The gift of life and the common good: The need for a communal approach to organ procurement

Hasting Center Report

Volumn 31, Issue 1, 2001, Pages 29-35

  Lauritzen, Paul ^a   Mcclure, Michael ^a   Smith, Martin L ^a   Trew, Andrew ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANALYTICAL APPROACH; ARTICLE; CAREGIVER; DECISION MAKING; DONOR; FAMILY; GIFT GIVING; HEALTH CARE AND PUBLIC HEALTH; HUMAN; LITERATURE; ORGANIZATION AND MANAGEMENT; PERSUASIVE COMMUNICATION; PSYCHOLOGICAL ASPECT; SOCIAL JUSTICE; TRANSPLANTATION; UNITED STATES;

ANALYTICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH;

CAREGIVERS; DECISION MAKING; FAMILY; GIFT GIVING; HUMANS; METAPHOR; PERSUASIVE COMMUNICATION; PLANNING TECHNIQUES; SOCIAL JUSTICE; TISSUE AND ORGAN PROCUREMENT; TISSUE DONORS; UNITED STATES;

EID: 0035230885     PISSN: 00930334     EISSN: None     Source Type: Journal    
DOI: 10.2307/3528731     Document Type: Article

References (26)

1. R.W. Evans and D.L. Manninen, "U.S. Public Opinion Concerning the Procurement and Distribution of Donor Organs," Transplantation Proceedings 20 (1988): 781-85.
2. L. Siminoff and K. Chillag, "The Fallacy of the 'Gift of Life,'" Hasting Center Report 29, no. 6 (1999): 34-41.
3. We do not mean to suggest that organs are merely "spare parts," as if the person is reducible to some set of cognitive capacities, and, once the capacities are gone, the body is just so much material stuff to be casually discarded. Nevertheless, even adopting a nondualistic, nonmechanistic model of the person leaves room to say that, in nonsymbolic terms, donating cadaveric organs is a relatively small thing.
4. See ref. 2, Siminoff and Chillag, "The Fallacy of the 'Gift of Life,'" p. 35.
5. S.J. Youngner et al., "'Brain Death' and Organ Retrieval: A Cross-Sectional Survey of Knowledge and Concepts among Health Professionals," JAMA 261 (1989): 2205-10.
6. D.A. Shewmon, "Chronic 'Brain Death," Meta-Analysis and Conceptual Consequences," Neurology 51 (1998): 1538-45.
7. See R.M. Veatch, "The Impending Collapse of the Whole-Brain Definition of Death," Hastings Center Report 23, no. 4 (1993): 18-24;
8. R.D. Truog, "Is It Time to Abandon Brain Death?" Hastings Center Report 27, no. 1 (1997): 29-37;
9. R.M. Taylor, "Reexamining the Definition and Criteria of Death," Seminars in Neurology 17 (1997): 265-70;
10. J.L Bernat, "A Defense of the Whole-Brain Concept of Death," Hastings Center Report 28, no. 2 (1998): 14-23.
11. New Jersey Declaration of Death Act. 1991 (West). New Jersey Statutes Annotated. Title 26, secs. 6A-1 to 6A-8;
12. and New York Codes, Rules and Regulations, Title 10, sec. 400.16 (1987).
13. Adopting this reasoning, state legislators in Ohio recently passed a bill that would, in the words of The Plain Dealer story on the bill, allow tissue banks to "seize the gift," even over the objections of a prospective donor's family. The fact that Ohio law would already allow such a seizure, and the fact that such a seizure would be contrary to the very idea of a gift, apparently did not deter the lawmakers. "Bill Puts Punch in Donor's Pledge to Give Organs," The Plain Dealer, 20 September 2000.
14. According to one poll, barely a majority (52 percent) of those who say they are likely to donate their organs indicate that they have talked to family members about their feelings on organ donation. See The Gallup Organization, Inc., "The American Public's Attitudes toward Organ Donation and Transplantation," conducted for the Partnership for Organ Donation, Feburary 1993.
15. J. Hardwig, "What about the Family?" Hastings Center Report 20, no. 2 (1990): 5-10;
16. J.L. Nelson, "Taking Families Seriously," Hastings Center Report 22, no. 4 (1992): 6-12;
17. J. Blustein, "The Family in Medical Decisionmaking," Hastings Center Report 23, no. 3 (1993): 6-13;
18. M.G. Kuczewski, "Reconceiving the Family: The Process of Consent in Medical Decisionmaking," Hastings Center Report 26, no. 2 (1996): 30-37.
19. See ref. 11, Hardwig, "What about the Family?" p. 5.
20. C.J. Dodd and M. DeWine (United States Senators), Letter to the United States Senate, 17 June 1998, http://www.family-pledge.org/senate/senate1.html.
21. See ref. 11, Kuczewski, "Reconceiving the Family," p. 34.
22. See ref. 11, Nelson, p. 7.
23. A. Mongoven, "Giving in Grief: Perspectives of Hospital Chaplains on Organ Donation," in Caring Well: Religion, Narrative and Health Care Ethics, ed. D.H. Smith (Louisville, Ky: Westminster John Knox Press, 2000), pp. 170-97.
24. Although it may seem odd to recommend that OPO staff not define success exclusively as consent to donate, we think it is consistent with the gift of life metaphor. As we see it, the value of the gift metaphor is that it encourages altruism and a sense of solidarity. If so, then we must recognize that the organ recipient is not the only person in need in the context of cadaveric organ donor decisions. Solidarity and compassion require that we take seriously the possibility that donating may harm families, if they are not prepared to do so. It is also possible that there will be disagreement about whether organ transplants themselves contribute to the common good. Someone could accept our proposal that the decision to donate be discussed communally and with attention to the common good and nevertheless conclude not to donate. For a discussion of such a case, see C. Gudorf, "The Need for Integrating Care Ethics into Hospital Care" in Medicine and the Ethics of Care, eds. D.F. Cates and P. Lauritzen (Washington, D.C.: Georgetown University Press, 2001).
25. A. Verhey, "Organ Transplants: Death, Dis-organ-ization, and the Need for Religious Ritual," in Caring Well: Religion, Narrative and Health Care Ethics, ed. D.H. Smith (Louisville, Ky: Westminster John Knox Press, 2000): 147-69, at p. 156.
26. See ref. 2, Siminoff and Chillag, "The Fallacy of the 'Gift of Life,'" p. 36.