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The "spare parts person"? Conceptions of the human body and their implications for public attitudes towards organ donation and organ sale
The interface of worldwide religions and the ideology behind the practice of end-of-life organ donation for transplantation
Mohamed Rady, Mayo Clinic Hospital
20 February 2009
The interface of worldwide religions and the ideology behind the practice of end-of-life organ donation for transplantation
Mohamed Y Rady; Joseph L Verheijde; Catherine Friederich-Murray Departments of Critical Care Medicine,Physical Medicine and Rehabilitation, and Biomedical Ethics, Mayo Clinic Hospital, Phoenix, Arizona, USA. Bioethics, Policy, and Law Program, Arizona State University, Tempe, Arizona, USA.
For more than 40 years, the end-of-life practice of heart-beating (called brain death) or non–heart-beating (called cardiac or circulatory death) organ procurement for transplantation has thrived on an ideology based on concepts of “altruism,” “gift of life,” or “saving human life” without scrutiny of that medical practice [1]. Proponents have used this ideology to dismantle any opposing fundamental values and beliefs about human life and culture. The study by the Schweda and Schicktanz confirms that religious and cultural values about the human body—both in life and in death—have implications on people’s attitudes and the acceptability of the current practice of procuring organs for transplantation [2].
In the zeal to support the current practice of organ procurement, transplant advocates and many in the transplant community have customized ethical arguments (often abstract and inherently conflicting), justifying serious infractions of centuries-old precepts firmly founded in all major worldwide religions [3]. A few examples of customized ethical justifications[4] that seriously challenge the core principles of worldwide religions include redefining human death to procure transplantable organs from the incipiently dying, resuscitating and reanimating human beings as part of procedures for organ preservation, avoiding transparency during the voluntary consent process [5], and legislating presumed intent to donate organs (in the United States)[6] and consent to donate organs (in the European Union countries)[7] at the end of life.
Organ-procurement agencies consistently claim that all major world religions approve of organ donation and do not address the growing ethical and religious controversies about organ procurement in the context of heart-beating (brain-dead) human beings [8, 9]. Instead, transplant advocates ignore these serious ethical and religious controversies as long as government agencies continue to sanction education campaigns about organ donation. These education outreach campaigns become an indoctrinating tool for an ideology in children as young as elementary-school age [10]. The ideologic transformation is launched not only without open and broad societal discussion, but also with proponents fully aware that this transformation transgresses the rights of others’ diverse religious and cultural values and practices and the respect of human dignity.
References 1. Verheijde JL, Rady MY, McGregor JL, Friederich-Murray C: Enforcement of presumed-consent policy and willingness to donate organs as identified in the European Union Survey: The role of legislation in reinforcing ideology in pluralistic societies. At [ http://0-dx-doi-org.brum.beds.ac.uk/10.1016/j.healthpol.2008.08.008 ]. Health Policy in press, Early online doi:10.1016/j.healthpol.2008.08.008
2. Schweda M, Schicktanz S: The "spare parts person"? Conceptions of the human body and their implications for public attitudes towards organ donation and organ sale. At [ http://www.peh-med.com/content/4/1/4 ]. Philos Ethics Humanit Med 2009, 4(1):4.
3. Bruzzone P: Religious Aspects of Organ Transplantation. Transplant Proc 2008, 40(4):1064-1067.
4. Rady MY, Verheijde J, Ali M: Islam and End-of-Life Practices in Organ Donation for Transplantation: New Questions and Serious Sociocultural Consequences. HEC Forum in press.
5. Truog RD: Consent for Organ Donation -- Balancing Conflicting Ethical Obligations. N Engl J Med 2008, 358(12):1209-1211.
6. Verheijde JL, Rady MY, McGregor JL. The United States Revised Uniform Anatomical Gift Act (2006): New challenges to balancing patient rights and physician responsibilities. Philos Ethics Humanit Med. 2007;2(1):19 [http://www.peh-med.com/content/2/1/19].
7. Mossialos E, Costa-Font J, Rudisill C. Does organ donation legislation affect individuals' willingness to donate their own or their relative's organs? Evidence from European Union survey data. BMC Health Serv Res. 2008;8:48: [http://0-www-biomedcentral-com.brum.beds.ac.uk/1472-6963/8/48 ].
8. Bresnahan MJ, Mahler K: Ethical debate over organ donation in the context of brain death. At [ http://0-dx-doi-org.brum.beds.ac.uk/10.1111/j.1467-8519.2008.00690.x ]. Bioethics in press, Early online DOI 10.1111/j.1467-8519.2008.00690.x
9. Pope Beneditc XVI: No suspicion or arbitration in certifying death. The Holy Father praises scientific advances while warning of the need to guard against unethical practices.In L'Osservatore Romano. 12 November 2008, Weekly Edition in English , Vatican City. [http://www.vatican.va/news_services/or/or_eng/text.html#4]
10. Woien S, Rady MY, Verheijde JL, McGregor J: Organ Procurement Organizations Internet Enrollment for Organ Donation: Abandoning Informed Consent. At http://0-www-biomedcentral-com.brum.beds.ac.uk/1472-6939/7/14. BMC Med Ethics 2006, 7(12):14-23
The interface of worldwide religions and the ideology behind the practice of end-of-life organ donation for transplantation
20 February 2009
The interface of worldwide religions and the ideology behind the practice of end-of-life organ donation for transplantation
Mohamed Y Rady; Joseph L Verheijde; Catherine Friederich-Murray
Departments of Critical Care Medicine,Physical Medicine and Rehabilitation, and Biomedical Ethics, Mayo Clinic Hospital, Phoenix, Arizona, USA. Bioethics, Policy, and Law Program, Arizona State University, Tempe, Arizona, USA.
