RUNNING HEAD: ETHICAL & LEGAL WAY

Transplanting the Ethical & Legal Way Toni ! C"nningha#

$U%&'(: Legal En)iron#ent *NA+,-(.C/ Instr"ctor: ar0 A! Cohen

+e1r"ary 2,3 2(,-

ETHICAL & LEGAL WAY Transplanting the Ethical & Legal Way

Ethics is the branch of philosophy that is concerne d with the study of morality

There is one state#ent that 1rings 1oth ethics an4 legalities into the organ transplant arena an4 that is3 5The organ #"st co#e 6ro# so#eone else an4 they either genero"sly share an organ they can Law concerns itself with issues of right and wrong and the administration of justice

li)e 7itho"t or they #"st 4ie in or4er 6or another to li)e8! To a44 to that state#ent 1eca"se it is 4eeper than that3 the scr"tiny that one #"st go thro"gh to 1e p"t on an organ list 7ill a#a9e #ost3 the

psychological e)al"ations that #"st 1e 4one3 the cre4it chec03 an4 chec0 an4 1alance in one:s 1an0 acco"nt #"st 1e s"66icient3 their caregi)ers #"st 1e e)al"ate4 an4 pre;selecte43 all #e4ications #"st 1e o1taina1le3 an4 a6ter all o6 that a patient #ay still 4ie3 1eca"se the 7ait can 1e )ery long! The 7ait is not <"st 1eca"se o6 the organ shortage 1"t 4"e to the 6act that #oney #a0es sense to e)eryone in the #e4ical in4"stry an4 there are rich people all aro"n4 the 7orl4 that #ay 1e a1le to pay #ore than a U!%! Citi9en3 an4 a patient 7ill ne)er 0no7 that their organ presente4 itsel6 1"t 7as gi)en to the highest 1i44er! Going 6or7ar4 in this paper 1e open;#in4e43 non;<"4ge#ental an4 4eci4e 7hat yo"r opinion is at the co#pletion3 so let:s <"#p into this 4isc"ssion! Ethically an4 1eca"se others #"st 4onate their organs the 7ait 6or a 4onation that #atches can ca"se #any to lose their li)es! When the tho"ght passes thro"gh yo"r #in43 yo" can not help 1"t thin0 7hy e)ery1o4y:s organs 7o"l4 not 1e #a4e a)aila1le i6 they 7ere still in goo4 7or0ing or4er! That is 7hat this paper 7ill co)er3 a 6e7 o6 the ethical iss"es that #ay co#e "p an4 so#e o6 the legalities that #any ha)e to 6ight to get 7hat they nee4! The i4eal that #any people 4ie e)ery year not 1eca"se the organ 7as not a)aila1le3 1"t really 1eca"se the organ 7as proc"re4 incorrectly lea4s things straight to the legal si4e o6 the proce4"re! =nce "pon a ti#e 0i4neys 7ere rea4ily a)aila1le 1eca"se the pay#ent 7as rea4ily a)aila1le 1"t that

ETHICAL & LEGAL WAY 1eca#e illegal 7hich re4"ce4 the n"#1er o6 4onations o6 this type an4 then there 7ere people 7ho 7ante4 to lea)e their organs 6or certain people3 7hich is another thing that 1eca#e illegal an4 again re4"ce4 the n"#1er o6 4onations 1eca"se so #any people 7ante4 the right to gi)e their organs to 7ho#e)er they li0e4 an4 this is not possi1le *Wat0ins3 2(,2/! In a 6e7 co"ntries s"ici4e an4 e"thanasia are still allo7e4 an4 there are #any that "se these proce4"res <"st to 4onate an organ to so#eone 7ho they 7ant to sa)e 6ro# 4ying3 1"t o)erti#e the resistance to this process ca"se4 a large re4"ction in the 4onation o6 organs! This resistance 1egan to

