Assessment 4 Robbing the Dead

Moral Concerns Surrounding Organ Conscription Policy

Organ conscription is a policy that raises a number of moral concerns centered on bodily autonomy and individual rights after death. The core ethical tension lies between maximizing life-saving medical resources and respecting personal sovereignty over one’s body (Zambrano, 2023). While the conscription would dramatically raise the rate of organ availability and thus save thousands of lives every year, it fundamentally challenges our deeply held beliefs about bodily autonomy extending beyond death. This creates a complex moral calculus between individual rights and collective welfare: Assessment 4 Robbing the Dead.

The utilitarian case for conscription is very strong. It could be shown that this policy saves 10,000 lives every year in the US alone, and then there would certainly appear to be a very strong moral case to pursue the policy. This, however, needs to be weighed against concerns about government overreach and religious/cultural beliefs about body integrity after death.

As Cotrau et al. (2019) observe, religious and cultural backgrounds have some beliefs concerning the treatment of the dead that may be in conflict with conscription policies. Comparing current policies on organ donation in various countries, different approaches are in place: Spain’s opt-out system achieves higher donation rates than the opt-in approach in the US, while Iran’s regulated payment system presents another alternative. Each system reflects different moral priorities and trade-offs between individual autonomy and collective benefit.

Fairness and Justice of Organ Conscription

The fairness of the conscription of organs depends on this: it would apply to all, and thus, all would be potential donors and potential recipients alike. This apparent fairness cloaks some underlying equity issues in justice. While the burden of providing the organs would fall equally, access to transplantation services frequently reflects socioeconomic status and access to health care. Additionally, certain religious and cultural groups might bear an unjust moral burden in cases where conscription goes against their beliefs about death and body integrity.

A genuinely just policy would weigh out such inequalities without losing the balance of both the benefits and the burdens on the equality side. Hansen and Schicktanz (2021) argue that any procurement system for organs should have a subtle balance between social justice and respect for autonomy. In order to allow higher public acceptance of the policies on organ conscription, several strategies might be taken, including establishing transparent allocation systems, religious and cultural exemptions, where appropriate, creating public education campaigns regarding the lifesaving potential of donation, and oversight committees to prevent abuse. Such steps will build trust in and support the expanded organ procurement policies.

Relevance and Significance of Consent

Consent is a cornerstone of medical ethics and patient autonomy. In the case of organ conscription, the central question is one of whether consent rights extend beyond death and whether overwhelming public health needs can override them. Those who oppose a consent requirement do so because cadavers cannot exercise autonomy, and allowing organs to go to waste when they could save lives is morally indefensible. However, consent proponents believe that submission to advance directives and family wishes concerning body disposition is vital in ensuring there is no public distrust of the medical system to begin with (Prabhu, 2019).

The repercussions of the absence of donor consent can be harmful and multifaceted: a diminishing faith in the provision of healthcare services, possible legal actions instituted by the family against them, a decline in the rate of voluntary donations owing to concern about government interference, and mental anguish for families who are against the procurement of organs. All these negative impacts could eventually mean a decreased number of available organs, even with conscription policies in place.

Evaluation of Alternative Policies

Of the various alternative policies Munson (2014) suggests, a regulated organ market system with improved public education is more promising than conscription. While a monetary incentive for donation is problematic in raising concerns of exploitation, a fixed compensation in a carefully regulated system would improve supply while preserving autonomy. This can be combined with better education on organ donation and ease of consent. The current opt-in system could be replaced with an opt-out system wherein organ donation is the default, but individuals may opt-out.

That would help preserve autonomy by capitalizing on the insights of behavioral economics regarding default choices. The consequences of continued organ shortages are severe, including unnecessary deaths, decreased quality of life for patients while waiting for transplants, increased healthcare costs from ongoing dialysis and care, and emotional trauma for the families who watch a loved one wait for an organ that may never come. Current estimates put the number of deaths due to organ shortage at about 17 people per day while waiting for transplants, with economic costs running into the billions annually (Hackmann et al., 2022).

