Donating and Procuring Organs


There is a growing scarcity of human organs for transplantation. The demand for organs and the insufficient supply pose a serious problem for the patients who must undergo an organ transplant in order to live. According to the report by UNOS, about 89,000 Americans are currently in anticipation of organs for life-saving transplants. In 2004, 24,812 transplants were done with the help of 12,940 donors. The United States is presently ranked fourth in per capita rate on organs donation (Gross 147). Considering the above statistics and the ongoing organ shortage, it is probable that merely twenty-five percent of potential recipients will benefit from a donor organ. The despairing deficiency of organs requires an urgent re-examination of the method of procuring organs as well as revising of policies to increase the organ donation. The current system is characterized by various obstacles, including the difficulties of obtaining consent by the physicians due to their reluctance. These difficulties can be avoided by implementing a different structure of organ procurement. This paper will examine the idea of autonomy and focus on the role that it plays in ethical contemplation as it relates to the donation of organs. It will also, argue that both the presumed consent and the presumed refusal do not preserve the autonomy and that the authorized choice is a more ethically sustainable answer to the growing problem of organ procurement.


The necessity for viable organs for transplant is increasing at a remarkable rate. In the past, there was always a wide gap between the number of organs required and donated. Moreover, it required a lot of drive to persuade people to become organ donors. The advancements in technology have helped save more lives through organ transplants than ever before. Nevertheless, these enhancements will mean nothing if there are no organs for transplantation. Physicians always find themselves asking the question how more organs can be procured for transplantation. Consequently, it raises ethical and moral considerations that should be tackled so as to arrive at a convincing answer. Autonomy should be preserved in any statute regarding organ donation, although the way it is seen will change the discrepancies of the presumed and refused consent, as well as obligatory choice (Grandtham 78). Therefore, the essay will prove the standpoint that the mandated choice is the best substitute to guarantee the appropriate handling of one’s autonomy while procuring viable organs to reduce the increasing gap between the supply and demand for organs.

Autonomy is said to be the self-governance or self-determination. People believe that individuals act autonomously when they, and nobody else, make a decision that affects their life and act according to the decisions. To make such a decision, one needs to have all the relevant facts; and as it is unattainable for a person to have all the facts, it can be argued that no person can make a strictly autonomous decision. Moreover, the decision-making process requires individuals to have an intention, understanding, and freedom from both external and internal restraints.

The mandated choice policy entails that people should document their consent related to organ donor status during their life. This important decision should be entered into an integrated database system that the medical professionals can access when the need arises. It is similar to the presumed consent. According to Sirico, individuals retain the right to determine how their organs should be used after their death. The law also enables the next of kin to give final directions if the deceased did not express the intentions during the lifetime. The latest amendment of this law provides that medial attendants should document each patient’s wish to donate an organ on admission. Furthermore, the health care provider staff should request the family of the brain-dead patients to contemplate organ donation. This amounts to an obligatory bid, which adds an unusual load to a heavy situation of both the family and the physicians. With statutes like the mandated choice, the necessity to get the family consent may be evaded, and the stressful argument on organ donation at a time of grief would be avoided (Sirico 8).

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The mandated choice is also preferred by the majority because it improves public awareness concerning the necessity for donor organs and dictates that persons should indulge in serious consideration as well as debate over organ transplantation. An additional advantage is that the policy would eliminate the delay or the waiting time that physicians have to deal with when trying to get consent to procure organs. Delays in the procurement of organs lead mostly to deterioration of the organ, thus affecting the ultimate outcomes of the transplant. Also, the mandated choice policy upholds the right of a person to exercise autonomy while preserving the altruistic as well as voluntary nature of organ donation since donors do so freely, apparently minding the well-being of other people. Healy is in favor of the structure founded on the basis of the mandated choice. He states that “the mandated choice will uphold altruism and voluntarism, which are philosophical pillars of the present structure of obtaining organs.”

The exclusion of the family or the next of kin in the process of the mandated choice has been a big problem for those opposing it. Consequently, it is more considerate to family members than in the current structure since it eradicates the need for distressed family members to face the emotional subject of organ donation at moments of grief. The worry that most family members would not stand being excluded from the process of the final consent has not been properly justified. The family members would not be fully removed from the process of decision-making. Each person still maintains the possibility to discuss organ donation before registering those desires. The mandated choice will ensure that the person’s desires will be executed; moreover, it avoids the sorrow of making a decision during a difficult time (Chen 90).

It must not be forgotten that organ donation can be an encouraging involvement for a family, even in the grieving moments that follow a demise of a family member. During most instances of organ donation, the organs are obtained from younger individuals who have perished from tragic road accidents. In these cases, there is a likelihood to provide meaning and recoup the good from an otherwise baffling tragedy. McDaniel argues that the decision of a family to allow donation, particularly in case of an accident, brain death, or death by accident, can be humanity in its utmost and unalloyed form. He also observes that the belief that the mandated choice policy may deny the family members a chance to act humanly as well as neglect the request of the next of kin by medical staff does not essentially contravene the human nature of the act. Regrettably, the mandated choice may also portray organ donation negatively when a refusal by the family is overturned by the after death wishes of a person. Although it is paramount to include family members in the process of decision-making regarding organ procurement, the above considerations should not be used as criteria for rejecting the whole policy. Alternatively, family members should be encouraged to actively discuss the issue of organ donation and familiarize with each other’s preferences and views.

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With the rising scarcity of organs, the effort of transplantation should not be portrayed in a negative light. The framework should be just and respectful of person’s wishes. Individuals agree to be donors on the assumption that they donate to an infrastructure function fairly. The issue also raises concerns regarding the handling of information of the mandated choice records. Many states keep databases of donation wishes of their citizens. Normally, the organ procurement organization (OPO) might utilize these records to sway family decisions on donation. By presenting that the deceased person had been listed as a donor, the OPO can convince family members to donate the organs. This also raises a concern about what may happen if the deceased was not registered as a donor, but the family members want to donate the organs. Ideally, it is unethical to hide the information and permit the family to donate the organs, regardless of the wishes of the demised person; however, this could see the structure lose the possibly viable organs, and the scarcity problem would not be addressed (Weimer 33).


There is a growing scarcity of human organs for transplantation, which poses a serious problem to a large percentage of the population that are in need of organs for transplant in order to save their lives. The concern of the organ scarcity can be addressed by adopting a different organ procurement structure. The mandated choice system seems to be the best alternative for changing the current system. Under this structure, persons will be required to state their wishes regarding the donation, thus respecting the autonomy of individuals. This system would be more autonomous. Moreover, it will increase the number of eager donors, thus reducing the gap between the need and obtainability of organs. For that reason, the mandated choice is the most suitable alternative to the problem of organ procurement because it esteems the person’s autonomy, saves the family members from difficult decisions as well as increases the availability of viable organs for transplantation.

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