7or0 against an in4i)i4"al:s choice an4 #any o6 the s"ppliers o6 these organs choices ca"sing #any to lose their li)es *Wat0ins3 2(,2/! Then there are the 6a#ily #e#1ers that ha)e )oice4 their "n7illingness to allo7 a 7illing 4onator to gi)e their organs an4 #any health care pro)i4ers 4o not 7ant to 1e in the #i44le o6 that 6ight so they 4o not ta0e any o6 the organs again ca"sing li)es to 1e lost *Wat0ins3 2(,2/! $eca"se o6 the o7nership that people 6in4 in organs lea)es so #"ch roo# 6or this ethical 4e1ate! The la7 has not really e)er state4 that a 4ea4 person o7ns anything 1"t 7hen they 7ere ali)e yes all these organs 1elonge4 to the#! In China Accor4ing to statics there are only ,3((( o"t o6 ,>(3 ((( patients 7ho can get organ transplantation an4 national organ 4onation rate is as e?tre#ely lo7 s"ch as .@ o6 ,((3((( people3 that is e?tre#ely lo73 an4 this has 1een 1la#e4 on the tra4itional Con6"cianis# )ie7s o6 the 1o4y3 7hich states ho7 i#portant it is to ha)e a 7hole3 co#plete 1o4y 7hen a person reaches the other si4e *Trey3 Caplan & La)ee3 2(,./! +ro# historical an4 ethical perspecti)e3 there are so #any rit"als an4 1elie6s attache4 to the re#o)al o6 parts 6ro# the 1o4y! There is 4oc"#entation regar4ing the relationship 1et7een Ren an4 the 1o4y3 one 1elie6 that is really too 4eep to 4el)e into to4ay 1"t these 1elie6s a66ect #any that 1elie)e in the#! *Trey3 Caplan & La)ee3 2(,./! The act o6 transplanting organs goes 7ay 1ac0 an4 since that ti#e has 1eco#e )ery i#portant in to4ay:s #e4icineA an4 has 1eco#e a )ery 4etri#ental part o6

ETHICAL & LEGAL WAY i#pro)ing #any li)es as 7ell sa)ing li)es3 an4 as the 4e#an4 6or organ transplantation e?cee4s the

a)aila1ility o6 the organ so has the legalities an4 ethical iss"es *$a0ari3 Bi#eta3 A1"1a0ar3 Alhassan & N7an07o3 2(,2/! Loo0ing to another co"ntry to see i6 ethics or legalities are attache4 to this proce4"re an4 i6 so WhyC Loo0ing at the r"les an4 g"i4elines in Nigeria is3 7hen it co#es to organ transplantation3 the 1ioethical principles li0e a"tono#y3 1ene6icence an4 <"stice has to 1e loo0 at an4 7ithin the Catholic religion 7hen it co#es to the #"tilation o6 a person in or4er to 1ene6it another person it 7o"l4 1e )iolating their principles o6 Totality3 1"t there are "sli# scholars an4 researchers 7ho legally

s"pport the proce4"re an4 there are so#e 7ho see transplanting as totally illegal! *$a0ari3 Bi#eta3 A1"1a0ar3 Alhassan & N7an07o3 2(,2/! When the rights o6 a person is 1eing in6ringe43 it goes against the Nigerian Constit"tion3 it is seen as an atte#pt to 1loc0 the rights o6 a person3 an4 this is 7here it 1eco#es a real stic0ler an4 1rings on the h"ge 4e1ates3 4e1ates that sho"l4 not really e?ist 1eca"se these proce4"res nee4 to 1e )ie7e4 as personal **$a0ari3 Bi#eta3 A1"1a0ar3 Alhassan & N7an07o3 2(,2/3 an4 since transplants are seen as the 1est #e4ical treat#ent 7hen it co#es to people 4ealing 7ith En4 %tage Renal Disor4er *E%RD/3 an4 Nigeria 4oes not really ha)e any la7s against this proce4"re an in4i)i4"al has a choice to #a0e 6or either their 7ell 1eing or the 7ell 1eing o6 a lo)e one *$a0ari3 Bi#eta3 A1"1a0ar3 Alhassan & N7an07o3 2(,2/! C"rrently there are #ore than 2 #illion E%RD patients 7orl47i4e3 an4 the cost o6 he#o; 4ialysis 6or a year in Nigeria cost 1et7een ,(3((( an4 2(3((( U% 4ollars an4 the cost o6 a 0i4ney transplant 7o"l4 1e 1et7een 2(3((( an4 .(3((( U% 4ollars3 the D,(3((( 4i66erence 4eci4es 7hether a patient contin"es 7ith 4ialysis or goes 6or7ar4 7ith their transplant an4 has a 1etter E"ality o6 li6e3 ethically a pro)i4er has to tell the patient this in6or#ation or they ris0 1loc0ing the patient 6ro# getting e?actly 7hat they nee4 an4 7ant yes3 a 1etter E"ality o6 li6e! %o#e #ay as0 i6 it is illegal to 0eep this

ETHICAL & LEGAL WAY in6or#ation3 that ans7er 7o"l4 1e no3 it is not illegal not to share this in6or#ation3 1"t i6 sharing 4oes occ"r3 #a0e s"re 7hat is 1eing share4 is the tr"th *$a0ari3 Bi#eta3 A1"1a0ar3 Alhassan & N7an07o3 2(,2/!

