ETHICS IN ACTUAL SURGERY - ETHICS AND ORGAN-TRANSPLANTATION

Actual organ transplantation evokes more and more ethical questions. T here is scarcity of donor organs. The waiting lists of potential recip ients for organ transplantation are steadily growing as is the number of deads among the waiting patients. In Belgium the mortality rate of traffic victims during the first thirty days of hospital admission has been reduced by half. Among this group the number of potential cadave ric donor candidates is further reduced following complications of sus tained intensive care. Shortage of cadaveric organs instigates some to select candidates for transplantation with exclusion of those conside red responsible for their illness. Some centres incline to reconsider the definition of cerebral death by extending this notion to the irrev ersible inconscious and therefore socially dead. Organ donation by liv ing donors opens the way to commercialism specially in case of unrelat ed living donation. Living donors are often insufficiently informed ab out their risks and the final outcome of these transplantations. The u se of implantable artificial organs should be the solution to many eth ical problems. But some experience with the Jarvik heart as a temporar y implant increases so far the shortage of donor heart supply and the number of patients on the waiting lists as well. It also excludes pati ents who became insuitable for transplantation after complication of t he Jarvik implantation. Xenotransplantation is largely under investiga tion. However it is out of question that primates, which are threatene d already with extinction should act as organ suppliers for mankind. X enograft organs should be found in animals for food consumption, suffi cient in number and more easily accepted as organ donors on ethical gr ound.