Deceased Organ Donation Ethical Considerations

How Journals Portray Organ Donation


This refers to deceased organ donation, but based on my copious files and two short analyses I’ve done of articles arriving via google alerts, this is applicable to living donation as well.


In their book Spare Parts, published in 1992, Fox and Swazey criticized various aspects of organ transplantation, including the routinization of the procedure, ignorance regarding its inherent uncertainties, and the ethos of transplant professionals. Using this work as a frame of reference, we analyzed articles on organ transplantation published in internal medicine and transplantation journals between 1995 and 2008 to see whether Fox and Swazey’s critiques of organ transplantation were still relevant…


In our sample, organ transplantation was described in positive terms and was presented as a routine treatment. Few articles addressed ethical issues, patients’ experiences and uncertainties related to organ transplantation. The internal medicine journals reported on more ethical issues than the transplantation journals. The most important ethical issues discussed were related to the justice principle: organ allocation, differential access to transplantation, and the organ shortage…


The various portrayals of organ transplantation in our sample of articles suggest that Fox and Swazey’s critiques of the procedure are still relevant.


More specifically:


Most of the wording associated with the evolution of organ transplantation was very positive and even emphatic. The most frequently used terms were “success” (18 articles) and “improvement” (21 articles). The successes of organ transplantation were described as “remarkable”, “unprecedented”, “great”, and “striking”.


The word “advance” was also used to describe all the improvements that have occurred in the field of transplantation, which have translated into positive outcomes for patients and organ survival


Although many advances and improvements have been made in the field of organ transplantation, which explain its successes, the practice is also described as a routine treatment (19 articles). It has become “commonplace”, “standard-of-care”, a “standard practice”, an “established” therapy and an “accepted treatment”


Ethics (emphasis mine):

A total of 84 articles in the internal medicine journals (24.1%) and 23 articles in the transplantation journals (6.6%) addressed ethical issues.




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