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C"rrently there are no religions that tr"ly 6or1i4 the practice o6 organ transplantationA ho7e)er there are religio"s gro"ps that 4isco"rage ca4a)eric organ proc"re#ent3 so #"ch 4isco"rage#ent that researchers are 4oing so#e research on ani#als3 7hat they are 4oing is trying to 6in4 a 7ay to #o4i6y their organsA yes the ani#als organs they 1elie)e that i6 they are a1le to #o4i6y these organs it 7ill help re4"ce the organ 4e#an4 especially 6or those 4ealing 7ith E%RD *$a0ari3 Bi#eta3 A1"1a0ar3 Alhassan & N7an07o3 2(,2/!
Medical providers must remember when deciding if an organ transplant should be done they have to use the bioethical principles, for example they need to use autonomy, beneficence and justice. This means that the well-being of each individual has to be the primary goal, meaning, the risk-benefit ratio has to be assessed and they must be fair, and the integrity of the donor and recipient must always be respected. The providers must make sure that they have a signed consent without coercion, and make sure that they person or persons involved truly understand what they are doing (Allho663 2((>). There are times when someone may seem alive but they are brain dead and not breathing on their own and their organs are in needed, during these times the states of merica look to the !niform "efinition of "eath ct, it is a state la7 that 7as appro)e4 6or the Unite4 %tates in ,FG, 1y

the National Con6erence o6 Co##issioners on Uni6or# %tate La7s3 in cooperation 7ith the A#erican e4ical Association3 the A#erican $ar Association3 an4 the Hresi4entIs Co##ission 6or the %t"4y o6 Ethical Hro1le#s in e4icine an4 $io#e4ical an4 $eha)ioral Research! What this 4oc"#ent is "se4

6or is to pro)i4e a co#prehensi)e an4 #e4ically so"n4 1asis 6or 4eter#ining 4eath in all sit"ations! It

ETHICAL & LEGAL WAY helps a healthcare pro)i4er #a0e the right 4ecision 7hen reco##en4ing that it is ti#e 6or the 6a#ily to o0ay the re#o)al o6 the li6e;s"pport 4e)ices *!niform "efinition of "eath ct, #$%&'.
(n so many places in the world predicting ones death is not acceptable, there are also religious groups that do not accept the life-support process and fight for so many lives when this subject arises. They do not concern themselves with the fact that the organs are needed they believe that only )*od+ can determine when someone has departed this life. There are lawsuits after lawsuits being filed, protest after protest being held, ethically, it is hard to know what is right and wrong because really who do you ask, -ho do you believe, nd who do you follow,

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*!niform "efinition of "eath ct, #$%&'.

There are (slamics that believe that organ donations are ok, there are .igerians that believe it is ok, but just as many that agree/ there are just as many that do not agree. There are even 0hristians from !nited 1tates that are totally against transplanting organs and blood donations so this is one procedure that it is really hard to apply )2thics+ to. To apply the )"o .ot 3arm+ principle to this procedure occurs more often than not. (t was believed by 0atholic theologians that to mutilate one living person to benefit another violates the principle of Totality

*!niform "efinition of "eath ct, #$%&'.

