Cause And Effect Argument Essay
The disparity between supply and demand for organ transplants has resulted in a shortage crisis that has persisted for years. This chasm between the two has lingered in the United States for over two decades, with the highest number of donors recorded being 19,267 in 2019 against a total of 112,568 patients registered in the national transplant waiting list (HRSA, 2020). There has been a lower registration of live and deceased organ donors compared to the number of patients getting added to the waitlist (Matas, 2008). While over 90 percent of American adult’s support organ donation, only 60 percent of this population has signed up to donate their organs (HRSA, 2020). The reasons for the continued domestic shortage of organs and its consequences are instrumental issues for consideration.
One reason for the low organ donation observed is a lack of knowledge and awareness. According to Irving et al. (2011), the experience held by some people concerning organ donation is informed by urban myths rather than correct information. Panwar et al. (2016) note that one of the important reasons for the discrepancy has been ignorance of the concepts of organ donation and brain death. People with a proper grasp of what brain death is are more likely to consent to organ donation (Panwar et al., 2016). Moreover, studies confirm that the taking up of donor cards and actual organ donation is more significant among people with high education (Panwar et al., 2016).
Non-acceptance of a patient’s brain death has stopped families from consenting to the donation of the patient’s organs. This has been caused by a lack of proper comprehension of the medical state of their loved ones (Panwar et al., 2016). In most of these cases, a mistrust of the diagnosis has proved to stand in the way of a family agreeing to donate the organs of their loved one (Panwar et al., 2016). This results in the delay in the availability of a life-saving organ.
General distrust in the healthcare system has contributed to the low numbers of organ donors. According to Panwar et al. (2016), there are fears of disfigurement and procedural delays in many people regarding the organ donation process. Moreover, previous negative experiences in seeking medical care cultivate distrust in the healthcare system (Irving et al., 2011). More distrust is expressed in fear of questionable declaration of the state of brain dead by medical personnel that would lead to premature removal of organs (Irving et al., 2011). A suspicion of the donated organ’s diversion to purposes not intended by the donor also exists (Irving et al., 2011). As such, the individuals would instead not donate.
Religious beliefs are an essential factor when it comes to organ donation decisions. Irving et al. (2016) advance that religious beliefs hold back some people who desire to preserve their afterlife bodies. Moreover, some religious people perceive organ donation to be a way of interfering with God’s will for the life of prospective recipients (Irving et al., 2011). Others hold that their bodies are the property of God, and therefore the decision of organ donation is not theirs to make (Irving et al., 2011). Consequently, the supply of organs for transplant suffers.
Some cultural beliefs on the issues of healthcare, death and dying influence the decision not to donate organs. A study conducted by Irving et al. (2011) showed that African Americans were generally private on matters touching on death. The superstition of inviting death upon oneself by getting a donor’s card also characterized some cultures. In contrast, others believed that ancestral approval was needed for organ donation since a body organ transfer was tantamount to transferring one’s spirit to the recipient (Irving et al., 2011). Moreover, organ donation was perceived by others to be an intrusion to the grieving rituals in certain cultures (Irving et al., 2011).
While some people were readily willing to donate their organs, family objection stood on the way of that realization. According to Irving et al. (2011), some people feel obligated to seek permission for organ donation from their families. However, more negative than positive influence exists at the family level (Irving et al., 2011). The feeling of interfering with their family’s grieving process has also stopped some people from considering organ donation (Irving et al., 2011).
Strong beliefs about the preservation of body integrity stand as opposed to organ donation. While some people would not mind what happens to their bodies after they die, others have complex personal demands for their bodies’ care even then (Irving et al., 2011). Further, some people fear the organ donation process is a traumatizing effect on their family (Irving et al., 2011). Moreover, the donation of some body organs such as corneas would disallow the body’s viewing at the donor’s funeral (Irving et al., 2011). These personal beliefs effectively stand in the way of the availability of an organ
Legal prohibition of financial incentives to living donors also stands in the way of higher rates of organ donation. The current system of living organ donation is pegged on the donor’s altruism. As Shaikh and Bruce (2016) note, the National Organ Transplant Act (NOTA) and the Uniform Anatomical Gift Act prohibit human organs’ selling in the US. This is the case in most other countries of the world (Howard & Cornell, 2016). Financial disincentives such as reimbursements of travel expenses, accommodation expenses, and lost wages are legal to
motivate living organ donors (Shaikh & Bruce, 2016). However, Shaikh and Bruce (2016) note that these reimbursements do not reach most donors since they are not included under the payments made by insurance companies. Consequently, this financial cost is a deterrent to prospective organ donors.
