Donating Organs from Anencephalic Babies
Walking the Ethical Plank?
Summary
Virtuous Ethics
Deontologism
For:
For
- Save as many lives as possible
- Dead Donor Rule should include anencephalic infants
- Definition of brain death
- Anencephalic baby = dead or alive?
- Violation of the Dead Donor rule?
- Is the benefit to society worth it?
- Various ethical standpoints?
- Issues regarding organ viability?
- American Medical Association Council (1994) supported, however donation not encouraged due to law.
Good for parental mental health.
Each anencephalic = four organs = four new lives. 30-50% babies die while waiting...
Against
Against:
- Violates Dead Donor Rule
- Slippery slope
- Problems with diagnosis
- Hippocratic Oath: "Do no harm"
- "The irreversible cessation of the circulation of blood or irreversible cessation of all function of the brain of the person" (ANZICS, 1998)
Pluralism
Consequentialism
For:
Parent's rights and wishes
For
No harm to infant
Net benefit to society (costs/lives)
- Brain dead (no higher brain function)
- Benefits of saving lives outweigh the costs
- Parental wishes are respected
Against
Organ transplantation does no harm to the infant. No pain is felt.
Parents informed of the risks involved.
Anencephalic Organ Donation
- Harm to baby, organ recipient, parents, medical professionals, society (policies)
- Limited application and benefit
Parent's wishes should be respected and meaning given to the birth of their baby.
Modification of Dead Donor Rule
Ethical Principles
Anencephaly is a congenital CNS abnormality
- Cranial end of neural tube fails to close completely
Results in:
- Absence of the forebrain, skull, and scalp
- Partial or fully functioning brainstem
Almost all die during birth or very shortly after.
So should we donate their organs?
Pluralism
Consequentialism
Against:
Deontologism
Not in patient's best interest Coercion of parents
Virtue Ethics
Virtuous character
Virtue midpoint
Pluralism
Breaking the Dead Donor Rule & Hippocratic Oath
Autonomy
Beneficence
Non-maleficence
Justice
Non-equitable treatment of anencephalic infants
References
- Byrne, P. 2005, Use of Anencephalic Newborns as Organ Donors, Paediatric Child Health 10(6): 335-7.
- Fost, N. 2004, Reconsidering the dead donor rule: is it important that organ donors be dead? The Kennedy Institute of Ethics Journal 14:249-260.
- James, R. 2003, "What is Morality", The Elements ofMoral Philosophy (4th edition). McGraw-Hill: Boston.
- Robley, R.L. 1998, Increasing the Availability of organs for transplantation: an ethical analysis, Journal of the Medical Association of Georgia 87(2):113-6.
- Steinberg, A. Katz, E. Sprung, C L. 1993, Use of Anencephalic neonates as organ donors, Critical Care Medicine 21:1787-1790.
- Willis, W. 1990, Anencephalic as organ donor: Whose baby is it anyway? Journal of Religion and Health 29(2):139-148.