4esearchers in the 5&6s who were reviewing transplants argued that this act of allowing someone to have one of the vital organs can only be justified by the principle of 7ove and 0harity. These researchers also looked at the living donations such as the blood and bone marrow and those parts that do not regenerate such as, the paired organs that we can live without like the dual kidneys, corneas and the dual lungs, these are definitely different from someone who wants to donate their heart after they are gone (Tha#1isetty3 2((F/! 1o many procedures are being researched, because of this large demand that merica has on these organs. They are now procuring organs and tissues from human fetuses or nencephalic

ETHICAL & LEGAL WAY

infants, meaning those born with a missing part of the brain, scalp or skull and these type of acts have been raising a lot of ethical and legal 8uestions, and when there has been an abortion that has developed organs, so many people think that this is a sin and they are totally against this simply because there are many who believe that if the baby dies are is killed it will be understood because everything has a reason and some justify using fetus tissue to help those with 9arkinson, they somehow find justification for one having an abortion if it can help their love ones (Tha#1isetty3 2((F/! The mentioned of transplanting comes across over and over again as an item where the demand clearly outweighs the supply and as much as this procedure is needed there still must be

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a fair and efficient way to administer these organs, not simply because someone6s bank account is overwhelming, transplants can not be given based on what someone looks like, what status they have in the neighborhood, if they are a great sports player/ no it has to be based on who needs it the most. 9roviders also have to look at the medical criteria such as blood and tissue matching and making sure that the patient does not have any life-threatening diseases. -hen being fair a medical provider can not forget to understand the patient6s will-to-live, their motivation and their ability to follow all post-operative directions, taking immunosuppressant, 20T: ( NoJl &

artin3

2((F/!
2arlier there was a brief statement regarding modifying animal organs and all the static that process is receiving but there are a few procedures that use animals successfully things like the extraction from animal6s pancreases, and also the fact that they are using catgut as absorbable sutures. There is still a lot of controversy over us using a baboon6s heart and a pig6s ( NoJl &

artin3 2((F/!

rtificial substitutes for tissues and organs have also been developed by the

researchers such as artificial limbs and joint, and they are still experimenting with the (mplantable artificial hearts.

ETHICAL & LEGAL WAY

The transplant iss"e has also 4ri)en 4octors into learning #ore a1o"t the 1rain 4ea4 patient3 so that they can start to proc"re organs as they sh"t 4o7n instea4 o6 7hen they 4ie! All hospitals 7ishing to retain eligi1ility 6or e4icare an4 e4icai4 rei#1"rse#ent ha4 to a4opt a 7ritten proce4"re so that

6a#ilies are ass"re4 o6 potential organ 4onors! Un6ort"nately3 this has not 1een s"ccess6"l 7hen the 6a#ilies are approache4! *NoJl & artin3 2((F/! %ee "n4er this syste# an in4i)i4"al is as0e4 to

4eclare their co##it#ent to 4onate 7hen they rene7 their 4ri)ing license! In or4er to #eet "p 7ith the 4e#an43 so#e 6a)or allo7ing h"#an organKtiss"es to 1e 1o"ght an4 sol4 to increase the s"pply an4 respect peopleIs 6ree4o# 1"t others arg"e4 against that! Concerning this iss"e paying 6or an organ can constit"te "n<"st #oral press"re on the 4onor an4 i6 1eco#e 7i4esprea4 altr"is# 4onation #ay 1eco#e 4i66ic"lt! H"#an organ tra66ic0ing can lea4 to the organ going to the highest 1i44er! Hence3 the organ 7o"l4 1e allocate4 in ter#s o6 a1ility to pay rather than #e4ical nee4 to 4eter#ine the 4istri1"tion o6 the organs *Uni6or# De6inition o6 Death Act3 ,FG(/!
;ecause of the controversy and ethical problems surrounding the buying and selling of human parts, -orld 3ealth <rgani=ation made a resolution in #$%$, which was supported by more than #5# members to take appropriate action against purchase and sale of human organs for transplantation, but it has been said by several ethicist that the internet has changed the game so much that most see it as a )beauty contest+, where people are evaluated based on their appearance and where they are from which should not have anything to do with who gets the organ. The internet has been called )>ery 9owerful+ when it comes to the good 1amaritan donating their organs to a stranger, there are social sites that are set-up to match donors but those in search of these organs believe that these social networking sites should block all personal information and allow the ethical principles to place the organs ( Nei4ich3 Nei4ich3 Cooper3

$ra#ste4t3 2(('/!

