Answer to Question 11. Paying donors for organs to transplant is prohibited by law in most countries, including
the U.S. Singapore, one of the exceptions, is implementing a new system of paying
donors the equivalent of about 36,000-50,000 for their organs. Iran began such a
system in 1988 and no longer has any waiting lists for organs. Living donors of one
kidney receive 1,200 from the government and recipients pay donors an additional fee
up to 4,500. (Charitable organizations pay that fee if the recipient is too poor to pay.)
Evaluate the ethics of a system of paying donors (or their estates) a significant sum for
donations. Could it be justified on utilitarian grounds? Does the ban on payment respect
other ethical concerns? Note that it is legal to pay people in most countries to donate
unfertilized eggs and sperm to assist in in vitro fertilization. Is there an ethical difference
between donating a kidney and donating an egg or sperm?
2. In the U.S., the End Stage Renal Disease Program was established in 1972 and signed
into law by President Richard Nixon. It is administered by Medicare, with some costs
paid by Medicaid or private insurance. Although exact costs vary considerably,
depending on whether dialysis is conducted in a special clinical setting or at home and
whether additional drug treatments are needed, the average annual cost is at least
25,000 per patient, with well over 300,000 patients receiving dialysis. Two Nobel prizewinning
economists Gar Becker and Julio Elias proposed recently that the federal
government pay 15,000 to living donors of kidneys, saving the government substantial
funds in the ESRD program. Use utilitarian reasoning to justify this proposal. What
ethical arguments can you make to object to it?
3. In many countries, including the U.S., organs cannot be harvested from a deceased
person unless he or she has signed an organ donor agreement prior to death or the
immediate family gives permission. A few countries have tried reversing this
presumption. That is, it is presumed that organs may be harvested from all deceased
persons, unless they have taken steps to prohibit this, an opt-out or presumed
consent program. Several countries with such opt-out laws have very high rates of
organ transplant, including Belgium, Portugal, and Spain. But other opt-out countries,
including Greece, Luxemburg, and Slovakia, have relatively low rates, for reasons that
are not entirely clear. Some provinces in Canada are considering a switch to this opt-out
approach, due to the low rates of organ donation in that country. What are the ethical
considerations presented by opt-out programs? Is merely living in one of these countries
sufficient to constitute the consent required in opt-in programs?
4. Some countries, including Israel and Singapore, are experimenting with yet another
approach to increasing organ donation, a no give, no take system. Persons who refuse
to sign an organ donation agreement agree that should they themselves ever need an
organ for transplant, they will be at the lowest priority for receiving one. Conversely,
persons who agree to organ donation, along with family members, will be higher on the
priority list. Do you see any ethical problems with this approach? Is it possible to give
meaningful consent early in life for a medical problem that might arise years, even
decades, later?
5. Another partial solution is being pursued through what are called routine removal
statutes that permit doctors to remove corneas without consent of the deceased or their
family. This has resulted in dramatic increases in corneas available for transplant. Do
you see any ethical problems with this approach? Should it be extended to additional
organs?
6. As long as shortages of organs for transplant persist, a continuing challenge is
determining how to allocate this scarce resource. How should assignment of these
organs be made most ethically? Should preference be given to the young who have a
longer life to live? To older persons who have contributed to society in substantial ways?
To people who can pay the full cost of the transplant procedure? Should felons who
have been sentenced to life without parole be eligible for transplants? Devise a hierarchy
of factors that you believe should be used for such decisions, with an ethical justification
for your ranking.
Answer to Question 21. Develop ethical arguments that support Pistorius' participation in elite athletic events.
Then develop ethical arguments that he should not be allowed to participate.
2. In 2001, disabled golfer Casey Martin won in a Supreme Court decision allowing him to
use a golf cart in professional golfing events. The Professional Golf Association argued
that being able to ride in a cart gave him an unfair advantage over the other golfers, who
are required to walk the course. This was a decision under the Americans with
Disabilities Act and the golf cart was considered a reasonable accommodation to enable
him to participate. Develop ethical arguments that support Martin's position. Then
develop ethical arguments on the side of the PGA.
3. Research reliable sources on the Internet to identify other athletes with disabilities
seeking to participate with regular sports teams. Assess their arguments using ethical
reasoning principles.
Traniello and his colleagues demonstrated that social insects may develop “social imm
Changing leaf area: (a) following rainfall ocotillo plants of the Sonoran Desert develop leaves and
Effect of clinical decison support systems
Siblings report on what life events triggered changes in their relationships with each other, how ...
The major events associated with the three phases of energy metabolism: the cephalic, absorptive, ...
Events in human fertilization. The light micrograph shows a fertilized human oocyte.