Table of Contents
Organ transplant is such a raging issue and debate in the contemporary society. As a process, organ transplant refers to the act of transferring living tissues or organs into an ill or injured person (Danovitch et al., 2013). The concept is such a grave concern in the modern society owing to the issues surrounding the cultural, moral and spiritual implications for organ transplantation. For instance, there is the question of the ethics of not considering the life and health of the donor after the transplants since the experiments are now done in private and at times, substandard (Gries et al., 2013). Kidney problems and issues have been the primary focus of organ transplants because many people are currently suffering from kidney problems like renal failure. Despite the new lease of life given to the recipient, there are cultural, religious and moral concerns surrounding the practice as this discussion seeks to explore in details.
The case: A patient requiring Kidney transplant (Acute Renal Failure)
Pathophysiology of renal failure, medical and nursing interventions
The contributory factors to renal failure result in the decrease in glomerular filtrate rate. The pathophysiology of renal failure, therefore, stems from such factors as low renal perfusion pressure, ATN, interstitial oedema, decreased filtration coefficient, interstitial nephritis and high intratubular pressure (Che, Yuan, Huang & Zhang, 2014). Adults are more likely to develop renal failure due to blood loss or septicaemia. Renal failure results from the loss in nephrons as well as the reduced functionality of the renal arteries. When they reach a certain point, the remaining nephrons form irreversible sclerosis thereby declining the filtration capacity or GFR decline (Che et al., 2014). At this point, the capability of the renal system is compromised, and this explains why, in extreme cases, the kidney is replaced through transplantation.
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Nursing diagnosis and intervention
For any client, it is vital to understand that the nursing interventions are limited to monitoring electrolyte and fluid balance checked by looking at the potential indicators of the complications (Che et al., 2014). The intervention also focuses on reducing the client’s metabolic rates, promotion of the pulmonary function like assistance during coughing to prevent infections in the respiratory tract. Infection-prevention is the goal of the nursing invention through the use of catheters for minimizing infections and increasing metabolism. Skin care and safety measures are part of the nursing intervention. Nurses can diagnose renal failure by looking at such elements or indications like electrolyte imbalance relating to the evidence of increased potassium levels, and diagnosis for the evidence of risks volume deficiency related to increased output of urine (Che et al., 2014).
For this patient, it will be imperative to teach him about the tiring role of monitoring and managing renal failure, especially the medical burden, and the feasibility of any approach. In the long run, acute renal failure does not have any cure. In this situation, I can tell the client, requires for the decision for a possible kidney transplant.
Cultural, ethical and spiritual issues in organ donation
Before receiving any donation of an organ (like kidney), it is a necessity to identify some of the moral or ethical considerations or issues surrounding such acts. Donations can come from the deceased. From an ethical perspective, it is argued that one should always show it praiseworthy donating body parts to benefit others (Coggon, 2013). However, with current techniques on surgeries to enable transplants, such should be undertaken by close and proper contemplations of the medical professions, the people in addition to the relevant law. From a moral viewpoint, organ donation, especially for kidney, it is obligatory to respect the donor’s last will in case of the donation from the dead. Furthermore, the family should provide a detailed consent (Coggon, 2013). Donation cannot harm a person who is dead while declining is a show of indifference, but should not be obligatory.
Moral or ethical considerations significantly influence the decision of live donors. The ethical concern is the action to mutilate the body of a living person for other’s benefit. The action is believed to violate the Principle of Totality that allows for the sacrificing of a particular body part or function for preserving another person’s life (Caplan et al., 2015).
From the medical perspective, one of the vital concerns is the informed consent and the principle of free will (Caplan, McCartney & Reid, 2015). In this regard, it is morally right and advisable to provide the donors with the best knowledge concerning all the risks involved and other pertinent information like the possibility of success or failure of the operation in addition to the availability of alternatives. Besides, the moral obligations have been defended by the law, especially in cases where the family is piling pressure on the donor (Kirby, 2016). Therefore, from an ethical or moral viewpoint organ donation should be subject to the free will and willingness of the donor, motivated by charity and having the will to offer organ to save the life of others.
The organ recipient equally faces ethical concerns or issues. For one, a major consideration is that nobody, especially the potential recipient of the organ, has the inherent right to claim tissue or organ of another person, whether living or dead (Kirby, 2016). In this case, the sick people are only left with the choice of accepting organs that are freely offered by others; this has been a widely accepted position in the field of organ donation. Conversely, the recipient has the right to informed consent. Therefore, for the recipient, it should be evaluated and defined his or her extent of comprehending the risks, benefits, burdens or the costs of transplant as well as the aftercare. On the other hand, it is morally right to inform the guardians of the possible risks and burdens in the case of an incompetent person (Coggon, 2013). Also, the guardians of the recipient should respect his or her wishes, and it is morally wrong to put pressure on the recipient as this leads to unfair influence. The recipient should be morally respected and while at the same time, advising the recipient to decline any organ that has been procured through illegal or immoral means.
