All attempts relying on pure altruism to meet the demand for transplantable donor organs have failed and continue to fail. The incentive of commercialization of an organ market would seem to be the only practical solution at this time. It is almost impossible to set fixed prices for such priceless items as human organs.
The number of "units" of human bone used during surgical procedures has grown to almost a quarter of a million. Medical demand for such bone is expanding rapidly and the nation's bone-banking system is struggling to grow apace. Unfortunately, because of this growth, bone banks must compete with organ banks for access both to hospitals and to potential donors. This conflict can, and may already be, negatively affecting the supply of transplantable tissues and organs.
This article examines the responses of bone marrow donors to the death of the unrelated person to whom they donated. Data analyzed were 330 questionnaires and fifty in-depth interviews collected from donors in the National Marrow Donor Program at one year post-donation. Death of the recipient produced feelings of guilt and responsibility in the donors in only a few cases (2% of donors from questionnaire data and 2 of the 23 donors interviewed). Grief occurred often (22 of 23 donors interviewed) and was often surprisingly intense, given the fact that the recipient was a stranger.
... One is struck by the high level of organ procurement charges in spite of the characterization of organ procurement as altruistic. Although the median organ procurement charges in 1988, documented by Evans, ranged from nearly $16,000 to nearly $21,000 (1991 dollars), there was not a penny for the accident victim's/organ donor's family. That some transplant hospitals routinely marked up charges they paid to organ procurement organizations by as much as 200% hardly seems consistent with altruism.
With tens of thousands of waiting recipients but only 4000-5000 organs available annually, there is a chronic and largely insatiable demand for organ transplants. This article draws on three sources of data regarding the sources of organs donated: a survey of the families of organ donors, a survey of the general public, and a prospective data collection effort from organ procurement agencies. It considers which Americans are willing to engage in this kind of altruism.
The main purpose of this study was to reach a deeper understanding of factors influencing the attitudes toward organ donation and other procedures with the dead body. From a survey of 400 inhabitants of Uppsala, a city in the middle of Sweden, concerning attitudes toward transplantation issues, 38 individuals with different attitudes toward donation of their own organs were selected for follow-up interviews. From the interviews, more than 600 statements concerning motives and reactions to medical procedures with the dead body were listed.
The analogy between gift-giving and organ donation was first suggested at the beginning of the transplantation era, when policy makers and legislators were promoting voluntary organ donation as the preferred procurement procedure. It was believed that the practice of gift-giving had some features which were also thought to be necessary to ensure that an organ procurement procedure would be morally acceptable, namely voluntarism and altruism.
A severe shortage of organs is perhaps the most important obstacle facing transplantation today. In an attempt to address this serious problem, several transplant centers have suggested a reconsideration of genetically unrelated living kidney donors. Recently, there have been reports of excellent results using such unconventional donors, and cogent arguments have been made that this approach is ethically acceptable, at least when the donor is motivated by altruism.
We report a survey in the UK of potential whole-body donors for dissection. 218 people (age range 19-97 years) answered a postal questionnaire, giving information about themselves, their reasons for donation, attitudes towards the dead body, funeral preferences and medical giving and receiving. In addition to altruism, motives included the wish to avoid funeral ceremonies, to avoid waste, and in a few cases, to evade the expense of a funeral. 44% understood that their bodies would be used as teaching material, 42% for experiments.
Transplantation surgeries contribute to conceptions of the body as a collection of replaceable parts and of the self as distinct from all but its neural locus. There remains substantial cultural resistance to these conceptions, which leads the medical community to attempt to link the surgeries to social values that are sufficiently powerful to minimize the sense of a disjuncture between traditional concepts of personhood and those consistent with transplantation.