Considering these insights, the conscription of organs-while this would no doubt significantly improve supply itself to too many ethical concerns to be morally acceptable. The potential violation of bodily autonomy and the erosion of trust in medical institutions it causes outweighs any utilitarian benefit it may bring about. Instead, policy efforts should go towards the improvement of existing voluntary donation systems through better education, incentives, and consent processes. This will balance the desperate need for organs with respect for individual rights and cultural beliefs.

References

Cotrau, P., Hodosan, V., Vladu, A., Daina, C., Daina, L. G., & Pantis, C. (2019). Ethical, Socio-Cultural and Religious Issues in Organ Donation. Mædica, 14(1), 12–14. https://doi.org/10.26574/maedica.2019.14.1.12

Hackmann, M., English, R. A., & Kizer, K. W. (2022). Introduction and Study Context. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK580031/

Hansen, S. L., & Schicktanz, S. (Eds.). (2021). Ethical challenges of organ transplantation. Bioethik / Medizinethik. https://doi.org/10.14361/9783839446430

Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Wadsworth.

Prabhu, P. K. (2019). Is presumed consent an ethically acceptable way of obtaining organs for transplant? Journal of the Intensive Care Society, 20(2), 92–97. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475984/

Zambrano, A. (2023). Organ Conscription and Greater Needs. Cambridge Quarterly of Healthcare Ethics, 32(1), 123–133. https://doi.org/10.1017/S096318012200055X

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Write a 2–3 page paper that examines the moral and ethical considerations of organ conscription policies and theories.

Scarcity of Medical Resources
For this assessment, you will continue your survey of ethical principles in health care. Especially in our contemporary world, where needs for health care outstrip available resources, we regularly face decisions about who should get which resources.

There is a serious shortage of donor organs. Need vastly outstrips supply, due not only to medical advances related to organ transplantation, but also because not enough people consent to be cadaveric donors (an organ donor who has already died). Munson (2014) points out that in the United States, approximately 10,000 patients die each year because an organ donor was not available, which is three times the number of people killed in the terrorist attacks on 9/11.

But what is an efficient and morally sound solution to this problem? The policy of presumed consent, where enacted, has scarcely increased supply, and other alternatives, such as allowing donors to sell their organs, raise strong moral objections. In light of this, some have advocated for a policy of conscription of cadaveric organs (Spital & Erin, 2002). This involves removing organs from the recently deceased without first obtaining consent of the donor or his or her family.

Proponents of this policy argue that conscription would not only vastly increase the number of available organs, and hence save many lives, but that it is also more efficient and less costly than policies requiring prior consent. Finally, because with a conscription policy all people would share the burden of providing organs after death and all would stand to benefit should the need arise, the policy is fair and just.

Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Articulate ethical issues in health care.
  • Articulate the moral concerns surrounding a policy of organ conscription.
  • Articulate questions about the fairness and justness of organ conscription policy.
  • Explain the relevance and significance of the concept of consent as it pertains to organ donation.
  • Evaluate alternative policies for increasing available donor organs.
• Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
  • Exhibit proficiency in clear and effective academic writing skills.

References

• Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Wadsworth.
• Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Disease, 39(3), 611–615.

Assessment 4 Robbing the Dead

Instructions
Do you consider the policy of organ conscription to be morally sound?

Write a paper that answers this question, defending that answer with cogent moral reasoning and supporting your view with ethical theories or moral principles you take to be most relevant to the issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella University Library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work.

In your paper, address the following:

• On what grounds could one argue that consent is not ethically required for conscription of cadaveric organs? And on what grounds could one argue that consent is required?
• Is the policy truly just and fair, as supporters claim? Explain.
• Do you consider one of the alternative policies for increasing available donor organs that Munson discusses to be preferable to conscription? Explain why or why not.

Submission Requirements

• Written communication: Written communication is free of errors that detract from the overall message.
• APA formatting: Resources and citations are formatted according to current APA style and formatting guidelines. Refer to Evidence and APA for guidance.
• Length: 2–3 typed, double-spaced pages.
• Font and font size: Times New Roman, 12 point.