Bioethical Issueson Organ Transplantation Some Philosophical Reflections

LUMINA An Interdisciplinary Research and Scholarly Journal Vol. 20 Vol.20, No.
1 March 2009
Holy Name University, Tagbilaran City, Bohol, Philippines
BIOETHICAL ISSUES ON ORGAN TRANSPLANTATION:

SOME PHILOSOPHICAL REFLECTIONS
Carlo Alfonsse Pangon

Holy Name University
Tagbilaran City
Introduction
Organ transplantation is a very critical issue. A lot of questions arise concerning

its morality. To what extent is an act moral? To what extent is a person responsible for
the well-being of others? Is organ transplantation morally justifiable? What are the
advantages and disadvantages of organ transplantation to humanity? What are the criteria
of donating organs? Is the donor really dead? These and similar questions need to be
addressed very clearly.
Organ transplantation is defined as the replacement of a diseased or not

functioning organ or part with one from another, either living or recently deceased.1
Organ transplantation is high-technology medicine in one of its most extreme forms. It is
very expensive, employs biotechnologies and requires large teams of highly trained
specialists. It is important for us to know that organ transplantation is costly and
expensive and that only the rich can afford to have it. And those who cannot afford for it
will eventually die a natural death.
Organ transplantation is used to intervene when the final stage of an illness is

reached and although it can save lives, it does not provide a “cure” or a return to a
preexisting condition of health.2
Several cases are recorded in different books regarding experiences in organ

transplantation. Take the case of a 43-year-old high school teacher who was so afflicted
by heart disease that he had to give up teaching. By the time he entered the hospital, he
was so weak he could not feed himself and needed the constant care of nurses. After
receiving a heart transplant from a human donor he was able to return to work. He
subsequently painted his house, rode a bicycle regularly and with his wife made plans to
adopt a baby girl.3
Another case was that of Ruth Blake. Two years after the removal of one
cancerous breast, she developed serious kidney disease. One kidney was removed for
malignancy. A year later, the other kidney became dysfunctional and was removed, but
no cancer was found. Kept on dialysis, the patient raised the question of a transplant.
While her brother was willing, indeed anxious, to donate a kidney to Ms. Blake, the
medical staff was not eager to accept his offer. They knew that post-transplant patients
receiving those drugs (immunosuppressive) which combat the body’s attempt to reject
the new organ are statistically more likely to develop malignancies than is the normal
LUMINA An Interdisciplinary Research and Scholarly Journal Vol. 20 Vol.20, No.1 March 2009
person. And Ms. Blake’s malignancy history was not good. On the other hand, a cadaver
kidney would not offer her as great a chance for success as one from her brother.4
Two aspects readily stand out when organ transplantation is talked about: First, a
distinction must be made between transplanting an organ (including tissue) from a dead
person to a living person, and second, transplanting an organ from a living person to a
living person. In the first instance, when the organ donor is a dead person, no moral
concern arises. On the latter issue, several criteria need to be addressed so that one can
enable himself/herself to donate his/her organ.
Everyday in the United States, 70 people receive an organ transplant and another
16 people die while in the “wait list”.5 According to the data published by the United
Network for Organ Sharing (UNOS), as of July 2002, the cost of kidney transplant in the
U.S. is estimated at $210,000. In the Philippines, dialysis costs an individual an estimated
US$125 or around 6,875Php per session for three times a week or an estimated cost of
82,500Php a month, whereas a life-time kidney transplant would only cost an individual
700,000Php with a better quality of life.6
According to Nephrologist Dave Tan, “as a consequence of the expensive costs of

dialysis in the Philippines, up to 50% of the 7,500 end-stage renal disease patients each
year cannot avail themselves of even a single dialysis treatment. More than 95% cannot
afford to follow the standard accepted dialysis recommendation of thrice a week. The
majority receives treatment only twice weekly, while there are even those who undergo
dialysis only once a week. Due to monetary constraints, many patients have to
discontinue their treatments.7
In August 2004, a liver transplant operation was conducted in Taiwan by a

Filipino liver transplant surgeon. The patient was a two-year old boy from Olongapo
City, Kirby Erick Hizon Ongkinko, who was diagnosed (four months after birth) to be
suffering from biliary artesia, “a condition wherein the bile ducts are absent or unable to
convey bile out of the liver, causing the liver to fail and the baby to die within two years
after birth.” The only hope for him was a liver transplant, which cost some 3 million
pesos. Kirby’s liver donor was his father.8
Why is there a need for a study behind the morality of organ transplantation?
Based from the aforementioned cases above, the process of organ transplantation is
rapidly increasing all through-out the world. In fact, it is already present and practiced
here in our country, and even in our province. And who knows, one day our family might
need an organ to survive. Eventually, he/she will be engaging in organ transplantation.
Now, in order for us to be aware of this issue, it is a must for us to dwell behind the
morality of this issue and for us to know the proper ways and guidelines in obtaining
organ transplantation.
Background
The idea of organ and tissue transplantation goes back to the ancient era.
According to the book of Genesis, Eve, the first woman, was fashioned out of a rib from
Adam, the first man, the donor.9 Although, it was not the kind of transplantation that we
have on today. The book of Genesis in the Bible does not literally talk about organ
transplantation. We have to take note that the message of the particular book in the Bible
does not dwell on the literal meaning of it. We have to reflect in order to get the real
meaning of the message. The Bible only serves as a guide to the Christian followers. But
some books in the Bible serve as the ground or foundation of the teachings which the
different Popes from different ages explain and expound from time to time. The Pope’s
one way of exhorting the people is through the encyclical letters. These are circular
letters addressed by the Pope to the Bishops throughout the world. These Bishops spread
the news and share the teachings of the Holy Father to the world.
According to James B. Nelson, et al., the Roman Catholic Church had not
declared an official position on organ donation at that time. Its statements and discussions
are centered on the principle of totality, and this has given a decidedly cautious cast on
organ donation.10 Pope Pius XI put it this way in 1930: “Individuals are not free to
destroy or mutilate their members, or in any other way render themselves unfit for their
natural functions, except when no other provisions can be made for the good of the whole
body.”11 It was this time that Pope Pius XI was concerned primarily on eugenic
sterilization. The principle of totality was reiterated by Pope Pius XII condemning the
Nazi abuses on human experimentations.12 However, in the principle of totality,
conservatively interpreted, the mutilation is allowed for the sake of one’s neighbor.
On March of 1995, Pope John Paul II made public his encyclical letter,
Evangelium Vitae, or the Gospel of Life. The Holy Father made himself in this way that
organ transplantation is great step forward in sciences’ services of man, and not only
have a few people today owed their lives to an organ transplant.13 He added that the
technique of transplants has proven to be a valid means of attaining the primary goal of
all medicine and service of human life. And he continued, that in the encyclical letter,
Evangelium Vitae, he suggested that one way of nurturing a genuine culture of life is the
donation of organs performed in an ethically acceptable manner, with a view to offering a
chance of health and even life itself to the sick who sometimes have no other hope.14 The
Pope, having stated this stressed out that there must be a fundamental criterion in doing
such transplant. The fundamental criterion must be the defense and promotion of the
integral good of the human person, in keeping with that unique dignity which is ours by
virtue of our humanity. For that essential criterion, a transplant is morally acceptable.15
However back in 1954, Dr. Joseph Murray performed the first successful kidney
transplant between living identical twins in Boston, Massachusetts. And in 1983, Dr. Joel
Cooper performed the first successful single lung transplant at the Toronto General
Hospital in Toronto Canada. And luckily, in 1986, he was able to perform the first
successful double lung transplant in the same hospital.16 On the other hand, Pedro Solis,
in his book Legal Medicine, noted the permission to use human organs or portions of the
human body for the medical, surgical or scientific purposes under certain conditions. The
act of using human organs is permissible according to Republic Act No. 349 as amended
by Republic Act No. 1056. It is an act to legalize permissions to use human organs or any
portions of the human body for medical, surgical or scientific purposes under certain
conditions.17
The primary concern of this study was to look into the moral grounds of organ
transplantation from one human person to another, based on the views of some
philosophers, teachings of the Catholic Church and some applicable laws in the
Philippines.
Specifically, this study sought to answer the following questions: What is organ
transplantation? Is organ transplantation morally justifiable? What are the merits of organ
transplantation to humanity?
MEANING AND TYPES OF ORGAN TRANSPLANTATION
Organ Transplantation: Definition
There are several definitions of organ transplantation. These definitions vary from
different sources. Basically, organ transplantation is the act of transplanting an organ.
These organs refer to the body parts of a human being. So, the organ or body part is
transplanted or transferred into another individual. The organ may also be transferred
from its original site to another part of the same individual.
Blackwell’s Nursing Dictionary defines organ transplantation as the replacement

