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Organ donation is the removal of the tissues of the human body from a person who has recently died, or from a living donor, for the purpose of transplanting. Organs and tissues are removed in procedures similar to surgery, and all incisions are closed at the conclusion of the surgery. Steps are taken to provide a traditional funeral viewing. People of all ages may be organ and tissue donors. See "organ transplant" for discussion of the mechanics and history of organ transplantation.
In numerical terms, donations from dead donors far outweigh donations by living ones. The laws of different countries allow either the potential organ donor to consent or dissent to the donation during his life time, or his relatives to consent or dissent. Due to these different legislative possibilities, the number of donations per million people varies substantially in different countries.
* 1 Organs and tissues which can be donated
* 2 Recipient protection
* 3 Legislation regarding organ donation
* 4 Bioethical issues in organ donation
o 4.1 Deontological issues
o 4.2 Teleological issues
* 5 Political issues
o 5.1 Organs for prisoners
* 6 Organ shortfall
* 7 Scandals
* 8 See also
* 9 Sources
* 10 External links
 Organs and tissues which can be donated
Organs that can be procured include: the heart, intestines, kidneys, lungs, liver, pancreas. These are procured from a brain dead donor or a donor where the family has consent for donation after cardiac death, known as Non-heart beating donation.
The following tissues can be procured: bones, tendons, corneas, heart valves, femoral veins, great saphenous veins, small saphenous veins, pericardium, skin grafts, and the sclera (the tough, white outer coating surrounding the eye). These are only procured after someone has died.
Organs that can be donated from living donors include part of the liver or pancreas and the kidney.
 Recipient protection
To protect the person receiving an organ, various health and safety tests are conducted. Because an organ transplant requires immune suppression, it is important that the organ not be infected with a disease that could harm the recipient. These tests are not perfect, but organ-related infections are relatively rare.
Precise regulations vary by country or even hospital to hospital. In most countries, organs are not accepted from a person who has an active or recent case of cancer (except a brain tumor which has not spread or certain mild kinds of skin cancer), who has ever had a blood cancer, or who has certain infectious diseases, including HIV or severe bacterial or fungal infections at the time of death. People with these conditions may be able to donate their bodies or tissues for lab research or education, but not to a living donor. Because most people die from infections, cancer, or organ failure, only 1% of people who die at a hospital will be able to donate their organs.
At least one case of a brain tumor being spread through liver transplant has been documented. However, transplant officials are reluctant to shrink the supply of organs because of this rare risk.
Some countries have proposed that HIV+ people be able to donate organs to other HIV+ people under some circumstances and has been passed into law in Illinois.
 Legislation regarding organ donation
There are four different legislative approaches to the donation, if the donor has not explicitly dissented. The least restrictive approach is the dissent solution, according to which the donor has to explicitly dissent to donation during his lifetime. According to the extended dissent solution, relatives may dissent in the event the potential donor has not consented.
The different legislative approaches are the main reason that countries like Spain (27 donors per million inhabitants) or Austria (24 donors per million inhabitants) have higher donor rates than Germany (13 donors) or Greece (6 donors). In most countries with the dissent solutions, there is no waiting list for donations, or the list is short, while most countries with consent solutions have substantial organ shortages. The reason for this is that, in both situations, most people do not explicitly state their wishes. Thus, in a country requiring dissent, most people will not have dissented, while in a country requiring consent, most people will not have consented.
Under United States law, the regulation of organ donation is left to states within the limitations of the federal National Organ Transplant Act of 1968. Each state's Uniform Anatomical Gift Act seeks to streamline the process and standardize the rules among the various states, but it still requires that the donor make an affirmative statement during her or his lifetime that she or he is willing to be an organ donor. Many states have sought to encourage the donations to be made by allowing the consent to be noted on the driver's license. Still, it remains a pure consent system rather than an extended consent system or even a dissent opt-out system. Curiously, though, relatives can still dissent even in the presence of evidence of explicit consent by the potential organ donor (driver's licence, living will, registry information, etc.). As such, many organ donation campaigns in the United States encourage family communication about one's decision to donate or not to donate.
In the United Kingdom organ donation is always voluntary and no consent is presumed. There is however a national database called the Organ Donation Register where those individuals who wish to donate their organs after death can register. All NHS hospital have access to this database so that in the event of a death it can be seen if someone was a donor or not. It is also usual for hospital staff to ask relatives directly, in the event of a patientís death if they would be willing to donate their organs or not. Some members of the public in the UK also carry Donor Cards in their wallets, which are credit card sized and state that the person wishes to be a donor in the event of their death. In patients who require kidney or bone marrow transplants and in some cases a lobe of liver it is common as in other countries for the patientís relatives to be tested to see if they are a match. All transplants in the UK are carried out on the NHS to ensure that the whole population has access to potential donors in the event of them needing a transplant.
On June 27, 2008, Indonesian, Sulaiman Damanik, 26, pleaded guilty in Singapore court for sale of his kidney to CK Tang's executive chair, Mr Tang Wee Sung, 55, for 150 million rupiah (S$ 22,200). The Transplant Ethics Committee must approve living donor kidney transplants. Organ trading is banned in Singapore and in many other countries to prevent the exploitation of "poor and socially disadvantaged donors who are unable to make informed choices and suffer potential medical risks." Toni, 27, the other accused, donated a kidney to an Indonesian patient in March, alleging he was the patient's adopted son, and was paid 186 million rupiah (20,200 US). Upon sentence, both would suffer each, 12 months in jail or 10,000 Singapore dollars (7,300 US) fine.
 Bioethical issues in organ donation
Since the mid-1970s, bioethics, a relatively new area of ethics, has emerged at the forefront of modern clinical science. Many philosophical arguments against organ donation stem from this field. Generally, the arguments are rooted in either deontological or teleological ethical considerations.