Question

discuss Kidney Donation Systems Around the World (not the us), no need to add a graph here. Explore the policies that are currently implemented across the globe (i.e. some discussed in the articles include - routine removal, presumed consent, organ donor points, "no give, no take", etc.). Evaluate the limitations of these policies. Also consider how these policies fare in terms of the efficiency vs. equity debate. (You do not need to critique them all, just select from 2 or 3 different countries that you find interesting/appealing.)

Answer 1

IN AUSTRALIA !

A organ donor is someone who gives a part of body to someone ; usually a relative or close friend who has very less chances of living without those organs.

Kidney transplants help improve the lives of people who have kidney failure or kidney diseases. Transplant allows the patient to live a healthy life.

Support for Living Donors

If you want to donate your kidney it is compulsary for you to undergo several tests and a long bed rest after the operation. When you take off from your job because of donation your salary or wages are given through Support for Living Organ Donors Program.

The laws are very strict and are against selling organs . Selling or buying organs is illegal in Australia, carrying a penalty of six months' jail and/or a fine of $4400.

Policies-

In Australia, families are asked to consent to organ and tissue donation, even if a person has registered their decision to be a donor. When you die your senior available next of kin may be asked if they consent to donate your organs and tissues for transplantation. S/He can decide not to donate your organs and tissues, even if you wanted to be a donor.

It is important that you discuss your decision to be an organ and tissue donor with your family. Families who know each other's donation decisions are more likely to uphold them.

There are two pathways to deceased donation (after death):

1. donation following brain death (irreversible cessation of all function of the person’s brain) and
2. donation following circulatory death, (irreversible cessation of circulation of blood in the person’s body, also known as DCD).

Brain death is when a person dies because the blood and oxygen supply to their brain stops. The brain stops working and dies with no possibility of recovery. This is usually as a result of severe injury to the brain or bleeding in the brain (ie a stroke).

Donation after circulatory death occurs when a person is not expected to survive a severe illness or injury. If the person is being treated in an intensive care unit or emergency department, a medical decision is made to withdraw life sustaining treatment. Organ donation can only go ahead if the person dies within 90 minutes after withdrawal of life sustaining treatment. Once the heart and circulation stop, 3 minutes must elapse to establish that the circulation has permanently stopped. Death can then be declared. Tissue donation is possible after circulation standstill.

In relation to all living kidney donations, local protocols must be developed which cover the following matters.

Information for donors

Written material should be made available to recipients and families about kidney transplantation, including the possibility of living donor transplantation. It must then up to an interested potential donor to indicate their willingness to begin an assessment process. Such information should include:

• Reason for using a live donor as opposed to deceased donation • A full description of the procedure

• Implications of the procedure for the donor, such as preparation for surgery by drugs or diet, hospital admission

• Risks to the donor inherent in the procedure including: o Surgical risks o Immediate complications as a result of the procedure including risk of kidney failure o Risk of death o Long terms risks.

• The process of recovery for the donor, including: o Physical rehabilitation and length of expected recovery time o Level of probable pain or discomfort after procedure o Inhibition of normal activity o Time off work required (and related financial impact such as access to life insurance, etc).

• The likely outcomes for the recipient (including possibility of failure of the donation, possible complications and prospects of success)

• Possible changes to the donor/recipient relationship (including possible feelings of ‘ownership’ towards the recipient by the donor, the donor feeling the need or right to make demands upon the recipient, and that the donor may be the object of feelings of gratitude by the recipient)

• That the donor may choose not to proceed with donation at any time before surgery and that it is not a foregone conclusion that donation will occur once donor assessment has begun.

Edited as per comment :)

Efficiency vs equity

Efficiency means that society is getting the maximum benefits from its scarce resources.  Equality means that those benefits are distributed uniformly among society's members...When government policies are designed, these two goals often conflict...In other words, when the government tries to cut the economic pie into more equal slices, the pie gets smaller.

Organ donation is never been in equity and maybe it cannot be as there are very less no. of givers and very large no. of takers and those givers only wanted to do that for profit which is illegal. Still many families struggle to get organs for their loved ones , which in turn would cost them too much because of the large difference between given and takers . To take the efficiency and equality both in consideration , strict policies are needed .So , we can conclude that Despite considerable efforts to promote organ donation and increase the amount of organ retrieval, demand for grafts is increasing and remains much higher then availability. This short supply is noticeable for all organ transplantation whether for heart, lungs, liver or pancreas but mainly for kidneys.