Summary
Title: The Ethics of Organ Transplants
Author: edited by Arthur L. Caplan, Daniel H. Coelho
Publisher: Prometheus Books
ISBN: 1573922242
Pro:
• Wide variety of ethical questions covered
• Much detailed information
• Essays written by leading professionals and ethicists
Con:
• Some essays may be difficult for average readers
Description:
• Exploration of many ethical questions relating to organ transplants
• 34 articles from a variety of medical professionals and ethicists
• Good for people seeking a serious study of many technical matters
Book Review
But this really is more appearance than fact, because right under the surface lurks a morass of ethical dilemmas and controversies which have threatened to undermine the entire practice of transplanting organs. These problems have only grown in scope as new medical advances have been made in recent years, with little prospect of an easy resolution any time soon.
What are the sources of organs used in transplantation? How can we make the procurement system more efficient? Should we pay for organs? Should someone who has already received one transplant be allowed a second? Should alcoholics be given liver transplants? Are transplants really worth the tremendous costs?
Lying at the heart of most of these ethical debates are the twin questions of procurement and distribution. How do we get organs, and how do we decide who will receive the implants? There are always fewer donors than there are potential recipients, and that’s why some 5,000 people die every year while waiting for new organs.
As far as distribution goes, everyone has to be able to pay in order to receive a transplant - and that is why many poor people never undergo the process. Overall, transplants are a procedure for people with lots of money or lots of insurance. But should the choice of who gets new organs also depend upon social worth? That is to say, should a doctor get a new organ but a prisoner be refused? What about alcoholics - should they be denied new livers because they “deserve” what has happened to them?
Procurement is also a problem, especially because not everyone agrees when “death” occurs. Does it happen when the heart and lungs stop, when the entire brain ceases to have activity, or just when the “higher functions” stop? This is an important issue, because no one wants to take organs from someone still “alive,” but waiting for “whole brain death” can leave many organs unusable.
And what about the question of consent? Right now, someone has to directly agree for transplantation in order for organs to be removed - but should the policy be changed so that consent is automatically assumed unless someone says “no”? Because most people can live just fine with only one kidney, it is something which can be donated while you are still alive - but should you be allowed to sell it, or is it not possible for there to be genuine consent in such a grave matter?
Caplan’s book, based upon the contributions from such a wide variety of professionals in medicine and bioethics, ends up providing a great deal more information - both over a wider range of topics and with more depth. The 34 articles are usually reprints form medical journals, and as such they are generally written for an audience of medical professionals. Lay readers can still get a lot out of it, but they will need to read a bit more carefully. Thus, Caplan’s is superior for anyone seeking to study the topic more thoroughly - it would, for example, be perfect for a class on bioethics.
