Organ Donation & Medical Research: Ethical Considerations
Organ Donation and Transplantation
What are Transplants?
The need to prolong life expectancy and improve quality of life for patients with irreversibly damaged organs led to the development of the medical-surgical technique of organ and tissue transplantation. This scientific age began in the 20th century. A transplant is the removal of a tissue or organ from an individual (the donor) and its implantation into the same or a different organism (the recipient). The terms “transplant” and “graft” are used interchangeably. The installation of an artificial prosthesis is called an implant.
When the recipient’s body does not recognize the transplanted tissue, rejection occurs, which destroys the graft. To prevent this, immunosuppressive drugs like cyclosporine are used, often for life. The most common transplants are kidney, heart, liver, lung, cornea, and pancreas.
Types of Transplants
- Autograft (Autologous or Autogenous): Tissue implanted from one healthy part of an individual to another damaged part. The patient is both donor and recipient.
- Isotransplant: Performed between genetically identical individuals, such as twins.
- Allograft (Allogeneic): Between members of the same species but with different genetic makeup.
- Xenotransplantation: Performed between individuals of different species, such as pig to human. These have not been successful.
The Social Function of Organ Donation
The National Transplant Organization (ONT) coordinates the national transplant system. Its functions are related to the collection and clinical use of organs, tissues, and cells, with the main objective of promoting altruistic donation to maximize patient success rates.
Medical Research and Ethical Considerations
The Role of Medical Research
Medicine is experimental, not an exact science. Medical research focuses on controlling and evaluating treatments to suit individual patients. Factors related to human health include:
- Disease distribution and impact (epidemiology)
- Social and cultural aspects of health
- Organization, financing, and delivery of medical care
- Law and ethics
A physician’s ethical values (compassion, competence, and autonomy) are essential for medical researchers. When there is a conflict between the roles of physician and researcher, the physician’s role must take precedence.
Clinical Trials
Clinical trials are a form of medical research, often conducted in hospitals. They must be approved by a bioethics committee, and participants must understand the study objectives and risks and sign an informed consent form. A drug must be tested for efficacy and safety in humans. If deemed valid and safe, it undergoes four phases of clinical research:
- Phase 1: Conducted with a small group of healthy volunteers.
- Phase 2: Conducted with a selected group of patients with the disease the medicine aims to treat.
- Phase 3: Involves administering the drug to a large number of patients and comparing it, if applicable, to another treatment or a placebo.
- Phase 4: If successful, approval for marketing is sought.
Ethical Constraints
In past centuries, many experiments were conducted without the consent of participants, disregarding their health and violating human rights.
Patents
A patent, granted by the state, gives its owner a monopoly on the industrial and commercial exploitation of an invention for a period defined by the WTO, a maximum of 20 years for medicines. Drugs are a universal good, essential for health.
Generics
Generics are drugs developed and manufactured under current regulations, with the same qualitative and quantitative composition as the reference product and bioequivalent to it.
Global Health Challenges
Health in Underdeveloped Countries
Health is a reflection of a country’s health systems and development level. Many governments fail to provide quality, integrated, and universal public health systems. The precarious state of a population’s health can impact life expectancy.
The AIDS Pandemic
The HIV epidemic is devastating globally, both in human lives and economic resources, with the least developed countries suffering the most.
Difficulties in Treatment
Disease treatment in underdeveloped countries is hampered by limited research and development of drugs for neglected diseases, often because those affected have low purchasing power. Examples include malaria. Lack of access to clean water, food, and medicine creates health emergencies in developing nations.