Religious perspective also plays a significant factor in organ donation. From some religious perspectives like the Muslims, the teachings and beliefs support any efforts aimed at protecting human life, but have mixed reaction and support to organ donation (Uskun & Ozturk, 2013). For instance, the Muslim clerics teach members of the faith to seek medical attention when sick and this opens the room for organ transplantation. However, the viewpoint is not respected as an implication that the Islamic teachings do not entirely support organ transplant. Christianity support organ donation, especially from the religious factions like Catholic and Protestants (Kirby, 2016). For both the donor and the recipient, Christianity recommends and compels or obligates for respective the free will of the individuals. Besides, Christianity argues that the physician determining death should never be part of the transplanting team (Caplan et al., 2015). Such should be considered when the donor or the recipient comes from the faith. As such, major religions of the world have a larger support for organ donation but argue that this should be done by the assurance of respecting the free will of the donors and the recipients.
Culture has a significant effect or implications on organ donation that affects both the donor and recipient. For instance, any attitude that the two parties have towards donations is inherently defined or influenced by culture (Uskun & Ozturk, 2013). The implication is that within cultures, there exist the embedded assumptions concerning the meaning of illness health and death influencing the process of communicating the concerns during the donation process. For the healthcare professions, there is the inherent moral responsibility to respect the cultural differences, more so on how donation and death are comprehended, experienced as well as the response that individuals have towards these elements. Culture determines the locus of control. In the western cultures, for instance, the locus of control is internal whereby individuals have the right to express their feelings about organ donation (Caplan et al., 2015). However, non-western cultures ascribe to the external locus of control whereby their decisions and ascriptions are defined by the external forces (Uskun & Ozturk, 2013). Hence, during the donation of kidneys for transplant, the cultural differences and how they affect attitudes towards death should be integrated into the entire decision-making process as this will ensure the avoidance of any cultural conflicts.
The case of conflicting ideas
At times, there can emerge a major conflict between the donor and the family. When a donor has agreed to perform the organ transplant, the situation can be regarded as a case of a person confining his reasoning to free will to do and act out of personal right. Nonetheless, in the case the family declines to accept this, a separate and special care should be provided for the donor. In this case, close medical monitoring, provision of the appropriate health care resources as well as assigning special caregivers to the donor should be an imperative for the medical profession (Gries et al., 2013). Therefore, the donor should be assigned special treatment and care since the family will have less commitment to attend to the individual.
In the case of my family, child or loved one needing an organ, I will restrict this to their wish and informed consent. For instance, when the family member or a loved one is competent and in sound mind to accept organ donation, I will not decline to support the request. However, I will make sure that the recipient knows the risks and burdens as well as ensuring that the organ is not obtained through illegal means. For a child, the case is different because he or she is not in the right mind and competent to make such decisions. In this case, a discussion with my partner will be necessary, and we must both agree and have one voice on this as the guardians, but the best is always the moral obligation to protect the life of humans.
Buying and selling of organs
Buying or selling of organs for transplantation is the worse that is happening in the world today. The situation has resulted in the exploitation of the poor and increased in organ traffic. Buying and selling of these organs has brought about the middlemen or brokers whose drive is on the monetary gains irrespective of the ramifications on the donors and the recipients (Danovitch et al., 2013). Therefore, organ donation should be subject to the national policy that states conditions through which such should be carried out, for instance, under close monitoring by medical professions. Organ trade takes advantage of the poor communities who have to serve the organ needs of the richer populations. However, medical ethicists argue that organ trade has eased the long waiting lists for kidney patients and if regulated, can be a remedy to the raging organ shortage.
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Organ transplant means a change in the body system, and this requires proper resources to deal with risks and burdens. Socioeconomic status plays a vital role, because, with such a condition, one will need to have the necessary resources, medical capability (ability to access health care resources) as a necessity in avoiding the adverse effects (Danovitch et al., 2013). Lifestyle is also important because, for a kidney transplant, a moderate physical activity is necessary as this will improve how the recipient acclimatizes to the body change.
In summary, organ donation especially kidney donations are subject to the ethical and moral obligations of respecting the right of the donor. For one, the donor should not be forced or coerced into donating, provided with informed consent and notified about the potential risks and dangers associated with the process. The same applies to the recipient, more so being highlighted on the potential dangers. Religious attitude has changed and most factions accept organ transplant although to some limitations like legal acquisition and providing informed consent and freewill to both donors and recipient. Culturally, medical profession should consider what each culture defines as death and illness as this addresses the possible conflicts with the family, the recipient and the donor. Conversely, organ transplant is now responsible for the increased organ trade but this should be regulated to reduce shortage of vital organs like kidney.
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