N-108 HEth Lecture 8: Organ Donation and Transplantation

Summary

This lecture delves into the ethical principles guiding human organ donation and transplantation, highlighting the historical development from the 19th century to the present. It emphasizes the importance of respecting human dignity, stewardship, and the integrity of the body. The discussion covers the challenges of organ rejection, the introduction of cyclosporine, and the ethical controversies surrounding organ trafficking. The lecture also outlines key bioethical principles, such as ensuring the donor's free and informed consent, and the just allocation of scarce organs. It concludes with insights from the Catholic Church on organ donation and the types of organ transplantation, including xenotransplantation.

Takeaways

• 📚 Organ transplantation was accepted as a treatment during the 19th and 20th centuries, with significant advancements in the field.
• 🏥 The U.S. Navy Tissue Bank, established in 1949, was a pioneering facility for tissue processing and storage, which also influenced the development of blood and sperm banks.
• 👨‍⚕️ Dr. Joseph Murray performed the first successful kidney transplant in 1950s, and Dr. Christian Barnard conducted the first heart transplant in 1967.
• 🇵🇭 In the Philippines, Dr. Domingo T. Antonio performed the first successful kidney transplant in the 1960s.
• 🛡️ The immune system's rejection of foreign organs is a major challenge in transplantation, which was initially addressed by the introduction of cyclosporine in 1978.
• 🧬 Ethical controversies surround organ transplantation, with three key bioethical principles guiding decision-making: human dignity, stewardship and creativity, and totality and integrity.
• 💔 The principle of human dignity emphasizes that body parts should be treated with respect and not as economic commodities.
• 🌱 The principle of stewardship and creativity suggests that we do not have absolute dominion over our organs and should take care of them for the benefit of others.
• 🔍 The principle of totality and integrity calls for ensuring the overall well-being of both the donor and the recipient in organ transplantation.
• ⚖️ Organ transplantation raises legal and ethical issues, including the scarcity of organs, unclear laws, and the potential for organ trading and trafficking.
• 💼 The Catholic Church supports organ transplantation when conducted ethically and with morally irreproachable intentions, emphasizing respect for the body.

Q & A

What is the significance of the U.S. Navy Tissue Bank in the history of organ transplantation?

The U.S. Navy Tissue Bank, established in 1949, was significant as it was the first bone and tissue processing and storage facility in the USA, which laid the groundwork for future advancements in organ transplantation.

Who performed the first successful kidney transplant, and where did it take place?

Dr. Joseph Murray performed the first successful kidney transplant in Boston, Massachusetts during the 1950s.

What major ethical principle should be considered when discussing organ transplantation?

Three major bioethical principles should be considered: the principle of human dignity, the principle of stewardship and creativity, and the principle of totality and integrity.

What does the principle of human dignity entail in the context of organ transplantation?

The principle of human dignity requires that every part of the body should be treated with respect and not merely as an economic advantage or currency.

How does the principle of stewardship and creativity apply to organ donation?

The principle of stewardship and creativity emphasizes that we do not have absolute dominion over our organs; we are entrusted to take care of them and use them responsibly, not for personal gain.

What is the main concern regarding the rejection of transplanted organs by the host body?

The host body's immune system tends to reject any foreign organ that is not recognized, leading to a need for treatments like the introduction of cyclosporine in 1978 to combat organ rejection.

What are the implications of organ trafficking and how does it disrespect the body?

Organ trafficking disrespects the body by treating organs as mere commodities for trade, which violates the principles of human dignity and the ethical treatment of body parts.

According to the Catholic Church's teachings, what is the stance on organ transplantation?

The Catholic Church does not oppose organ transplantation as long as it is done with morally irreproachable intentions and respects the dignity and integrity of the human body.

What are some ethical guidelines for organ donation and transplantation mentioned in the script?