of a diseased or not functioning organ or part with one from another, either living or
recently deceased.18 Transplantation is the procedure by which cells, tissues and organs
are transferred from a donor to a recipient. So, basically, an organ transplant is the
moving of a whole or partial organ from one body to another (from the donor’s site to the
recipient’s own body), for the purpose of replacing the recipient’s damaged or failing
organ with a working one from the donor site.
Types of Organ Transplantation
Several different forms of transplantation are currently being performed and

researched. These include autografts, allografts, and xenografts. Autograft is a transplant
of tissue from one to oneself. Sometimes this is done with surplus tissue, or tissue that
can regenerate or tissues more disparately needed elsewhere. One example of this is
skingraft.19 Allograft is another kind. It is a transplantation of organ or tissue from a
genetically non-identical member of the same species. Most of human tissue and organ
transplants are allografts.20 In the mid-twentieth century, the modern transplant era began
when the skill of suturing blood vessels was adopted. The failure of transplants revealed
the problem of rejection, and in further experiments it was discovered that successful
transplants depend on a close genetic resemblance between donor and recipient.21
Another type of transplantation is xenograft or xenotransplantation. It is a transplant of
organ or tissue from one species to another. Examples include porcine heart valves,
which are quite common and successful, a baboon-to-human heart, and piscine-primate
(fish-to-non-human primate) islet (i.e. pancreatic or insular tissue) the latter’s research
study directed for potential human use if successful.22
Organs That Can Be Transplanted
Major organs and tissues which can be transplanted are rising in number. Here are
some of the organs, tissues, and cell fluids that can be transplanted.
Thoracic organs which are located between the neck and the abdomen:
• Heart (deceased donor only)
• Lung (deceased donor only)
• En bloc heart/lung (deceased donor only)
Other organs:
• Kidney (deceased and living donor)

• Liver (deceased and living donor)
• Pancreas (deceased donor only)
• Intestine (deceased donor only)
Tissues and cell fluids:
• Hand (deceased donor only)

• Cornea (deceased donor only)
• Skin graft including face transplant (deceased and living donor)
• Penis (deceased donor only)
• Islet of langerhans (pancreas islet cells) (deceased and living donor)
• Bone marrow (living donor and autograft)
• Blood transfusion/blood parts transfusion (living donor and autograft)
• Blood vessels (autograft and deceased donor)
• Heart valve (deceased and living donor and xenograft)
• Bone (deceased and living donor and autograft)23
So, as enumerated above, almost every part of the human body is having the
potential to be transplanted. But in what way these organs can be transplanted? What
situations justify an organ transplant to be done? Is it really morally justifiable?
Death and Transplantation
The one immutable medical criterion for organ transplantation has been brain
death, or more exactly, the determination of death by brain-death criteria.24 What is
death? An ethical debate that remains unresolved is regarding when a person’s organs can
be retrieved in accordance with the legal definition of death. The question of death’s
definition has medical, legal, theological and philosophical dimensions. We know that
certain organs can be transplanted from a dead person to a recipient. We also know that
the cadaver donor must not be “so dead” that deterioration has made the kidney or heart
useless for the transplant. This implies that the success of organ transplantation
significantly depends upon the freshness of the organ. That is why it must take place as
soon as the donor has died. But what is really the criterion for ascertaining the fact of
death?
In its seminal work “Defining Death”, the President’s Commission for the study
of Ethical Problems in Medicine and Biomedical and Behavioral Research articulated a
formulation of brain death that has come to be known as the “whole-brain standard.” In
the Uniform Determination of Death Act, the President’s Commission specified two
criteria for determining death: (1) irreversible cessation of circulatory and respiratory
functions or (2) irreversible cessation of all functions of the entire brain, including the
brainstem.25 Once the circulation ceases, an organ very rapidly becomes useless for
transplantation unless it is cooled. For this reason organ donors must be kept on machines
that maintain respiration and heartbeat after death. Because the heart must be keep
pumping, death must be declared on the basis of total and irreversible cessation of brain
function-brain death.26
The accepted criterion in determining death is the formulation of brain death.

