Wednesday, 26 December 2012

The Gift of Life

I didn't see this is the national news, so it's fortunate that I happened to be visiting relatives, since it was on the front page of the local newspaper on Christmas Eve. A 62 year old woman, Sue Dawson, donated a kidney to an anonymous recipient. It's good to see positive coverage of such acts, to reinforce the message that organ donation can do a lot of good.

That said, I think live donation, at least to a stranger (as here), is more than ought to be expected from anyone. It's what philosophers call supererogatory, which means basically beyond the call of duty. Those like Mrs Dawson who want to do this should rightly be praised for their generosity and the good that they do, but others shouldn't feel bad about not volunteering their live organs.

The issue of posthumous (after death) donation, however, is different. Morally speaking, I'm inclined to think that most people act wrongly by refusing to donate posthumous organs.

Tuesday, 18 December 2012

Smoker's Lungs

A tragic story in the news today concerning a 27-year-old cystic fibrosis sufferer who died of lung cancer after being given a transplant from a smoker.

In this case, the family of the deceased are angry that she was not warned that these lungs came from a smoker and of the consequent risks. The Royal Brompton and Harefield NHS Foundation Trust seem to acknowledge this and apologise for not giving her the choice of whether to take these lungs or wait for a match with a non-smoker, though they do note that almost everyone given such a choice opts to take the first healthy match available rather than wait (the woman in question had already been waiting 18 months).

This, of course, raises issues regarding informed consent. It is a dogma of medical ethics that medical professionals should not do anything potentially harmful to patients without their informed consent. What it is for consent to count as 'informed' is a thorny issue, but it is clear that risks - such as those imposed here - should be explained to the patient, before the patient consents to proceed (or refuses).

Obviously the use of 'marginal' organs is less than ideal. Everyone, given the choice, would prefer young and healthy organs. However, according to statistics given in the BBC article, 40% of lung transplants involve lungs taken from a smoker. If all of these were routinely rejected as unsuitable, there would be fewer lungs available for transplant, resulting in longer waiting lists and more people dying on them.

One of the aims of my work on organ policy is to see how donation can be encouraged, in order to combat what I take to be a pressing moral problem. Increasing the supply of healthy lungs (and other organs) available for transplant could save lives. The policy challenge is to find measures that will be both effective and ethically sound. The aim of the workshops I'm organising next year is to explore some of the possibilities.


This blog is intended as a forum for discussing organ policy and issues of medical ethics more generally. It belongs to Dr Ben Saunders, Lecturer in Philosophy at the University of Stirling. I've been blogging in a personal capacity since 2005 - over seven years now I realise - and often comment on matters of interest in the news. This new blog marks an attempt to keep comments on one particular area of interest together.

It's intended that this blog will tie in with a workshops grant I was recently awarded by the Royal Society of Edinburgh to investigate Organ Donation and Transplantation Policy. This grant begins in March 2013. I hope, then, to report on the discussions in those workshops and, if possible, involve some of my collaborators. In the meantime, this will be a repository for thoughts and news items on the issue. Comments very welcome!