Some ethical guidelines include ensuring there is a serious need for the organ, maintaining the functional integrity of the donor, ensuring the donor's consent is free and informed, and selecting recipients justly without bias towards social class or status.

What does the Philippine law (Republic Act 7170) encourage regarding organ donation?

Republic Act 7170 encourages voluntary organ donation and specifies that organs can be harvested for transplantation from patients who are irreversibly brain dead or clinically dead, with proper consent.

What are the different types of organ transplantation mentioned in the script?

The script mentions auto-transplant (within the same individual), allo-transplant (from another person of the same species), and xeno-transplant (from one species to another, such as from pigs to humans).

Outlines

00:00

🏥 History and Principles of Organ Transplantation

This paragraph introduces the topic of organ transplantation, highlighting its historical development from the 19th and 20th centuries. It mentions the establishment of facilities like the U.S. Navy Tissue Bank and the pioneering work of doctors like Joseph Murray and Christian Barnard. The paragraph discusses the problem of organ rejection and the introduction of cyclosporine to combat this issue. It also touches on the ethical controversies surrounding organ transplantation and emphasizes three major bioethical principles: human dignity, stewardship and creativity, and totality and integrity. These principles guide the ethical considerations in organ transplantation, ensuring respect for the body and its parts, proper stewardship, and maintaining the integrity of the donor and recipient.

05:03

📚 Ethical Considerations in Organ Transplantation

Paragraph 2 delves into the ethical principles underlying organ transplantation and donation. It stresses the scarcity of organs and the need for proper selection of candidates. It also addresses the legal ambiguities and potential for organ trafficking, which can cross national borders. The paragraph emphasizes the importance of treating body parts with reverence and not as commodities. It references the Catholic Church's stance on organ transplantation, which supports it as long as the intentions are morally irreproachable. The paragraph concludes with a set of ethical guidelines for organ donation and transplantation, focusing on the seriousness of need, the donor's condition, and the proportionality of risk and benefit.

10:03

🚫 Social Media and Organ Transplantation

Paragraph 3 discusses the sensitivity required when dealing with organ transplantation, particularly in the context of social media where jokes about donating organs for trivial reasons can be in poor taste. It emphasizes the seriousness of organ transplantation and the need for respect for both the donor and the recipient. The paragraph outlines ethical guidelines that include maintaining the donor's functional integrity, ensuring the risk taken by the donor is proportionate to the recipient's benefit, and obtaining free and informed consent from the donor. It also stresses the importance of clear financial implications and the selection of recipients based on medical need rather than social status.

15:10

🏢 Legal and Ethical Frameworks for Organ Donation

This paragraph outlines the legal and ethical frameworks that govern organ donation. It mentions the Republic Act 7170, which encourages voluntary organ donation and allows for the harvesting of organs from brain-dead or clinically dead patients, provided there is free and informed consent. The paragraph also discusses the role of the hospital in the organ donation process and the importance of not treating organs as property. It references various church teachings on organ donation, emphasizing the importance of ethical conduct and the respect for human life and dignity in the process of organ transplantation.

20:18

🌐 Types of Organ Transplants and Church Teachings

Paragraph 5 explores different types of organ transplants, including auto-transplants (within the same individual), allo-transplants (between individuals of the same species), and xeno-transplants (between different species). It mentions a specific case in the Philippines where pig valves were transplanted into humans. The paragraph also discusses the ethical considerations of xeno-transplants, focusing on the potential impact on the recipient's psychological and genetic identity. It concludes with references to church teachings that advocate for a just allocation of scarce organs and the importance of treating the donation process with humanity and respect.

25:19

📖 Conclusion and Invitation for Questions

The final paragraph wraps up the lecture by summarizing the key points discussed and inviting questions from the audience. It reiterates the importance of ethical considerations in organ transplantation and the need for a culture of life that values the donation of organs. The speaker encourages further discussion and provides a means for the audience to reach out with any questions they may have, fostering a continued dialogue on the topic.

