Jonathan Cannon Installment 1

For my first installment, I will be discussing the ethics surrounding organ transplant experimentation. In all cases when working with other people as healthcare professionals it is essential that the respect is always to be given to the individual as well as the preservation of their dignity. Before diving into the subject, I want to provide a little background for organ transplants. Every year there are over 116,000 people are on the organ transplant waiting list and Every day 20 people die waiting for an organ transplant. One donor can donate up to 8 lifesaving organs. Around 1% of deaths in America occur in a way that individual able to donate their organs.

I was unaware of the controversy surrounding experimentation with organ transplants until I came across an article by Sarah Zhang in the Atlantic. In this article, the author highlights the ethical issue surrounding organ transplant experimentation specifically when dealing with brain-dead patients. The brain death can be defined as the irreversible loss of all functions of the brain, including the brainstem. The three essential findings in brain death are coma, the absence of brainstem reflexes, and apnoea.  Essentially the body is capable of living but the brain is completely unresponsive and the damage is irreversible. While physicians can use equipment to ensure that the lungs keep supplying the body with oxygen and the heart continues to beat circulating blood throughout the body, in the absence of hormonal regulation provided by the brain the body can no longer function properly and begins to experience organ and tissue damage.           

Researchers want to study drugs and procedures that could be used to slow down if not stop the damage that sets in minutes after brain-death in order to improve organ transplant success. These types of studies are nearly impossible to perform due to the ethical implications of performing human subject research. As we learned in our readings from Bioethics: The Basics by Campbell, The Nuremberg Code of 1947 laid down ground rules in order to protect subjects of medical experiments, stressed the necessity for fully informed and voluntary consent (p15).  This is the biggest setback to organ transplant studies, from whom does the researcher obtain informed consent? Is it necessary only for the donor to provide informed consent or do the recipients need to provide informed consent? It is on institutional bases whether or not a study is considered human subject research and IRB approval must be obtained before a study can begin. In a case where an IRB determined that brain dead individuals were not considered human subject research, removing the need for the researchers to obtain informed consent. Public opinion in response to this study was hostile enough to deter any future research on a promising procedure for improved kidney transplants.

It is my personal belief that it is ethically justifiable to perform studies for drugs or techniques to improve the potential for organ transplant success. These studies provide an outlet by which the donor can be honored by ensuring that the doctors performing the transplant are doing so in the best way possible.