Introduction
This topic covers the ethical questions raised by taking organs and tissues from one person and placing them in another. A good answer explains the main types of donation, the criteria for death and consent, the principles of fair allocation, why organ trade is condemned, and the duties of the transplant team toward both donor and recipient.
Definition and scope
Transplantation is the transfer of cells, tissues or organs (the graft) from a donor to a recipient to replace a function lost to disease. Moral questions arise at three points: obtaining the graft, allocating scarce grafts among patients, and the lives of donor and recipient afterwards. Because the donor is often healthy, the ethical standard for harm and consent is stricter than in ordinary treatment.
Brain death and the dead donor rule
- Brain death is the irreversible loss of all function of the cerebrum and brainstem, confirmed by defined clinical and, where needed, ancillary tests. Most organs are taken after this diagnosis because the organs must remain perfused.
- The dead donor rule: organs must not be removed before death has been determined. The donor's life is not shortened for the sake of the graft.
- Death should be certified by doctors independent of the transplant team, so that the transplant team does not judge the donor's death.
- Public trust depends on the absence of doubt about timing; any suspicion of premature removal damages donation as a whole.