meaning of organ donation essay

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The Power of Organ Donation to Save Lives Through Transplantation

Organ and tissue donation is more important than many of us realize—for society and for the individuals it directly affects. Today, there are nearly 118,000 individuals waiting for an organ transplant to live healthier, more productive lives (Unpublished data, Organ Procurement and Transplantation Network [OPTN], April 2013). For some people with end-stage organ failure, it is truly a matter of life and death. Add to these the thousands more whose lives will be improved through tissue and cornea donation and transplants that can help them move better, see better, and live better.

Donation affects more than the donors and recipients. It also affects the families, friends, colleagues, and acquaintances who love and support those in need of transplantation, and who benefit from their renewed life and improved health after transplant. For my part, I have experienced not once, but twice how donation and transplantation affects individuals.

Twenty years ago, my wife, Donna Lee Jones, died in a severe automobile accident. Her death was a shock, and my family did not know what to make of our tragedy. Then we were offered the opportunity to donate her organs and tissues for transplantation. While it did not lessen the pain of her loss, it brought comfort to us knowing that out of our tragedy, some good would come, and others could receive the gift of life. Because of her donation, several people received a new lease on life: a man in Tampa, Florida, received her heart; a teenage boy in Washington, D.C., received a kidney and pancreas; a hospital custodian received her other kidney; a woman in Pennsylvania received her liver; and her corneas went to a young woman in Baltimore, Maryland, and a government worker.

Four years later, my 20-year-old daughter, Vikki Lianne, was struck by a car and died. Losing a spouse was tragic enough, but the pain of losing a child cannot be expressed. Falling back on our previous experience, we decided to donate Vikki's organs and tissues for transplantation. Again, several individuals benefited from her gift: a mother of five children from Upstate New York received her heart; a widow with four children received her lung; a 59-year-old man from Washington, D.C., who was active with a local charity, received her liver; a widower with one daughter received her kidney; a working father received the other kidney; and her corneas went to a 26-year-old man in Florida and a 60-year-old woman in Pennsylvania. And we, her family, took comfort in the idea that Vikki's legacy was one of life and giving.

Organ donation provides a life-giving, life-enhancing opportunity to those who are at the end of the line for hope. And the need for organ donors is growing. When Donna Lee died in 1992, there were 27,000 people on the transplant wait list. When Vikki died just four years later, that number had grown to 47,000 (Unpublished data, OPTN, January 2010). As of April 5, 2013, there were 117,812 people waiting, with hope, for an organ to become available (Unpublished data, OPTN, April 2013).

One way to expand the number of organs available for transplantation is to expand the number of donors, through carefully and safely considering individuals who in the past were not included. The guideline in this special issue of Public Health Reports provides a scientific, evidence-based process to assure a balance between organ safety and availability for each individual on the transplant wait list. As our knowledge and scientific capabilities regarding safety and availability grow and evolve, donors who in the past would not have been considered as donors are now able to provide the gift of life to others.

This guideline will help improve organ transplant outcomes, leading to more individuals being able to live healthier and longer lives. The science and evidence are clear and will improve the safety of organs, balanced with a clear and conscious regard for donors and recipients. It is the human aspect of donation and transplantation—helping people. It is the right thing to do.

Rear Admiral (Ret.) Kenneth Moritsugu is a former Acting Surgeon General of the United States.

This article was supported in part by Health Resources and Services Administration contract #234-2005-370011C. The content of this article is the responsibility of the author alone and does not necessarily reflect the views or policies of the Department of Health and Human Services.

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Home > Books > Organ Donation and Transplantation - Current Status and Future Challenges

Organ Donation and Transplantation: “Life after Death”

Submitted: 13 November 2017 Reviewed: 03 April 2018 Published: 25 July 2018

DOI: 10.5772/intechopen.76962

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Organ Donation and Transplantation - Current Status and Future Challenges

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Organ donation is defined as giving an organ or part of an organ to be transplanted into another person. Organ transplantation is the only option to save lives in patients affected by terminal organ failures and improve their quality of life. However, there is a disparity exists between the supply and demand of donated organs, leads to a loss of many lives. The number of organ transplantation have gradually increased in the last two decades and provide excellent results in children and young adults, and are challenging by the growing proportion of elderly transplant patients with co morbidity. The results of organ transplantation continue to improve, as a consequence of the innovations and the improvements in peri-operative management. This chapter describes organ donation and transplantation and its trends and challenges.

• organ donation
• psychosocial

Author Information

Kanmani job *.

• Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Kochi, India

Anooja Antony

*Address all correspondence to: [email protected]

1. Introduction

Organ donation is defined as giving an organ or part of an organ to be transplanted into another person. Organ transplantation is the only option to save lives in patients affected by terminal organ failures and improve their quality of life. However, there is a disparity exists between the supply and demand of donated organs, leads to a loss of many lives. The number of organ transplantation have gradually increased in the last two decades and provide excellent results in children and young adults, and are challenging by the growing proportion of elderly transplant patients with co morbidity. The results of organ transplantation continue to improve, as a consequence of the innovations and the improvements in peri-operative management.

Organ transplantation currently depends on the availability of human organs. Their scarcity means that there is a waiting list of almost 63,000 in the European Union, and over 100,000 people in the United States according to the recent survey. The process of obtaining organs for donation and transplantation purely depends on the resources of health services and by health professionals’ performance in potential donor identification and management tasks. However, in accordance with the current legislation it is mainly subjected to a personal or family decision, strongly mediated by psychosocial processes. Therefore, the need to analyze and intervene both in the practices of the professionals involved in the process of organ generation and in the attitudes of the general population need to stressed and addressed [ 1 , 2 , 3 , 4 , 5 ].

2. Organ transplantation and organ donation: an overview

Organ transplantation involves the surgical implantation of an organ or section of an organ into a person whose own organ is failing. The donor organ may come from both deceased individual as well as from a living donor. The patients psychological and behavior aspect as well their emotional response and mental health and adherence to medical regimen should be assessed before and after organ transplantation. The living donor’s psychological response towards organ donation (most commonly for kidney and liver segment transplantation) is an important aspect to consider in the transplantation process.

Organ donation is defined as “giving an organ or part of an organ to be transplanted into another person” (Organ procurement of Transplant Network (OPTN), 2015), organ donation has the potential to save lives. The organs donated from one single donor can save up to eight lives. Organ transplantation may be one of the options left to sustain someone’s life. However, the disparity that exists between the supply and demand of donated organs, leads to a loss of many lives. Based on recent OPTN data, approximately 21 people will die each day while waiting for a transplant in the United States (US). Currently, 123, 358 people are awaiting organs and on the transplant list in the US with this number growing and the number of donated organs declining.

Asian Indians are more likely to have higher rates of having obesity and diabetes when compared with other Asian subgroups which make them at an increased risk of needing a donated organ [ 35 ]. These conditions can lead one to develop coronary artery disease and hypertension which then can lead to chronic kidney disease and other chronic illnesses. Patients who suffer from chronic kidney disease need regular dialysis which can ultimately lead them to organ transplantation to improve one’s quality of life. Also, conditions such as diabetes and obesity can be detrimental to one’s life and can lead to fatty liver disease which can lead to chronic liver disease requiring liver transplantation if the liver decompensates.

The development of organ transplantation in the second half of the 20th century has been a remarkable achievement. Recently; organ transplantation is one of the most effective options for those with an end-stage organ failure. Its success has been basically dependent on public awareness, support and active participation. Without these factors, the efficiency of organ transplantation and the consequent saving or extension of lives would have undoubtedly suffered adversely.

The number of patients in need of organ transplantation has increased at a rapid pace; in contrast, the number of available organs has increased only slightly. Expanded criteria for donor selection, such as older age, have resulted in more people who meet the criteria for brain death becoming organ donors although fewer organs are transplanted from each donor. Improvements in automobile and highway safety, as well as increased enforcement of gun control laws, have also contributed to a plateau in the number of young, healthy donors. Public education efforts that encourage organ donation may be effective in getting more people to sign organ donor cards, but most individuals who do so will never be in a position to become organ donors.

Faced with increasing numbers of patients who need transplantation, deaths on the waiting list, and a fixed number of available organs, some transplant programs are working to increase the number of transplants from living donors. Although living donation has always been an option for some types of transplants, many programs have been reluctant to promote it, as living donation requires invasive surgery on a healthy person with associated risks of morbidity and mortality. For example, since dialysis is an option for patients with end-stage renal disease, surgery on a healthy donor may be difficult to justify, despite the dialysis patient’s diminished quality of life.

The most important in organ donation is to maximize the psychological status and well-being of the donors before and after transplantation has become the foremost goal of all transplantation centres. The psychological issues that mainly concern with the living organ donation includes prevention of psychological harm, ensuring the donors are fully informed and decide to donate without coercion, monitoring donor psychosocial outcomes are intimately linked to the factors that historically served as barriers to use of organs from living donors. These barriers can be overcome by the motivating of the public and creating awareness and responsibility among oneself.

Organs that can be transplanted from the living donor includes one kidney, part of intestine, pancreas, islets of Langerhans, bone, part of liver, one testis, bone marrow and blood. The organ that can be transplanted from the deceased donor are heart, kidney, pancreas, stomach, hand, skin, blood vessels, lungs, liver, intestine, testis, cornea and heart valve.

Autograft: Transplanting a person’s tissues from one site and use it in another site of his body and is called autograft. For example, removal of skin from the legs and using it for damaged skin face or other exposed part.

Allograft: Transplant of an organ between two genetically non identical individuals, it is called allograft. Due to the genetic difference, the donor’s organ will be treated as foreign by the recipient and will try to destroy it. This is called s rejection.

Isograft: Transplant of organ/tissue from a donor to genetically identical recipient is called isograft. There will not be any immune response hence no transplant rejection.

Xenograft: Transplantation of organ/tissues forms one species to another species. For example, the heart valve of pig is transplanted successfully to human.

Split transplant: An organ like liver retrieved from the deceased donor can be divided between two recipients, usually an adult and a child.

Domino transplant: When the lungs are to be transplanted, surgically it is easier to replace them along with the heart. If the recipient’s original heart is healthy, it can be transplanted into another recipient in the need of one.

ABO incompatible transplantation: The immune system of young children aged below 12 months might have developed fully. They can receive organs from incompatible donors.

Live donors: A living person, mentally and physically healthy can donate one of a paired organ, part of an organ or a tissue. The organs donated are kidneys, part of live, one of the lung, part of small intestine, skin, bone marrow, one of the testis and one of the ovaries. Live donor can either be related or unrelated.

Unrelated donors: For altruistic reasons, a person can donate one of his organs to an unrelated donor. According to TOHO act, the unrelated donor should be known to the recipient and have some obligation to him. It has to be established that there is no monetary transaction between them. But in many other countries, even a stranger can donate one of his organs to a needy person on altruistic grounds.

Deceased donors: Organs are harvested from brain dead person whose respiration and circulation are maintained artificially. Brain dead has to be certified by a team of doctors nominated by Government I every organ retrieval centers.

