ORGAN DONATION AS A MANDATORY CHOICE (Essay Sample)

Organ Donation as a Mandatory Choice Student’s Name Institutional Affiliation Course Instructor Date Organ Donation as a Mandatory Choice The shortage of organs for transplant has been a persistent problems in the healthcare sector around the world. Many countries have fronted proposals to help address the problem. Two of the systems that governments have often fronted include the explicit consent system (opt-in) and the presumed consent system (opt-out). In the former, system, people are not automatic donors whereas in the latter, every adult citizen is a donor by default, unless the individual chooses to “opt-out” of the system. Both systems have specific advantages and disadvantages. However, with the increases cases of organ shortage, there is a need to institute a mandated choice consent for the diseased to help increase organ donation rates while remaining ethical. Presence of the Problem Organ transplant has proven to be a lifesaving procedure that has benefited many people around the world. According to statistics from the Global Observatory of Donation and Transplantation, there were 140,964 organ transplants in 2018 worldwide, with the kidney and liver being the most frequently transplanted organs (Lewis et al., 2021). On the contrary, small bowel transplants were the least undertaken procedures. The common organs transplanted in the U.S. according to the U.S. OPTN include the kidney, pancreas, liver, intestine, heart, lung, and kidney/pancreas. The U.S. has continued registering an increasing number of transplants, whereby in 2018, a total of 36,528 people received transplants. The donations not only saves the receiver’s life, but also leads to a better quality of life and more productivity. This act of saving a life leads to a sense of satisfaction to the donor and in the case of a deceased donation, the donor is able to continue their legacy through the life that they save or improve. Sadly, the demand for organ transplants has continued increasing significantly, without any major increase in the number of willing donors. According to Lewis et al. (2021), in 2019, the U.S. recorded a total of 113,000 demands for transplants, with over half of this number comprising demand from ethnic minority groups. This discrepancy is based on the fact that slightly more than half of the Americans (58%) are potential donors. This shortage has resulted in significantly high waiting times, which vary depending on the organ under consideration. Bentley and Ortner (2020) provide an overview of the average waiting times for the various organs between 2017 and 2020 shown in the table below. Organ 2017 Milliman Research Report, 2014 OPTN/SRTR Annual Report 2020 Milliman Research Report, 2017 OPTN/SRTR Annual Report Average Waiting Time in Days Heart 191 213 Intestine 181 224 Kidney 679 685 Liver 239 236 Lung (Single and Double) 185 186 Pancreas Alone 281 289 Pancreas after Kidney 532 514 Kidney-Pancreas 394 370 Source: Bentley and Ortner (2020) Based on the above figures, only three of the eight organs reported a decrease in the waiting time. These organs were the liver, the pancreas after kidney, and the kidney-pancreas. The rest of the organs, including the heart, intestine, kidney, lung, and the pancreas registered increases in the patient’s waiting time. In early 2022, OPTN reported that 2021 was the year that most lives were saved, with over 40,000 lifesaving transplants. More specifically, there were 41,354 transplants, which was a 5.9% increase over the 2020 number (OPTN, 2022). This number is significantly high, considering that the number of willing donors has not been increasing in equal measures. Sadly, many individual die while on the waiting list for organ donation. According to statistics from Donate Life (2024), another person is added to the national transplant waiting list every 8 minutes and 17 people die each day while waiting for an organ transplant. Data further indicates that 6,000 people in the U.S. died in 2021 while on the transplant waiting list (Donate Life, 2024). The above findings confirm that organ transplant continues to be a persistent problem in the United States. Many studies have shown an overwhelming public support for organ donation of up to 97.6% (Etheredge, 2021). However, only a small percentage of those who die with the organs suitable for donation eventually become actual donors. Several states in the U.S. currently rely on the “opt-in” system, where an individual or their family has to explicitly present their consent before donating. Although this system is responsible for the current shortage and the long waiting times, the “opt-out” system has received immense criticism as appertains to autonomy of the donors. Proposed Action The most suitable solution to this problem is implementation of the mandated consent model, where individuals have to make a choice on whether to become donors or not at the point where they receive government services. The current shortage and deaths while on the waiting list do not result from the lack of transplantable organs, but the inability of many suitable donors to enter the supply stream. This lack of willingness is attributed to several factors, including the myth that registered donors may not receive enough life-saving treatment compared to non-donors, certain religious beliefs and practices that discourage donation, the fear that the donation exercise will interfere with burial rituals, and the assumption that an individual’s organs are unsuitable for donation. All these beliefs are propaganda because the organ procurement organizations are only contacted after life-saving efforts have ceased. Therefore, the registered donors suffer no risk of compromised treatment as purported. The mandated choice in organ transplant is a suitable strategy because it solves the autonomy problem and ethical consideration problems associated with both the “opt-in” and the “opt-out” systems. Rather than assuming consent by default, as in the case of the opt-out system, the mandated choice system requires active engagement, giving individuals the opportunity to express their preferences regarding organ donation. In this case, the government takes the initiative of sensitizing the members about the benefits of becoming a donor and debunks the myths associated with the process. After the sensitization process, the individuals get an opportunity to choose whether to become donors or not. The entire process is ethical because it upholds the principle of informed consent, where individuals voluntarily choose based on their understanding (Saunders, 2023). By following all these guidelines, the model helps to streamline the donation process and reduce potential conflicts that may arise between the parties involves. Under this plan, all adults of sound mind get to make a choice about organ donation during government service applications, such as driving license applications, filing of tax returns, or the application of identity cards. The decision that the individual makes at this point is binding and cannot be overridden by their family, expect in circumstances where the individual has accorded their family members veto power to make such decisions. In addition to safeguarding individual autonomy and observing ethical considerations, this plan has several other advantages, such as elimination of the family consent barrier, reducing stress on the family members and the medical staff handling the deceased, and shifting the decision for organ transplant from a stressful setting to a relaxed one. The exercise will also encourage public participation on the issue because the people will engage in an effort to establish the truth. Such discussions will help to dispel some of the myths associated with the practice, which will in turn encourage more people to become donors. Justification The mandatory choice system will help to bridge the gap between intention and action. As noted earlier, many people support and are willing to engage in the organ donation exercise. However, many of them procrastinate because they lack a good reason to compel them to voluntarily go to the hospital and “opt-in” to the program. Tying the decision to donate or not to a mandatory exercise, such as applying for government identity card will help to bypass the apathy or protracted procrastinations of those with good intentions to donate. This method bears the advantages of the opt-out system while observing the patient autonomy and ethical considerations, which are the main points of criticism for the opt-out system. Several other countries have utilized a model similar to the mandatory choice method, where governments establish a team that is responsible for following up on potential donors and obtaining their consent. Those that have embraced such measures have ...