There are different types of diseases affecting the human race. They range from chronic illness, to communicable diseases, and psychological diseases. Chronic kidney disease is one of the major diseases affecting a high number of people in the world. Approximately 15% of US citizens are diagnosed with the disease (Centers for Disease Control and Prevention, n.d.). The disease results in damaged kidneys and therefore, restricting them from performing their function which include excretion of toxic waste from the body. High blood pressure, heart diseases, and stroke are associated with his disease. In fatal cases, the disease results in early death of the patients. Dialysis which entails removing waste products and extra fluid from the body artificially is one of the treatment procedures for the disease. However, the procedure is expensive and most people cannot afford the treatment. Similarly, kidney transplant which involves surgical replacement of a damaged kidney with a health one obtained from a donor is an alternative treatment procedure. Kidneys for transplants come from living or dead donors. In general, human beings would do anything possible to avoid death and live a healthy life. While kidney donation is an ethical means off obtaining a healthy kidney, the number of donors is low. Most people have therefore, resulted to buying human organs in the black market. More so, organ donation is a global problem and is caused by various factors.
According to ("Organ donation statistics," (2020), 107000 people were on the waitlist for kidney donation on February, 2021. The kidney therefore, is one of the frequently transplanted human organs in the world. Studies reveal that are approximately 8000 organ donors dying annually and they provide an average of 3.5% of the required organs. The living donors are estimated to produce approximately 6000 organs annually, and therefore, approximately 5000 people die while on the waiting list per year ("Organ donation statistics," 2020). The demand for kidneys for transplant continues to register an increase, and therefore resulting in an influx of the waiting list. Kidney diseases are caused by progressive poor health and other chronic diseases such as type II diabetes and obesity which is resulted by poor eating habits. The rising market for fat foods and restaurants is considered a risk factor for obesity as people consume uncontrolled portions of these foods which cause obesity. Obesity has been classified as growing pandemic in the United States and results in an increased number of obese patients with renal disorders ("Obesity: Overview of an epidemic," n.d.) Research indicates that obese patients with renal complications have better survival chance with kidney transplant compared to other treatment procedures such as dialysis. These factors have contributed to an increased rate of kidney diseases and thus, untimely need for organ transplant globally. The alternative method for treating and controlling kidney disorder has resulted in a decline in donors as some of them interpret the organs are not in high demand as a result. The deaths registered on patients on the waiting list continue to rise on daily basis.
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According to WHO, globally, there has been a shortage of the organs donated for transplant ("WHO task force on donation and transplantation of human organs and tissues," n.d.). There are a number of factors contributing to this fact. Culturally, some people believe that it is unethical to remove part of a body regardless of the reasons. While some organs are obtained from patients in end- of- life care, whom doctors believe that with all the scientific evidence available they cannot heal or line without the assistance of life support machines, most people believe that is not right to harvest their organs (Kocaay, 2015). Therefore, their families refuse to give consent towards harvesting of their organs. More so, people from different people respect the dead and believe that everyone should be buried or cremated without tampering with their organs, a factor which restricts harvesting of organs for transplant. In Asian countries, obtaining cadaver kidneys for transplant is difficult due to the beliefs and customs of the people. There are a lot of myths, misconceptions and fears surrounding the issue of organ donation. A lot of Asian people fear death and believe that organ removal interferes with the sanctity of the deceased. They have the fear of the unknown regarding what happens after one is cut after dying (Li, 2019). More so, some people desire to be buried whole while others do not approve the idea of having another person’s kidneys. Lastly, organ donation undermines religious beliefs and practices in the Asian communities. The cultural, religious, and social issues therefore, reduce the global number of organs available for transplant.