Following the criteria for death from the Uniform Determination of Death Act, the
medical community has adopted two guiding moral principles, known as the dead donor
rule, as the norm for managing potential organ donors. The principles are the donor must
be first dead before organs are retrieved and (2) a person’s life and care must never be
compromised in favor of potential organ recipients.27 The first principle must fit to the
legal and accepted definition of death before the retrieval of potential organs to be
transplanted and the second principle states that the donor’s life must not be hastened in
favor of the recipient.
Speaking of the legal criterion of death, the question now is: “Is the legal criterion
of death accepted in the religious perspective?” We cannot escape from the fact that
sometimes the Church criticized the decisions which are made by the state because not all
legal are moral and vice versa. But what about the issue of death? Is it accepted by the
Church? The legal criterion of death is also accepted by the Catholic Church. In fact, the
Holy Father, Pope John Paul II, in His address to the International Congress on Organ
Transplantation which took place in Rome, the second critical issue addressed by the
Holy Father in His discourse identifies as “the problem of ascertaining the fact of death.”
He states that vital organs which occur singly in the body can be removed only after
death. The Pope speaks of the death of a person in a primary sense as a separation of the
life-principle from the corporeal reality of the person. This he says is an event which no
scientific technique or empirical method can identify directly. Rather what can be said is
that once death occurs certain biological signs inevitably follow. Following this, Pope
John Paul II states that the criteria for ascertaining death used by medicine today should
not be understood as the technical-scientific determination of the exact moment of a
person’s death, but as a scientifically secure means of identifying the biological signs that
a person has indeed died.
The Pope makes specific reference to the cessation of breathing and of heartbeat
as traditional criteria for ascertaining the fact of death. He acknowledges, too, that
increasingly, the “irreversible cessation of all brain activity” has become an accepted
criterion in the international scientific community. For as much as this is so, the Holy
Father states that this criterion of the complete and irreversible cessation of all brain
activity, if rigorously applied, does not seem to conflict with the essential elements of a
sound anthropology. He insists that when using this criterion, moral certainty is
considered the necessary and sufficient basis for an ethically correct course of action.
Where this certainty exists then, and when informed consent has already been given by
the donor or the donor’s legitimate representatives, the technical procedures can begin for
removal of organs for transplant.28
Donors: Living and Dead
Talking about organ transplantation, a distinction must be made between

transplanting an organ from a dead person to a living person and transplanting an organ
from a living person to a living person. In the former, when an organ donor is a dead
person, it qualifies for the legal criteria of death, i.e., brain death, where no moral concern
arises. In the latter, several questions are addressed regarding its processes. As we all
know, living donation is a process wherein the recipient receives an organ from a living
donor. It is an alternative for individuals awaiting organ transplantation from a deceased
donor.29 Living donation takes place when a living person donates an organ or part of an
organ for transplantation to another person. One of the organs that a living donor can
donate is his/her kidney, which is the most frequent type of donation. For the donor, there
is little risk in living with one kidney because the remaining kidney compensates to do
the work of both kidneys. Individuals can also donate a segment of the liver, which has
the ability to regenerate and regain full function. The lung is also included, although the
lung lobes do not regenerate; individuals can donate a lobe of one lung. Intestine and
pancreas are also included, although the former is very rare because it is impossible to
donate a portion of the intestine but the latter is possible. Like the lung, pancreas does not
regenerate, but donors usually have no problems with reduced function.30
Living donor transplants have many advantages. For example, some living donor
transplants are done between the family members who are genetically similar. A better
genetic match lessens the risk of rejection. In addition, potential donors undergo a battery
of tests to make sure they are healthy. In order to qualify as a living donor, an individual
must be physically fit generally, in good health, and free from high blood pressure,
diabetes, kidney and heart diseases.31 Individuals considered for living donation are
usually between 18-60 years of age. Gender and race are not factors in determining a
successful match. The living donor must first undergo a blood test to determine blood
type compatibility with the recipient. If the donor and recipient have compatible blood
types, the donor undergoes a medical history review and a complete physical
examination.32
The decision to become a living donor is a voluntary one and the donor may
change his/her mind at any time during the process. The donor’s decision and reasons are
kept confidential.33 The living donor is of three kinds. We have related living donation,
non-related living donation and non-directed donation. The first refers to the related
blood relatives of transplant candidates. They can be brothers and sisters, parents,
children over 18 years of age and other blood relatives like aunts, uncles, cousins, nieces
and nephews, etc. The second, i.e. non-related donation refers to the living donors who
are healthy individuals and emotionally close to but not blood related to transplant
candidates. They can be spouses, in-law relatives, close friends, co-workers, neighbors or
other acquaintances. The third, which is non-directed donation, refers to living donors
who are not related to or known by the recipient, but make their donation purely out of
selfless motives. This type of donation is also referred to as anonymous, altruistic,
altruistic stranger and stranger-to-stranger living donation.34 Given the severe shortage of
donated cadaver organs, relatives, especially parents, may feel compelled to donate.35
The donor is informed of the risks and benefits of the donation. Although they place
themselves at risks, donor may experience a greater psychological benefit from saving, or
attempting to save, for instance, their child’s life.
The Rejection Problem
In 1951, Dr. David Hume of Boston did the first modern kidney transplant,
followed by a number of similar transplant experiment, all using cadaver organs. The
longest survivor lived six months. A major medical and moral decision came in 1954
when Hume’s Boston colleagues Dr. Joseph Murray and Dr. John Merril performed the
first living-donor renal transplant.36 With rare exceptions, kidney transplants throughout
the 1950’s had poor results, largely because of the strong tendency of the recipients’ body
to reject the foreign organ. This is the problem of rejection. Once the new organ is
transferred in the recipients’ site, the immune system attacked and destroyed the organ.
Our immune system has an antigen that recognizes alien bodies that enter into out body
and attacks and rejects foreign matter by means of production of antibodies.37 Because of
this, it paved the way for the development of tissue-typing, where the donors’ and
recipients’ tissues are examined with a view to compatibility, such that these antigens of
both tissues are sufficiently similar to prevent recognition as alien bodies and thus, avoid
exciting the destructive immune systems’ response.38
During the 1950’s, anti rejection drugs had not yet been developed, so transplants
were limited to kidneys from identical twin donors.39 In 1959, however, Dr. Joseph
Murray and his colleagues at the Brigham Hospital again achieved a historical feat. They
transplanted a kidney from a non-identical twin to his brother who had undergone body
X-ray treatment. And the patient lived 26 years.40 “X-ray treatment (irradiation) had
suppressed his immune response so that this body accepted the new organ.”41
Several efforts had been made to overcome the problem of rejection. A lot of
drugs were developed which lessened the organism’s ability to develop antibodies and
weakens the immune system in order to prevent rejection. In 1983, a Swiss
pharmaceutical company produced cyclosporine. It is an immunosuppressive drug that
selectively inhibits the rejection of foreign bodies without destroying the immune
system’s ability to combat viruses and bacteria.
Nowadays, several transplants are done from two persons with no close genetic
resemblance. But it does not assure the patient or recipient of how many years he/she will
live. Although it prolongs the patients life but it does not offer a pre-existing condition of
life.
ETHICAL AND LEGAL ISSUES
An Act of Charity and the Principle of Totality
If there is anything else, organ transplantation could be understood as an act of