ETHICAL & LEGAL WAY I6 the ethical principles 7ere applie4 patients 7o"l4 not r"n into the 6inancial iss"es that s"rro"n4 the transplant proce4"re! Hrior to the Hresi4ents ne7 healthcare initiati)e 7e 4i4 not ha)e "ni)ersal healthcare an4 6inances 7as a 1ig pro1le# 6or #any in the transplant arena3 so hope6"lly no7 this 7ill change 1eca"se those that 4i4 not ha)e the #oney 7ere 1loc0e43 i6 yo" co"l4 not pay yo" 7ere not in)ite4! The 6act that yo" co"l4 not a66or4 the proce4"re co"l4 stop yo" 6ro# 1eing p"t on the 7aiting list3 th"s stopping yo" 6ro# getting the transplant an4 6orcing the patient to see0 alternate treat#ent *La"rentine & $ra#ste4t3 2(,(/! To sho7 that ethically 7e as a Nation are trying to 6i? so#e o6 the pro1le#s in the transplant arena3 the Unite4 Net7or0 +or =rgan %haring *UN=%/ has starte4 e)al"ate all the proce4"res that are 1eing 4one to non;citi9ens3 6or years people 6ro# other co"ntries ha)e 1een sli4ing into the list an4 recei)e4 an organ 6ro# the U!%! In 2((' there 7as a 1ig hoopla a1o"t the 6o"r gangsters 6ro# Bapan that 7ere gi)en li)er transplants story o6 6o"r Bapanese gangsters 7ho got li)er transplants3 it 1ro"ght "p #any ethical E"estionsA people as0e4 7hy 7e allo7 non;U!%! citi9ens to get transplants here!

%ho"l4n:t A#erican organs go to A#ericansC %ho"l4 4onors 1e a1le to 4esignate that they only 7ant their organs to go to 6ello7 citi9ensC *Aronson3 2(('/! With these E"estion the UN=% 4eci4e4 to 7rite a policy regar4ing these types o6 transplants3 1"t 4i4 it really 6i? the iss"eC 5Un4er the policy the UN=% 1oar4 state4 that any transplant in)ol)ing a person 7ho is not a citi9en o6 the U!%! can no7 1e re)ie7e4 1y the =rgan Hroc"re#ent an4 Transplantation Net7or0 *=HTN/3 an4 the Transplant centers has to pro)i4e 4ata to the =HTN! They ha)e to s"1#it all the in6or#ation regar4ing the patient s"ch as the recipient:s co"ntry o6 origin3 the reason they are co#ing to the Unite4 %tates 6or their proce4"re3 an4 6inally ho7 this proce4"re is going to 1e pai4 6or3 an4 all this in6or#ation has to #a4e p"1lic! They also ha)e 1loc0e4 pro)i4ers 6ro# entering contracts 7ith 6oreign agencies an4 6oreign go)ern#ents in regar4s to transplants ser)ices3 an4 all Transplant centers #"st a1i4e 1y =HTNKUN=% r"les in or4er to 1e pai4 1y e4icare8 *Aronson3 2(('/!

ETHICAL & LEGAL WAY

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+ollo7ing this policy there 7ere still 7ell o)er 2(( non;U!%! citi9ens that got organ transplants here! When there is a1o"t 2( U!%! Citi9ens that 4ie e)ery 4ay 1eca"se o6 o"r shortage o6 organ is it right that a 6oreigner 7ho has #oney an4 7ho is 7illing to pay 7ith cash are allo7e4 to co#e here an4 ta0e an one o6 o"r organs that #ight other7ise ha)e gone to one o6 "s! With r"les that state that none o6 the A#erican Transplant Centers can ha)e a list that consist o6 #ore than >@ 6oreigners3 1"t they still so#eho7 get o"r organs e)en illegal aliens ha)e 1een allo7e4 to recei)e organs 6ro# the U!%! *Aronson3 2(('/! E)en a6ter all the research an4 all the ne7 g"i4elines that ha)e 1een set;"p the 1iggest E"estion re#ainsA 7ho on the 7aiting lists sho"l4 get transplants 6irst: the patient 7ho nee4s it the #ost or those #ost li0ely to 1ene6it 6ro# recei)ing itC E?a#ple3 i6 a choice has to 1e #a4e 1et7een an G( year ol4 7ho has 1een 4iagnose4 as 4ying "nless he gets a heart transplant an4 a sic0 1"t healthier .( year ol4 #otherA 7ho sho"l4 get the heartC Logically spea0ing3 #ay1e the #o# 7o"l4 co#e o"t the 7inner3 si#ply 1eca"se she ha4 #ore ti#e to li)e an4 1ene6it 6ro# ha)ing the transplant!! The selection process is sai4 to 1e a 1lin4 choice3 #eaning the patient con4ition3 their age3 an4 any other 6actors are 0no7n 1"t not their na#e or social stat"s! With ,>( transplant centers in the U!%! each one 4eci4es 7ho is a44e4 to their listA there are g"i4elines 1"t there are not real "ni6or#e4 so the centers ha)e 4e)elope4 their o7n criteria 6or a44ing patients *Aronson3 2(('/! %o i6 anyone is 7on4ering ho7 yo" get on one o6 these lists3 it starts 7ith a 4octor 7ho 1elie)es the patient is sic0 eno"gh to 1e re6erre4 to a transplant center an4 once the 4octor 4eci4es to sen4 that patients na#e other 6actors 1egin to co#e into play3 one o6 the 1ioethicist 1y the na#e o6 Art Caplan calls one o6 the 6actors 5Wallet 1iopsy8! What happens in this stage is the patient #"st pro)e that they can pay not only 6or the proce4"re 1"t the 6ollo7;"p an4 the anti;re<ection 4r"g that a patient #"st ta0e 6or the rest o6 their li6e! The 4r"gs alone r"n o)er D,((( a #onth 1"t all this #"st 1e pro)en 1e6ore a re6erral is s"1#itte4! =nce #oney is pro)en the 4octor has to #a0e s"re that the patient is a