Paired exchange: When a living donor is not compatible with the related recipient, but may be compatible for another recipient. That second recipient related donor is compatible to the first recipient, then permission can be granted for transplantation. The surgery for all four donors and recipient are conducted simultaneously and anonymity is kept until after the transplant.

Spousal donation: A spouse can donate an organ to the partner. It has to be recorded that the couple is legally married.

3. Current scenario: trends

Despite advances in medicine and technology, and increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen. Each year, the number of people in the waiting list is increasing in both donor and transplant. The donation statistics according to OPTN Annual report shows that in 2016, total of 41,335 organs were donated. It can be either deceased or living and four out of five donations came from deceased donors and four out of ten from living donors. According to the report by OTPN 2018, 115,033 people need life-saving organ transplant, of those 74,926 people are the active waiting list candidates.

The real reason behind a living person’s interest in donating one’s organ is important to determine but it is often difficult. Now days, money has become the motivation for donation. The relationships also have played a great role in increasing donation rates. The shortage of available organs can be reduced if; people choose to donate their organs after they die. If more people did that the issue regarding organ shortage can be minimized.

The trend is expected to accelerate each year. Many organ procurement and the Joint Commission on Accreditation of Healthcare Organizations actively participate to increase the donation rates. The organizations take various to steps against traditional social taboos.

The approach, known as “donation after cardiac death” (DCD), usually involves patients who have suffered brain damage, such as from a car accident or a stroke. After family members have made the difficult decision to discontinue a ventilator or other life-sustaining treatment, organ-bank representatives talk to them about donation. Sometimes, the donor is suffering from an incurable disease also end up with the decision of organ donation.

According to U.S Department of Health and Human Services, more than 1,23,000 men, women and children currently needed life-saving organ transplants every 10 minutes and another name is added to the national organ transplant waiting list. In 2014, more than 8500 deceased donors made possible approximately 24,000 organ transplants. In addition, there were nearly 6000 transplants from living donors. In India, nationally with a population of 1.2 billion people, the statistics stands 0.08 persons as organ donor populations. Mrithasanjeevani, Kerala network of organ sharing which began in 2012, also states that the need for organ transplantation is high as the patients in waiting list is increasing day by day who requires organ transplantation.

The need for organ has gone up substantially all over the world. India also suffers from acute organ shortage with little to no solution for this issue. It is estimated that every year 1.5 lakh people suffer from renal failure out of which only 3000 people get donors. Similarly, every year around 2 lakh people die of liver failure or cancer and rarely get any help in the form of organ donors. It is the same for heart patients, for every 50,000 heart attack patients there are only 15 hearts available for transplant. Therefore, there is an urgent need for widespread campaigns to spread awareness about organ donation in India and to bridge the gap between supply and demand. The numbers that are mentioned here are estimates and real numbers could be far more than this, it is scary because this means very few people get relief and get a second chance in life.

The main reasons for organ shortage in India are mainly ignorance and lack of knowledge. People are not well informed enough about the benefits of organ donation. Today social media and so many other forums can promote the positives of organ donation and how it will save so many lives if more people register themselves for organ donation. The reason for organ shortage is myth and superstition. Many people do not want to donate their organs even after death because of so many myths and superstition they are instilled with. People with existing medical condition or old people, who wish to donate, do not donate thinking they are not fit or eligible. Almost everyone can donate some part or the other unless you have any extreme medical condition.

The need for organ donation is necessary because out of the 1.5 lakh people who need kidney in India only 3000 people receive them, only 1 out of 30 people receive kidney and 90% of people in the waiting list die without getting any donor. Around 70% liver transplants are dependent on a live donor but 30% dependent on cadaver (corpse) donations. Hence, there is an urgent need to increase the organ donation rates and give a person a second chance in their life.

4. Challenges in organ donation

As far as the challenges concerned it includes mainly donor’s motives for donation, the predominant ways in which donors arrive at the decision to donate, and the donors’ psychological status and its relationship to their fitness as donors.

4.1. Pre-donation challenges

4.1.1. donor’s motives.

Most donors are likely to be motivated by multiple factors. These factors include intrinsic factors (e.g., desires to relieve the suffering of another or to act in according to the religious convictions) and extrinsic factors (e.g., the social pressures or perceived norms) that may operate simultaneously. The particular combination of motivational forces will also differ depending on whether and how the donor is related to the recipient.

Among living related donors, it has long been assumed that family members or emotional partners are motivated primarily for saving the lives of their loved ones. Such motives are indeed the most commonly expressed feelings, as noted in a variety of studies over the past 30 years. Among nondirected living donors (individuals donating to unrelated patients whom the donors did not select)(NDLDs), it was identified as the altruistic/humanitarian motives, along with beliefs that the donor’s self-worth would be improved, and feelings of moral and religious obligation or self- identity.

4.1.2. Donor’s decision-making

The motivation for the organ donation is purely on the donor’s decision of organ donation and it may be influenced by many factors including the relationship to the recipients. Decision-making swiftness may indicate the type of decision being made. There appear to be two decision-making approaches that include the moral decision making and the rational decision making. “Moral decision-making” involves awareness that one’s actions can affect another; ascription of responsibility to oneself; acceptance of the social/moral norm governing the behavior; and taking action consistent with that norm. Because moral decision-making does not involve the costs and benefits of a given behavior but, instead, is based on perceived norms governing that behavior, it is likely to lead to non- deliberative, instantaneous decisions. In contrast, “rational” decision-making includes various steps that focus on gathering relevant information, evaluating alternatives, selecting an alternative, and implementing the decision.

4.1.3. Support

It includes mainly the assessment of the donor’s available physical, financial and emotional support. It is necessary to identify whether the donor have someone to provide care in the recovery period, have sufficient financial support and so on. This important to avoid distress if the donor develops any complications. Finally, does the donor have the support of significant others for being a donor, or is he or she choosing to donate over the objections of persons who have a legitimate interest in the outcome of an autonomous decision.

4.1.4. Family attitudes toward donation

Spouse and family attitudes about donation should also be explored. Collateral interviews with significant others is necessary, especially those who will be providing tangible support to the donor during the recovery period, should be conducted whenever possible. Conflicts between potential donors and significant others should be addressed and, ideally, resolved prior to surgery itself in order to avoid conflicts later. Family members should provide a good understanding of the donor’s wishes and motives, even if they agree to disagree to the donor’s decision.

4.1.5. Behavioral and psychological health

The behavioral and psychological health of the donor should also be considered before donation. It is important to identify donor’s lifestyle is sufficiently healthy to reduce unnecessary risk for both donor and recipient. Many potential donors may have some unhealthy behaviors, such as moderate obesity or smoking. It is necessary to identify that there is sufficient time for the donor to reduce risks (e.g., lose weight, stop smoking). Moreover, it needs to be taken care of that the donor is emotionally stable to cope with stresses which may come up before, during, and after the donation. Hence it is important to identify psychological and behavioral status of the donor or else it may affect the quality of life.

4.1.6. Donor-recipient relationship

The relationship between the donor and recipient is a complex matter. Even when both parties are agree for donation and transplant, family dynamics may be complicated, and other family members may assertively involve themselves in the decision-making process. The donor may have unrealizable expectations that transplant will alter his or her relationship with the recipient. The health care team should not expect an ideal relationship in which all interactions between donor and recipient are harmonious. However, obvious tensions and overt psychological issues should be addressed. Joint interviews, involving both donor and recipient, should be avoided early in the evaluation process in order to preserve privacy and give the potential donor the opportunity to express reservations or “opt out” gracefully.

4.1.7. Diversity issues

Non directed donors may have diversity concerns that may affect the organ donation. The potential donors should be assessed for comfort with donation to recipients of different genders, races, religions, sexual orientations, nationalities, ages, underlying diseases, and lifestyles. Donors who express objections, fears, or concerns about who might receive their organ may need to be deferred until they can receive counseling.

4.1.8. Psychological status of potential donors

The potential donor’s psychological status is of greatest concern for donation and transplantation. Concerns have been particularly high in case of unrelated donation (either directed to a specific patient, or NDLD): the willingness or desire to donate to a stranger has been historically viewed with suspicion and as likely to reflect significant psychopathology. There is no doubt that some potential donors will be psychologically poor candidates to serve as donors.

4.1.9. Post-donation challenges

The donors’ perceptions of their physical functional, psychological, and social well-being were found to be either nonsignificantly different from or significantly better than levels reported in the general population. The post challenges mainly includes recipient death or graft loss, donor medical complications, donor history of mood or other psychiatric problems, and poor donor relationships with recipient or family. The other factor is that it may affect the donor’s quality of life if any complication arises.

The post transplantation challenges are many which include minimizing rejection risks, immunosuppression, organ shortage, handling of the stressors of transplantation, psychosocial adaptation and psychological disorders and so on.

4.1.10. Minimizing rejection risks

The twin conditions of antibody sensitization and antibody-mediated rejection remain challenging and frustrating to treat. The recent drugs which are used to desensitize patients or reverse antibody-mediated rejection, especially chronic antibody mediated rejection is totally unsatisfactory. Development of therapies those are more effective and less toxic should be made available. Recent regimens used for antibody desensitization and reversal of antibody-mediated rejection include plasmapheresis, immunoglobulin (IVIG), and rituximab, an anti-chimeric, anti-CD20 antibody. Recently, the proteasome inhibitor Velcade has also been reported to reverse refractory antibody rejection. Eculizumab, a humanized anti-C5 monoclonal antibody appears to protect the renal allograft despite the presence of donor-specific antibodies (DSA). None of these agents have been tested in rigorous studies.

4.1.11. Immunosuppression

This is one of the major challenges after organ transplantation. Many studies have suggested that most of the late graft loss occurs because of immunologic reasons, frequently antibody-mediated. So the approach of minimizing immunosuppression is necessary with the present drugs to reduce toxicities may actually be helpful in the long-term survival of the graft. The toxicities are minimized by allowing more grafts to be rejected by immune mechanisms. Hence, development of effective agents that lack long-term toxicities so that we can maintain optimum immunosuppression over the long-term.

4.1.12. Stressors after transplantation

In the perioperative period, the focus is on the patient’s physical recovery, with possible rejection episodes and other medical complications causing anxiety and emotional strain. Within the first days after transplantation, a postoperative delirium can occur. The patient can present with symptoms of mental confusion, language disturbances, and occasional hallucinations and delusions are often a frightening experience to patients and their families. Acute brain dysfunction can occur in intensive care patients and patients after surgery. The corticosteroids which are administered for immunosuppression cause these problems. Some of the patients experience problems in accepting the new organ from another individual and suffer with feeling of guilt towards the donor which, in turn, can increase psychological stress and nonadherence [ 6 , 7 , 8 , 9 , 10 , 11 ].

In the long-term postoperative period, medication side effects and associated comorbidities become central stressors impeding patient’s life quality. Most common comorbidities seen are infections, diabetes mellitus, hypertension, lipometabolic disorders, adipositas, cardiovascular diseases, oncological diseases, osteoporosis, and chronic kidney failure [ 12 , 13 ]. Furthermore, psychiatric symptoms (e.g., depression, anxiety, agitation, psychosis) and neurological symptoms (e.g., sleep disturbances, cognitive impairment, delirium) can occur as neurotoxic side effects in patients receiving immunosuppressive drugs.

