The limited availability of organs for transplantation remains a widespread issue. In 2019, about 114,000 people were registered as waiting for donor organs, while in 2018, only about 33,500 operations were performed (as cited in Cherry, 2019, p. 603). Patient waiting times for transplantation increase every year, putting pressure on organ procurement agencies, policymakers, and patients. Therefore, the need to facilitate access to organs for transplantation is becoming increasingly urgent. Receiving donated organs from a recently deceased person is one way to obtain them. Relatives must agree to the procedure and allow it to the procurement agency, which they often disapprove of. Nevertheless, in order to reduce the scarcity of organs for transplantation, it is usually thought to limit the right of families to deny donation. Continued donor organ shortage may result in the death of many people who could fully recover after the transplant. In order to increase the number of saved patients the policy of conscription is morally sound.
After the death of the donor and the confirmation of brain death, it is necessary to obtain the consent of the family. There are two different policies for obtaining consent currently in the developed world (Spital & Erin, 2002). The first one is common in the UK, Canada, and the US and involves obtaining either the donor’s direct or family’s consent for organ harvesting. In European countries, a system has been adopted according to which the organs of a recently deceased person can be removed if the person or the family did not express objection (Spital & Erin, 2002). However, even with this approach, the opinion of the family is often taken into account. In relation to donation, the concept of consent is significant in order to show attention to the grief and opinions of the deceased person’s relatives. The consequence of refusal is a shortage of donor organs, which does not allow a sufficient number of people to get transplantation.
To increase the number of transplants, various policies have been proposed, including financial and non-financial incentives, as well as the obligation of everyone to make a decision about organ donation after death. However, none of the initiatives will achieve a 100% result, so an alternative was proposed in the form of a “conscription of all usable cadaveric organs” (Spital & Erin, 2002, p. 612). According to the concept, organs from all recently deceased people will be used for transplants without the need for consent. The approach can cause a number of ethical disputes in society, although having evident advantages.
First of all, conscription is 100% efficient, which will result in a significant increase in the number of transplants. Moreover, the approach is much simpler and cheaper than all other organ procurement methods. Conscription facilitates organ procurement mechanisms and reduces stress for families and healthcare professionals. The policy will also allow for an even and fair distribution of benefits and burdens, satisfying the “ethical principle of distributive justice” (Spital & Erin, 2002, p. 613). The approach is more morally justified as opposed to financial or non-financial incentives, which people can use to benefit. A voluntary decision to donate also creates an injustice in which people’s lives will depend on the generosity of others.
Despite a number of advantages, conscription also poses ethical concerns. The major one is a possible “violation of the ethical principle of respect for individual autonomy” (Spital & Erin, 2002, p. 613). From this point of view, it can be argued that consent is required since even after death, a person can retain critical interests. However, such a belief is unconfirmed, which makes it insufficient to abandon conscription. Consent is not required due to the fact that a deceased person cannot make decisions and express will; therefore, he does not have autonomy. To increase public acceptance, the government should articulate the importance and results of such policy, which can save many lives.
There are alternative initiatives to increase the number of transplants and donors. Munson (2014) discusses living-donors transplantation as a more ethical approach. It is assumed that with the voluntary consent of a person, the principle of autonomy is observed since a person makes a decision. It is also proposed to encourage voluntary donors and provide care for the physical condition of their organs. However, from a financial perspective, this approach is many times more expensive than conscription. Moreover, the method violates the principle of distributive justice since people’s lives depend only on the generosity of others. On the contrary, conscription assumes that all people share the same burden of donation, while patients receive an equal chance of transplantation. Thus, the initiative appears to be truly ethically fair, and just since all people are in the same conditions.
The lack of organs for transplantation remains an acute problem that can be addressed by a conscription policy. Everyone has the right to access health care, as it is a fundamental right of all society members. In terms of political rights to justice and equality, conscription suits them the most. Everyone should have an equal chance of receiving donor organs, while all available resources should be used to improve the situation. From an ethical perspective, the main principles are observed, which can improve the standard of living of many people.
Cherry, M. J. (2019). Contested organ Harvesting from the newly deceased: First-person assent, presumed consent, and familial authority. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 44(5), 603-620.
Munson, R. (2014). Intervention and reflection: basic issues in bioethics (concise ed.). Wadsworth.
Spital, A., & Erin, C. A. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Diseases, 39(3), 611-615. Web.