Altruism, Autonomy, and Human Dignity for the Sustainability of Post-Mortal Organ Donation Aiyub Mohammad Fahad Alwehaibi
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Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Spring 1-1-2017 Altruism, Autonomy, and Human Dignity for the Sustainability of Post-Mortal Organ Donation Aiyub Mohammad Fahad Alwehaibi Follow this and additional works at: https://dsc.duq.edu/etd Recommended Citation Alwehaibi, A. M. (2017). Altruism, Autonomy, and Human Dignity for the Sustainability of Post-Mortal Organ Donation (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/120 This One-year Embargo is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. For more information, please contact [email protected]. ALTRUISM, AUTONOMY, AND HUMAN DIGNITY FOR THE SUSTAINABILITY OF POST-MORTAL ORGAN DONATION A Dissertation Submitted to the McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Aiyub Mohammad Fahad Alwehaibi May 2017 Copyright by Aiyub Mohammad Fahad Alwehaibi 2017 ALTRUISM, AUTONOMY, AND HUMAN DIGNITY FOR THE SUSTAINABILITY OF POST-MORTAL ORGAN DONATION By Aiyub Mohammad Fahad Alwehaibi Approved April 27, 2017 ________________________________ ________________________________ Henk ten Have, MD, PhD Gerard Magill, PhD Director, Center for Healthcare Ethics Vernon F. Gallagher Chair for Integration Professor of Healthcare Ethics of Science, Theology, Philosophy and (Dissertation Chair) Law Professor of Healthcare Ethics (Committee Member) ________________________________ ________________________________ Joris Gielen, PhD Henk ten Have, MD, PhD McAnulty College and Graduate School Director, Center for Healthcare Ethics of Liberal Arts Professor of Healthcare Ethics Assistant Professor of Healthcare Ethics (Center Director) (Committee Member) ________________________________ James Swindal, PhD Dean, McAnulty College and Graduate School of Liberal Arts Professor and Dean of McAnulty College (Dean) iii ABSTRACT ALTRUISM, AUTONOMY, AND HUMAN DIGNITY FOR THE SUSTAINABILITY OF POST-MORTAL ORGAN DONATION By Aiyub Mohammad Fahad Alwehaibi May 2017 Dissertation supervised by Professor Henk ten Have, MD, PhD In most countries, the shortage for transplant organ sources has become common due to the significant increase in number of awaiting organ recipients, which, in turn, urges countries develop systemic programs in order to increase the number of organ donors and resolve their problems. Generally, either living or deceased organs are accepted in transplant practice, yet, each source holds its own benefits and adverse effects. Living organ donation encounters controversial and problematic issues at individual, social, and humanity levels. Cadaveric organ donation faces the obstacles of the criteria of death, which vary from cultural to medical perspectives, and the effective means to attract the public. Currently, presumed consent policies operating in Spain, Belgium, and Singapore have proved their effectiveness in increasing the number of donor organs. However, the increasing number of donor organs should not be a sole, iv sufficient indicator for the effectiveness of a policy. Instead, the sustainable growth in the number of organ donors after their death should be the goal of a policy in order to promote a promising outlook for organ donation sources. And, the factor that enhances the sustainability is public trust. The dissertation proposes a new approach for a more long-run outcome in increasing the number of organ donors. It is a model for a sustainable source of post- mortal organ donation. The model encourages deceased organ donation by assurance of the core value of donation act- altruism, and the protection and appreciation for donors as well as healthcare professionals. Most importantly, the model targets on obtaining and maintaining public trust by protecting one’s autonomy and human dignity, thereby creating a sustainable source of donor. v DEDICATION I dedicate this work to my father, mothers, and siblings. Mohammed Alwehaibi Amenah Alwehaibi Fatimah Almarshad Omar Alwehaibi Norah Alamor Rehab Alwehaibi Abdulrahman Alwehaibi Ayman Alwehaibi Hosah Alwehaibi Maitha Alwehaibi Afra Alwehaibi Sarah Alwehaibi Abdulsalam Alwehaibi Fahad Alwehaibi Wohibi Alwehaibi Haia Alwehaibi Wafa Alwehaibi Norah Alwehaibi Mansur Alwehaibi Abduallah Alwehaibi Khaulah Alwehaibi Faisal Alwehaibi Jalal Alwehaibi Nariman Alwehaibi Ahmed Alwehaibi Rema Alwehaibi vi ACKNOWLEDGEMENT بسم هللا الرحمن الرحيم In the name of Allah, the Entirely Merciful, the Especially Merciful. First and foremost, I would like to express my extreme gratefulness to my mentor, Professor Henk ten Have. I thank him for his valuable guidance, scholarly inputs, and consistent encouragement throughout my degree. I thank him for encouraging and supporting my attendance at various conferences and engaging me in new ideas. He has been very kind and patient and always willing to guide me whenever I approached him despite his busy schedules; I acknowledge and appreciate him for all his efforts. My achievements were possible because of Dr. ten Have’s unconditional support. Additionally, I would like to thank my committee members Professor Gerard Magill and Professor Joris Gielen for their insightful suggestions and comments of my works. I am greatly privileged to receive their scholarly knowledge, academic support, and encouragement. I would like to express my sincere gratitude to Ms. Glory Smith, who wholeheartedly supported me during my degree. She has been very understanding and encouraging throughout my hardship. I would like to thank to my clinical Dr. Sarah Warfield who patiently taught me and provided me opportunities to have the most valuable clinical experience. I would like to thank my friends Saleh Alnahdi, Fahad Alresheed, Saeed Baeshen, and many others for their friendship, academic interactions, and unyielding support. I would like to thank everyone who has supported me throughout my academic path. I owe a lot to my parents, brothers, and sisters, who consistently encouraged me and longed to see this achievement come true. vii TABLE OF CONTENTS Page Abstract .............................................................................................................................. iv Dedication .......................................................................................................................... vi Acknowledgement ............................................................................................................ vii Chapter one- Introduction ....................................................................................................1 I. Backgrounds and problem statement ................................................................................1 II. Ethical considerations .....................................................................................................5 III. Deceased organ donation- the future for organ transplantation .....................................9 IV. Public trust- a novel ethical issue in organ donation ...................................................13 V. The impacts of cultures on a public policy ...................................................................19 Chapter two- The Development of Organ Donation ..........................................................23 I. Overview of history and current practice of organ donation ..........................................23 1. Organ donation before 1954- aiming at survival ............................................23 2. Organ donation after 1954- the concurrence of success and ethical controversies ...................................................................................................24 II. Common ethical obstacles in organ donation ...............................................................25 1. Traditional organ sources: living and deceased organ donors .......................25 2. Alternative organ sources: stem cells, savior siblings, xenotransplantation, Persistent Vegetative State patients ................................................................29 III. Normative ethical background .....................................................................................35 1. Autonomy- Rights and Responsibility ...........................................................37 viii 2. Human dignity- the existential value ..............................................................46 3. Altruism- the universal common morality ......................................................54 Conclusion .........................................................................................................................56 Chapter three- The Evolution of Organ Transplantation ...................................................61 I. The era of ideology and experiments .............................................................................61 1. The era of primal organ transplantation ..........................................................61 2. From ideology to experimentation ..................................................................63 II. The era of breakthroughs (the twentieth century) .........................................................67 1. Organ transplantations as temporary bridges in surgeries ..............................67 2. Organ transplantation as medical treatments ..................................................72