ETHICAL & LEGAL WAY goo4 can4i4ate 6or the proce4"re #eaning they are psychologically 6it3 socially 6it an4 the 6actors to pro)e a person a goo4 can4i4ate )ary signi6icantly *Aronson3 2(('/! When a 4octor 1egins the e)al"ation 7hat they are loo0ing 6or is contra4ictions in a person character3 things li0e are they #arrie43 4o they ha)e #any 6rien4s3 7ill their 6a#ily 1eco#e a caregi)er i6 nee4e43 an4 7ill one o6 their 6rien4s 1eco#e a caregi)er i6 nee4e4! =nce those E"estions are ans7ere4 they contin"e to as0 #ore E"estions li0e3 7ere there any 4eaths in the 6a#ily recently3 4oes these patient ha)e a cri#inal #in43 4oes the patient ha)e a cri#inal history3 any #ental health iss"es3 s"ici4e atte#pts3 personality 4isor4ers3 #ental retar4ation3 schi9ophrenia3 4epression an4 so on! All o6 this co#es into play 1e6ore a patient is re6erre43 yes I sai4 1e6ore a patient is e)en re6erre4 *Aronson3 2(('/!

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$o1 Aronson3 o6 $o1:s Ne7Heart3 is a transplant patient an4 he create4 a 1log that has a lot o6 in6or#ation regar4ing the ethics 1ehin4 a transplant an4 he ha4 this to say 5I 6in4 it 4isgrace6"l that any A#erican citi9en 7o"l4 1e 4enie4 an organ transplant 6or any reason 1"t to 1e 4enie4 an organ 1eca"se it 7ent to so#eone 6ro# another co"ntry <"st 4oesn:t see# right8 he sai4 5I 4i4 a consi4era1le a#o"nt o6 5goggling8 to 6in4 a satis6actory e?planation 6or this practice an4 ca#e "p e#pty han4e43 Ha)ing 1een on a list 6or a )ery long ti#e an4 0no7ing o6 the shortage really scare4 #e8! 5Ha4 I 0no7n that so#eone 6ro# another co"ntry #ight get an A#erican organ 1e6ore I 4i43 7o"l4 ha)e terri6ie4 an4 enrage4 #e3 I <"st 4on:t thin0 its right8 *Aronson3 2(('/! That is the 7ay a lot o6 people are thin0ing to4ay3 there are so #any patients that nee4 this proce4"re an4 to ha)e to co#pete 6or an organ3 6irst 7ith their poc0ets an4 then 7ith a 1rie6 s"r)ey an4 then against people 6ro# other co"ntries is 7il43 an4 it #ight 1e a lot #ore co#ple?e4 than that 1eca"se 7e 0no7 that o"r go)ern#ent 4oes not tell "s e)erything an4 there are policies aro"n4 the 7orl4 7here organs are proc"re4 1y 0illing in#ates an4 0illing #e#1ers o6 a religio"s gro"p that 1elie)es in #e4itation an4 e?ercise3 transplanting organs has to 1e the #ost challenging #e4ical