Faced with the multiple health risks, patients often continue to experience anxiety and worries regarding possible retransplantation, serious comorbidities, and death. Even patients in good physical health are confronted with severe challenges, for example, regaining their previously lost or restricted social roles as family members and partners (including sexual activity) and returning to work or taking up other meaningful activities. Financial constraints and legal disputes with health or pension insurance agencies constitute other possible sources of psychological strain.

5. Psychosocial adaptation and psychological disorders

After the transplantation, the psychosocial burden more severe in preoperative period than postoperative period. Nevertheless, patients themselves have to demonstrate considerable coping skills. In the best case, transplant patients learn to adapt to their new situation, often by reevaluating life goals and by focusing on more positive consequences, for example, personal growth. On the other hand, unsuccessful readjustment can lower the quality of life and psychiatric morbidity. The most common psychological disorders among patients before and after transplantation are affective and anxiety disorders.

The literature review shows that prevalence of depression in 20–25% of cases before and after kidney transplantation. Less information is available concerning patients receiving other organs. Prior to and following lung transplantation, depression seems to be prevalent in approximately 30% of patients. Hence these show that the depression is a major challenge after transplantation. These issues can be reduced by personal and social resources (resilience factors), that is, favorable coping skills, self-efficacy, sense of coherence, optimism, and social support.

6. Factors affecting donor’s motivation

There are many factors affecting donor’s motivation which includes feelings of love and responsibility, spiritual motives, and greater success rate of organ donation.

6.1. Feelings of love and responsibility

Motives for donating organ to their relative patients were that they tended to do something for their loved ones. In fact, they feel responsible for their problems. They do not treat others’ problems with indifference and attempted to do whatever they could for resolving the problems experienced by transplant recipients. It is considered as their own responsibilities to help them to get rid of their problems. The feel like they are the ones who need to support their patients.

6.2. Close and constant companionship

Another factor affecting the participants’ feeling of responsibility for donation to their family members was close and constant companionship with recipients. This close and constant companionship made the participants to clearly understand the recipients’ conditions and hence, it had resulted in their decision on organ donation in order to alleviate recipients’ problems. This close and constant companionship with patients help family members understand patients’ problems well and increase their degree of commitment to do something for patient’s pain and discomfort. They also noted that this had made them experience deeper shared emotions with their patients and hence, required them to feel responsible for minimizing their patient’s problems.

6.3. Inability to tolerate recipient’s discomfort

Another motive for organ donation was one’s difficulty in tolerating recipient’s discomfort. Love for their sick family members had made the participants feel responsible and decide on doing something for solving their patient’s problems. Their patient’s pain, suffering and discomfort cause a great inconvenience and irritation which lead them to the decision of organ donation. They hoped that organ donation alleviate their patient’s problems [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 ].

6.4. Spiritual motives for donation

Religious beliefs played a significant role in motivating to organ donation. Some of them believed that donation was a way for expiating their past sins. They referred to faith in God, reliance on Him, and hope for a successful transplant as the important motives for organ donation. Some of them even accused themselves of causing their family members to develop organ failure and believed that donation was a way for alleviating their feelings of guilt. Such a practice was particularly common among the parents of sick children. Some of them considered donation as a God-approved practice, and noted that God has helped them donate their organs. They noted that they donated their organs for gratifying God and believed that he sees it and help them in all bad situations.

6.5. Greater success rate of organ transplantation

The category is the greater success of organ transplantation. In other words, obtaining information and realizing the greater benefits of organ transplantation had motivated the participants to opt for organ donation. Some of them reported that they had never thought about donation until obtaining information from their patient’s physicians. However, after obtaining adequate information, they had made an irreversible decision about organ donation. Accordingly, a major motive for organ donation was the lower likelihood of organ rejection.

7. Measures to overcome challenges for organ donation

The decisions regarding organ donation based on the personal beliefs (religious, cultural, family, social and body integrity) levels of knowledge about organ donation and previous interaction with the health care team. Many maintained positive attitudes to organ donation despite significant reservations about the organ donation process. Resistance to organ donation found to be less in the case of living donation for family.

There are some religious beliefs that can have both positive and negative influences, these often stemmed from uncertainty or misrepresentation of religious edicts. One solution would be to actively engage religious leaders in the transplant community, especially when it has been reported that, across the major religions, there are very few cases where organ donation can be seen to be inconsistent with religious beliefs. Religious leaders should be made available in hospitals and other transplantation setting to assist families in making decisions regarding organ donation and potentially to remove the misperceptions. Staff members who are involved in approaching families to request consent for donation should be part of the awareness programs and resources about religious concerns. Similarly, cultural sensitivity to issues such as apprehensiveness to discuss death among certain groups or individuals and the importance to many of death rituals may improve dialog regarding organ donation.

Studies have shown that engaging some minority groups in the health care system and creating a sense of belonging and ownership can improve compliance with organ donation. As a consequence, more efforts should be made to create positive interactions within the health care team members, especially for minority groups, to improve the organ donation rates. Although many of the studies have showed that higher socio-economic status and education were associated with a stronger willingness to be an organ donor. Some of the strong reservations held, even among those with generally positive views towards donation, such as concerns that agreeing to donation would discourage doctors from caring so much about saving their lives in case of an emergency or that it would result in the premature removal of their organs or indeed prevent them from having an open coffin at their funerals, are examples of very real barriers that can be readily addressed through information. Through a proper awareness and motivation the donation rates can be improved which can save many lives.

7.1. Psychological care

Psychological consultation is essential for all disease stages enabling patients to better cope with their extraordinarily stressful situation. A need for psychological care was found in up to 50% of transplant patients. Educational and supportive therapies are of utmost importance but also cognitive-behavioral interventions including relaxation techniques can also be considered. Less common methods like hypnotherapy and “Quality of Life Therapy” have also been utilized for overcoming the challenges.

Moreover, family members as well as caregivers of transplant patients show increased psychological strain before and after transplantation. Family counseling, and psychotherapeutic support, can help reduce psychological strain, thus also maintaining the valuable social support provided by care givers and family members of the transplant patient. Henceforth, the family and care givers should also be considered in psychosocial evaluation to overcome the problems.

7.2. Alternative methods to increase donation

In view of ethical, legal and political issues, it was deemed important to obtain some opinion about alternative methods to increase organ donation rates. Financial incentives were given to increase organ donation. Many in both donor and non-donor groups were given a reasonable incentive. Education and dissemination of information about donation and transplantation was important to increase organ donation rates. There was nearly universal agreement that implied consent (presumed consent) should not be tried. The use of financial incentives was not markedly opposed (some accepted the idea of funeral expense reimbursement), although there was not strong support either. In general, methods to increase organ donation had not been well thought out by either donors or nondonors indicating, perhaps, that the assumption of altruism or motivation is the best way to increase the donation rates.

8. Responsibilities of nurses in organ donation and transplantation

Organ and tissue transplant nurses need comprehensive and scientific knowledge. They include the evaluation and management of deceased donors, transplant recipients, potential donors or live donors, teaching and counseling of transplant recipients and live donors related to self-care management, healthy life and a peaceful death when this is imminent. This is important in order to improve the posttransplant quality of life.

Nurses have important role in the development of a successful transplantation program. They are key members of the team that works to deliver care to patients and relatives, through the use of technological, logistic and human resources, with a view to coordination, care, education and research on organ and tissue donation and transplantation. Therefore, the nurses need adequate knowledge on the principles of good ethical principles and should have resources available for them to assess patient’s risks and social issues related to organ transplants and donation. The researchers hope that the future studies will encourage further researches on the role and responsibilities of nurses.

9. Conclusion

The organ donation decision is a complex one, based strongly on personal beliefs. There are some factors, such as religious and cultural beliefs, that are seemingly intractable and are often cited as reasons for a refusal to donate. In this chapter, it is shown that these have often been found to be tied in with more complex issues such as a distrust of the medical system, misunderstandings about religious stances and ignorance about the donation process. Interventions to better engage the community, including disadvantaged and minority groups, to foster trust and provide information represent promising opportunities of promoting organ donation in the future.

Donor motives directly contribute to their decision to donate, is not uniform and is influenced by multiple factors. Majority of the donors were relationship oriented donor, whose major motives were desires to relieve the suffering & save the life of their loving ones. Creating awareness to the organ donation will directly influence the donor motives and willingness. By deriving the motives many more intervention to improve the willingness to be a living organ donor can be evolved. Recruitment of living donors represents a medical and moral responsibility. The possibility of organ removal from healthy donor to a recipient needs great inner motivation. Saving one’s life is divine.

The psycho social assessment must be made as a routine part of the nursing process. These assessments are meant to identify patients at risk for poor outcomes, provide guidelines for their management and improve the post-transplant quality of life [ 6 ]. “Because donated organs are a severely limited resource, the best potential, recipients should be identified. The probability of a good outcome must be highly emphasized to achieve the maximum benefit for all transplants” (OPTN/UNOS Ethics committee General Considerations in Assessment for Transplant Candidacy White paper-2010).

