May 20, 2012

Quid pro quo: organ donation slippery slope

Health and medicine has always been a minefield of moral measurement; too often physical and mental health are used as a moral judgement of the individual.  Not so in the realm of failed organs though.  A failing kidney or heart failure is deemed an unfortunate, and possibly prematurely life ending event, unless medicine can intervene with dialysis or a stent, or at the extreme, someone else's kidney or heart. 

The means by which medicine has sought to increase the number of organs available for harvesting and transplanting to other humans is dodgy and self-serving, yet remarkably unchallenged.

Israel recently sat down on the slippery slope of medicine as a moral domain, of reward and punishment, and pushed off with a big whoosh.
Touched by the unfairness of the deal, Dr Lavee performed the transplant, then set about revolutionising the way Israel manages its organ donation program.

Last month, [Israel] became the first country in the world to give transplant priority to patients who have agreed to donate their organs over those who have not - that is, allowing something other than medical need to be considered.

For Dr Lavee, the director of the Heart Transplantation Unit at Sheba Medical Centre, it has been a long process to fix what he believed was an inbuilt unfairness in the health system.

''If you do not donate something for the greater good of society, how can you then expect to get something back from that society?'' he said.
Which is bizarre, and morally corrupt. There is, after all, no greater good to society stemming from a person being given a new heart, kidney, lungs or face.  The benefit, which for some is dubious, accrues to the individual and, arguably, their nearest and dearest.  And there is a cost, a huge cost, to society's limited medical budget.

Dr Lavee and the medical profession in Israel have offered up a scurrilously simple and manipulative argument, and unfortunately, gotten away with it.  We have to hope that other countries don't succumb to such empty, non-medical emotive claptrap. 

What, other than money to pay the price of medical services, should people have to do in order to have a broken bone fixed, a brain tumor removed, a baby vaccinated?  Is there some "extra" service that should be offered up, some penance for being fixed?  Something more that one must do, for the greater good, to appease the gods for having broken a bone or developing a tumor?  If not, then how can such an argument be extended to human organs?  How has such an argument gained legitimacy in the modern era?

Of all the things any of us have, or believe we have, in our short time on Earth, surely the one thing - the only thing - to which we can claim possession, ultimate integrity, is our own bodies.  Take that away, and we are less than human.  No one has the right to another person's body, another person's organs.  That's a generosity and personal philosophy that must be given freely.


Bedside chat that changed Israel's rules for organ transplants



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