charity and fraternity. Organ transplantation is a fraternal act. “If there are no undue
pressures it is widely agreed that organ donation is one of the finest gestures of fraternity
of which human beings are capable.”42 Organ donation is a selfless human endeavor by
virtue of one’s giving up one’s healthy organ to the one who is in need of it. The Roman
Catholic Church accepted organ transplantation as a morally selfless action. The Gospel
of Life is to be celebrated above all in daily living filled with self-giving love for others.
It is in this context that heroic actions are born, made up of gestures of sharing big and
small, with the particular praiseworthy example of organ donations.43 Here therefore, the
Catholic Church allows organs transplantation in the context of charitable actions. On
March of 1995, Pope John Paul II made public His encyclical letter, Evangelium Vitae or
The Gospel of Life. The Holy Father made himself clear in this way that organ
transplantation is a great step forward in science’s services to man, and not only have a
few people today owed their lives to an organ transplant.44 He also added that the
technique of transplants has proven to be a valid means of attaining the primary goal of
all medicine and services of human life. And the Pope continued in the encyclical letter
Evangelium Vitae and suggested that one way of nurturing a genuine culture of life is the
donation of organs performed in an ethically acceptable manner with a view to offering a
chance of health and even life itself to the sick who sometimes have no other hope The
Pope having stated this stressed out that there must be a fundamental criterion in doing
such transplant. The fundamental criterion must be the defense and promotion of the
integral good of the human person in keeping with that unique dignity which is ours by
virtue of our humanity.45 For that essential criterion, a transplant is morally acceptable.
According to James B. Nelson, et al. there was a time wherein the Roman
Catholic Church has not declared an official position on organ transplantation. Its
statements and discussions centered on the principle of totality and this has given a
decidedly cautious casts to organ transplantation.46 The principle of totality maintains that
a part exists for the sake of the whole. Conservatively interpreted, this would mean that
self-mutilation is justifiable for the sake of one’s own total well-being, and only for that
reason. Nevertheless, autograft falls under the principle of totality. And by virtue of that
principle, autograft is morally accepted and justifiable. However, organ donation is
morally permissible under certain conditions. The Ethical and Religious Directives for
Catholic Health Care Services provides the following guidance: The transplantation of
organs from living donors is morally permissible when such a donation will not sacrifice
or seriously impair any essential bodily function and the anticipated benefit to the
recipient is proportionate to the harm done to the donor. Generally, in the case of
donating organs after death, the gifts that God has given to us to use in this life, i.e., our
eyes, hearts, liver, and so on, can be passed on to someone in need. In the case of organ
donating while alive, such as giving a healthy kidney to a relative in need, the donor
needs to weigh all of the implications; in charity, a potential donor may decide he cannot
offer an organ, such as if he were a parent and would not want to increase the risk of not
being able to care for his own dependent children. Although organ donation is not
mandatory, it is commendable as an act of charity.47
Republic Act No. 349 and Republic Act No. 7170
In the book of Pedro Solis entitled “Legal Medicine”, he enumerated several

criteria so that a human being can donate his/her organ. He also noted the permissions to
use human organs or portions of the human body for medical, surgical or scientific
purposes, under different conditions. Here, we are talking about state laws and policies
regarding organ transplantation. In what legal situation can a person donate his/her
organ? Is a person authorized to donate his/her organs? In what way?
In the Philippine setting, organs from the human body are legally accepted for
donation and transplantation. Republic Act. No. 349, as amended by R.A. 1056, states the
act to legalize permissions to use human organs or any portion of the human body for
medical, surgical and scientific purposes. This R.A. is divided into different sections.
Section 1 of the said law states:
Any person may validly grant to a licensed physician,

surgeon, known scientist or any medical or scientific
institution, including eye banks and other similar
institutions, authority to detach, at any time after the
grantor’s death, any organ, part of his body and to utilize the
same for medical, surgical, or scientific purposes.
Similar authority may also be granted for the utilization for
medical, surgical, or scientific purposes of any organ or
part/s of the body which, for legitimate reason, would be
detached from the body of the grantor.48
Section 2 of the same law provides for the authorization of taking human organs
from a
specific body. It states:
The authorization referred to in section one of this Act must

be in writing; specify the person or institution granted the
authorization; the organ, part or parts to be detached, the
specific use or uses to which the organ, part or parts are to
be employed; and, signed by the grantor and two

disinterested witnesses.
If the grantor is a minor or an incompetent person, the
authorization may be executed by his guardians with the
approval of the court; in default thereof, by the legitimate
father or mother, in the order named. Married women may
grant the authorization referred to in Section one of this
Act, without the consent of the husband.49
After the death of the person, authority to use human organs
or any portion of the human body for medical, surgical or
scientific purposes may also be granted by his nearest
relative or guardian at the time of his death or in the absence
thereof, by the person or head of the hospital, or institution
having custody of the deceased. Provided, however that the
said person or the head of the hospital or institution has
exerted reasonable efforts to locate the aforesaid guardian or
relative.50
The Republic Act No. 349, as amended by Republic Act No. 1056 was approved
on May 17, 1949, and its amendment was approved on June 12, 1954.51 There is also a
new and updated law concerning organ transplantation. The Republic Act No. 349 was
revised and updated into Republic Act No. 7170. The said new act refers to the act of
authorizing the legacy or donation of all or part of a human body after death for specified
purposes. Section 3 of the said act states that any individual, at least eighteen (18) years
of age and of sound mind, may give, by way of legacy to take effect after his death, all or
part of his body for any purpose specified in Section 6 hereof.52 Section 6 of the said act
states that the following persons may become legatees or donees of human bodies or parts
thereof for any of the purposes stated hereunder:
Any hospital, physician or surgeon - for medical or dental

education, research, advancement of medical or dental
science, therapy or transplantation; any accredited medical
or dental school, college or university - for education,
research, advancement of medical or dental science, or
therapy; any organ bank storage facility - for medical or
dental education, research, therapy, or transplantation; and
any specified individual - for therapy or transplantation
needed by him.53
The section 4 also of the said new act enumerated the different persons who may
execute donation. They are, the spouse, son or daughter of legal age, either parent, brother
or sister of legal age or guardian over the person of the decedent at the time of his death.54
The Republic Act No. 7170 was approved last January 7, 1992. Therefore, organ
transplantation is permissible in our country on the aforementioned grounds, and those