Keywords

💡Organ Transplantation

Organ transplantation refers to the surgical procedure of replacing a failing organ with a healthy one from another person or sometimes an animal. In the context of the video, it is a medical procedure that has evolved significantly since the 19th and 20th centuries, with the first successful kidney transplant performed in the 1950s and the first heart transplant in 1967. The video discusses the historical developments, ethical considerations, and principles guiding organ transplantation.

💡Host Rejection

Host rejection is the body's immune response to an organ transplant, recognizing the new organ as foreign and attacking it. The script mentions that this is a significant problem in organ transplantation, as the body's immune system will naturally try to reject anything it does not recognize. The introduction of cyclosporine in 1978 was a breakthrough in combating this rejection.

💡Cyclosporine

Cyclosporine is an immunosuppressive drug used to prevent the body from rejecting a transplanted organ. The video script explains that it was introduced in 1978 to help manage the host rejection issue but is not without side effects, leading to ongoing research for better treatments.

💡Bioethical Principles

Bioethical principles are the moral guidelines that should be considered when dealing with issues in biomedicine, such as organ transplantation. The video outlines three key principles: human dignity, stewardship and creativity, and totality and integrity. These principles are crucial in ensuring that organ transplantation is conducted ethically and respects the value of human life and body.

💡Human Dignity

Human dignity is a bioethical principle that emphasizes the inherent worth and respect that should be accorded to every human being. In the video, it is applied to organ transplantation by stating that every part of the body should be treated with respect and not merely as a means for economic gain.

💡Stewardship and Creativity

Stewardship and creativity refer to the concept that humans are not the absolute owners of their bodies but are entrusted with the responsibility to take care of them. The video suggests that body parts should be maintained in accordance with this principle and not exploited for financial gain.

💡Totality and Integrity

Totality and integrity is a principle that emphasizes the importance of considering the overall well-being and functionality of both the organ donor and the recipient. The video stresses that organ transplantation should not compromise the health and well-being of either party.

💡Organ Trafficking

Organ trafficking is the illegal trade of human organs, often involving exploitation and a disregard for the ethical principles surrounding organ transplantation. The video condemns this practice as it disrespects the body parts and the individuals involved.

💡Informed Consent

Informed consent is a principle in medical ethics that requires the recipient of medical treatment or procedure to understand the risks and benefits before giving their agreement. The video emphasizes that organ donation should never be an obligation, and donors must give their consent freely and with full information about the procedure.

💡Auto Transplant

An auto transplant is a type of organ transplantation where an individual's own tissue or organ is transplanted to another part of their body. The video mentions this as one form of transplantation, contrasting it with allotransplantation, which involves receiving an organ from another person.

💡Zeno Transplant

A zeno transplant refers to the transplantation of organs or tissues from one species to another. The video provides an example of a doctor in the Philippines who performed xeno transplants using pig valves. The ethical considerations of such procedures are discussed in terms of potential harm and the integrity of the recipient.

Highlights

Introduction to the principles guiding human organ donation and transplantation.

A brief history of organ transplantation, including the first successful kidney transplant.

The establishment of the U.S. Navy Tissue Bank and its role in tissue processing and storage.

The introduction of cyclosporine in 1978 to combat organ rejection.

Ethical controversies surrounding organ transplantation.

The three major bioethical principles in organ transplantation: human dignity, stewardship and creativity, and totality and integrity.

The importance of treating body parts with respect and not as economic gains.

The concept of stewardship and our responsibility towards our body parts.

The principle of totality and integrity in ensuring the well-being of organ donors and recipients.

The scarcity of organs and the ethical implications of selecting candidates for transplantation.

Legal ambiguities and the potential for organ trafficking.

The obligation to give reverence to our bodies due to the principles of organ donation.

The Catholic Church's stance on organ transplantation and its ethical considerations.

Ethical guidelines for organ donation and transplantation, emphasizing the seriousness of the need.