ETHICAL & LEGAL WAY proce4"re o6 all ti#es! The #ission o6 the pro)i4ers o6 this proce4"re sho"l4 1e to sa)e li)es or to i#pro)e the li)es o6 the patients 1"t 7hat is occ"rring are 5$o4y %natching8 cri#es3 %elling an4 $artering 6or organs3 4el)ing into patient:s personal li6e 6or the o44est reasons an4 #ost 4e6initely #a0ing s"re that the patient can a66or4 the proce4"re *Trey3 Caplan & La)ee3 2(,./!

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Hresently the shortage o6 organs has thro7n this proce4"re into the light once again an4 the rise o6 the cri#es to o1tain organs has once again reache4 an all ti#e high! =rgan tra66ic0ing an4 the process no7 calle4 transplant to"ris# is occ"rring )ery o6ten 1eca"se the shortage o6 organs are ca"sing people to go to other co"ntries to o1tain 7hat they are loo0ing 6or! In so#e places in the 7orl4 the 7aiting list are not long at all3 1"t that 4oes not #ean that e)erything is legal3 see in these places that 4o not ha)e long 7aiting list people 1"y their )ital organs in se)eral places li0e the internet3 1ro0erages an4 6ro# tra66ic0ers 7hich is illegal in U!%3 1"t these are all hot e)ents that occ"r o6ten in places li0e In4ia3 Ha0istan3 an4 China! =6ten3 these 4onors are not really 4onorsA #ost are 1eing 6orce4 to sell their organs to pay o66 so#e o6 the 4e1t that they #ay ha)e acc"#"late4! When a 4ecision is #a4e to get into the to"ris# o6 transplanting a person has to 6in4 a 7ay to loo0 o"t 6or any o6 the 4iseases that are attache4 to the 1loo4! Those li0e HIL3 Hepatitis3 an4 any o6 the other pathogens that are 1eco#ing so acti)e to4ay! Re#e#1er also that all o6 these illegal 7ays to get an organ co#e 6"ll o6 clinical3 legal an4 ethical iss"es 1"t #any people see it as a 7ay to stay ali)e so the ris0 to the# is )ery s#all *Trey3 Caplan & La)ee3 2(,./! The ne?t proce4"re to 1e 4isc"sse4 is not really ne73 1"t it is occ"rring #ore o6ten 4"e to the shortage o6 organs! Heople are 4eci4ing to ha)e 7hat is 1eing calle4 5%a)ior %i1lings8 1eca"se o6 the #atching iss"e people are creating the e?act #atch 6or their sic0 chil4ren3 is this ethicalC %"re it is! It re#o)es the choice an4 the right to o7n yo"r 1o4y! As o6 2((& o)er ,>3((( o6 these 4iagnostic 1a1ies ha)e 1een 1orn an4 o)er ,(@ o6 those ha)e 1een create4 to sa)e a si1ling3 there are so#e that 7ere 4one to select the se? o6 the ne7 chil4 1"t #any o6 the# 7ere 4one 6or genetic reasons *Do Car#o3

ETHICAL & LEGAL WAY

,.

2(,./! Re#e#1ering the #o)ie 5 y sister:s 0eeper8 there 7as a sister 7ho 1eca#e tire4 o6 li)ing 1"t the #o# 4i4 not 7ant to accept that3 so the sic0 sister con)ince4 the sa)ior chil4 to ta0e the parents to co"rt to earn o7nership o6 her 1o4y! %he ha4 1een h"rt so #"ch to help the sic0 chil4 an4 that 7as her p"rpose 6or 1eing create4 so the parents 4i4 not e)en thin0 t7ice a1o"t p"tting her thro"gh this pain3 ethicalC De6initely! All o6 7hat has 1een co)ere4 in this paper lea)es #"ch to thin0 a1o"t3 the 7ait is long3 tra66ic0ing is large3 to"ris# is occ"rring3 sa)ior si1lings are 1eing create43 there are those that 1arter 6or organs3 selling o6 organs3 0illing 6or organs an4 so #"ch #ore! Mno7ing this in6or#ation 4oes not 4o #"ch to change things 1eca"se the UN=% has no one that is really 7atching the#3 they 4o not really ha)e anyone to report to3 so this proce4"re is a long 7ay 6ro# 1eing 6i?e4! I6 any o6 "s 6all into the nee4 to proc"re an organ this is 7hat 7e ha)e to loo0 6or7ar4 to an4 personally 1eing a Transplant Clai# %pecialist 7ithin the #e4ical ins"rance arena seeing all the changes that one #"st go thro"gh I a# not s"re 7hat ro"te I 7o"l4 ta0e i6 this happene4 to #e!

