The Ethics of Organ

Transplant
Emma Broussard, Jackie Hirohama, Michelle Marks &
Sheryl Sato

Organ Harvesting:
the Ethical Dilemmas
ICU Patient declared brain dead. Patient was not
designated as an organ donor and never expressed his
beliefs on organ donation. Family is left to decide if the
Patients organs will be donated or not.
Nurses Actions:
Encourage organ donation
Discourage organ donation

For every eight potential donors, only one donor is

notified to a local Transplant Center, and only 20% of those
become effective multiple organs donors, which has
serious re- percussions for the already long waiting lists,
(Virginio 2014)

United Network
for Organ Sharing
UNOS private, non-profit organization, handles nations transplants
Fair chance to recipients (not based on age, sex, race, religion,
lifestyle, financial/social status)

1. Recipient is added to UNOS database:

severity of illness, time spent waiting, blood type, other pertinent
medical info

2. Match made based on door-recipient compatibility, creates a

ranked list:
Tissue match, blood type, length of wait, immune status, distance
between donor & recipient, (heart, liver, lung & intestines degree of
medical urgency)

3. Recipient must meet criteria at time of match:

Healthy for surgery, transported immediately, more extensive
compatibility (antibodies)

The Ethical Principles

at Play
Autonomy To respect anothers right to
independent decision-making.
Beneficence To promote goodness,
kindness, and charity; to provide benefits to
others by promoting their good.
Nonmaleficence A duty not to inflict harm.
Fidelity A duty of loyalty and dedication to
the patient.

Relevant Values
Culture & Religion
values and beliefs of client, family members & RN.

Morality: 3 Questions to Ask

Is the donor patients death being hastened?
How well informed is the informed consent?
Is the family able to be with the patient donor at the
moment of death?

Respect:
Definitions of Death: Brain & Cardiac
Brain Death

Rights

Client & Family Rights

Dignity of the client
Dignity of the body
Ethical aspects of consent

Laws in Hawaii
2012 Hawaii Revised Statutes
TITLE 19. HEALTH
327C. Death
327C-1 Determination of death.
Organ Donor Center of Hawaii (ODCH)

The Uniform Anatomical Gift Act (2007, HI enacted)

established that a signed organ donation card is
sufficient to proceed with donation. The Revised Act
intentionally disempowers families from making or
refusing to make gifts in contravention to a donors
wishes.

The Issues
Caring for and maintaining a cadaver that is a
potential organ donor
A philosophical perspective on the dignity of
the person and the dignity of the body
Ethical aspects of consent for organ donation
The perception that a client is being treated
as a means, and not an end in and of himself

The Ethical Principles

Violated
A nurses vow to do no harm
A nurses vow to tell the truth
A patients autonomy

The Course of Action

Ethics Committee
Respecting patients original health care
directive
Some RNs may choose to refuse care
Follow family decision
Follow state law

References
Cherry, B., & Jacob, S. R. (2014). Contemporary nursing: Issues, trends, & management (Sixth ed.). St. Louis,
Missouri: Elsevier.
Hans Haddersa and Anne Hambro Alnsb
Howard, R., & Cornell, D. (2005). Family disagreement over organ donation. AMA Journal of Ethics. 7 (9). Retrieved
from: http://journalofethics.ama-assn.org/2005/09/ccas2-0509.html
Faculty of Nursing, Sr-Trndelag University College, Trondheim, Norway, Section for Medical Ethics, Department of
General Practice and Community Medicine, University of Oslo, Oslo, Norway. 17 April 2012 DOI: 10.1111/j.14401800.2012.00603.x
http://law.justia.com/codes/hawaii/2011/division1/title19/chapter327
Monforte-Royo, C. and Roqu, M. (2012), The organ donation process: a humanist perspective based on the
experience of nursing care. Nursing Philosophy, 13:295301. doi:10.1111/j.1466-769X.2012.00544.x
The ethics of organ donation: what every nurse should know. (2011). Massachusetts Nurse Advocate. 82(3).
Virginio BCAE, Escudeiro CL, Christovam BP, Silvino ZR, Guimaraes TCF, Oroski G. Death and organ donation from
the point of view of nurses: a descriptive study. Online braz j nurs [internet]. 2014 March; 13 (1): 92-101. Available
from: http://www.objnursing.uff.br/index.php/nursing/article/view/4164