Abstract
On November 1, 2012, legislative amendments to the German law governing organ transplantation came into force. From this date forward, the German transplantation law was no longer restricted to regulating the removal and donation of human organs and tissues. Instead, it is now declared purpose of the law “to promote the willingness to donate organs” (§ 1, (1) TGP). The amendments are intended to solve a problem which is typical not only for Germany: the problem of supply shortage in transplantation medicine, which is usually referred to as organ shortage. In the wake of this change in legislation, a lot of money is being spent on advertising to encourage people to sign a donor card—a measure which is considered as helpful for increasing the number of donor organs available for transplant. While many aspects of transplantation medicine are currently controversial in Germany, due to the scandals that occurred there in 2012, this measure taken for itself is entirely beyond dispute: it seems to be unquestionable that the problem of organ shortage could be solved by increasing the number of donor card holders. The underlying idea is that if there were enough donor card holders—if, for example, every German citizen would sign a donor card—there would thus be enough organ donors to meet demands.
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Notes
- 1.
Due to a number of scandals in 2012 in which transplant clinics violated organ allocation guidelines.
- 2.
- 3.
The only body parts which can be transplanted after being extracted from a real corps are ear ossicle, eye lenses and some other kind of graft but no whole organs.
- 4.
- 5.
Active Eurotransplant waiting list, by organ, as per December 31, 2012, Table 4.5 (ii). See Eurotransplant Foundation (2014).
- 6.
To remember: Brain death concept means the equation of the complete and irreversible functional failure of the brain and brainstem with the death of a human being.
- 7.
See for example the famous critic from the ethicist Hans Jonas (1974).
- 8.
Manzei (2003).
- 9.
This is a completely different story than the development of the same discussion in the US. Here, the answer to the question when death occurs is provided in a special act, the “Uniform Determination of Death Act” (UDDA) from 1981: “§ 1. [Determination of Death]. An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.” See President’s Commission (2008) 5.
- 10.
In any case, the opt-out-solution, too, would not solve the problem of organ shortage because it does not increase the number of brain dead people but only number of donor card holders. To be precise, it does increase the quantity of transplantable organs somewhat, as a comparison of several European countries shows, but the problem of organ shortage would remain—because the opt-out-solution does not increase the number of brain dead people.
- 11.
- 12.
Shewmon (1998a).
- 13.
See President’s Commission (2008, p. 42).
- 14.
For the conventional justification and its critic see Byrne ed. (2009).
- 15.
- 16.
- 17.
- 18.
See Eurotransplant Foundation (2014).
- 19.
A problem which is more and more seen and is problematized by transplant physicians as well. See http://www.freiepresse.de/NACHRICHTEN/DEUTSCHLAND/Wissenschaftler-setzen-auf-Alternativen-zur-Organspende-artikel8987550.php.
- 20.
Geisler (2010).
- 21.
- 22.
Keller (2011).
- 23.
Wilkinson and Savulescu (2010).
- 24.
Birnbacher (2007).
- 25.
Meanwhile, there are prestigious physicians and scientists who are postulating this suggestion, too. See footnote 19.
- 26.
Cf. Müller (2011).
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Manzei, A. (2016). Organ Shortage as a Structural Problem in Transplantation Medicine. In: Jox, R., Assadi, G., Marckmann, G. (eds) Organ Transplantation in Times of Donor Shortage. International Library of Ethics, Law, and the New Medicine, vol 59. Springer, Cham. https://doi.org/10.1007/978-3-319-16441-0_12
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