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Ethical Problem of Harvesting Donor Organs

The ethical problem of harvesting the donor organs of people who are in a state of irreversible coma exists in the present time. On the one hand, transferring the organs of such patients can save lives. On the other hand, the considerations of potential organ donors need to be involved in making the decision (Dalal, 2015). It is possible to consider this problem from an ethical point of view using specific approaches for making the decision (Katz, 2017). To find the appropriate solution, it is important to describe the ethical dilemma of harvesting organs taking into account all involved sides, examine possible decisions with their benefits and limitations, and apply the utilitarian approach for making the decision and developing an implementation plan.

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Description of the Ethical Dilemma

In the present time, the development of medicine allows keeping people in irreversible comes alive. These patients have brain damage that cannot be cured. Thus, their brains do not function; however, their bodies remain clinically alive due to the work of medical equipment in hospitals (Moskopp, 2017). At the same time, the problem of organ donation remains urgent due to the significant number of patients who require this procedure. These people could potentially live if they receive an organ transplant. However, because of the lack of donor organs, they frequently die (Sade & Boan, 2014).

It has been proposed that one of the possible solutions to this problem is to take needed donor organs from people in an irreversible coma. This procedure is called organ harvesting (Truog, Miller, & Halpern, 2013). To take the donor's organs, consent from relatives or caregivers of a patient is necessary. Moreover, these relatives can obtain financial compensation for the organs. Some bioethicists, who believe that harvesting the organ is an ethical and helpful procedure, are in favor of revising the law and allowing such organ donation in terms of legislation. To decide whether such revision of the law would be ethical, it is necessary to consider all stakeholders and possible decisions of the problem.

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Several sides are involved in this ethical dilemma. First, it is important to consider people who are involved directly in the problem. These would be the patients in a state of irreversible coma who could be organs donors, and patients who require organs transplantation. Second, it is necessary to consider the sides that are indirectly involved in the problem. These would include the relatives and caregivers of potential organ donors, and physicians who are involved in examining the state of health of these patients.

Obviously, patients in irreversible coma do not have the capacity to express opinions regarding the problem. However, some of them sign a donor card before their coma state. Thus, it is possible to recognize their intentions and wishes to donate their organs (Dalal, 2015). According to others, nothing can be known with complete certainty. Regarding the adverse and positive effects of the procedure on a patient in an irreversible coma, there is no consensus. On the one hand, the procedure of organ donation adversely affects the patient's body. On the other hand, based on the results of the medical examination, this patient will not recover. Thus, it is evident that the patient does not need these organs anymore (Moskopp, 2017). Also, it is important to consider the attitude of the relatives of this patient. Their opinion could be ambivalent. Some relatives would agree to the procedure because it could save someone's life and because in some cases, they could obtain financial compensation. Other relatives would be against the procedure because of their strong hope for their loved one's recovery, even against the odds. Thus, it is possible to state that some of these people are interested in revising the law, while others are against it. Patients who require organ donations and their relatives are definitely interested in revising the applicable laws because the results could save lives. The opinion of patients and their relatives, as well as society as a whole, could be obtained in the survey and taken into account. However, these people should not participate directly in the decision-making process.

Physicians who examine patients in coma bear the responsibility for making the diagnosis. Thus, if they observe no brain activity and brain death, a coma can be considered irreversible, and organs can be taken from this patient. However, cases of medical misdiagnosis are known to occur periodically (Moskopp, 2017). Thus, physicians must develop a method of diagnosis that can minimize the probability of an incorrect diagnosis. In general, it is possible to assume that healthcare workers would support revising the law because it would increase the number of patients who are saved. Representatives of medical workers should be involved in the decision-making process as well. They would present a point of view of professional physicians and would be able to evaluate the new law critically.

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Finally, Congress and state legislatures also should be involved in the decision-making. Legislatures should develop new laws while considering all benefits and limitations of possible decisions. It is possible to suppose that they would apply the principle of the common good because their goal is to improve the situation with a maximum of positive outcomes for the whole society.