provisions must be legally followed.
PATERNALISM
Paternalists maintain that restricting the autonomy of persons is justified if these

persons would likely cause serious harm to themselves.55 The main ethical issue is
whether paternalistic interventions are morally justified, and if so, under what conditions?
The word paternalism refers loosely to acts of treating adults as a benevolent

father treats his children, but the term has been given both a narrow and a broad meaning
in ethical theory. In the narrow sense, paternalism refers to acts or practices that restrict
the autonomy or liberty of individuals without their explicit consent; justification for such
actions is either the prevention of some harm they stand to do to themselves or the
production of some benefit for them that they would not otherwise secure.56 The doctor-
patient relationship has generated moral issues for philosophical consideration.57 It is a
given fact that a physician owes it to his patient always to act in the patient’s best
interests, but there are varying accounts of why this is so. When and under what
conditions may the doctor, in order to do the best for his patient, limit his autonomy,
where he can justify the action exclusively by the goal of helping the person whose
autonomy is limited?58 Following this definition, an act of paternalism overrides the
value of respect for autonomy on some grounds of beneficence. Paternalism seizes
decision-making authority by preventing persons from making or implementing their own
decisions. Is paternalism justifiable wherein it overrides the autonomy of the patient? Is it
one way of disrespecting the autonomy of the person? Many writers object to this
analysis of paternalism because it does not comprehend the meaning of the term as it has
descended from common usage and venerable legal precedent, where the notion is linked
to guardianship, surrogate decision making and government intervention to protect the
vulnerable.59 But defenders of paternalism in ethical theory have paid more attention to
the justifying grounds for paternalism. They often appeal to either a principle of rational
consent or a principle of welfare or beneficence in order to justify their positions.60
In one prominent justification, Gerald Dworkin argues that paternalism should be

regarded as a form of “social insurance policy” that fully rational persons would take out
for their protection. That is, paternalism is justified under conditions to which an
impartial rational agent would consent if he/she were to appreciate the possibility of
being tempted at times to make decisions, to commit acts that are potentially dangerous
and irreversible.61 There are possibilities that the agent might, at other times, be driven to
do something too risky for himself/herself. For instance, smoking and drinking heavily
that health and life are endangered. The implementation of removing or severely
restricting the availability of tobacco and alcohol would be an example of paternalistic
health policy. In other cases, persons might not sufficiently understand or appreciate the
danger of their conduct or might distort information about their circumstances. Seatbelt
laws and motorcycle helmet laws are often enacted on this paternalistic basis.62
PHILOSOPHICAL REFLECTIONS
St. Augustine
The focal point of Augustine’s moral imperative is God, and because love
is the highest attribute of God, love, eventually, is considered by him as the basis and
central point of his moral teaching.63 St. Augustine believed that man is created by God.
According to him, God created everything out of love and love therefore is the driving
force that moves God to create. And since we are all created by God, He expects us all to
come back to Him. In understanding Augustine’s ethical teaching, we must pre-suppose
God’s existence in order for us to embrace his ethical theory. According to St. Augustine,
human acts are nothing else but gestures of man’s free will.64 Because God loves us so
much, He gave us freedom to do whatever we want. So, all our actions are rooted on our
freedom.
Man, for St. Augustine, like everything else, is conceived as part of a vast
interrelated thing within the cosmos.65 Man, having situated in the cosmos, is not
stationary, but is in a dynamic rapport. Everyone is pursuing his/her own end and comes
to rest only upon attaining those ends. So, everyone is in constant flux. Their striving for
rest, for completion or satisfaction, is the motivating power that drives all things toward
their purposes, just as weight, according to this image, causes things to move to the
places proper to them in the cosmos; the heavy things go downward and the light go
upward.66 According to the famous passage written by St. Augustine, “my weight is my
love, by it I am carried wheresoever I am carried.” 67 Because we are capable of doing
anything, we have freedom to choose between good and evil actions. St. Augustine
thought of the forces that move men as analogous to weight and called them love/s. this
makes love the center of moral injunction in Augustinian moral teachings.
Another important point in St. Augustine’s teaching is his doctrine of voluntarism

or the primacy of the will over the intellect. This will is love, and according to him, it is
necessary to love in order to know and vice versa.68 The primacy of the will is the
intrinsic law of being, which finds its first actuation in God, who created out of love.
Since the first love must be love of God, all other loves must be subordinated to this first
love.
Augustine teaches that love signifies order. Action is activity according to love.
Any sin is an act of hatred, for sin is separation from the order of love which has God as
its center. Every good action is an action according to love.69 In what way we can
consider organ transplantation as a good action and as an action according to love? Does
this act fit to the act which is rooted in love according to St. Augustine? Organ
transplantation can be considered as a good act if it does not harm anyone and if it is done
properly and promotes charity. It is considered good if it is done out of love and charity.
For Augustine, man should practice the cardinal virtues, namely, prudence, justice,
temperance, fortitude, and charity or love.70 These virtues must be practiced in the name
of charity or love because, for him, love is the foundation of all other virtues. And this
can be shown by sharing our organs to others in order to save others’ life. This love of St.
Augustine is tantamount to the unconditional love of Jesus Christ wherein He offers His
life to us by sacrificing and dying on the cross. The act of organ transplantation by
donation must be rooted in the unconditional love of the donor to the recipient. The
driving force of donating organs must be love, love of one’s neighbors. Because man is
free in doing actions rooted or not in love, and man has the will and intellect to choose
between actions that are good or evil, St. Augustine suggests that man should practice the
love given to us by God. We must act according to love, and this includes the
praiseworthy act of sharing our organs, or even life. The greatest virtue is neither
prudence nor justice, neither temperance nor fortitude. Rather, it is love.71
St. Thomas Aquinas
Most surveys on ethical theories classify St. Thomas’ ethics as a natural law
theory. He described natural law as the rational participation in the eternal law of God
and suggested that all men have sufficient knowledge of what is morally right to be able
to regulate their own actions.72
Since the theory of natural law developed by St. Thomas is widely regarded as the
epitome of the pre-modern position, let us summarize his view. In the Summa
Theologica, Aquinas maintains that for something to be called law, it must be (1)
reasonable, in the sense of directing action; (2) ordained to the common good; (3)
legislated by proper authority and (4) duly promulgated.73 The eternal law, whereby the
world is ruled by divine providence, satisfies these criteria in an exemplary way. Natural
law, however, is principally that part of divine reason accessible to human intelligence. It
is not to be confused with the order of the physical or biological world. In a famous
passage, St. Thomas explained the way he thought that rules of natural law are known.
The judgment of synderesis or the intellectual quality enabling any man to intuit the first
principle of practical reasoning is simply the proposition, “Good should be done and
sought, evil is to be avoided.”74
Since this principle does not specify what is good, it cannot be further analyzed to
find more specific moral rules. It is a principle formally governing practical reasoning,
and in this sense, St. Thomas calls it the first precept of natural law.75 To determine what
are the proximate natural goods for man, Aquinas suggests that reason naturally
apprehends as good those objects that satisfy man’s basic inclinations. Here, he proceeds
to describe three kinds of inclinations natural to man, namely, (1) that of man’s
substantial nature toward the conservation of its own existence and physical well-being,
(2) man’s animal nature to seek such biological goods as sexual reproduction and the care
of the offspring, and (3) man’s tendency towards universal goods, such as consideration
of the interests of other persons, and the avoidance of ignorance. All these three kinds are
presented as natural and good provided they area reasonably pursued.76
In relation to the concept of human actions, St. Thomas maintains that every agent
acts for an end.77 Mans’ actions are always geared towards its end. Once these ends are
attained, they will become another means to attain other ends. So, there is a series of ends
of human actions. Here, man’s actions always directed towards a certain end. The
question is: How can an end be called a final end? St. Thomas enumerated four criteria
for an end to be called final. They are: “(1) If it is desirable to us for its own sake; (2) If it
is sufficient in itself to satisfy us; (3) If it is attainable by the wise among us and (4) if it
offers happiness to us.”78 If the end of an action fits these criteria, then that end is
considered final. Because human actions are always directed towards an end, it
necessarily follows that man does an action because of the end that he/she seeks. This is
what makes human actions voluntary.79 Here, Aquinas speaks of the will in relation to
human actions. It is voluntary because it is willed by the agent. This means that the agent
has the intention for a certain act that he/she performs.
According to Aquinas, an agent performs willful actions through the following