ETHICAL & LEGAL WAY References Allho663 +rit9 *2((>). Ethics Journal of the American Medical Association %epte#1er Lol"#e '3 N"#1er F =p;E4! %ho"l4 Alcoholics $e Deprioriti9e4 6or Li)er Transplantation? Aronson3 $o1 *2(('/! $o1:s Ne7Heart! Official UNOS Response On Transplants for Non U.S. Citizens. In UN=% & =rgan Donation $a0ari3 A!3 Bi#eta3 U!3 A1"1a0ar3 !3 Alhassan3 %!3 & N7an07o3 E! *2(,2/! Or an transplantation!

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le al" ethical and #slamic perspecti$e in Ni eria. *Re)ie7 Article/! Nigerian Bo"rnal =6 %"rgery3 *2/3 Do Car#o3 ariana *2(,./! Child Autonom% and the Ri hts to One&s O'n (od%! )*+ and )arental

+ecision Ma,in . Retrie)e4 6ro# http:KK777!the1ioethicspro<ect!orgKessaysKchil4;a"tono#y; an4;the;rights;to;ones;o7n;1o4y;pg4;an4;parental;4ecision;#a0ingK on +e1r"ary 2&3 2(,La"rentine3 M!3 & $ra#ste4t3 M! A! *2(,(/! Too poor for transplant! finance and insurance issues in transplant ethics. Hrogress In Transplantation3 2(*2/3 ,'G! Nei4ich E3 Nei4ich A3 Cooper B3 $ra#ste4t MA! *2(('/! The ethical co#ple?ities o6 online organ solicitation )ia 4onor;patient 7e1sites: A)oi4ing the 51ea"ty contest8! A# B Transpl 2(,2A ,2: -.;-'! NoJl3 L!3 & artin3 D! *2((F/! )ro ress to'ards national self-sufficienc% in or an transplants.

$"lletin =6 The Worl4 Health =rgani9ation3 G'*F/3 &-'! %eaE"ist3 G! *2(,2/! (usiness la' for mana ers. %an Diego3 CA: $ri4gepoint E4"cation3 Inc! This te?t is a ConstellationN co"rse 4igital #aterials *CD / title! Tha#1isetty3 %! *2((F/! .E*A. TRANS).ANTS #N )ATENT .A/! /01 2UT#.#T12 #S T0E NE/ 2#N+USTR#A. A)).#CA(#.#T12. B"ri#etrics: The Bo"rnal =6 La73 %cience & Technology3 -F*2/3 ,>>!

ETHICAL & LEGAL WAY Trey3 T!3 Caplan3 A! L!3 & La)ee3 B! *2(,./! Transplant ethics under scrutin% - responsi3ilities of all medical professionals. Croatian e4ical Bo"rnal3 >-*,/3 ',;'-! 4oi:,(!..2>Kc#<!2(,.!>-!',

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Trey3 T!3 Caplan3 A! L!3 & La)ee3 B! *2(,.). Transplant ethics under scrutin%--responsi3ilities of all medical professionals! *E%%AY =N $I=ETHIC%/*Report/! Croatian e4ical Bo"rnal3 *,/3 ',!

!niform "efinition of "eath ct (#$%&'. )resident4s Commission for the Stud% of Ethical )ro3lems

in Medicine and (iomedical and (eha$ioral Research. Retrie$ed from http!55uniformla's.or 5ActSummar%.asp67title8+etermina-tion9:;of9:;+eath9:;Act on <e3ruar% ::" :;=> Wat0ins3 %! *2(,2/!The Ethics of Transplants--/h% Careless Thou ht Costs .i$es! *$rie6 article/*$oo0 re)ie7/! N"rsing %tan4ar43 *-'/3 2G!