• 1. United Network for Organ Sharing. 1999 Annual Report of the U. S. Scientific Registry of Transplant Recipients and the Organ Procurement and Transplantation Network.: Transplant Data 1989–1998. Richmond, Va: US Department of Health and Human Services, Health Research Services Administration, Office of Sponsored Projects, Division of Transportation, and United Network for Organ Sharing; 2000
• 2. Alexander JW, Zola JC. Expanding the donor pool: Use of marginal donors for solid organ transplantation. Clinical Transplantation. 1996; 10 :1-19
• 3. Kumar A, Mandhani A, Verma BS, et al. Expanding the living related donor pool in renal transplantation: Use of marginal donors. Journal of Urology. 2000a; 163 :33-36
• 4. Mandal AK, Kalligonis AN, Ratner LE. Expanded criteria donors: Attempts to increase the renal donor transplant pool. Advances in Renal Replacement Therapy. 2000a; 7 :117-113
• 5. Simmons RG et al. Gift of Life: The Social and Psychological Impact of Organ Transplantation. NY: Wiley; 1977. Reprinted with additions, Brunswick, NJ: Transaction Books, 1987
• 6. Corley MC et al. Attitude, self-image, and quality of life of living kidney donors. Nephrology Nursing Journal. 2000; 27 (1):43-52
• 7. Goldman LS. Liver transplantation using living donors: Preliminary donor psychiatric outcomes. Psychsomatics. 1993; 34 (3):235-240
• 8. Pradel FG et al. Exploring donors’ and recipients’ attitudes about living donor kidney transplantation. Progress in Transplantation. 2003; 13 (3):203-210
• 9. Fellner CH. Renal transplantation and the living donor. Decision and consequences. Psychother Psychosomat. 1976/77; 27 :139-143
• 10. Toronyi E et al. Attitudes of donors towards organ transplantation in living related kidney transplantations. Transplant International. 1998; 11 (Suppl 1):S481-S483
• 11. Henderson AJZ et al. The living anonymous kidney donor: Lunatic or saint? American Journal of Transplantation. 2003; 3 :203-213
• 12. Jacobs CL et al. Twenty-two nondirected kidney donors: An update on a single center’s experience. American Journal of Transplantation. 2004; 4 :1110-1116
• 13. Matas AJ et al. Nondirected donation of kidneys from living donors. The New England Journal of Medicine. 2000; 343 (6):433-436
• 14. Olbrisch ME et al. Psychological, Social and Behavioral Characteristics of Living Donor Candidates for Adult Liver Transplantation. Biennial Meeting on Psychiatric, Psychosocial and Ethical Issues in Organ Transplantation. Santa Monica, CA; February, 2005
• 15. Crowley-Matoka M et al. Long-term quality of life issues among adult-to-pediatric living donors: A qualitative exploration. American Journal of Transplantation. 2004; 4 :744-750
• 16. Karliova M et al. Living-related liver transplantation from the view of the donor: A 1-year follow-up survey. Transplantation. 2002; 73 (11):1799-1804
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• 18. Beavers KL et al. The living donor experience: Donor health assessment and outcomes after living donor liver transplantation. Liver Transplant. 2001; 7 (11):943-947
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• 20. Pradel FG. Exploring donor’s and receipient’s attitudes about living door kidney transplantation. Progress in Transplantation. 2003; 13 (3):203-210
• 21. Smith MD. Living related kidney donors. A multicenter study of donor education, socioeconomic adjustment and rehabilitation. American Journal of Kidney Diseases. 1986; 8 (4):223-233
• 22. Jacobs CL. Expanding living donor options. Minnesota Medicine. 2001; 84 :46-48
• 23. Switzer GE. Understaning donor;s motivations. A study of unrelated bone arrow donors. Social Science & Medicine. 1999; 45 (1):137-147
• 24. Rosenthal JT. Expanded criteria for cadaver organ donation in renal transplant. The Urologic Clinics of North America. 1994; 21 :283-292
• 25. Shiel AGR. Transplantation and society. In: Ginns LC, Cosimi A, Morris PJ, editors. Transplantation. Malden, MA: Blackwell Science; 1999. pp. 897-913
• 26. Callender CO, Bay AS, Miles PV, Yeager CL. A national minority organ/tissue transplant education program: The first step in the evolution of a national minority strategy and minority transplant equity in the USA. Transplantation Proceedings. 1995; 27 :1441-1443
• 27. Surman OS et al. Live organ donation: Social context, clinical encounter, and the psychology of communication. Psychosomatics. 2005; 46 :1-6
• 28. Papachristou C et al. Motivation for living-donor liver transplantation from the donor’s perspective: An in-depth qualitative research study. Transplantation. 2004; 78 :1506-1514
• 29. Haljamäe U. Remaining experiences of living kidney donors more than 3 yr after early recipient graft loss. Clinical Transplantation. 2003; 17 :503-510
• 30. Hamburger J, Crosnier J. Moral and ethical problems in transplantation. Rapaport F, Daussert J. Human Transplantation. NY: Grune & Stratton; 1968. pp. 68
• 31. Sadler HH et al. The living, genetically unrelated, kidney donor. Seminars in Psychiatry. 1971; 3 :86-101
• 32. Walter M et al. Psychosocial outcome of living donors after living donor liver transplantation: A pilot study. Clinical Transplantation. 2002; 16 :339-344
• 33. Fukunishi I et al. Psychiatric disorders before and after living-related transplantation. Psychosomatics. 2001; 42 (4):337-343
• 34. Crowley-Matoka M, Switzer G. Nondirected living donation: A survey of current trends and practices. Transplantation. 2005; 79 (5):515-519
• 35. Boparai J, Davila H, Chandalia M. Cardiovascular disease in Asian Indians living in the United States. Current Cardiovascular Risk Reports. 2011; 5 :240-245
• 36. Ji WR, Frederick B, Hsin CY. Trends in prevalence of Type 2 diabetes in Asians Versus Whites results from the United States National Health Interview Survey 1997-2008. Diabetes Care. Feb 2011; 34 (2):353-357

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution 3.0 License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Essay on Organ Donation for Students and Children

500+ words essay on organ donation.

Essay on Organ Donation – Organ donation is a process in which a person willingly donates an organ of his body to another person. Furthermore, it is the process of allowing the removal of one’s organ for its transplanting in another person. Moreover, organ donation can legally take place by the consent of the donor when he is alive. Also, organ donation can also take place by the assent of the next of kin of a dead person. There has been a significant increase in organ donations due to the advancement of medical science.

Organ Donation in Different Countries

First of all, India follows the opt-in system regarding organ donation. Furthermore, any person wishing to donate an organ must fill a compulsory form. Most noteworthy, this form is available on the website of the Ministry of Health and Family Welfare Government of India. Also, The Transplantation of Human Organs Act 1994, controls organ donation in India.

The need for organ donation in the United States is growing at a considerable rate. Furthermore, there has also been a significant rise in the number of organ donors in the United States. Most noteworthy, organ donation in the United States takes place only by the consent of the donor or their family. Nevertheless, plenty of organizations are pushing for opt-out organ donation

Within the European Union, the regulation of organ donation takes place by the member states. Furthermore, many European countries have some form of an opt-out system. Moreover, the most prominent opt-out systems are in Austria, Spain, and Belgium. In England, no consent is presumed and organ donation is a voluntary process.

Argentina is a country that has plenty of awareness regarding organ donation. Most noteworthy, the congress of Argentina introduced an opt-out organ donation policy. Moreover, this means that every person over 18 years of age will be a donor unless they or their family state their negative. However, in 2018, another law was passed by congress. Under the new law, the family requirement was removed. Consequently, this means that the organ donor is the only person who can state their negative.

Get the huge list of more than 500 Essay Topics and Ideas

Benefits of Organ Donation

First of all, organ donation is very helpful for the grieving process. Furthermore, many donor families take relief and consolation due to organ donation. This is because they understand that their loved one has helped save the life of other people. Most noteworthy, a single donor can save up to eight lives.

Organ donation can also improve the quality of life of many people. An eye transplant could mean the ability to see again for a blind person. Similarly, donating organs could mean removing the depression and pain of others. Most noteworthy, organ donation could also remove the dependency on costly routine treatments.

Organ donation is significantly beneficial for medical science research. Donated organs offer an excellent tool for conducting scientific researches and experiments. Furthermore, many medical students can greatly benefit from these organs. Most noteworthy, beneficial medical discoveries could result due to organ donation. Organ donation would also contribute to the field of Biotechnology.

To sum it up, organ donation is a noble deed. Furthermore, it shows the contribution of an individual even after death. Most noteworthy, organ donation can save plenty of lives. Extensive awareness regarding organ donation must certainly be spread among the people.

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Essay Examples on Organ Donation

Brief description of organ donation.

Organ donation is the selfless act of giving one's organs or tissues to help save the lives of others. It plays a crucial role in addressing the shortage of organs for transplantation and has the potential to improve and even save the lives of those in need.

Importance of Writing Essays on This Topic

Essays on organ donation are significant as they provide a platform for individuals to explore the ethical, medical, and societal implications of organ donation. They also encourage critical thinking and awareness of this life-saving practice.

Tips on Choosing a Good Topic

• Consider the ethical implications of organ donation
• Explore the impact of cultural and religious beliefs on organ donation
• Examine the role of public policy in promoting organ donation

Essay Topics

• The ethical considerations of organ donation
• Cultural and religious perspectives on organ donation
• The impact of organ donation on recipient and donor families
• Public policy and organ donation incentives
• The role of social media in promoting organ donation awareness
• Organ donation and the medical community
• Organ trafficking and illegal organ donation
• The future of organ donation and transplantation
• Organ donation and the concept of altruism
• The psychological impact of waiting for an organ transplant
• Organ donation and the concept of brain death
• Organ donation and age restrictions
• The economics of organ donation and transplantation
• Organ donation and the role of family consent
• Reflective essay on personal experiences with organ donation
• Argumentative essay on the need for a change in organ donation policies
• Compare and contrast the organ donation system in different countries
• The impact of organ donation on diverse communities
• The role of education in promoting organ donation awareness
• The importance of organ donation for pediatric patients

Concluding Thought

Exploring the topic of organ donation through essays can lead to a deeper understanding of the ethical, medical, and societal issues surrounding this life-saving practice. Engaging in critical dialogue and exploration of organ donation can contribute to greater awareness and potential solutions for addressing the shortage of organs for transplantation.

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Pros and Cons of a New Opt-out System of Organ Donation

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After assessing the lungs of a deceased patient, the thoracic surgeon Thomas Charrier (second from right) gives the green light for transplantation to his colleagues on the phone at the Foch hospital in Suresnes, Paris. This and all photos below taken on 9 December 2022 by Christophe Archambault/AFP. Courtesy Getty Images

Last hours of an organ donor

In the liminal time when the brain is dead but organs are kept alive, there is an urgent tenderness to medical care.

by Ronald W Dworkin   + BIO

My patient was dead before I even saw her. She had been in a car accident. Now she was scheduled for organ donation.

She was called an ‘ASA 6’. To estimate operative risk, the American Society of Anesthesiologists (ASA) has a classification system built around how sick a patient is, ranging from a healthy ASA 1 to a moribund ASA 5, the latter meaning someone is not expected to live 24 hours. When the system was created in the mid-20th century, a sixth class for dead people seemed pointless. Death was known to the dead only, and life to the living only, and between the two there had been no bridge. When the definition of death changed in the late 1960s, making it possible for a person to be ‘brain dead’ but with organs still very much alive and available for donation, a bridge appeared and a sixth class was created in the early 1980s. Since 1988, when officials started collecting organ transplant data, almost a million organ transplants have been performed in the United States. Most of the organs have come from brain-dead donors. In 2021 alone, the US had almost 10,000 such donors.

When told of my upcoming case, I had mixed feelings. On the one hand, being in perfect health, unaccustomed to suffering and therefore easily disconcerted by the thought of death, I was horrified. My attitude toward death was like that of a young person standing blindfolded and tied to a post, awaiting a volley from a firing squad. The whole concept made my blood run cold. Yet the case also aroused in me a feeling of relief. Simply put, there was no risk of malpractice, as my patient was already dead. Many anaesthesiologists have such self-centred thoughts when taking care of ASA 6 patients.

I n her early 30s, she had a youthful face, without the traces of severe illness that ICU patients typically have. With her hair wrapped inside a bright, polka-dotted kerchief, she gave off an expression of almost pleasant, good-humoured cheeriness.

Who was this young person whose life had been tragically snuffed out? I jabbed into every crack of her medical record to find out. But little had been written down. Both her life and death seemed simple enough to be chronicled in a few lines. Something had happened inside her brain with the car accident, and the end came.

We wheeled her toward the operating room. Before departing, I pulled the sheet over her exposed feet. Why? I had an objection to her being dead, but I had an even more serious objection to her being undignified. With my patient still partly in the world of the living, I wanted to keep a place for her in the part that pretends to be genteel.

Six hours she had been officially dead. Now she had re-entered the world of the living

When we arrived in the operating room, something turned over inside me, sank, and went cold. After all, she was dead. The day before, she was as whole as me – and now look. She would never rise again.