conditions: (1) If the act is in itself overt or externally manifested; (2) If the agent acts
because of a motive that drives him to act, and (3) If the agent is responsible for the
consequences of his/her actions.80 Aquinas contends that man’s volition can only intend
what is good. An agent does an act because he sees the end in the act itself. And his/her
motive in doing such act is good. “Once the agent does an act, it follows that he acts
because, by doing so, he is gratified.”81 For St. Thomas, what is moral is what reason
discovers that one ought to do. This human act, which is done deliberately and freely, is
directed by reason. And it has everything it is supposed to have. To be directed by reason
means that an act has as its object the true good as reason discovers it. Thus, an act which
tends toward a true good, as discovered by reason is a good act.82 Therefore it is not
enough to act toward a good end. In order for a human act to be good, one must employ
means which reason determines to be appropriate, and thus, also good.
As we all know, St. Thomas, enumerated the proximate natural goods for man.
But he suggests that reason naturally apprehends as good those objects that satisfy man’s
basic inclinations. On the lowest level are the physical goods to which all beings incline
to, such as self-preservation. Second are the biological goods that men tend towards, like
procreation and care of the offspring. And the highest level is the knowledge of truth
about God, and the advantage of living in society with other humans, which is the highest
value that can satisfy man as a rational being.
Isn’t it that organ donation is included among the natural goods that man tends
towards? Organ donation is one way of expressing self-preservation to others. By organ
donation, anyone can preserve his/her life, although not long lasting, but the essence of
self-preservation is there. In the situation of parents and their children, parents can show
their care and love to their offspring by organ donation. In cases where a child needs a
kidney donor, the parent can volunteer to be the donor, as in the case of Kirby Erick
Hizon Ongkinko, who was transplanted with a new kidney from his father.83 During that
critical situation, his father donated the kidney in order for his son to survive. It is one
way of preserving the life of our love ones, and showing the care and love of a parent to
his offspring. In a way, the agent’s (donor) intention is to save another person’s life,
which is intrinsically good. In that way, the agent is gratified of his/her action, i.e.,
donating his/her organs to the one who needs it. The agent’s end is always good. And this
maintains St. Thomas principle that good should be done and sought; evil is to be
avoided.84
MERITS TO HUMANITY
Risks and Benefits of the Donor
Living persons may donate a variety of organs and tissues to others. Several
organs and tissues include kidneys, portion of the lungs, liver, bone marrow, blood and
blood vessel, ova and sperm. One way of estimating risk to a potential donor is to
consider whether the body can replace the donated material. For instance, the liver is not
a replaceable organ, but it can regenerate overtime. Thus, donating a lobe of one’s liver
does not lead to significant loss of liver function.85 Other examples are the bone marrow,
sperm, ova and blood products. Our body continually produces these things, and
therefore, those who donate them do not lose an irreplaceable tissue.86
The discomfort and risks of procedure used in obtaining these organs and tissues
must also be taken into account. The acquisition of sperm is painless; blood products are
obtained through a slightly painful but risk-free procedure; and bone-marrow or ova
retrieval is more complex and painful, and requires anesthesia.87 Removal of kidneys,
liver, lobes of lung, section of the pancreas and other major organs involve major surgery
with concomitant risk due to general anesthesia. “Although the risk of vital organs
retrieval is still small in experienced centers, the procedures have, on rare occasions,
resulted in donor’s death.”88 Surgery in the US, on kidney transplant centers, shows five
donor deaths in 19,368 live donor transplants.89
In live kidney donation, the benefits of the procedure for the donor are not
anticipated. Both the medical community and the public view it primarily as an act of
altruism, whereby a person sacrifices himself/herself in order to help another human
being. As the transplant centers gained experience with kidney donation, benefits for the
donor became evident. Psychological studies reveal significant increases in the donor’s
self-esteem. They show that the benefit of increased confidence and self-esteem remain
nine years after the transplant, when others’ appreciation had vanish. This would show
that live donation produces an impact to the donor in terms of self-gratification and in
terms of his/her act done to the recipient. “Most of the donors felt closer to the recipient,
whether or not the treatment was successful.” 90
Risk and Benefits to the Recipient
The risk and benefits to recipients of organ or tissue transplants from living
donors depend mainly on the organ, the prospects of success and the possibility of
alternative therapy, including cadaver donation.91 Live transplantation, for instance, is a
life saving procedure with a high likelihood of success from a genetically close matched
individual. Living donors can save lives by shortening the time of the patient in waiting
for another organ in the wait list.
How many people benefit from the practice of organ transplantation?

