMC) enacted a new, complicated policy for procuring organs from NHBCDs after the elective removal of life support. Seventeen months later only one patient has become a NHBCD. This article describes her case and the results of interviews with the health care team and the patient's family. The case and interviews are discussed in relation to several of the ethical concerns previously raised about the policy, including potential conflicts of interest, the definition of cardiopulmonary death, and a possible net decrease in organ donation. The conclusion is reached that organ procurement from non-heart-beating cadavers is feasible and may be desirable both for the patient's family and the health care providers.