After we moved her from the gurney to the operating table, the doctors and nurses, so used to taking care of living patients, stared at one another stupidly, as if not knowing why they had come together or why they stood around the table. For a brief moment, each one of us likely had the same supernatural vision, how for the past six hours, after being declared brain dead, this woman had lain under the measureless power of death. Six hours she had been officially dead. Six times had the hour hand on the clock moved – and she had lain dead. Now she had re-entered the world of the living. I would support her blood pressure and pulse. I would make her blood bright red with oxygen. Indeed, she might even wake up and look at us, I fantasised. She might be raised from the dead.

Ghoulish thinking, yet I do not write about this case to be ghoulish. Nor am I trying to stake out a new position in the bioethics debate. My purpose is more practical. Today, artificial intelligence (AI) looms over medical practice. Although unlikely to replace doctors completely, AI makes some medical activities especially ripe targets for takeover, including the harvesting of organs from brain-dead donors. And why not? Bedside manner and the common touch cease to be concerns. Using AI machines rather than doctors to harvest organs also promises to save money.

Yet this impersonal, nonhuman method of organ retrieval may discourage people from becoming organ donors , or from letting dead relatives become so, thereby exacerbating the current organ shortage. People will see pictures of organ retrieval being carried on all around by inanimate machinery in a room completely abandoned by human beings. Bodies will be brought in and sent out, while the invisible, sleepless work of the machines goes on. ‘Please, tell me this is not my end,’ people will fret privately. And they will resist consenting to organ donation.

O rgan retrieval can take place at odd hours because the time between retrieval and transplantation must be minimised. A donor heart or lungs can last only four to six hours outside the body. A kidney, liver or pancreas can last a bit longer. Because donation and transplantation must be synched perfectly, surgical teams must be allowed to work at any hour of the day.

Although donors are dead, managing their anaesthesia can be tricky. To keep their organs healthy, their physiology must be carefully attended to, yet brain death affects each organ system differently. High intracranial pressure can lead to an enormous outpouring of adrenaline, which can injure the heart and other organs as circulation fails. Brain death can cause pulmonary oedema (fluid in the lungs), making it hard to oxygenate the blood, thereby damaging the organs by a second route. Brain death also wreaks havoc on the body’s endocrine system, causing vital hormone levels to fall and damaging organs by a third route.

My patient lay stretched out on the table. The room was silent, as I had not yet placed any vital sign monitors on her body. It was a sinister silence. The monitors typically emit sounds that resemble the unconcerned twitter of birds. In an operating room, they symbolise life. Their absence suggests that a patient is not alive. In fact, mine wasn’t.

Nature will never permit anyone to know the exact point where brain death becomes real death

Ready to cut, the surgeon spoke through his headphones to surgeons in other cities waiting for the organs. The rest of us said nothing as he gave them an estimated time of arrival. The team had a real need for a stout word in these last few moments before the operation began. Sensing the mood, the surgeon said some dignified things about how our patient was giving other people a chance to live. Everyone nodded in agreement. He seemed thankful and sincere, yet he had to be that way for, at such a moment, anyone with even a modicum of intelligence would have felt anything else as an affront.

The surgeon cut into the patient’s chest. Almost immediately the patient’s heart rate and blood pressure jumped. It resembled the powerful surge of life that comes during a period when a person’s very existence and survival are at stake. The jump originated in a spinal reflex that stimulated the woman’s sympathetic nervous system below the level of the brain. Still, it seemed a manifestation of her will to live. Even more so when her hand moved – a sure sign of life! But that, too, was mediated through a spinal reflex.

I gave the patient some anaesthetic gas. I also gave her some opioids. Why the latter? After all, a dead patient doesn’t feel pain. In part because opioids help to lower heart rate and blood pressure directly, but also, I must admit, because I thought my patient might still be a ‘little alive’, whatever that means, and therefore in pain. Irrational on my part, yes, but the secret of life, including the definition of life, still remains the deepest and most mysterious one. Here Nature permits no eavesdroppers; never will she permit anyone to know the exact point where brain death becomes real death. At this, she draws a veil. I wanted to hedge my bets.

The woman’s blood pressure soon dropped too low. I poured fluid into her intravenous line. In the meantime, the surgeon moved hurriedly to extract her heart, clamping the large blood vessels leading both to and from it. Our fast pace betrayed another incongruence. Speed is thought to be a bit unrefined in an operating room. True, it is needed to save money, but ideally the operating room is an ordered world with calm transitions, a world without haste, except during an emergency to save a patient’s life. The visibly hasty fashion in which I and the surgeon worked made it seem like one of those urgent situations. In fact, I was trying to keep her circulation going long enough for the surgeon to tear her heart out.

I transfused a unit of blood, as excessive blood clotting, common after brain death, had made her dangerously anaemic. I turned on the warming mattress lying underneath her to keep her body temperature from dropping below 36 degrees Celsius. Brain death interferes with the body’s ability to regulate temperature, and the resulting hypothermia poses a risk to the organs. Finally, I gave her insulin to control her blood sugar level, as brain death often causes blood sugar to rise. All of these are routine lifesaving measures. In the past, I had used them to fight off death in my sickest patients, but here I had to remind myself that my patient was already dead.

T he surgeon removed her heart. The irrevocable instant had come. It was as when a train starts with a violent jerk, as if to overcome a disinclination to change its state of inertia. For many in the operating room, this was the moment when the woman’s life really ended.

A minute before, I had heard the melodies of the electrocardiogram (EKG) and pulse oximeter without really thinking about them. An anaesthesiologist’s ear is so capable of adapting itself that a continuous din, like the noise of a street or the rushing sound of a river, adjusts itself completely to their consciousness. But the unexpected halt in the sounds startled me into listening – and looking. I stared over the ether screen into the woman’s now-vacant chest cavity. It was shameful and terrible to gaze upon. Part of me felt as if I had abetted a murder around the corner.

I tried to make this last sigh worthy of the moment, a sigh that only another human being could replicate

The surgeon injected the heart with cold preservative and put it in a box. His next target was the lungs. He asked me to manually give the woman one last deep breath so that he could confirm that all parts of her lungs had been expanded before their removal. The breath I gave her was slow and gentle, like a sigh. Indeed, medically speaking, it was a sigh. On ventilators, there is a function labelled ‘sigh’ which, when pressed, gives a patient a single sustained deep breath to open up the lung’s small air sacs. Almost proudly, I imagined the sigh I gave this woman to be more human than what a machine could give. Compressing the anaesthesia bag with my hand, I imagined how she might have sighed in the past, on her own, in the face of some bitter reality, some trick or force of fate, crushing her heart but also uplifting her. I tried to make this last sigh worthy of the moment, a sigh that only another human being could replicate, a deep breath that begins with disappointment, passes into resignation, and ends in acceptance. I crafted that last sigh as if it were the epilogue to a tragedy.

When the woman exhaled her last bit of sigh, I removed her breathing tube. The surgeon took out her lungs and stapled her windpipe shut. At this point, there was little for me to do, and my inactivity plunged me into a sense of nothingness. I felt I was going to gag on my thoughts if I didn’t do something. I walked away from my patient to look inside a cupboard. I opened a few drawers. Then I felt badly for doing so. Although one of us was dead, still there seemed to be two of us here. It’s as if the woman and I were friends and I didn’t want to leave my friend. I went back and stood by her head.

The surgical team removed the rest of her organs and the case finished. Here the woman and I reached a parting of the ways. I stared at her face seriously and fixedly as though I wanted to look my fill and imprint forever on my memory her image. I cannot recall for how long I looked. Great moments are always outside of time.

Our relationship proved significant. Nothing is more characteristic of the total lack of spiritual connection between myself and other patients than the fact that I have forgotten most of their names and faces. But this woman’s name and face I remember. And when I speak of memory, I do not mean something akin to a register kept in a well-ordered office, a place in which documents are laid away in store. I mean something submerged in the rushing stream of my blood, memory as a living organ in which every feeling experienced that day retains its natural essence, its original intensity, its primary historical form.

M y patient lived longer than what her death certificate says. She lived in my mind during the organ retrieval and continues to live in my memory because I do not want to forget her, and because I cannot forget her. Although I know only her general outlines, our connection satisfies some deep law of harmony underlying all life, in which every person must enter into communion with another person in order fully to live. By that standard, my patient lived past her official time of death.

When AI replaces the anaesthesiologist during organ retrievals, you, the organ donor, will not live any longer than what’s listed on your death certificate. The air inside the operating room is already cold, dry and unpleasant. Various monitors will sit on the top shelf of the anaesthesia machine, regulated by AI. Their special melodic rings will no longer be necessary, as their data will be sent along to AI in silence. Care will be delivered without the mediation of human minds, senses or hands.

Before your lungs are removed, the machine’s ventilator bellows will go up, down, up, down. Capable only of whooshing and not ringing, the bellows will seem to call sadly through the cold air to the monitors sitting above, waiting fruitlessly for a response. What a simple, insignificant movement: up, down, up, down, never getting away from the same place. It will be the only activity surrounding your head amid the metal machines, with their cold, menacing gleam. Nobody will be sitting next to you to wonder about what you were like, or about the things that distinguished your personality and made it special. A vision of the future arises: similarly deserted operating rooms with AI machines all moving automatically, while the people who used to work in them have gone off somewhere to sit dreamily on the grass beneath the sky.

Medicine has tapped a new source of organs in the form of donation after circulatory death

It seems a decidedly unpleasant environment in which to meet one’s end, and enough to discourage those on the fence from becoming potential organ donors. Rather than live a bit longer in the mind of another person, rather than have that person think about you and wonder about you, entertain irrational imaginary concerns about you, slip a little extra narcotic into your intravenous line ‘just in case’, engage in metaphysical speculations about your breathing pattern, and imagine you a friend, you will be alone on the table, and your surgery will more closely resemble a bandit raid. The machines will be determined to take everything, every organ. Reduced to financial terms, it will be as if you were left penniless.

Worse, a new danger will come to overlie the chilling sense of emptiness, scaring even more people away from becoming organ donors. Because there are already too few brain-dead donors – each year, more than 8,000 people in the US die while on the waiting list for organs – medicine has tapped a new source of organs in the form of donation after circulatory death (DCD). These organ donors are not brain dead, although many of them are unconscious. Instead, they lack circulatory or respiratory activity after being disconnected from artificial life-support systems. Without such activity after a few minutes of so-called ‘no touch’, they are declared dead, and their organs become available for donation. Their numbers have been growing over the past two decades. Today, they account for about 10 per cent of transplanted organs in the US.

The problem is that certain medicines necessarily given to these donors before death, but in expectation of death, may hasten their death. The medicines are given for the sole purpose of making their organs more viable for transplantation. Heparin, for example, prevents blood clotting, while phentolamine dilates blood vessels and improves blood flow to the organs. Yet heparin also increases the chances of bleeding into the brain, while phentolamine may lower blood pressure to the degree that a person goes into shock. Although these patients are near death for other reasons, the medicines may become their actual cause of death. This makes doctors uneasy; hence the rule not to give these medicines to donors prone to bleeding or with low blood pressure.

