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Given the fact that organ transplantation has become a public good that is scarce and subjected to human ethical standards, discussions have taken place in order  to clarify the issues surrounding this medical procedure.  More importantly, discussions on the bioethics involved in the practice of organ transplantation have been at the forefront of all these exchange of ideas.

Academic and clinical academics in bioethics have been issuing their positions or opinions on the matter of organ transplantation. Many of them do not support “Presumed Consent”. (See discussion of this in succeeding pages).

Islamic bioethics emphasizes prevention and teaches that the patient must be treated with respect and compassion and that the physical, mental and spiritual dimensions of the illness experience be taken into account. Because Islam shares many foundational values with Judaism and Christianity, the informed Canadian physician will find Islamic bioethics quite familiar. (Khitamy, 2001)

With respect to organ transplantation, almost all Muslim countries practice organ transplantation[1].  This generally involves kidney donations from living relatives, but cadaveric donation is increasing.[2]

Concerning the Catholic faith, the Catholic Health Association of Canada (1991) has the following position on organ transplantation:

In the donation and transplantation of human organs, respect is to be given to the rights of the donor, the recipient and the common good of society. (p. 44)

In a report by the Canadian Council for Donation and Transplantation (2006), it showed that Christians, Islam, Mormons, Hinduism, and Shintoism generally support organ transplantation.

On Canadian Law and Public Policy, Chenier (1996) explains that organ transplantation is governed by the Uniform Human Tissue Donation Act which was promulgated in 1989. This law was developed by the Conference of Commissioners on Uniformity of Legislation in Canada. The provinces have equivalent Acts to regulate procurement and use.

In 1992, the Law Reform Commission of Canada issued a working paper on the procurement and transfer of human tissues and organs.  The focus was on questions about legal reforms that might alleviate perceived tissue scarcity and on whether selling body parts or substances was an acceptable means of increasing the supply.

At the data collection level, the Canadian Organ Replacement Register, a joint project of the federal and provincial governments, provides statistics that allow comparisons among provinces and facilitate decision-making in health care. (Copleston, 1995)

Defining Public Policy on Organ Transplantation

Treatment of organ transplantation in terms of promulgating laws and public policies by various provinces in Canada seems to relatively conform to each other. There are instances however where application of a particular law or public policy promulgated by the Government of Canada on the matter would  suffer defeat  in the process of its execution by a certain province.

Chenier (1996) demonstrated this particular instance when she wrote the following in her article:

In Canada, organ transplantation is fully funded by provincial health insurance plans. In June 1995, controversy erupted in Alberta when it was learned that Alberta Health had paid about $500,000 for a baby to have a heart transplant in the United States although a pediatric transplant service existed in Edmonton.

Most provinces have policies that out-of-country funding for such procedures will be covered only if the service does not exist within the province. In the Alberta case, procurement of organs was problematic as it has been in other provinces. (p. 11)

Other European countries have also addressed the issue of organ transplantation through their respective laws and public policies but oftentimes with varying degrees of enforcement.

For instance with respect to the Presumed Consent law, which stipulates that organs and tissues would be harvested from the deceased unless they have expressly forbidden it (TheStar.com, 2007), some European countries have this law on Presumed Consent but some of their European counterparts do not have such provision in their legal statutes.

It would be  noted that “countries such as Belgium, France, Austria, which have presumed consent laws, transplant more organs per million people than do Germany, the Netherlands, and the United Kingdom, countries seen as culturally, socially and economically similar, but that lack presumed consent laws.” (Spital, 1991)

Canada had the opportunity to consider the stipulation of the Presumed Consent rule in its legal statutes but it eventually rejected the said provision affecting the course of organ transplantation in this country.  (TheStar.com, 2007)

The Role of Media and Other Instruments of Popular Culture

There is said to be so much fear, confusion, and lack of education among the general public and health professionals concerning the issue of organ transplantation. Even in developed countries, there are still many people who are unaware of the severe shortage of organs and tissues for transplantation.

The social benefits of organ transplantation has not actually sinked into the level of consciousnes of many citizens these countries. Many have unfounded fears or reservations or are confused about some of the issues of being a donor for an organ donation program.

For instance, in a previously conducted survey in the United States, “the two most common reasons given for not permitting organ donation were (1) they might do something to me before I am really dead; (2) doctors might hasten my death.”  (Law Reform Commission of Canada, 1992)

The above evidence clearly demonstrates ignorance of standard policy and procedures concerning transplants, as this include strict criteria for determining total brain death and the separation of the ill or dying patient’s health care team and the transplant team. Although surveys show that most people think organ transplantation is a good thing, only a minority sign an organ donor card.

Evidently, many are not fully aware of the advantages of this type of voluntary expressed consent. This is an obvious case where popular culture has not yet significantly dealt with the issue of organ transplantation in a positive way.

[1] Daar, A. S. (1997). A survey of religious attitudes towards donation and transplantation. Dordecht: Kluwer Academic Publishers.

[2]  Shad A.R. The rights of Allah and human rights. Lahore: Kazi Publications; 1981.

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