Possible Decisions and Their Benefits and Limitations

In the present time, harvesting the organ from living patients in an irreversible coma is illegal in the United States. To take donor organs, a patient should be declared clinically dead and removed from life support (Capron, 2014). However, present laws could be revised. Several possible decisions could be taken.

The first two decisions are the most rigorous. The first one is to not revise the law and maintain the status quo in which the harvesting the organs is forbidden. The main benefit of this decision is that people who are against this procedure on ethical grounds would be content. The limitation is that people who require transplanted organs would not obtain them and would most likely die.

The second choice is to make the procedure of harvesting organs from people in an irreversible coma legal regardless of the opinion of their relatives. In this case, people who require new organs to save their lives would receive them, which is the main positive outcome. The main limitations of this decision would involve the feelings of relatives who are against the procedure could suffer from emotional distress as well as the interests of people in a coma in case of a wrong diagnosis (Truog et al., 2013).

Between these two decisions, several solutions exist. First, it is possible to allow the harvesting of the organs if a patient in a coma signs a special organ donation card, which would include one writing agreement on organ donation in case of coma. In the other case, harvesting the organ should not be conducted. In this case, the procedure could be performed only if a person would want to donate their organs. This decision is positive for all sides. However, a lot of people do not sign an organ donor card because they are disinterested. Thus, they are not against organs transplants per se, they just do not think about it. Moreover, a lot of people who are already in a state of coma could not be donors because they did not have an opportunity to sign a card. It leads to the main limitation of this decision, which is the significant number of potential organ donors would not be counted.

Finally, another possible decision is to allow the harvesting of organs if a patient signed an organ donor card or if one's relatives or caregivers provide consent. In this case, the interests of people who require organs and relatives of people in coma are taken into account, which is the main benefit of this decision. The limitation is that not all people would agree to sign a donor card or allow harvesting organs from their relatives.

Utilitarian Ethical Model for Decision Making

To make a decision based on an ethical dilemma, it is possible to use an ethical model as a guideline. In the decision, the utilitarian approach can be applied. According to this approach, the right decision is the one that brings the maximum benefits and the least harm to everyone (Katz, 2017). In this ethical dilemma, the decision based on utilitarian principles is the fourth solution listed above. It would be best for everyone to revise existing laws and to make harvesting organs possible if a person signed an organ donor card or if that patient's relatives would agree to conduct the procedure. In this case, people, who require an organ transplant, would obtain the needed procedure, and relatives of a person in a coma would obtain moral satisfaction and financial compensation.

Making the Decision and Developing the Implementation Plan

Based on the ethical model and the framework described above, it is possible to make a decision. The most ethical decision is to revise the law and to allow the harvesting of organs from patients in an irreversible coma, if they signed an organ donor card or if their relatives agreed to conduct the procedure. To implement this plan, it is necessary to perform several steps.

First of all, Congress or state legislatures need to revise the current laws or pass a new one. A special committee should develop strict criteria for examining the patient's organs state (Capron, 2014). After that, it is possible to create a nationwide database with all potential donors and organs to which they could donate, their medical parameters, such as blood group. Thus, medical centers all over the country would have access to this database. In case of necessity, physicians could find the needed organ for a patient (Edgren et al., 2015).

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Nowadays, the harvesting of organs is an important ethical dilemma. Reconsidering the law and allowing this procedure might help to save many lives. On the other hand, it is necessary to decide how ethical it would be to use a person in an irreversible coma as an involuntary donor of organs. Several stakeholders are involved in the dilemma, including people in coma and those who require organs transplantation, relatives from both sides, healthcare workers, and the federal and state governments. To make the decision, it is possible to apply the utilitarian ethical approach. The optimal decision is to revise the law and to allow the harvesting of organs if a person signed an organ donor card or one's relatives agree to a procedure. After revision of the law, new decisions should be implemented.

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