The importance of maintaining the donor's anatomical and functional integrity.

The principle that the donor's risk should be proportionate to the recipient's benefit.

The necessity of free and informed consent in organ donation.

The selection of organ recipients should be based on medical need, not social status.

The Philippine law on organ donation and its emphasis on voluntary action.

Church teachings on organ donation, including the importance of ethically acceptable practices.

Types of organ transplantation: auto, allo, and xeno transplants.

The ethical considerations of xenotransplantation and its potential impact on human identity.

Conclusion and invitation for questions, highlighting the educational value of the lecture.

Transcripts

hi students so for today we will discuss

about

the principles that should guide human

organ donation and transplantation

now for us to understand what organs

transplantation is

we have to get a little brief or a brief

history about this

procedure now organ trans

transplantation was only

uh to treat illness no was accepted

as a treatment only during the 19th and

20th century

that there are some establishments not

like the u.s navy tissue bank in 1949

which is given usa its first bone and

tissue

processing and storage facility now this

facility young things happen at the u.s

navy tissue

bank is also a facility that gave rise

not to to eye no organs to blood

sperm banks etc okay the concept goes on

like that

during the 1950s dr joseph murray has

performed the first successful kidney

transplant in boston massachusetts

while in 1967 you know

the first heart transplant was was done

in uh in growth shore hospital

in cape town okay by dr christian

barnard

while here in the philippines dr domingo

antonio

performed the first successful kid

transplant in the 1960s

now organ transplant seems a promising

procedure however there's a

there's one problem that they encounter

this is the rejection of the host body

okay because

anything that you put inside your body

be it

another organ as long as it is not

recognized by your body

your body tends to reject that because

of your immune system

now to combat this host rejection in

1978

no cyclosporine was introduced not to

counteract organ rejection now

cyclosporine is not without side effects

so they continuously research to

neutralize the side effects

of the drug okay and also

even though the intentions of organ

transplantation is

initially good the procedure is however

not without

ethical controversies

now when we deal with

cases of organ transplantation

three major bioethical principles

have to be have to be in our mind

and in our hearts no when we

try to examine these cases

first the principle of human dignity

second we have the principle of

stewardship and creativity and third

the principle of totality and integrity

when you say when we consider the

principle of human dignity in organ

transplantation

we have to bear in mind that every part

of your body

should be treated as if it is a person

no

it should be treated with respect okay

it should be treated not as an economic

uh advantage

just to uh just to gain economic gains

no just to have economic gains your

your body parts should be treated not as

an economic gain

not as a currency but as a person as

part of you

okay number two

being uh the principle of stewardship

and creativity tells us

that we are uh we are the owners no we

are not the

we are we do not have absolute dominion

over this

kidneys these organs

no we have to understand

that uh that this

that this body parts of yours

should be taken care of

that's in principle of that's in

conformance with the principle of

stewardship

no because you take care

no of others other people's lives

but if you if you did it in

in case of uh in case that you want to

gain money out of it then your ethical

morality

or your morality may be in question

third the principle of uh

totality and integrity tells us that we

should ensure

no the the overall

functionality overall well-being of

people who are going to donate

and who are going to receive an organ

okay

now there are some principles also

that tells us how to uh that underlies

not the organ transplantation and

donation

first young organ snapping are scarce

therefore your candidates who wait for

the procedure

they should be selected properly

indeed has implication in choosing

the person who should be who should be a

recipient of that organ

number two you applicable laws

outside lugar are not so clear about the

practice of organ transplantation

no third there may be

an incidence of trading and trafficking

organs

that even cross national borders

so those are the issues that underlie

organ

donation and transplantation okay

we must remember that we have an

obligation to give reverence

that is due to our body because of these

principles

incarnate principles human dignity

stewardship and creativity

and totality and integrity okay

now if we try to sell

our body parts systematically

or in an organized manner