For more than 40 years, the end-of-life practice of heart-beating (called brain death) or non–heart-beating (called cardiac or circulatory death) organ procurement for transplantation has thrived on an ideology based on concepts of “altruism,” “gift of life,” or “saving human life” without scrutiny of that medical practice [1]. Proponents have used this ideology to dismantle any opposing fundamental values and beliefs about human life and culture. The study by the Schweda and Schicktanz confirms that religious and cultural values about the human body—both in life and in death—have implications on people’s attitudes and the acceptability of the current practice of procuring organs for transplantation [2].
In the zeal to support the current practice of organ procurement, transplant advocates and many in the transplant community have customized ethical arguments (often abstract and inherently conflicting), justifying serious infractions of centuries-old precepts firmly founded in all major worldwide religions [3]. A few examples of customized ethical justifications[4] that seriously challenge the core principles of worldwide religions include redefining human death to procure transplantable organs from the incipiently dying, resuscitating and reanimating human beings as part of procedures for organ preservation, avoiding transparency during the voluntary consent process [5], and legislating presumed intent to donate organs (in the United States)[6] and consent to donate organs (in the European Union countries)[7] at the end of life.
Organ-procurement agencies consistently claim that all major world religions approve of organ donation and do not address the growing ethical and religious controversies about organ procurement in the context of heart-beating (brain-dead) human beings [8, 9]. Instead, transplant advocates ignore these serious ethical and religious controversies as long as government agencies continue to sanction education campaigns about organ donation. These education outreach campaigns become an indoctrinating tool for an ideology in children as young as elementary-school age [10]. The ideologic transformation is launched not only without open and broad societal discussion, but also with proponents fully aware that this transformation transgresses the rights of others’ diverse religious and cultural values and practices and the respect of human dignity.
References
1. Verheijde JL, Rady MY, McGregor JL, Friederich-Murray C: Enforcement of presumed-consent policy and willingness to donate organs as identified in the European Union Survey: The role of legislation in reinforcing ideology in pluralistic societies. At
[ http://0-dx-doi-org.brum.beds.ac.uk/10.1016/j.healthpol.2008.08.008 ]. Health Policy in press, Early online doi:10.1016/j.healthpol.2008.08.008
2. Schweda M, Schicktanz S: The "spare parts person"? Conceptions of the human body and their implications for public attitudes towards organ donation and organ sale.
At [ http://www.peh-med.com/content/4/1/4 ]. Philos Ethics Humanit Med 2009, 4(1):4.
3. Bruzzone P: Religious Aspects of Organ Transplantation. Transplant Proc 2008, 40(4):1064-1067.
4. Rady MY, Verheijde J, Ali M: Islam and End-of-Life Practices in Organ Donation for Transplantation: New Questions and Serious Sociocultural Consequences. HEC Forum in press.
5. Truog RD: Consent for Organ Donation -- Balancing Conflicting Ethical Obligations. N Engl J Med 2008, 358(12):1209-1211.
6. Verheijde JL, Rady MY, McGregor JL. The United States Revised Uniform Anatomical Gift Act (2006): New challenges to balancing patient rights and physician responsibilities. Philos Ethics Humanit Med. 2007;2(1):19 [http://www.peh-med.com/content/2/1/19].
7. Mossialos E, Costa-Font J, Rudisill C. Does organ donation legislation affect individuals' willingness to donate their own or their relative's organs? Evidence from European Union survey data. BMC Health Serv Res. 2008;8:48: [http://0-www-biomedcentral-com.brum.beds.ac.uk/1472-6963/8/48 ].
8. Bresnahan MJ, Mahler K: Ethical debate over organ donation in the context of brain death.
At [ http://0-dx-doi-org.brum.beds.ac.uk/10.1111/j.1467-8519.2008.00690.x ]. Bioethics in press, Early online DOI 10.1111/j.1467-8519.2008.00690.x
9. Pope Beneditc XVI: No suspicion or arbitration in certifying death. The Holy Father praises scientific advances while warning of the need to guard against unethical practices.In L'Osservatore Romano. 12 November 2008, Weekly Edition in English , Vatican City. [http://www.vatican.va/news_services/or/or_eng/text.html#4]
10. Woien S, Rady MY, Verheijde JL, McGregor J: Organ Procurement Organizations Internet Enrollment for Organ Donation: Abandoning Informed Consent.
At http://0-www-biomedcentral-com.brum.beds.ac.uk/1472-6939/7/14. BMC Med Ethics 2006, 7(12):14-23
Competing interests
none