Social network: Find your organ match

Philosophers have long registered their vote in favour of mandatory organ donation from cadavers.  Harris, a legal philosopher registers his opinion in favour of mandatory organ donation in the following words – “it is surely implausible to think that having one’s body remain whole after their death is an objective anyone is entitled to pursue at the cost of other people’s lives! It is implausible to the point of wickedness, not least because the objective is irrational and impossible of achievement… No dead body remains intact; the worms… or the fire and eventually dust claim it… The alternatives are not burial intact or disintegration. There is no alternative which does not involve disintegration’.

Opposing this idea, there is a school of thought that argues that people retain an interest in their bodies even after their death and there are some religions which insist on the burial of an intact body. Emson answers this by stating that – ‘Separation of body and soul is so irrevocably complete and the individual is incapable of reconstitution. The person no longer exists, the soul has departed, and the individual who was but is no longer has no further use for the body which has been part of him or her during life’.

This article is not about whether organ donation from cadavers should be made mandatory or not? A lot has been said about this. The ink of this debate has not dried out yet and we are, in the recent state of things, made to consider another all-together hi-tech & social question about organ donation - the Facebook initiative of soliciting kidney donation in the face of increasing demand for this organ.

Endeavour appreciated, indeed! What I wish to write about is the hurdles it is likely to face, which may curtail the ‘full- social – virtual – medical impact’ of the initiative. Will this initiative peter out for being just another ‘recommend and like’ button on Facebook. Let me also state, that because I am discussing the drawbacks it does not mean that, I do not support the endeavour. I do, with full enthusiasm and to the extent of putting my name down in the list of online donors.

I wish to consider probable issues in foresight. The issues of ‘Glaring Demands’: ratio of patient requiring donation to those virtually consenting to donate and then the supply of these organs that are donated, most appropriately.

Case based discussion of issues: Social Networking for Organs

Since not much action has taken place on this front, I decide to write about the issues that may potentially arise because of the initiative in hypothetical case study format. These case studies would be released in parts over a period of time. Each of these case studies would highlight a possible issue.  

Here is the first one: Limited Access to Social Networking jeopardises medical interests:

Social Media has always been a beneficial platform for networking but unfortunately, not for all. It is for the few not the masses. This has been the clichéd debate around radios (at a point of time), the Televisions, followed by Computers and recently Internet – Social Networking being a gene of the last two. Social networking is for the ones who can a) access it and b) use it creatively (like for creating a page for organ donation). So the first issue is clear in bold: limited access to the probable finite source of organs (online users again). The more interesting issue arising out of this is: whether it is correct to use the access to social networking of one individual for the benefit of another individual. The case study below endeavours to illuminate the second issue and indeed talks about the first one.

Before the case study – facts: ‘Facebook users’ are soliciting kidney donation for themselves or their family members by creating private pages and inviting family members, friends, relatives and others to donate. 130 such pages were found by facebook before launching the ‘donate button’ for individual user to project their interest in donating kidney’s on their home page – making the search easy and narrow. The problem is all this is ‘facebook users centric’ and not ‘medical need’ centric.

The case study:

Let us consider an extremely hypothetical (but possibly likely) situation where two people - A and B are seeking kidney transplant from the same doctor in the same hospital in state X. Both of them are equally critical and are surviving on dialysis twice a week for over a year now. Let us assume that according to the state health care rationing laws (which decide on the allocation of resources), ‘A’ should be given priority for a kidney transplant over ‘B’. Let us also assume that a kidney that would help A would also help B, that is their tissues etc are of the same type and their bodies would adapt to a similar type of kidney. Here, if A (or any of his family members) is not a facebook user and cannot solicit a kidney online, whereas B (or any of his family members can) can, what should be the right thing to do after the kidney donor is brought to the hospital? Should the doctor’s (same) use the kidney searched by B for A (given the policy reasons etc) or should it be used for B, as he is the one who arranged for the kidney? Now, let us consider that ‘A’ is an 18 year old and ‘B’ is 66 years old (in this situation it is difficult to carry forward the assumption that A could not use facebook. It is although, not all together difficult to consider this as he might belong to a family with extremely poor socio-economic condition). Would in this case then, it would be the duty of the doctors to solicit B to pass on the kidney searched on facebook to A – as he would be able to live longer (a kidney transplant done stays alive for an average of 21 years after the kidney transplant).

The solution to such an issue is difficult and not definite. But what is certain is this the probability of the situation arising.

More case study based issues to follow soon!

Author’s Note: Comments, discussions and constructive criticism invited because I believe that solutions are not an end, they are a process.

Reference:

Interview of the Facebook team _ possible benefits and threats of the initiative: http://www.huffingtonpost.com/2012/05/29/facebook-organ-donations-_n_1554240.html?ref=health-news