Y et the rule risks driving away potential donors, who will naturally think: ‘Doctors won’t give you these medicines to kill you; on the other hand, they won’t give you these medicines to help you. At some point, doctors aren’t really on your side. But when?’ As the number of brain-dead donors drops, medicine will increasingly rely on DCD donors to compensate. Already sensitised by the image of surrendering their organs to machines in a metallic desert, potential donors will fear being herded into the ‘imminent death’ category to meet some organ quota, a fear only heightened when word gets out that doctors are not always their advocates.

Currently, doctors in the US must get consent before declaring people DCD donors, but another model, called the ‘presumed consent model’, already operates in other countries and allows the recovery of organs without prior authorisation. A cascade of events threatens to turn organ retrieval into a kind of science-fiction nightmare, where organ shortages lead to medicines being given to people to preserve their organs while possibly hastening their death, all without telling them the plan or asking for their permission.

My experience in the operating room serves as a warning to those eager to cut corners and replace doctors with AI machines

Whenever people start to think about becoming an organ donor, they immediately make a leap to their own precious person. Who am I, what am I, what am I without my organs, and so forth. It is part and parcel of being a human being. That some people are willing to surrender their organs after death suggests that, to feel oneself human, they need more than merely having a whole body; they also need an atmosphere of simple humanity. To feel human, people need to feel that they occupy space in the thoughts and feelings of others. It is why they consider becoming organ donors in the first place. They imagine helping others by giving up a part of themselves in the future. In exchange, they imagine the recipients thinking from time to time about what they, their donors, were like. In that way, the donors feel a connection with whomever those recipients might be, and feel somehow fulfilled.

I’d like to think that caring for my brain-dead patient satisfied some small part of this need to feel human, whether on the part of my patient before she died and who perhaps lived in expectation of becoming a donor one day, or on the part of her relatives who gave their consent to the procedure after she was declared brain dead. Either way, I connected with her or with her family.

My experience in the operating room serves as a warning to those eager to cut corners and replace doctors with AI machines willy-nilly. You don’t satisfy people’s urge to feel human by making the bridge to the next world a totally inhuman one.

The lesson extends far beyond organ donation. AI promises to make healthcare quicker, more precise, and error-free. To the degree that it replaces doctors and nurses, it portends a massive shift in medicine that seems to come every 30 years, when people are so overwhelmed by the burden of their own technological creations, they need every iota of their strength to adjust. Once again, with the advent of AI, advancements promise to put healthcare on an entirely new footing and, once again, the inevitable backlash will be there. So it was in the 1960s, when new medical technologies and procedures, such as home dialysis machines and coronary artery bypass surgery, improved life, and yet, during this same period, the medical profession’s reputation plummeted, as patients complained that doctors had grown cold and impersonal. So it was in the 1990s, when the rise of managed care promised greater efficiency at less cost, and a ‘win-win’ strategy anchored in preventive medicine, led to a patient rebellion against being treated like cattle, including their inability to choose their own doctor, and rushed visits to practitioners ‘on the plan’.

Now, in the 2020s, the stage is set for outrage, yet again. AI promises to elevate healthcare; but, to the degree that it replaces doctors and nurses, it also threatens to depersonalise patients and to wash off their distinctive colours until everyone has the same drab tint. In the crucible that looms, patients are going to rebel. And it is in the arena of organ donation, where they face death by machine, that they are likely to baulk loudest, and first.

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Organ Donation Essay

Organ donation is a noble act of transplanting healthy organs from a donor to a patient receiver. Human body organs and tissues that function properly are collected and transplanted into patients’ bodies to save their lives. In most cases, organ donations are performed after the donor’s death. But some organs can be donated even when the donors are alive. Kids learning activities like organ donation essays will help them attain more scientific knowledge and better their academic performances.

Superheroes are not born; they are made by society. By participating in activities like organ donations, people can save lives and turn themselves into real superheroes. The following short essay in English on the necessity of performing organ donation in society will help kids improve their basic knowledge about the human body. BYJU’S importance of organ donation essay for kids will also help develop social consciousness and humanity in their minds.

Table of Contents

What is organ donation, necessity of organ donation in the society.

Organ donation can be defined as the process of transplanting an organ or tissue from one person to another person through surgical methods. The recipient performs the transplantation because of organ failure or damage caused by disease or injury. Organ donation marks the advancement of science in the medical sector.

People of all ages can perform organ donation. Organ donations are completely voluntary actions, and people cannot be compelled to engage in these activities. Illiteracy, lack of proper guidance, lack of awareness, the fright of surgery, etc., are some of the major reasons that stop a person from engaging in such charity practices. People hesitate to donate organs because of their misunderstandings related to organ donation procedures. Myths and misconceptions about organ donation have to be cleared from people’s minds. Teachers can direct their students to visit online resources like BYJU’S essay on health education to learn more about human health.

The kidney, eyes, liver, heart, skin tissues, small intestines, and lungs are some of the organs that people commonly donate. Participation in organ donation is a great form of charity and social service. It marks the contribution of individuals after death. We all should pledge to donate our organs to save lives and promote the importance of organ donation by participating in various campaigns.

World Organ Donation Day is observed annually on August 13. It is celebrated by people worldwide to raise awareness about the necessity of organ donation in society. The World Health Organisation and other health organisations conduct live classes on health-related topics to educate people. Essay writing activities on topics like the necessity of organ donation in society and organ donation essay are excellent tools for teaching the little ones about the process and importance of organ donations. For more essays, worksheets and stories , visit BYJU’S website.

Frequently Asked Questions

What is organ donation.

Organ donation is the practice of surgically transplanting an organ or tissue from one person to another person.

When is World Organ Donation Day?

August 13 is observed as World Organ Donation Day.

What do children learn from BYJU’S organ donation essay?

BYJU’S organ donation essay provides an opportunity for kids to attain knowledge of the human organ system. Practising essay writing activities will help them perform well in their academics and score good marks.

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93 Organ Donation Essay Topic Ideas & Examples

🏆 best organ donation topic ideas & essay examples, ⭐ good research topics about organ donation, 👍 interesting topics to write about organ donation, ❓ organ donation research questions.

• Importance of Organ Donation Considering the huge number of people in need of different body organs today, and the many that are dying each day due to organ problems, a socially upright member of our society should not consider […]
• Organ Transplantation and Donation Since people donate organs to others regardless of their locations, nations need to be cautious in order to avoid spread of diseases in the process.
• Organ Donation: Willingness to Donate Organ Among Medical Students In conclusion, organ donation is a vital and life-changing procedure that can help save lives and improve the quality of life for those in need.
• The COVID-19 Impact on Organ Donation The official statistics of the United States government also support the idea that with the onset of the pandemic, the number of organ transplantation procedures has decreased. The pandemic appears to be the main cause […]
• The Organ Donation Legislation Critique She expresses outrage and condemnation of the current organ donation legislation and the politicians who drafted it. If the global majority accepts such a perspective, it will lead to a worldwide spike of violence and […]
• Researching of Xenograft and Organ Donation Doctors have been searching for methods to save lives all along, and xenograft has shown to be one of the most reliable, particularly when it comes to organ replacement. A xenograft is fraught with dangers, […]
• Organ Donation: Donor Prevalence in Saudi Arabia Donating organs does not pose a threat to the life of the donor; however, it can save the lives of many other people who need organ transplants.
• Organ Donation Registry Beginning 16th February 2010 through to the 18th the Ypsilanti Lions club organized the organ donation registry table whose main purpose was to invite people from all walks of life to literally give a piece […]
• Organ Donation: Postmortem Transplantation The ethicality of such actions has been questioned, as this procedure may be ambiguously perceived by the relatives of the deceased patient and the recipient of organs.
• The Issue of Compensation for Organ Donation Nevertheless, in spite of the fact that proponents of the compensation for the organ donation indicate obvious advantages of using this approach for the healthcare system, opponents emphasize the unethical character of such approaches.
• Organ Donation: Ethical and Legal Considerations The other approach is by requesting the family of the deceased to give consent for the donation in a case where the deceased did not permit earlier on.
• Organ Donation in Saudi Arabia: Survey Results A total of 27 participants answered the questions that were asked in the survey. The problems that are behind the ambiguity that people have over this issue are some of their limitations and perceptions.
• Organ Donation: Ethical Dilemmas An example of an ethical dilemma surrounding the procedure is the case of rich man vs.poor man, or rather, the case of a person who can afford to buy an organ on the black market […]
• Ethics of Organ Donation After Human Death In reference to this case, the ethical dilemma is related to the fact that the hospital administrator needs to disregard the necessity of informed consent for organ donation.
• Medical Ethics of Child’s Organ Donation Obviously, the parents are the only people who represent the wishes of the patient in the case. The above-mentioned position seems to be viable when it comes to the concept of the greatest good used […]
• Gene Patenting and Organ Donation Profitability is the key to violating the law, and that is the reason for the lack of transparency in the tissue market.
• Organ Donation and Transplantation Medicine Although money and financial support will be a major factor in the process of body transplant that Canavero expects to take two years, pegging human life on money is unethical.
• Organ Donation Myths: Critical Thought This essay is aimed at subverting three of the most common myths about the subject matter by considering the facts closely, relating them to the values concerning the organ donation, and isolating the issues related […]
• Organ Donation: Importance Information Because of the improved and advanced technology, the practice of organ transplant is becoming more popular and acceptable in the society.
• Ethical Issues in Organ Donation According to the authors of the study, death is defined as, “the irreversible loss of the integrated and coordinated life of the person as a single living organism”.
• The Ethics of Organ Donation in Modern World The patient is referred to a transplant center and is to their “dismay” put on a national waiting list, after a “series of interviews, physical and medical tests” to determine the suitability of the recipient […]
• Pros and Cons of Paying for Organ Donation: Arguments for Prohibition Although the potential of people to purchase organs might bring in profits to health care and increase supply and demand of transplanted organs, the fact of increased supply rates is doubtful because recent surveys prove […]
• The Nebraska Laws on Organ Donation in the United States
• Factors Influencing Organ Donation Among African Americans
• Pros and Cons of a New Opt-Out System of Organ Donation
• An Argument in Favor of Encouraging Organ Donation After Death for Transplantation Opportunities
• Beneficence Justice Malfeasance and Autonomy in Organ Donation
• The Cases of Brain Death and Organ Donation in Children and Adults
• Comparison of the Organ Donation in the U.S. and Sweden
• Compensation for Organ Donation: The Sale of Organs
• Could Death Row Inmates Be a Viable Source for Organ Donation
• Overview of the Dutch and Belgium Organ Donation Acts
• Donation of the Organs and Their Harmful Effects on the Society
• Knoweldge and Attitudes of Health Professionals on Organ Donation
• Financial Compensation for Organ Donation
• Analyzing the Importance of the Organ Donation
• The Benefits and Shotrcomes of Organ Donation
• Improving Organ Donation Through Clarification and Education
• Increasing Organ Donation via Changes in the Default Choice or Allocation Rule
• Organ Donation: Why Everyone Should Be a Donor
• Legal and Ethical Issues Regarding Organ Donation
• Mandatory Organ Donation: Ethical or Unethical
• Organ Donation: How Recipients Are Chosen and Should Donors Be Compensated
• The Discussion of the Legalization of Organ Donation
• Effects of the Organ Donation on the Lives of Thousands of Recipients
• Ethical Issues Surrounding Organ Donation
• Why Cash for Kidneys Is Better Than Organ Donation
• Organ Donation Issues and Laws: Federal and California State
• Social Madia Initiative May Help Increase Organ Donation
• Organ Donation: Life That You May Have the Power to Save
• The Best Ways to Decrease the Shortage of Organs for Transplantation
• Public Policies in the Question of Consent for Organ Donation
• Organ Donation: Keeping the Gift of Life Alive
• Description of the Commercial Market for Organ Donation
• The Controversy Associated With the Opt-Out Organ Donation
• The Life Saving Benefits of Organ Donation
• Comparing Organ Donation Programmes Across the World
• The Global Need for Organ Donations
• Why Organ Donation Should Be Encouraged
• Organ Donation: Two Deaths or One Life
• Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications
• Organ Donation and Forest Depletion Depicted in Fitzhugh’s “The Organ Grinders”
• Is There a Black Market for Organ Donation?
• What Are the Advantages and Disadvantages of Organ Donation?
• How Is Organ Donation a Lucrative Business?
• Why Do Muslims Disagree With Organ Donation?
• Is Organ Donation Against God and Nature?
• What Are the Ethical Issues in Organ Donation?
• Is the US Opt-in or Opt-Out for Organ Donation?
• Why Is Organ Donation a Moral Issue?
• How Does the Process of Organ Donation Work?
• What Ethical Theory Is Against Organ Donation?
• Does Islam Support the Concept of Organ Donation After Death?
• What Is the Most Complicated Organ Donation?
• Are Organ Donations Compulsory in China?
• Why Can’t Organ Donation Be Mandatory?
• Is There an Age Limit for Organ Donation?
• What Do Religions Think About Organ Donation?
• Why Is Organ Donation in Exchange for Money Illegal?
• Is an Opt-in or Opt-Out More Effective for Organ Donation?
• What Are the Disadvantages of Organ Donation After Death?
• Are Religious Beliefs Keeping Organ Donations From Going Mainstream?
• What Cultures Don’t Believe in Organ Donation?
• Why Is Organ Donation Uncommon in India?
• Should Presumed Consent for Organ Donation Be Used in the US?
• What Are the Laws Behind Organ Donation?
• How Does the Debate on Deontology vs. Consequentialism Stand When It Comes to Organ Donation?
• What Are the Emotional Tolls of Organ Donation for the Donor?
• How Do Living Organ Donations Compare to Deceased Organ Donations in the United States?
• What Are the Challenges of Organ Donation?
• Are There Barriers to Organ Donation in the US?
• Why Are Donated Organs Sometimes Rejected?
• Chicago (A-D)
• Chicago (N-B)