you are actually performing organ

trafficking

organ trafficking is the tested because

it disrespects not it disrespects

our um our

body parts it disrespects our body parts

now human organs should not be treated

as if they were spare parts because on

the first place

no and on the first place

and that should be respected no

is that that your respect should be

given to that body part

now uh we are at the church teaching

uh the catholic church would uh would

tell you uh

it's not it's not against no

transplantation

as pope pius 12 said you may dispose of

your body

no to the sting it to ends that are

useful

more morally irreproachable and even

nobel ibis

as long as your your your intentions

your motives

no are useful morally irreproachable

okay

your decision no should have still

respect on your own body

hindi out of your own whim

out of other people's pressure and

pinaki

okay this decision sabingani

the 12 should not be condemned but

positively

justified now here are some ethical

guidelines for organ donation and

transplantation

when i say guidelines no in the in the

perspective of bioethics these are not

the set rules but rather guiding

principles

that are guiding guiding planets not for

organ donation and transplantation

number one if you're going to donate

something to someone make sure that

there is a serious need

on the part of the recipient that cannot

be fulfilled

in any other way superficial and shallow

motives cannot be

an overriding reason to affect

or implement human organ transplantation

by a donor to a recipient

there should be seriousness of condition

okay or

dialysis machine no it's a procedure

there is a serious need among them

so that's why uh in this uh in this

regard

we must also be sensitive no

on the seriousness of organ

transplantation because

there are some people know who are

posting

in social media jokes about

they donated their kidneys their organs

just to buy the new iphone

the new ps5 no even though they are

joking they are they did it

in in a tasteless manner

no why because

and they are seriously in dire need of

that

then here comes the social media joking

about it

so that's an improper way you know to

treat your body organs and to treat the

seriousness of the condition

of your patients no of patients needing

organ donation

no so that's not a proper job because of

the seriousness of their condition

and the seriousness of this issue

okay number two if you're if you have

decided not

to do to donate something you should

also consider

know the functional integrity of that

person

of the donor because

in uh in donating organs ethically

the functional integrity of the donor

should not be

affected or should not suffer

okay it should remain intact

or will change

anatomical integrity and functional

integrity in terms of ethical principles

no

or in in the perspective of bioethics

when we say anatomic integrity or

anatomical integrity

this refers to your quantitative

completeness

completely

now functional integrity refers to your

systematic

efficiency of your body

function

etc

logic function or psychological function

that refers to your functional integrity

now if you donate something

an atomic integrity as long as your

functional integrity is

is efficient

but if your if your functional integrity

will be

affected no then

you are not uh you cannot donate your

body part

no for example those who are diabetic no

diabetic patients cannot donate

because a body part la luna for example

because if you remove one part of their

kidney

no another only one kidney will suffer

on the effects of the of their disease

number three the risk taken by the donor

as an act of charity

should be proportionate to the good

effect in favor of the recipient

this only says that when we donate when

a donor donates something to a patient

it should be proportionate to the the

good effect on the

recipient should be proportionate no

don't

act

you gave one of your kidneys to a

patient no

this this tenant is satisfied

when that patient new recipient not

improving quality of life after the

donation

okay

an act of donation is done it should the

good effect

no should be foreseen as to be good

because it's a total waste of resource

it's a total waste of effort

on the part of receipt of the donor if

magda donates

to a dying patient no or a terminal case

the next guideline should be that the

donor's consent is free and informed

no remember that organ donation is never

an obligation an indian obligation

but rather an act of charity

donate

but you do not donate because you expect

something back

okay so for the donor to act freely

that that person should have free

and informed consent all

information

there should be no pressure on him or

her

no i say uh let's say let's

let's face it in our society

unfamiliar emphasize unfamiliar

you may feel that you are obligated no

to help that person again i

i tell you organ donation

is never an obligation okay

if you want to give give kung

aya hinde

but they have to understand no that

