NCPA - National Center for Policy Analysis


September 14, 2007

Organ transplant advocates are becoming increasingly aggressive in their efforts to procure hearts, livers, kidneys and other organs in the hope of saving more of the thousands of desperate Americans who die languishing on waiting lists.  For some doctors, nurses and medical ethicists, it represents their worst fear -- the extreme end of a spectrum of practices that have been raising alarm in hospital wards, emergency rooms and intensive care units around the country.

  • Organ-donation agencies argue that they walk a careful line between advocating effectively for those who need transplants and violating ethical boundaries meticulously calibrated to protect dying patients and their families.
  • Even the critics agree that most organ-donation advocates are acutely sensitive to ethical concerns, help save many lives and enable families to find solace in their losses; but they worry that disturbing lapses may be increasingly common.

How did this policy evolve?

  • The more aggressive drive for organ donations grew out of a federal campaign known as the Breakthrough Collaborative, which the Department of Health and Human Services launched in 2003.
  • The project was designed to boost the number of organs retrieved by the nation's 58 organ-procurement organizations, or OPOs.
  • These private, nonprofit government-authorized entities deploy nurses, social workers and other specialists to identify potential donors, obtain consent from families, and work with doctors and nurses to recover as many organs as possible.

"The greatest fear the public has when it comes to organ donation is their loved one will not receive aggressive treatment and will wind up having their death hastened because of the zeal people have to get organs," said Arthur Caplan, a University of Pennsylvania bioethicist."  You create a tremendous fear on the part of the public whenever any crossing of that line takes place."

Source: Rob Stein, "New Zeal in Organ Procurement Raises Fears; Donation Groups Say They Walk a Fine Line, but Critics See Potential for Abuses," Washington Post, September 13, 2007.

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