Accordingly, there are currently 85,000 waiting candidates in the US, and 2,000-3,000
transplants are performed each month in the US. About 52,000 people receive whole
organ replacements in the world yearly.92 According to the UNOS, a daily average of 70
people receive either cadaveric or living tissue donations, while an average of 16 patients
die everyday waiting for an organ, due to limited availability. Current research in fields,
such as tissue engineering and cloning aims to eliminate the scarcity of available
organs.93 The advantages of living donor transplants are visible, if done between family
members who are genetically similar. A better genetic match lessens the risk of
rejection.94
There is a question in relation to living donation about its costs. What are the
costs related to living donation? Most medical costs associated with living donation are
covered by the recipient’s insurance. The government requires all certified transplant
centers to charge a recipient’s insurance an “acquisition fee” when he or she receives a
transplant. The medical costs related to the donor’s medical evaluation, transplant
procedure and post-operative care, called the “donor protocol,” are covered by this fee.
Anything that falls outside of this protocol
is not covered. These costs could include annual physicals, travel, lodging, lost-wages
and other non-medical expenses.95
Basically, the donor increases his/her self-esteem and gains more self-confidence
thinking that he/she was able to save another persons’ life. And on the side of the
recipient, although risks are present, but at least he/she was able to extend his/her life and
extend his/her time with her loved ones is a great feeling of eudaimonia and euphoria. It
is good news also for the recipient if his/her donor is blood related to him/her, because
successful transplants are attained if they are genetically close match.
Conclusion
This study revolves around organ transplantation and its moral and legal
implications. Based on moral and legal grounds, that is, from the teachings of the
Catholic Church, St. Augustine, St. Thomas and the Philippine laws, the researcher
concludes that organ transplantation is a gift. It is a gift which only human beings can
have. The fact that human beings have reached a high peak in scientific and technological
development, and have achieved this extra ordinary way of preserving life by means of
organ transplantation, it is a great step towards a new way of prolonging the life of the
human kind. Since the researcher sees organ transplantation as a gift, it is therefore a
must to share it with others and that it must be properly done considering the different
moral and legal conditions discussed in this study.
Recommendations
After giving an assessment, the researcher stipulates the following

recommendations:
That the moral grounds in organ transplantation be followed at least anytime and
anywhere;
That the legal and accepted definition of death must be attained before the
retrieval of the organs of the donor;
That the different criteria of a living donor must also be taken into consideration
in order to become a qualified donor and to achieve a successful transplant procedure;
That the legal grounds of the Philippine laws must be followed, at least, if organ
transplantation is applied in the local setting;
That the readers of this study would research further on the topics concerning the
alternative ways on how to minimize the costly and very expensive procedure of organ
transplantation; and,
That the readers of this study would research further regarding the syndicate
organizations that forcibly kidnap people and make use of their organs.
Endnotes
1
Dawn Freshwater and Sian E. Maslin-Protherto (ed.), Blackwell’s Nursing Dictionary, (2nd
edition), s.v. “Definition of Organ Transplantation,” (Oxford, Blackwell Publishing, 1994), p.417.
2
Jeffrey Prottas,”Medical and Organizational Aspects,” in Encyclopedia of Bioethics. Edited by
Warren Thomas Reich. (NY: Simon and Schuster Macmillan), 1995, pp. 1852-1857
3
James B. Nelson and Joanne Smith Rohricht, Human Medicine: Ethical Perspective on Today’s
Medical Issues, (Minneapolis Augsburg Publishing House, 1984), p.176.
4
Ibid. p. 176,177
5
Janie Butts and Karen Rich, Nursing Ethics, (Sudbury Massachusetts, Jones and Bartlett
Publishers, 2006), p.59.
6
Emmanuel B. Dispo, “Organ Donation: A Moral Issue,” University of San Carlos Graduate
Journal, Vol. XXII, March 2006, p.144.
7
Ibid.
8
Ibid. p.145.
9
Dispo, op. cit., p.142.
10
Nelson, op. cit., p.183.
11
Ibid.
12
Ibid.
13
Available at: www.archstl.org/commoffice/200/columns/000929.htm. Accessed: August 10,
2007
14
Ibid.
15
Ibid.
16
Availabe at:www.biomed.brown.edu/courses/B1108_2004_Groups/Groups04/Organ_
Transplantation. Accessed Date: September 26, 2007.
17
Pedro P. Solis, Legal Medicine, (903 Quezon Avenue, Quezon City, RP Garcia Publishing Co.,
1987), p. 230.
18
Freshwater and Maslin, loc. cit.
19
Available at www.wikipedia.org/wiki/organ_transplant. Accessed date: September 20, 2007.
20
Ibid.
21
22
Available at www.wikipedia.org/wiki/organ_transplant. Accessed date: September 20, 2007.
23
Ibid.
24
Prottas, op. cit., p. 1853.
25
Robert Troug, “Is it time to abandon brain death,” in Hastings Center Report, Vol. 27, No.1
(January-February 1997), pp. 29-37.
26
Prottas, loc. cit.
27
Butts and Rich, op. cit., p. 61.
28
2007.
29
Available at: www.house.gov/mcdermott/kidneycaucus/livdon.html. Accessed date: December
3, 2007.
30
Ibid.
31
Ibid.
32
Ibid.
33
Ibid.
34
Ibid.
35
Calvin R. Stiller, “Medical Overview,” in Encyclopedia of Bioethics. Edited by Warren Thomas
Reich. (NY:Simon and Schuster Macmillan), 1995, pp. 1871-1881.
36
James B. Nelson and Joanne Smith Rohricht, Human Medicine: Ethical Perspective on Today’s
Medical Issues, (Minneapolis Augsburg Publishing House, 1984), p. 174.
37
Dispo, op. cit., p. 143.
38
Ibid.
39
Stiller,op. cit., p.1872.
40
Ibid.
41
Ibid.
42
43
Joseph G. Donders, (ed.), John Paul II: The Encyclicals in Everyday Languages, (Maryknol,
NY, Orbis Books), 2001, p.283.
44
2007.
45
Ibid.
46
Nelson, op. cit., p.183.
47
Available at:www.catholiceducation.org/articles/religion/re0347.html.Accessed date: September
20, 2007.
48
Solis, loc. cit.
49
Ibid.
50
Ibid.
51
Solis, op. cit., p.231.
52
Available at:http:www.lawphil.net/statutes/repacts/ra1992/ra_7170_1992.html. Accessed date:
February 22, 2008.
53
Ibid.
54
Ibid.
55
Beauchamp,op. cit., p.1914.
56
Ibid.
57
Paul Edwards (ed.), The Encyclopedia of Philosophy, Vol. 1 and 2, USA, 1996, p.62.
58
Beauchamp,loc. cit.
59
Ibid p.1915.
60
Ibid. p.1916.
61
Ibid.
62
Ibid.
63
Eddie R. Babor, Ethics: Philosophical Discipline of Action, (Manila: Rex Book Store, 1999),
p.47.
64
Ibid.
65
Edwards, loc. cit.
66
Ibid.
67
Ibid.
68
Available at: www.radicalacademy.com/philaugustine2.htm Accessed date: December 12, 2007.
69
Ibid.
70
Babor,op. cit., p.48.
71
Ibid.
72
Edwards, op. cit., p. 112.
73
Russell Hittinger,”Natural Law,” in Encyclopedia of Bioethics. Edited by Warren Thomas
Reich. (NY: Simon and Schuster Macmillan), 1995, pp.1805-1811.
74
Edwards, loc. cit.
75
Available at:www.caae.phil.cmu.edu/Cavalier/80130/part1/sect3/Aquinas.html.Accessed date:
December, 12 2007.
76
Edwards, loc. cit.
77
Babor, op. cit.,p.49.
78
Ibid. p. 50.
79
Ibid.
80
Ibid.
81
Ibid.
82
Available at:www.aquiansonline.com/questions.html.Accessed date: January 29, 2008.
83
Dispo, op. cit., p. 144.
84
Edwards, op. cit.,p.112.
85
Peter A. Ubel and Mary B. Mahowald,”Ethical and Legal Issues Regarding Living Donors,” in
Encyclopedia of Bioethics. Edited by Warren Thomas Reich. (NY: Simon and Schuster Macmillan), 1995
p. 1865-1871.
86
Ibid.
87
Ibid.
88
Ibid.
89
Ibid.
90
Edwards, op. cit.,p. 1866.
91
Ibid.
92
Ibid.
93
Availabe at:www.biomed.brown.edu/courses/B1108_2004_Groups/Groups04/Organ_
Transplantation. Accessed Date: September 26, 2007.
94
Available at: www.house.gov/mcdermott/kidneycaucus/livdon.html Accessed date: December
3, 2007.
95
Ibid.
Bibliography
Books
Beauchamp, Tom L. “Paternalism” in Encyclopedia of Bioethics. Vol. 4. Edited by
Warren Thomas Reich. New York: Simon and Schuster Macmillan, 1995. pp.
1914-1920.
Butts, Janie, et al. Nursing Ethics. Sudbury, Massachusetts: Jones and Bartlett Publishers,
2006.
Donders, Joseph G. (ed.), John Paul II: The Encyclicals in Everyday Languages.
Maryknol, NY: Orbis Books, 2001.
Edwards, Paul, (ed.) The Encyclopedia of Philosophy. Vol. 1 and 2, USA, 1996.
Freshwater, Dawn et al. Blackwell's Nursing Dictionary. (2nd edition). Oxford:

