in Organ Donation?
The Family's Perspective
in Mandated Choice
Ann C. Klassen and David K. Klassen
Voluntary donation of cadaveric organs for transplantation is often referred to as "the gift of life." Indeed, for transplant recipients, this second chance at life ultimately depends on the receipt of an organ, which, without a doubt, is a gift of great value. The most unusual aspect of this gift, however, is that the giver and the recipient can never meet; moreover, setting the rules for this gift-giving depends on a host of others—family, medical professionals, and society as a whole. More than thirty years after the advent of cadaveric transplantation, the essential ethical dilemmas of organ donation show no signs of disappearing. They are, in fact, intensifying as transplantation becomes more successful. 1,2,3
The medical potential for cadaveric solid organ donation exists in less than 2 percent of hospital-based deaths in the United States. 4 Most persons in the transplantation community are painfully aware that even the recovery of every usable organ could not keep pace with the ever-increasing demand. The supply of cadaveric organs has actually increased substantially over time; from 1988 to 1993, the number of cadaveric donors increased from 4,083 to 4,844, a 19 percent increase. However, in the same period, the number of waiting-list registrants increased from 16,026 to 33,496, an increase of 109 percent. 5
Strategies to change the number of potential organs currently include efforts to expand the definition of eligible donors, identify nonhuman sources of organs, and even divide single organs among multiple recipients. Difficult as these new technological solutions to the shortage may be to achieve, many find it more frustrating that a very "low-tech" barrier to organ availability____________________