Alnour et al. (2021) states that the Global Financial Integrity Statistics approximates 10% of all transplanted organs are obtained via organ traffic. World Health Organization Statistics estimates that 10,000 kidneys are traded in the black market globally on annual basis. These numbers relate to the supply and demand curve of the patients on the waiting list for organ donors ("state of the international organ trade: A provisional picture based on integration of available information," n.d.). In Canada for example the average waiting time for a kidney donor is four years and some patients wait up to seven years. In the US the average waiting time is 3.6 years while in the UK the waiting time is 2-3 years ("Waiting time as an indicator for health services under strain: A narrative review," 2020). Most patients die while waiting as the waiting duration is long. Organ traffickers, have therefore, discovered the desperation experienced by these patients and their families and thus ventured into the illicit trade; organ trafficking. Bain and Mari (2018) state that the traffickers orchestrate the recruitment plan of organ donors from a vulnerable condition. In most cases, the donors come from developing countries and have a poor background. They are enticed with promises of hefty payments and given a small percentage of the promised amount them to entice them into the recruitment plan. The victims do not undergo screening or ant medical procedures to determine their fitness for the procedure. More so, substandard operation procedures while harvesting the organs are used and there is no after care for the victims. The traffickers then identify disparate patients who fall prey to their schemes and are financially exploited. They pose as representatives of organ matching organizations and sell the organs. The vulnerable populations (donors and recipients) in this case, experience severe exploitation and long-term health consequences as a result. Most of organs sold in the black market, therefore, originate from victims of human trafficking. The victims are abducted, deceived, and are victims of fraud. Most people therefore are willing to do anything to prolong their lives. Kidney and other organ transplants are scientific breakthroughs which help to treat a lot of disorders, prolong and improve the quality of life. The fear, the desperation, and the shortage of these organs have resulted in improvised methods of obtaining the organs. These methods include; the black market where illegal trade of the organs is practiced.
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Lack of awareness on the importance of organ donation and the procedures associated with the process has resulted in a continuous shortage of organ donors. Different people have different attitudes and perceptions towards organ donation. An NCBI statistical analysis to determine attitudes towards organ donation concluded that 887% of the participants understood that the purpose of organ donation was to save lives while 87% of the subjects were aware about organ donation was not for monetary donations (National Center for Biotechnology Information, n.d.). However, a smaller percentage of the population, did not fully understand the concept of organ donation. Therefore, lack of information prevents potential donors from participating in the process of organ donation which can increase the number of organs available for donation. Lack of correct information has resulted in superstitions and beliefs within communities which are against organ donation. More so, lack of proper health care facilities in different countries; especially the developing countries increases the fear of organ donation to the donors (Kiani et al., 2018). They fear that they will not receive adequate care during the surgical procedures and after care, and therefore refrain from undergoing the procedures. There also lacks organizations to support and advocate for organ donors and therefore, they fear exploitation and long-term complications associated with organ donations. Organ donors should not cater for hospital bills and other treatment costs associated with the impacts of medical procedures they undergo. However, most healthcare institutions lack policies to address the issue and therefore, discourage donors from donating their organs. These factors continue to cause an influx on the patients on the waiting list and shortage of organs.
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Policies that advocate for organ harvesting such as organ conscription, which refers to the harvesting of all usable organs from cadavers without consent were put in place to increase the number of available organs for donation (Rosoff, 2018). Despite the forecasted increase foreseen to be resulted by the strategy, the results are yet to be achieved. The concept is faced with a lot of ethical and moral issues which restrains its application. The policy undermines different ethical principle such as autonomy which requires personal decisions to be respected and gives human beings a right to make their own decisions. It allows harvesting of organs regardless of whether consent was issued or not. It therefore undermines people’s beliefs and decisions. More so, it is a form of injustice towards the victims and their families as they are denied their right to fulfill their desires. It also increases the rates of human trafficking and murder in the society, which undermines the human rights. Human beings are trafficked, killed and their organs sold off to the desperate patients. The policy is therefore, regarded as unethical in most cases and has not been legalized in most countries. It continues to contribute towards a shortage of transplant organs globally and promotes human trafficking where allowed. Patients on waiting list continue to die while waiting for the availability of organs as a result.
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In conclusion, there are many causes of organ shortage in the world. Lack of awareness on the significance of organ donations, cultural and religious beliefs, lack of policies to advocate for human donors, policies such as organ conscription which are believed by, many to be unethical contribute significantly to the shortage of transplant organs. Due to desaturation and fear of death by patients and their families, they fall prey to manipulation and exploitation by organ traffickers. Different organizations should create awareness organ donation through the media and through education. The strategy will help to create a deep understanding of the concept of organ conscription and donation and increase the number of organs available for donation.
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