this is a this is a life-changing

decision

and that all other all other

um all other influences to your decision

should be disregarded

rather than your own voluntary

decision you know matter no

okay you showed uh

in organ donation also an organ

recipient receiving an organ there are

there's a big no

financial implication on the surgery

so that you must be clearly it must be

clearly specified in detail

to avoid legal and even ethical

repercussions

number uh the next guideline or the next

tenet that we should uh take into

consideration is the is that the

recipients for the scarce organ

should be selected justly

a debilitating disease no which can be

improved by organ donation

no but never the social class

no or the never the social status

because

well that's not ethically possible

but reality it happens no

but what i'm telling you is that we must

follow the ideal

we must follow or we must observe the

principle of justice

that's an act of charity but in terms of

the recipient

what is the act of charity on the part

of the recipient

no on the part of the recipient the act

of charity is by

shouldering the expenses of the receipt

of the donor

in terms of

recipients

okay now

another act of charity on the part of

the recipient is by

taking care of the organ being given to

you

you have to take care of that organ no

you have to take care of that

part given to you you have to treat it

with respect

no in respect not to the virtuous act

of the person who gave it to you okay

so here in the philippines organ

donation uh was is guided not by the

republic of 7170

or the organization organ donation act

of 1991

okay the main gist of this law is that

it encourages the donor to donate their

kidneys or liver or

any other human organs when opportunity

opens up for them

okay and

it's a concept that donation is a

voluntary action

okay now when the patient

in this law it specifies also that when

the patient

is uh irreversibly brain dead or

clinically dead

uh they can also their organs can be

harvested upon

upon

now if the body or

it says that in this law the hospital

can harvest the for transplantation

no don't cut the

without formal and free informed consent

provided

within 48 hours

by means of public uh public

announcement

no radio tv newspaper or even social

media

okay

um

[Music]

the hospital can harvest

that body part if needed okay

if needed as long as

up for sale well donation does not go

that way

no so the hospital can harvest the organ

but it's not their property

no it's not their property

so here are some church teachings on

organ donation

you may want to look into it because

it's uh it specifies no

it specifies uh one way or another

no numa pina gusapan ordinis not in

canina

like for this like for example

evangelion vitae

which was published in 1995. now

amsabirito one way of nurturing a

genuine culture of life

is the donation of organs so ibiza okay

as long as you perform it in ethically

and acceptable manner in a view to

offering a chance of help

and even of life to the sick okay

next in the in a document published in

1987 the donald v

day which says that any procedure which

tends to commercialize

human organs or to consider them as an

item of exchange or trade must be

considered immoral

yet using that it should not be part

no or should not be considered as

something of economic value

another type or another uh another

document

which says that in uh in which was

published

in 2005 that they used carrick as s

it says that we are dealing with human

beings and human beings always need

something more than technically proper

care

they need humanity it espouses no

the humanity of every part of your body

so and while the cbcp our local church

uh bishop conference in 2008

issued a statement stating that

a just allocation of the scarce resource

should be safeguarded

scarce organs organ donors should be

made available first

to local recipients okay to local

recipients

now onsen transplantation um we all we

are uh

that there are several types of uh

transplantation it can be an auto

transplant meaning one part of your body

to another part of your body while allo

transplant is

getting a transplant from

from another person or the of the same

species not a transplant from one

of a transplant within the same species

so from from humans to humans that's an

aloe transplant

but if you transplant no animal organs

not to human you call that a zeno

transplant

it is it possible yes it is possible

because in the philippines

no one doctor dr avedilo aventura

performed several zeno transplantation

of pig bulbs

to humans now if you

try to examine this this is actually

ethically indifferent

okay if it impairs the integrity of

psychological or

genetic identity of the person receiving

it

if it will bring more harm

then you should not do a zeno transplant

that's the end of my lecture for for

this week i hope you learned something

from me

if you have any questions you may send

me a direct message

through my facebook messenger have a

nice week