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Definition of Organ Donation

How it works

Organ donation is defined as the process of transplanting human organs from one person to another (“Organ donation,” 2017).

As of November 2018, there are more than 114,600 people on the national waiting list for a donor organ, and a new person is added to the list every 10 minutes (“Organ Procurement and Transplantation Network,” n.d.). So far in 2018, over 30,400 transplants have been performed from more than 14,500 donors (“Organ Procurement and Transplantation Network,” n.d.). The most commonly transplanted organs are kidneys, as they can come from living or deceased donors (“Organ donation,” 2017). The process of organ donation is rather complex, and so are the perspectives of the people involved.

• 1 The Process
• 2 Consenting to Donation
• 3 Matching Donors and Recipients
• 4 Perspectives of Those Involved in the Process
• 5 Potential Donors
• 6 Waitlisted Patients
• 7 Donor Families
• 8 Conclusion

The Process

There are many elements to the organ donation process. The Organ Procurement and Transplantation Network (OPTN) is the database in the United States responsible for matching potential transplant recipients to identified organ donors (“Transplantation, Medical,” 2017). The organization in charge of running the OPTN is the United Network for Organ Sharing (UNOS), a non-profit that is based in Richmond, VA (“Transplantation, Medical,” 2017). This network takes a variety of factors into account when matching donors and recipients to increase the probability of a successful transplant.

Consenting to Donation

The U.S. and the U.K. use a consent system called “informed consent,” meaning that the donor or family of the donor has to approve the donation (“Organ donation,” 2017). One can register to become a donor by marking a space on their driver’s license or registering online; however, most hospitals will still consult the donor’s family and get their final approval even if the patient is a registered donor (“Organ donation,” 2017). Other countries use a system called “presumed consent,” meaning that healthy organs are removed for transplant in any patient, unless there is written evidence that the person did not want to become a donor (“Organ donation,” 2017).. This system does increase the number of available organs and transplants, but it does some people who may not have wanted to donate will be organ donors. A majority of donor organs come from deceased/brain dead donors, which are usually young and healthy patients that have sustained a fatal head injury and no longer have brain activity (“Organ donation,” 2017).  These deceased or “brain dead” donors can donate both kidneys, both lungs, a heart, pancreas, and intestines. Living organ donors can give one kidney, one lung, and portions of the liver, pancreas, or intestines (“How Organ Donation Works,” n.d.).

Matching Donors and Recipients

When the UNOS list is matching donors to recipients, it considers the blood type, body size, severity of potential recipients’ condition, how long he or she has been on the waiting list, and the distance between the two to find the closest match (“How Organ Donation Works,” n.d.). One of the biggest problems facing the actual donation is the possibility of rejection. Each person’s tissues bear a distinctive set of antigens, and scientists now know the closer the human-leukocyte-antigens are between the donor and the recipient, the higher chance for a successful transplant (“Transplantation, Medical,” 2017). If the antigens are not a close enough match, the recipient’s immune system will attack the antigens of the new organ thinking that they are foreign, which makes the body reject the transplanted organ (“Transplantation, Medical,” 2017).  There are two types of rejection; acute rejection happens very quickly after the transplant, while chronic rejection involves the organ slowly failing (“How Organ Donation Works,” n.d.). To combat this rejection, the recipient will be prescribed immunosuppressive drugs for the rest of his or her life (“Transplantation, Medical,” 2017). However, the result of a suppressed immune system can cause other issues; is that it cannot fight off germs and bacteria as easily and make the body more susceptible to illness and unable to recover as quickly, especially in the first few months after the transplant (“How Organ Donation Works,” n.d.).

Perspectives of Those Involved in the Process

Organ donation affects many lives, well beyond just those physically involved in the process. Whether it be the potential donors, people on the waiting list, or the donor’s family, each has their own unique opinion about their experience or how they feel about certain aspects of the donation. Taking these perspectives into account makes one understand just how complex the process is and why it is still a somewhat controversial topic.

Potential Donors

A study conducted in Northern France by Munoz Sastre et al. (2012) interviewed 200 people on their willingness to be organ donors in a variety of theoretical situations. The factors included in the possible scenarios included: the donor’s relation to the recipient (a stranger versus a family member), the possible surgical complications/long-term health issues for the donor, the likelihood of success, and the probability of matching to a potential recipient (Munoz Sastre et al., 2012). The study resulted in three categories of responses. The first group, which consisted of 49% of the participants, had a high willingness to donate for a family member versus a low willingness to donate to a stranger (Munoz Sastre et al., 2012). The second category was comprised of 37% of participants who were highly inclined to donate to a family member, but also moderately inclined to donate to a stranger (Munoz Sastre et al., 2012). The third category included 14% of participants, who had a low willingness to donate to a family member as well as an unfamiliar person (Munoz Sastre et al., 2012). This study gives helpful insight into what makes people want to become organ donors.

Waitlisted Patients

This study, conducted by Merola et al. (2016), surveyed 225 people who are currently on the UNOS transplant list on their willingness to be donors as well as their attitudes about the process as a whole. The results were that 32% of participants were registered donors, 28% had no interest in becoming donors, 38 % felt that their medical condition disqualified them from as potential donors, and 18% felt that they should be prioritized on the list if they agreed to donate (Merola et al., 2016). According to Merola et al. (2016), only 28% of these participants reported discussing the possibility of donating with their doctor. If the 68% of waitlisted patients were not registered did so, 9,500 new people would be added to the potential donor pool which could increase the number of transplants each year by 19,000 or more (Merola et al., 2016). Merola et al. (2016) also noted that more than half of the participants of this study confirmed misconceptions regarding organ allocation and eligibility, indicating that these waitlisted patients need to be more informed on the topic in order for more transplants to take place.

Donor Families

A study performed by Marck et al. (2016) in four Melbourne hospitals interviewed forty-nine families of deceased organ/tissue donors to evaluate their experiences after they consented (or did not consent) to organ donation. The results revealed that the families were highly satisfied with the care received from health professionals, noting that they felt like they were well-informed of their loved one’s status and the prospective outcomes of the donation process (Marck et al., 2016). Also, according to Marck et al. (2016), most of the families suggested that they found comfort in the fact that their loved one was able to save other people’s lives, even though the process was difficult and somewhat stressful. The only families in the study that regretted their choices were some of those who did not consent to organ donation (Marck et al., 2016). It is important to understand the family’s outlook because they ultimately make the final decision as to whether or not their loved becomes an organ donor, making them just as involved in the process as the donor or the recipient.

For those waiting on the UNOS list, receiving a donor organ is literally a matter of life and death. Medicine is continuing to evolve and every year more and more selfless donors give the ultimate gift. Names are always being added to the UNOS list, but more donors allow for more people to have the opportunity for a healthy life. The whole process of organ donation has several moving parts and complex outlooks of those involved.

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Body Language

‘Failure to Thrive,’ or a Failure to Investigate?

An outdated medical term often masks treatable illnesses, health experts contend.

Credit... Sol Cotti

Supported by

By Rachel E. Gross

• May 13, 2024

The word “failure” is rampant in medicine. Hearts, livers, lungs, and kidneys all “fail,” which simply means they cease to do their job. But the failures that patients tend to remember are the ones that seem to indict not an organ but an entire person. Just ask anyone who has been told that they have “failed” vaginal delivery (meaning that labor was slow or the cervix didn’t dilate) or “failed” chemotherapy (meaning that the tumor didn’t respond to treatment).

Worst among these phrases, many doctors say, is a common diagnosis for both infants and older adults: “failure to thrive.”

In pediatrics, the term refers to infants who struggle to hit key milestones in size, weight and cognitive development. When Dr. Deborah Frank, a retired pediatrician, was in medical school in the 1970s, the diagnosis meant one of two things: “Either you had major congenital heart disease or cystic fibrosis, or you had a bad mother,” she said. “Or maybe you had both.”

If the term sounds slightly accusatory, that’s because it is. It arose from the idea that struggling infants were ailing not because of any underlying disease or lack of nutrients but because of poor parenting.

The first known appearance of “failure to thrive” was in the 1933 edition of a medical textbook, “The Diseases of Infancy and Childhood.” An explanation for the condition came near the end of World War II, when René Spitz, an Austrian psychoanalyst, observed that infants in a Mexican orphanage tended to be listless, scrawny and slow to develop.

