The Ethics of Solid Organ Donation and Transplantation:

An Alternative View

Abstract

Current bioethical frameworks supporting the Western medical model are criticised for failing to offer appropriate guidance to doctors in a climate of increasingly complex medical decision-making - an ethically demanding situation that renders bioethical guidelines both contested and problematic.
The Principlist bioethical framework of choice for numerous medical institutions globally comprising the four principles of autonomy, beneficence, non-maleficence and justice is deemed too high-level, reductionist, static and out-dated. Considered a universal model that covers all bioethical
eventualities by the developers Tom Beauchamp and James Childress, the framework fails to give human embodiment its significance at a time when medical technologies are advancing apace, but gives preference to rational and intellectual control over medical matters rather than valuing affective or embodied states. Organ donation and transplantation has been chosen as a research field to mount a robust challenge to Principlism and other alternative bioethical models. Being both emotionally sensitive and physically demanding on donors and recipients, transplantation medicine sits at the extreme limit of ethical acceptability. That biotechnology has progressed to the point where the traditional meaning of the body is brought into question is critical. The case for arguing the body from a perspective that reads it as wholistic, meaningful, relational and continually in a state of flux has implications for the future of medicine and any attendant ethical support. It requires a radical departure from a dualist interpretation of the repairable body, to one that places the relief of suffering at the forefront of patient care. Patient narrative is considered helpful in foregrounding individual care and the need for co-operative decision-making. It strengthens a flexible approach to bioethics capable of adapting to future sophisticated developments in medicine; it ensures inclusivity and multi-vocality, and allows for the creation of ethical norms and values worthy of the complexity of our times.

Date of Award	12 Aug 2018
Original language	English
Awarding Institution	University of Winchester
Supervisor	Anna King (Supervisor) & Lisa Isherwood (Supervisor)