One effect of the domestic shortage of organs is the suffering and death of many patients in need of organ transplants. According to Lentine and Schnitzler (2011), many patients missing a timely allocation of kidneys end up with protracted renal dialysis, resulting in massive cost implications. More extended pre-transplant dialysis periods expose these patients to comorbid conditions of coronary artery disease and congestive heart failure (Lentine& Schnitzler, 2011). The National Kidney Foundation (2016) estimates that the mean wait time for a kidney transplant is 3.6 years, a period that is variable depending on the factors of compatibility, health, and availability of a kidney. An estimated 13 people die while in the waiting line for a kidney transplant (National Kidney Foundation, 2016).
Another effect of the domestic shortage of organs has been a thriving international organ market characterized by substandard healthcare. According to Shimazono (2007), many patients with unmet organ needs end up looking for help abroad through unofficial channels. While there, they are exposed to higher chances of medical complications and lower survival rates than patients operated in medical environments regulated by internationally acceptable standards (Shimazono, 2007). Moreover, with financial stakes involved, low organ sellers may fail to reveal underlying conditions that may result in a transfer of disease to the recipient out of ignorance of their health status or a fear of being rejected as a donor (Howard & Cornell, 2016).
Criminal and exploitation practices have also resulted from an official shortage of organs. Howard and Cornell (2016) note that the poor in developing countries are the most willing sellers of organs. The financial compensation they get is insufficient for obtaining medical care for health complications that may arise after that, such as hypertension and kidney insufficiency (Howard & Cornell, 2016). Their failed health consequently leads them deeper into poverty (Howard & Cornell, 2016). Moreover, donors in unregulated markets have suffered the brunt of abuse, coercion, and exploitation by unscrupulous dealers (Shimazono, 2007). Ohio State University (2019) notes that organ trafficking cartels use brokers to recruit people from vulnerable populations with the enticement of money and deception that their organs will grow back or are unnecessary in the body. Other organ dealers’ resort to human trafficking with the intent of harvesting the organs, killing some victims in the process (Ohio State University, 2019).
The domestic shortage of organs has resulted from fewer organs donated for transplant procedures relative to the soaring demand. Many people lacking the knowledge and awareness of the need and significance of donation are not likely to be registered as donors. Even where
registered, lack of acceptance of brain death as the actual death of a patient by the family may prevent such organs’ availability. Moreover, a general distrust of the healthcare system deters people from donating organs. Cultural, religious, and personal beliefs have stood in the way of donating organs. The willingness of some individuals to donate their organs has been overwhelmed by the family objection. In contrast, other individuals have preferred to preserve their body integrity as opposed to donating their organs. The legal prohibition of financial incentives for organ donors has also played a role in the constrained supply of organs. A domestic shortage in organs has led to the continuous suffering and mortality of patients with no option but to wait for allocation. Some patients have ended up looking beyond national boundaries for organs. Moreover, the unmet demand has meant the exploitation of the poor who are most vulnerable to financial enticement and from the criminal activities of human traffickers intending to harvest and profit from their organs.
References
HRSA. (2020). Organ donation and transplantation statistics: Graph data. Organ Donor. Retrieved from https://www.organdonor.gov/statistics-stories/statistics/data.html
Irving, M. J., Tong, A., Jan, S., Cass, A., Rose, J., Chadban, S., Allen, R. D., Craig, J. C., Wong, G. &Howard, K. (2012). Factors that influence the decision to be an organ donor: a systematic review of the qualitative literature.Nephrology Dialysis Transplantation, 27( 6), 2526–2533. Retrieved from https://doi.org/10.1093/ndt/gfr683
Lentine, K. L, &Shintzler, M, A. (2011). The Economic Impact of Addressing the Organ Shortage with Clinically High-Risk Allografts. Missouri Medicine, 108(4), 275-279. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188414/
Matas, A. J. (2008). Should we pay donors to increase the supply of organs for transplantation? Yes. BMJ, 336(7657), 1342-1342. Retrieved from https://doi.org/10.1136/bmj.a157
National Kidney Foundation. (2016). Organ donation and transplantation statistics. Retrieved from https://www.kidney.org/news/newsroom/factsheets/Organ-Donation-andTransplantation-Stats
Ohio State University. (2019). Chapter 9: Organ trafficking – The cause and consequence of human trafficking: Human rights violation. Retrieved from https://ohiostate.pressbooks.pub/humantrafficking/chapter/chapter-9-organ-trafficking/
Panwar, R., Pal, S., Dash, N. R., Sahni, P., Vij, A., &Misra, M. C. (2016). Why are we poor organ donors: A survey focusing on attitudes of the lay public from northern India. Journal of clinical and experimental Hepatology, 6(2), 81–86. Retrieved from https://doi.org/10.1016/j.jceh.2016.04.001
Shaikh, S. S., & Bruce, C. R. (2016). An ethical appraisal of financial incentives for organ donation. Clinical Liver Disease, 7(5), 109-111. Retrieved from https://doi.org/10.1002/cld.548
Shimazono, Y. (2007). The state of the international organ trade: A provisional picture based on integration of available information. Retrieved from https://www.who.int/bulletin/volumes/85/12/06-039370/en/