This concerning syndrome, Spitz surmised, resulted from a lack of “maternal affection, maternal care and maternal love.” Pediatrics took the idea and ran with it​ — “in the fine old tradition of mother-blaming,” Dr. Frank said. (A similar psychoanalytic idea that became popular around this time was “refrigerator mother theory,” which posited, incorrectly, that autism was caused by “cold mothering.”)

That thinking remained in the mainstream in pediatrics until the 1980s, when some doctors began questioning whether, by blaming mothers , they had failed to pay enough attention to another key factor: nutrition. In 1984, Dr. Frank founded a pediatric clinic and food pantry at the Boston City Hospital for children growing up in poverty. She called it the Failure to Thrive Clinic.

While the intentions were sound, the undertones were not lost on some parents. A donor to the clinic, herself a mother, soon pointed out the obvious: “Who wants to bring their kid to the failure clinic?” Dr. Frank recalled being asked. She changed the name to the Grow Clinic.

Just as pediatricians were beginning to challenge the wisdom of this term, the use of “failure to thrive” spread to a new field, geriatrics. In 1976, three neurologists noted the similarity between this “well-defined pediatric syndrome” and a pattern of muscle wasting and cognitive decline in some of their older patients that led to sudden death. Before long, adult “failure to thrive” had become an official diagnosis and a research priority for the Institute of Medicine. Like a virus jumping from species to species, it had made the jump across specialties. And in this field, too, problems soon appeared.

Geriatrics is a field of sleuthing. To solve medical enigmas, doctors must become detectives, teasing out the effects of overlapping causes that include chronic conditions, acute injuries, social factors and the normal process of aging. It is a challenge that tests the patience of many doctors; the number of certified geriatricians in the United States, now just over 7,000, has been decreasing since 2017.

By masquerading as a diagnosis, the term “failure to thrive” cuts that sleuthing process short, shutting down inquiry before doctors can determine the real cause, said Dr. Clara Tsui, a geriatrician at St. Paul’s Hospital in Vancouver, British Columbia. Last month, she saw the label in the medical notes of an 82-year-old man with Alzheimer’s, who had fallen and hit his head. Even though a brain scan showed internal bleeding, the man had been diagnosed only with “failure to thrive” — which, Dr. Tsui noted, “is not a diagnosis at all.”

Dr. Martha Spencer, a geriatrician and colleague of Dr. Tsui at St. Paul’s, called the phrase vague, demeaning and ageist. “It baffles me as to why it’s lingered so long,” she said.

In 2020, Dr. Spencer and Dr. Tsui led a study that found that older patients who were given the label “failure to thrive” waited significantly longer to be admitted to a hospital. Once admitted, these patients experienced longer hospital stays, which are known to increase the risk of infection and other complications. By the time these patients were released, most of them — 88 percent — had received specific diagnoses, such as kidney failure or severe dehydration.

In other words, the authors concluded, the “failure” label tended to mask treatable illnesses, while burdening the patient with unnecessary delays in their care. A diagnosis of “failure” could become a self-fulfilling prophecy, leading doctors to assume that they were just another older patient on the inevitable path to decline. (Similarly, researchers have found that “acopia,” a bit of medicalese that literally means “not coping” and is still sometimes used in the U.K. and Australia, often leads doctors to overlook acute illnesses.)

The term is the diagnostic equivalent of throwing one’s hands up and saying there is nothing more to do, said Dr. Catherine Sarkisian, a geriatrician at the University of California, Los Angeles, School of Medicine: “‘We’re done here, you’re already going down the drain.’”

Dr. Sarkisian first encountered the geriatric incarnation of “failure to thrive” when both her grandmothers received the diagnosis, for different reasons. The label struck her as “arguably inappropriate” to apply to older adults, who were not expected to grow and develop in the same way young children are. “Maybe it’s OK not to thrive when you’re in your 90s, but your life is still worth living,” she said.

In 1996, Dr. Sarkisian and her mentor, Dr. Mark Lachs, argued that doctors ought to stop using the term. The general concept, though, was not new . As a resident, Dr. Lachs, now a geriatrician at Weill Cornell Medicine, often heard older patients labeled with ‘the dwindles,’ which was “basically lazy shorthand for ‘I don’t know what’s going wrong and I haven’t really evaluated and I can’t find anything,’” he said.

In pediatrics, the term can also function as an unhelpful catchall diagnosis. “It’s a wastebasket of things we put children into when we don’t understand what the specific cause of their problems is,” said Dr. Jeanne Lewandowski, a pediatric palliative care physician and chief of pediatrics at Corewell Health Beaumont Grosse Pointe Hospital in Detroit.

Dr. Lewandowski’s concern differs from Dr. Spencer’s: Many of her patients are nearing the end of their young lives, and there is nothing medicine can do for them. To her, “failure to thrive” is a way for doctors to avoid admitting that they don’t have the answer, by foisting blame onto the patient instead.

“The challenge with these words is that somehow it’s either the fault of the baby or the fault of the parent,” Dr. Lewandowski said. “As if, if they only tried harder, they could have gotten better.”

The diagnosis remains common in pediatrics, despite efforts in the literature to replace it with the more neutral “growth faltering.” All 65 children that Dr. Lewandowski currently cares for in hospice had “failure to thrive” written somewhere in their charts, she said.

Geriatrics is slowly gravitating toward use of the term “frailty,” which captures a vulnerability to stressors and relies on a more quantitative definition. Still, Dr. Spencer said she comes across “failure to thrive’ several times a week. Her goal before retiring is to see her institution break the habit, and be more thoughtful in exploring the causes of an older patient’s decline.

Achieving that will require doctors to have patience, and a willingness to spend more time in the discomfort of the unknown. “In medicine there’s always a reluctance to say ‘I don’t know,’” she said. “We need to be curious, rather than dismissive.”

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ChatGPT and the skeleton: A tale of artificial intelligence and misinformation

When Dan Goldstein, a West Palm Beach physical therapist, was vacationing in Norway recently, he saw an unusual sight. 

A skeleton was perched atop the organ pipes in Oslo City Hall, the setting where the Nobel Peace Prize ceremony is conducted every year. 

Goldstein took photos of the skeleton on the organ and did a Google search for an explanation, but it came up empty. 

His friend suggested he research it on ChatGPT, an online artificial intelligence source that gathers a wide range of data from a variety of sources to serve as a kind of knowledgeable personal assistant capable of conversationally answering questions, and writing everything from college essays to business correspondence to newspaper columns on the spot.

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And yes, when Goldstein asked ChatGPT about the skeleton, it knew all about it. And in great detail.

"The skeleton above the pipe organ in the Oslo City Hall is known as the "Death Organ" or "Dødsorgel" in Norwegian. The skeleton is positioned in a seated position above the organ pipes, with its hands resting on the keys of the organ. 

The skeleton is made of plaster and was created by Norwegian artist Emanuel Vigeland, who was commissioned to decorate the hall in the early 1900s.

The Death Organ is meant to symbolize the fleeting nature of life and the inevitability of death. The organ itself was also designed with a special sound to evoke a sense of mortality, with deep and mournful tones that are said to resemble a funeral march."

One man's quest for putting some meat on the skeleton story

After he returned home from Norway, Goldstein mentioned to a client how impressed he was with the “magical computer” capabilities of ChatGPT.

“How do you know it’s true?” she responded.

Well, now, he had to know. So, Goldstein sent an email to an Oslo tourist guide with an explanation of the skeleton from ChatGPT and a request for verification on the skeleton’s history. He was surprised by the answer he got in return. 

“It was put up there as a prank from the night guard for the day guards, and it was there only maybe half a day before it was removed again,” the response said. “I would say this ‘story’ of Chat GPT shows we should not trust what it says — at least not yet.  Nothing in the text was correct.”

Goldstein told me the story of the Oslo skeleton and ChatGPT, and that made me want to see for myself. And when I asked ChatGPT to give me the history of the skeleton on the pipe organ, it gave me a completely different, and very detailed, fictitious answer.

A case of multiple fake stories?

The skeleton above the pipe organ is named “Leif”, and has an interesting history that dates back to the 1930s, ChatGPT told me.

“The story behind Leif goes back to the time when architect Arnstein Arneberg and artist Hugo Lous Mohr were working on the design of the building. 

“As legend goes, during a conversation about the organ loft, Mohr jokingly suggested placing a skeleton there to keep the organist company. Arneberg found the idea amusing and decided to incorporate it into the design. However, the idea was not entirely without meaning.”

The explanation went on with four more detailed paragraphs that included some symbolic meanings people have given to the skeleton over the decades. And it contended that it wasn’t a real human skeleton, but a plaster and iron rod creation of artist Carl Nesjar, who worked with Mohr on the decorations in the city hall building.

“Today, Leif continues to fascinate visitors to Oslo City Hall, serving as a quirky and thought-provoking piece of art,” the explanation said.

Goldstein got the “Death Organ” response. And I got “Leif.” His story said it was created by Norwegian artist Emanual Vigeland, and mine said it was the work of Carl Nesjar. And neither of these detailed histories dovetailed with each other or the simple truth.

Yikes. It isn’t hard to see the downside of such an authoritative source of misinformation.

Using ChatGPT while acknowledging its shortcomings

I spoke about this with Diane Gayeski, a professor of strategic communications at Ithaca College. Gayeski requires her students to use ChatGPT as a research tool, while acknowledging its limitations, and the ease in which it enables sloppy research and plagiarism. 

“It knows how to be very convincing while making things up,” she said. “And it’s very good at connecting dots that shouldn’t be connected.”

She used her own bio on ChatGPT as an example. It claims that she has won the State University of New York Chancellor’s Award, even though she has never taught in the SUNY system or won that award.

“It probably thinks I should have won that award by now,” Gayeski said.

Gayeski said she wants her students, who often go into careers in corporate communications, to use ChatGPT as a starting point for gathering information. 

“For example, give me an example of a letter I can write to a $100 donor to make them a $1,000 donor,” she said. “It’s a good way to get something down on paper when you’re looking at a blank screen.”

Gayeski said that college professors, as well as students, are using it. 

“It’s being used by professors to design quizzes or to write course syllabi for subjects they might have to teach for the first time.” 

She puts the quality of the output it creates at a “B-minus, C-plus” level. 

“It’s better using it for things you can’t make up, like answering questions in calculus or coming up with sentences in basic Italian,” she said. 

I asked ChatGPT to write a column in my voice about ChatGPT.

Here’s a snippet of the column it instantly wrote for me: 

“I must admit, when I first encountered ChatGPT, I was skeptical. Could a machine truly engage in meaningful conversation and provide intelligent responses? But let me tell you, dear readers, I was pleasantly surprised.” 

Let me tell you, dear readers, I was not pleasantly surprised. On behalf of the temporary prank skeleton on the organ at Oslo City Hall, my advice is be afraid, be very afraid.

Frank Cerabino is a columnist at The Palm Beach Post, part of the USA TODAY Florida Network. You can reach him at [email protected] .