Organ transplantation is a surgical operation done whereby a bodily organ, such as the heart, liver, kidneys, skin, or parts of the eye, is moved from one person, who is an organ donor, to another person who is suffering from organ failure (Kobashigawa et al., 2019). Organ transplantation has been a successful operation for close to 50 years, according to the World Health Organization. Ethical considerations are at the forefront when dealing with organ transplant patients. Such may include patient satisfaction, especially when there are shortages of organs, which drives most people into the trafficking of human body organs. Nurses should, therefore, be aware of all ethics surrounding organ transplants to ensure patient safety and avoid bias. This essay seeks to explain and highlight the different ethical considerations in organ transplant, the roles along with the responsibilities of nurses, determine concepts and the styles of learning, and determine patient needs through analysis, prioritization, decision making and problem-solving.
Organ transplant is a clinically relevant procedure as it has been shown to save the lives of patients suffering from terminal illnesses due to organ failure. Over the past few years, solid organ transplantation has improved the quality of life in both adults and children. Kidney transplants have improved lives among the elderly suffering from kidney failure. This procedure is the miracle of the twentieth century (Kobashigawa et al., 2019). The World Health Organization records a significant increase in patient survival, the quality of life globally, and a reduction of comorbidities (World, 2020). Patients eligible for transplant are those who have suffered severe organ failure and are on the verge of death or permanent disability. Such patients are on the waiting list, awaiting organs from eligible candidates.
The greatest challenge in organ transplant is that the number of donors is less than that of patients needing organs. In the United States, it is estimated that 21 people die as they wait for organs (World, 2020). The candidates have to be in healthy clinical conditions to increase the chances of survival of the recipient.
Anyone can be a potential candidate for an organ transplant. The Organ Procurement and Transplantation Network reviews organs relevant to the blood type, organ size, and type of organ to meet the recipient’s needs best (Cengiz & Wareham, 2020). Nurses and medical practitioners are responsible for understanding the ethical guidelines surrounding organ transplants. For instance, patients needing organs must be registered members recorded on the waiting list, which is a key requirement for transplant. Nurses have the major responsibility of caring for caring for critically ill patients, which includes the donors and the potential recipients. According to the National Organ Transplant Act, there should be “equity”, “utility”, and “respect for persons” receiving organ transplants (Cengiz & Wareham, 2020). Ethical principles must be generally understood to understand patient needs and help in decision-making. Utility refers to the ability to consider the probability of harm and benefit and the quantity of both. The utility principle incorporates beneficence as it requires one to do good for the patient and specifies that organ transplantation is expected to bring out “good” improved quality of life (Cengiz & Wareham, 2020). Thus, the allocation process should consider the potential consequences of benefit and harm.
The role of nurses is to understand that not all good can be met and that potential harm may result in catastrophic consequences. The nursing profession is a continuous learning process.
Nurses should thoroughly exhaust all available options before communicating with the patient when determining potential organ donor recipients.
The patient’s family should also be informed in a manner they understand to make an informed decision. During this time, the nurses should provide emotional and psychological support and reassure the family of their support (Vlaisavljevic et al., 2020). The National Organ Transplant Act effectively expresses equitable allocation of organs for transplant. There should be fairness in determining patients eligible for organ transplants. This specifically involves allocating organs according to the period on the waiting list (Cengiz & Wareham, 2020). Nurses express their concerns about having difficulties meeting patient needs, especially in critical patient care. They are equipped with the knowledge to care for patients until they are pronounced dead. In addition, the nurses are responsible for caring for the family members of both the donor and the potential recipient up until the moment of death (Tocher et al., 2019). The nurses are also equipped with knowledge concerning organ transplants and have a role in educating the patients about the good and the potential harm. Patient education is critical as it enables the patients to consent.
Respect for persons is another ethical consideration that embraces honesty in commitments. This principle reflects the importance of respect for autonomy, meaning that everyone has a right to make good decisions for themselves and others (Cengiz & Wareham, 2020). In this case, nurses are responsible for respecting the donor’s decision made in regards to donating that is if the donor accepts or rejects. Respecting the recipient’s decision to refuse the organ, and respecting the organizations level of transparency in the allocation process is very important for nurses adhere to at all times.
The nurses should also understand the cultural aspects of the patient as they influence the attitude and decision-making process. Expressing a level of understanding of the patient’s culture will play a key role in how a nurse handles the patient. This includes showing compassion, commitment to care and knowledge (Vlaisavljevic et al., 2020). Nurses should, therefore, be equipped with knowledge of different aspects of organ transplants to ensure equality in care. In addition, nurses must retain their knowledge and understanding to maintain patients’ dignity and promote a good and caring environment.
An important role for the nurses is ensuring that patients consent to all information given. The nurses should ensure that the patient has completely understood the procedure, what to expect, the risks involves and any possible options. After patient education, the nurse can again brief the patient and even ask them to explain whatever they have understood. Emphasis is based on ensuring that the recipient has completely comprehended the treatment process prior to agreeing to undertake the procedure. During the procedure, the nurse’s job is to ensure that the patient is provided with emotional and psychological support, as well as a supportive family for care after the procedure.
In conclusion, ethical aspects cannot be ignored in the context of organ transplants. The principles of autonomy and benevolence are in great play in organ transplants. The ethical dilemmas involved in this field should be explored and understood by the public, especially medical practitioners. The nurses must consider the cultural principles, religious principles, and personal and moral needs in patient care. Nurses should continuously learn ways to improve patient care, relate with patients from different cultural backgrounds, and integrate this knowledge into care without bias.
Such knowledge is also important as it can be used to educate others. Continuous education to other nursing students will ensure knowledge retention in the healthcare system. In addition, nurses can help reduce donation rates through patient education, partnering with local organ donors and showing empathy when handling critical care patients at any given moment.
References
Cengiz, N., & Wareham, C. S. (2020). Undefined. Current Opinion in Organ Transplantation, 25(5), 483–488. https://doi.org/10.1097/mot.0000000000000796
Kobashigawa, J., Dadhania, D., Bhorade, S., Adey, D., Berger, J., Bhat, G., Budev, M., Duarte-Rojo, A., Dunn, M., Hall, S., Harhay, M. N., Johansen, K. L., Joseph, S., Kennedy, C. C., Kransdorf, E., Lentine, K. L., Lynch, R. J., McAdams-DeMarco, M., Nagai, S., … Lai, J. C. (2019). Report from the American Society of Transplantation on frailty in solid organ transplantation. American Journal of Transplantation, 19(4), 984–994. https://doi.org/10.1111/ajt.15198
Tocher, J., Neades, B., Smith, G. D., & Kelly, D. (2019). undefined. Journal of Clinical Nursing, 28(9-10), 2020-2027. https://doi.org/10.1111/jocn.14741
Vlaisavljevic, Z., Jankovic, S., Maksimovic, N., Culafic, M., Stulic, M., Milovanovic, T., & Oluic, B. (2020). Attitudes of nurses toward organ donation in Serbia. Transplantation Proceedings, 52(3), 673-679. https://doi.org/10.1016/j.transproceed.2020.01.031
World. (2020, June 23). Transplantation. Who. Int; World Health Organization: WHO. https://www.who.int/health-topics/transplantation#tab=tab_1
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