Blackwell Publishing, 1994.
Hittinger, Russell. “Natural Law,” in Encyclopedia of Bioethics. Vol. 4. Edited by

Warren Thomas Reich. New York: Simon and Schuster Macmillan, 1995.
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Prottas, Jeffrey. “Medical and Organizational Aspects” in Encyclopedia of Bioethics.

Vol. 4. Edited by Warren Thomas Reich. New York: Simon and Schuster
Macmillan, 1995. pp. 1852-1857.
Solis, Pedro P. Legal Medicine. 903 Quezon Avenue, Quezon City. RP Garcia Publishing
Co., 1987.
Stiller, Calvin R. “Medical Overview” in Encyclopedia of Bioethics. Vol. 4. Edited by

Warren Thomas Reich. New York: Simon and Schuster Macmillan, 1995. pp.
1871-1881.
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Donors,” in Encyclopedia of Bioethics. Vol. 4. Edited by Warren Thomas Reich.
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Graduate Journal. Vol. XXII, No. 2, March 2006.
Troug, Robert. “Is it time to abandon braindeath,” in Hasting Center Report. Vol. 27,
No. 1, (January-February 1997), pp. 29-37.
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Transplantation.
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http://www.lawphil.net/statutes/repacts/ra1992/ra_7170_1992.html

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LUMINA An Interdisciplinary Research and Scholarly Journal Vol. 20 Vol.20, No.

BIOETHICAL ISSUES ON ORGAN TRANSPLANTATION:

Carlo Alfonsse Pangon

Organ transplantation is a very critical issue. A lot of questions arise concerning

Organ transplantation is defined as the replacement of a diseased or not

Organ transplantation is used to intervene when the final stage of an illness is

Several cases are recorded in different books regarding experiences in organ

According to Nephrologist Dave Tan, “as a consequence of the expensive costs of

In August 2004, a liver transplant operation was conducted in Taiwan by a

MEANING AND TYPES OF ORGAN TRANSPLANTATION

Organ Transplantation: Definition

Blackwell’s Nursing Dictionary defines organ transplantation as the replacement

Types of Organ Transplantation

Several different forms of transplantation are currently being performed and

Organs That Can Be Transplanted

• Kidney (deceased and living donor)

Tissues and cell fluids:

• Hand (deceased donor only)

Death and Transplantation

The accepted criterion in determining death is the formulation of brain death.

Donors: Living and Dead

Talking about organ transplantation, a distinction must be made between

The Rejection Problem

ETHICAL AND LEGAL ISSUES

An Act of Charity and the Principle of Totality

If there is anything else, organ transplantation could be understood as an act of

Republic Act No. 349 and Republic Act No. 7170

In the book of Pedro Solis entitled “Legal Medicine”, he enumerated several

Section 1 of the said law states:

Any person may validly grant to a licensed physician,

The authorization referred to in section one of this Act must

be employed; and, signed by the grantor and two

Any hospital, physician or surgeon - for medical or dental

transplantation is permissible in our country on the aforementioned grounds, and those

Paternalists maintain that restricting the autonomy of persons is justified if these

The word paternalism refers loosely to acts of treating adults as a benevolent

In one prominent justification, Gerald Dworkin argues that paternalism should be

Another important point in St. Augustine’s teaching is his doctrine of voluntarism

St. Thomas Aquinas

According to Aquinas, an agent performs willful actions through the following

Risks and Benefits of the Donor

Risk and Benefits to the Recipient

How many people benefit from the practice of organ transplantation?

After giving an assessment, the researcher stipulates the following

Freshwater, Dawn et al. Blackwell's Nursing Dictionary. (2nd edition). Oxford:

Hittinger, Russell. “Natural Law,” in Encyclopedia of Bioethics. Vol. 4. Edited by

Prottas, Jeffrey. “Medical and Organizational Aspects” in Encyclopedia of Bioethics.

Stiller, Calvin R. “Medical Overview” in Encyclopedia of Bioethics. Vol. 4. Edited by

Dispo, Emmanuel B. "Organ Donation: A Moral Issue," University of San Carlos

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