When does organ transplant become obligatory? Is organ transplant ever obligatory? When asking these questions it is important to remember that the answer varies in different cases and in different people’s minds. Genetic relations, intimate relations, religion, Social Darwinism and reasons for transplant are all factors that can or cannot make an organ transplant obligatory.
In class we have studied Mcfall vs. Shimp, a case where Robert Mcfall attempted to sue David Shimp with the intention of obtaining bone marrow from David. Robert suffered from aplastic anemia; a condition requiring an immediate bone marrow transfusion or else Robert would die. Robert eventually lost the case because the court claimed that no human being was obliged to donate body parts.
David was Robert’s first cousin and one might argue that David was morally wrong if not legally bound to donate his bone marrow. An important question raised is whether Robert and David’s genetic relationship has an effect on the moral perspective of the case. Do any relationships (genetic or non-genetic) make giving body parts obligatory? Walter Glannon and Lainie Friedman say “Given that altruism consists in purely optional actions presupposing no duty to aid others, any parental act that counts as meeting a child’s needs cannot be altruistic. Hence, if a parent donates bone marrow to her child to save his life, then it would not be discretionary or supererogatory and thus not altruistic but instead one way of discharging her duty to the welfare of her child (GLANNON, W. and ROSS, L.F. (2002).” By this logic, David and Robert have a genetic relationship but it is not necessary that there be an expectation of generosity in their relationship. Duty usually stems from the level of attachment of a relationship. For example, ever since my little sister was born, I have been encouraged to look out for her. My personal relationship with my little sister demands my responsibility. I have also been trained by my parents to respect other women but this is more of a passive quality. I do not feel responsible for other women or people like I feel responsible for my sister. It is only in the case of my sister that my parents and I would expect myself to act directly with a sense of commitment. This notion leads me to partially agree with Glannon and Friedman when they say that a personal relationship has a greater requirement for involvement. But not all genetic relationships have a raised standard of interaction and responsibility. Since genetic relationships do not necessarily have a level of intimacy, it seems that genetic relationships do not always make organ donation obligatory. If this is the case then the concept of family duty is negated. Only certain relationships would qualify to make organ donation obligatory.
To put things simpler David was not obligated to give his bone marrow to Robert because their relationship was not intimate enough. A sense of duty is not always characteristic of the relationship between siblings, let alone cousins. For example, siblings generally do not accept responsibility for the actions of fellow siblings, but parents do accept responsibility for the actions of their children. This leads me to believe that the outcome of the situation would have been different if David was more than just Robert’s cousin. When considering which relationships Robert could have really fallen back on for bone marrow only two really come to mind.
Marriage and parentage are universally recognized moral and legal relationships that contain an aspect of responsibility and duty. It is important to analyze parentage and marriage and their relationship to organ donation. McFall vs. Shimp, in a way laid down the grounds for organ donation by coming to a conclusion that there was no moral or legal ground for what Robert was asking despite him bringing up ancient statutes and standpoint of other societies. It is important to understand that this court ruling is specific to this one case involving cousins. The monumental question arises whether McFall vs. Shimp should stand as a guideline for future cases of similar nature or whether or not there need for revision when future cases involve more personal relationships.
Common wedding vows are usually like the following: I, ____, take you, ____, to be my lawfully wedded (husband/wife), to have and to hold, from this day forward, for better, for worse, for richer, for poorer, in sickness and in health, until death do us part. From this we can deduce that Robert’s wife has a duty to help Robert in times of sickness. Some may argue that if Robert’s wife is able to donate bone marrow, she should because of her wedding vows. While this notion has a strong moral argument, it can be seen to invade Robert’s wife’s autonomy. If she were legally required to donate her body parts to Robert, this would violate her right over her own body. People refusing organ donations have parallels with women refusing to carry a fetus, and hence opting for an abortion. Both involve an intimate relationship where certain responsibilities are expected. Both refusing organs and carrying out abortions have been discouraged in many moral and religious viewpoints. For example: based on Leviticus 19:16, “Do not stand idly by the blood of your neighbor.” Jewish religion encourages donation of body parts. It sets a ‘mitzvah,’ or commandment, to save a life if we have the opportunity to do so. Abortion on the other hand is seen as murder and sin according to fundamentalist Christians. The term “my brothers keeper” is a reference to Cain and Abel from the book of Genesis. It means being obliged to look after one’s brother or sibling or, by extension, for cousins and other human beings in general. Hence, it is easy to understand why so many people saw David Shimp to be in the wrong. But both abortion and refusing body part donation have been legalized in accordance with Roe vs. Wade and McFall vs. Shimp respectively.
It is very important to consider the possible points of views of David Shimp since the decision primarily came down to David’s mindset on organ donation. David might of thought that refusing his bone marrow would be the smarter decision. According to Darwin’s “survival of the fittest” evolutionary theory, Robert was meant to die. David could have believed that Robert’s condition was part of a greater phenomenon known as Natural Selection. Natural selection would state that Robert’s condition is simply a representative of a weaker organism in terms of genotypic and phenotypic traits. David might also have considered an evolutionary perspective to nature regarding Robert’s condition. For example many animals in the wild will abandon weaker offspring, which have a lower chance to survive because of some sort of deformity. David might of wanted to prefer his life in favor of Robert’s in the way that a lioness may prefer her healthy cub above her unhealthy cub. Infanticide in wild animals is another example of where nature favors survival over compassion. David might of thought it would be better to make a rational decision based on self-interest than any personal feelings. It is true that if a person takes the time to consider not donating organs, the person may experience a conflict of interest between their rational self-interest and instinctive chaotic selflessness. Objective angles of thinking might encourage a person to value his/her life over someone’s because the person will consider the combined futures of the receiver and donor to be lower in quality of life if the transplant occurs. The person might value his/her life because of a way of thinking that his/her life is more valuable than the patient or that saving the patients life won’t make a difference to the world. These may be the points of view of David Shimp.
Another reason for bringing up abortion and animal behavior is because a main argument for not carrying out some transplants is that nature should be allowed to carry out its ‘supposedly better’ outcome. Natural Selection is in play when a person is dying. People making the same argument say that abortions should not be done because it is direct interference with nature and/or God. My personal belief is that nature and God are closely linked with knowledge and technology. Hence there is nothing wrong with using biological methods and innovation to save a life because why else would we have the ability to do so.
Looking back at McFall vs. Shimp, we can see that David was clearly not obliged to donate his bone marrow. The case was decided on the fact that David could not be forced to do something he refused to do. I can deduce from extensive analysis that David was morally and legally merited to make his decision. While this tells us me a lot about how organ donation can be viewed, it only covers one particular case. I have come to the conclusion that organ donation can be both obligatory and voluntary depending on the relationship between the patient and the donor. It is impossible to label any scenario to be associated with obligation because different people have different views and expectations of their relationships. The decision to donate an organ remains a personal decision.
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