Ethical Issues In Organ Donation

Organ donation and distribution to patients in need is a highly controversial issue that is one of the main concerns of the subject of bioethics. Many ethical questions arise when a possible organ is available to use from a person, whether they are alive or dead, in order to save the life of another. These include whether it is “right” to ask the family of someone who just died for use of the subject’s organs and if it is technically considered consent if the family does agree to donate an organ from a loved one during this tragic time in their lives. Another question that naturally arises is how to distribute the scarce amount of organs available to the large population that needs them. Many different moral principles come up on the issue

of organ donations from Kantian, utilitarian, and virtue ethicists.
A Kantian ethicist would argue that people in need of an organ should enter a lottery system because everyone should be treated equally and have the same chance of getting an organ as the next. This principle ensures complete fairness to all in the system and follows the universality principle. Kant would say that this is the way to distribute ethically as anyone who needs a kidney, for example, would have the same chance of getting one as anyone else regardless of wealth, race, ethnicity, social class, or even geographic location. However, Kant himself would urge against a live person donating an organ because he considers that as violating the absolute rule of never degrading your own body even if it is for a noble cause (Pence 56). Although a utilitarian ethicist would embrace an organ donation for how its numerous positive consequences outweigh its few repercussions and a virtue ethicist would embrace an organ donor for partaking in a virtuous act, Kant would stay firm in his or her decision to protect the intrinsic value of a human by arguing against donating. For Kant, a person in themselves is an ends and by donating an organ, one violates this as a member of the “Kingdom of Ends” by harming the body as a means (Pence 55). Modern day Kantians tend to oppose Kant’s strict views on live organ donors in believing that the individual should have the autonomy to make their own decision on whether or not they want to donate an organ. In making this decision, an individual is enacting their free will to help someone which is one of the key elements to a Kantian viewpoint.
A utilitarian ethicist would offer a much different viewpoint of distributing available organs based on who can gain the most net worth from it. This viewpoint relies on analyzing all the possible consequences of an organ donation. Short-term thinking by someone with a utilitarian mindset might be to support organ donation because statistics show that a very small percentage of those who donate have been harmed and the major result is saving the life of a human. However, a utilitarian ethicist must consider the much greater social and long-term outcomes that will occur from an organ donation. The opportunity cost of an organ transplant, which costs in the hundreds of thousands of dollars, could be the alternative use of that money to send the equivalent number of dollars in mosquito nets to combat Malaria in African countries. To a utilitarian, the latter is the most obvious choice, as the ability hundreds of thousands of lives has much larger implications and is not worth the one life saved from an organ transplant. Another major problem with organ donation in bioethics that this moral stance attempts to resolve is how to distribute the scarce number of organs of available to the large population that needs them. A utilitarian would be in favor of a system, like the God Committee who denied Ernie Crowfeather from getting a hemodialysis, which includes interviewing individuals to rank their social power to determine who would profit best from an organ transplant (Pence 23). This mindset would favor a married cancer researcher with two kids who has a genetic issue which caused his need for a new liver over a single, unemployed man who has a drinking problem which caused his need for a new liver. The cancer researcher has great social worth as he is performing research on a world-wide issue and has a family to support. On the other hand, the unemployed man has very little net worth to gain from a kidney since he only has to provide for himself which he is struggling to do and, as his past shows, will most likely damage the new kidney with his drinking problem. In the end, a utilitarian would support organ donation if there was no other way the resources involved could be used to do more good by helping more people in that situation and would favor a system of ranking social worth to dictate the allocation of the limited number of organs to individuals.
The altruistic moral character of an organ donor would be the focus of virtue ethicists, in contrast to the deontology of which emphasizes the rules a specific action has and consequentialism which analyzes all the positive and negative outcomes of that action. Virtue ethicists would choose to disregard the statistics of the number of organ donors that are harmed during a transplant saying that this rarely happens and instead praise the bravery of the person through the act itself, as in the case of Laura Giese (Pence 77). A virtue ethicist would also turn a blind eye on how the organs from donors should be distributed fairly to society. Instead of focusing on these sorts of issues of organ donation, a virtue ethicist would want everyone, alive or dead, to donate because this is what demonstrates a strong moral character.
Ultimately, I believe that the utilitarian mindset of ‘do the most good for the most people’ is the most persuasive of these viewpoints on the controversial issue of organ donation.

Since there are a finite amount of available organs, I believe we should distribute the supply we do have to those who would do the most good with an organ. A utilitarian would consider an alcoholic, like Ernie Crowfeather (Pence 26), who needs a new kidney because of his drinking problem and ultimately decide that a married woman with two kids should get the kidney over him. I do not side with Kant on the belief that both the alcoholic and married woman should have an equal chance as the woman has the most to gain from receiving the kidney. The reason why I believe utilitarianism is the most persuasive argument for organ donations is because it incorporates many of the ethical principles of the other two branches while still weighing all the risks in a genuine attempt to do the most good. Since it initially considers everyone for a transplant it treats everyone fairly in that each individual is thoroughly reviewed. Also, I find a flaw in the absolutism belief of Kantians because each situation is different and a utilitarian acknowledges this by examining all the possible rewards and disadvantages of each situation. By embracing organ donation, both the autonomy that Kantian’s embrace for patients in the medical field and the heroic moral character that virtue ethicists support are upheld in this thinking. While some may argue that a utilitarian ethicist would be irrational by doing something like killing a human to use his or her organs to save the lives of many other people, I disagree. A utilitarian would not just look at the short-term rewards of this seemingly immoral act but instead also consider the much larger long-term repercussions such as how society would negatively react and distrust the medical system if an organ harvesting business was revealed like that of in China, and

in the end choose to do the morally rational act as it results in the most good.
In my opinion, I think that many of these ethical issues can be avoided simply by changing the organ donor policy we hold in America. In most states, you are asked when you receive your eighteen year old license if you want to be an organ donor. I believe this system is flawed in that we are asking teenagers who are just beginning to transition into adulthood if they want to donate all their organs for transplant at the time of their death. Instead of this system of having adolescents decide this important issue at this point in their life, I believe the United States government should transition the organ donor policy to an “opt out” system. In this sense, all individuals would become organ donors at the age of eighteen, however if they decided at any point in their lives past this age they want to refrain from being an organ donor, they could change it when they get their license or have it renewed. I think Kantian, utilitarian, and virtue ethics would all approve of this new system. Kantians would favor this system still as it would allow individuals to enact their autonomy if they wanted to opt out and it is still universalized in that this system would affect everyone in society past the age of eighteen. A utilitarian ethicist would support this system as well because there would statistically be a larger population of organ donors with practically no harm done to anyone in both the short-term and long-term. Lastly, a virtue ethicist would also sponsor this system because by increasing the number of American’s who are organ donors, it would also increase the number of people who would act virtuously in the fact that they would chose to not opt out of the system and make the heroic choice of donating their organs to someone in need. In my opinion, I think this system of organ donation in America would enact massive change in the bioethical field by eradicating many of the issues brought about by the currently scarce number of organs. As a direct result of the drastic increase in the number of organs available from this new opt out system, many of the ethical questions that arise such as how to distribute the limited number of organs and should people in poverty be allowed to sell their organs would simply no longer exist.