Name: De Guzman, Cameron Josh B.

Section: 2B SN-A
NCM108 – Bioethics

Case Study on Organ Donation

Instructions
After reading this case study, critique the case on Organ Donation.
1. List at two positive and two negative aspects of organ donation according to the Principle of Totality
and Integrity.
Positive Aspect
a. When the OPO representative arrives, she discovers that JD’s driver’s license has a little heart
and “organ donor” stamped on the front. Yet on the basis of his driver’s license, it’s determined
that JD had authorized donation, a “first person consent,” leaving no record of revocation or
refusal of authorization.
- According in the principle of totality and integrity, “A person’s right to mutilate parts of his/her
body for the well-being of the whole is the protective responsibility of human person over
his/her life. In addition Thomas Aquinas said that did not develop particular limitations on
humas person’s right to use his/her body or, more clearly, the right of the whole’s domination
over the part”, in this case the patient can make his own decisions on what actions will be done
with his body, it also proves that the patient is well aware in organ donation that he applied and
is already indicated in his driver’s license.

b. JD is not brain dead and he might qualify to be a donor under the hospital’s “Donation after
Cardiac Death” protocol. Further evaluation of the potential donor may take several hours,
including tissue testing, reviewing the medical record, external communications, and the
medical history interview with next of kin. The ICU nurse manager already had notified the
regional organ procurement organization (OPO) for assessment of donor potential.
- In the principle of totality and integrity it states that “The entire patient should be considered
when planning care. This is important where serious side effects may be associated with a
treatment, despite the potential to relieve certain symptoms or alter the management course.
Thomas also added that only those who are entrusted with the good of the community can
deprive the individual of his life.” In this case only the ICU nurse are the one who will contact
the regional organ procurement organization (OPO), where they are not-for-profit organizations
responsible for recovering organs from deceased donors for transplantation in the U.S. There
are 58 OPOs, each mandated by federal law to perform this life-saving mission in their
assigned donation service area.
Negative Aspect
a. After four weeks in ICU and several neuro consults, the prognosis for “meaningful recovery” is
said to be less than 1%. JD has not regained consciousness, and is apt to remain permanently
in a vegetative state.
- In accordance on the medical perspective, the principle of totality would mean that “all the
parts of the human body, as parts, are meant to exist and function for the good of the whole
body and are thus naturally subordinated to the good of the whole body.” In the case of JD he
is already in a vegetative state were the chance of recovery is less than 1%, unlike the
numerous people who he can help by organ donation have a higher chance of recovery, this
may seem Rule Utilitarianism where it is morally right decision and action complying moral
codes/ rules which will lead onto a better consequences.

b. He had not signed up for the online state donor registry and has no healthcare directives on no
healthcare directives on file. JD’s driver’s license has a little heart and “organ donor” stamped
on the front but on the backside is scuffed so as to make illegible any signature or date that
might have been there.
- This may indicate that it is lacking in some areas that the patient may have doubts or second
thoughts since the patient did not yet discuss this with his relatives. But since it is his own body
and he is already in his 20’s he can decide on his own accord. It can also be an older version
of his driver’s license since the date cannot be seen properly this may result in ignoring the
stamped heart, but considering he is in a motorcycle accident which may result of the scuffed
backside of his driver’s license and since the heart stamp is still clear and legible it can still be
noted as legit

2. What is the Ethico-moral responsibility of a Nurse in this case of organ donation?

In organ donation, a nurse provide safe care, practice within a legal and ethical scope, maintain life-
long learning, and are advocates for quality health care, they also builds a relationship between
nurse and patient and patient’s family and/or significant other to give rapport and care they need.
Nurses are often the coordinator for the procurement process with four primary roles:
identification of potential organ donors, obtaining consent and supporting of the family, successful
retrieval of the organ, and maintaining current knowledge and skills. The first role “identification
of potential organ donor” requires the nurse to assess the patient for suitability for organ
donation. Then Maintaining Life Support, when an individual has been determined to be a possible
organ donor life support must be maintained to allow time for all the necessary arrangements to
be made. Next is to Evaluate the Suitability for Organ Donation, it is usually the OPO
representative that coordinates the donation process along with the nurse. Next is Obtaining
Consent, in this case it is a little hard since the family do not consent in organ donation on the
contrary of what the patient decides about the organ donation. Last is by implementing facility
advance directive policies. A Follow-Up is scheduled after a period time, the OPO representative
will communicate with the family telling them what organs were transplanted. The OPO
representative remains available to the family for as long as the family needs the support.