The Ethics of a Heart Transplant
I have always been fascinated and impressed by organ transplants, and moved to tears when they are successful. I think most people are. The recipients that receive organs from donors also take a new interesting approach to life. Some in which their philosophies and values change entirely.
Not long ago, a man was given a genetically modified pig heart from the fantastic medical team of the University of Maryland. The transplant was successful. Not long following the successful transplant, controversy was stirred after looking deeper into the man's past and background. The man had paralyzed another from a terrible stabbing, effectively changing the man's life forever. The victim's mother came forward, and made an argument that this man should not have received the transplanted heart. He did not deserve it. This may be correlative to the fallaciousness of the death penalty. That those who have been victimized by murderers often support the ending of the perpetrators life to get even. Others countered the woman's cries with the man that had received the heart had taken the risk, and he won fair and square.
TL;DR.
I am curious to know everyone's thoughts on a few things, particularly around the ethics and moral discussion.
Ex; 1 - There are two men. One man has committed not only a series of heinous homicides in terms of breaking the law, but has also effectively taken multiple lives of numerous moral agents without remorse or justification. The second man, has no such background. Instead, he goes to work, comes home, attends to his community with a series of good deeds, and feeds his family. The only important commonalities are both need a new heart, and there is only one.
Did the above woman, removing all reactionary emotions and logical inconsistency, make an interesting point to consider?
Not long ago, a man was given a genetically modified pig heart from the fantastic medical team of the University of Maryland. The transplant was successful. Not long following the successful transplant, controversy was stirred after looking deeper into the man's past and background. The man had paralyzed another from a terrible stabbing, effectively changing the man's life forever. The victim's mother came forward, and made an argument that this man should not have received the transplanted heart. He did not deserve it. This may be correlative to the fallaciousness of the death penalty. That those who have been victimized by murderers often support the ending of the perpetrators life to get even. Others countered the woman's cries with the man that had received the heart had taken the risk, and he won fair and square.
TL;DR.
I am curious to know everyone's thoughts on a few things, particularly around the ethics and moral discussion.
Ex; 1 - There are two men. One man has committed not only a series of heinous homicides in terms of breaking the law, but has also effectively taken multiple lives of numerous moral agents without remorse or justification. The second man, has no such background. Instead, he goes to work, comes home, attends to his community with a series of good deeds, and feeds his family. The only important commonalities are both need a new heart, and there is only one.
Did the above woman, removing all reactionary emotions and logical inconsistency, make an interesting point to consider?
- 1. Would it then be in our best interest to choose the latter man, over the former to receive a new heart? And if not, if the decision is simply to be random, and the former man receives the heart, and the man has a complex and patterned negative behavior history and recidivism, where as the former has the same, but positive, and the decision turns out to be more harmful than the previous selection, to whom does this speak to?Should these then be elements be taken into account, when selecting recipients of organ transplants?
Comments (37)
If you look at the Maryland event: here vengeance and legality has come into play. Vengeance is an emotion; legality is rule-living. Neither is moral in its essence.
If you want me to give you an intelligible answer, please state the philosophical definition of morality. Not by negative terms, but by inclusive and completing terms. Thanks.
So you give the heart to the good guy who becomes a serial killer, while the evil guy would have cured cancer.
If they have the same prognosis, flip a coin.
I'm not really sure what you mean, but I am essentially asking if the elements of ones past and history where they have demonstrated to be indifferent, or at least, disinterested in preserving the well-being of others, should be taken into account when giving someone an organ transplant, that may prolong their life further, when there are demonstrably better candidates to pick, but may not be "next in line".
The prolonging of their life isn't so much interesting, but instead the decision to select over another, and whether or not that is the best one to make.
That seems like an uncalculated risk. There are knowns. The man turning into a serial killer after the fact is his own random business and to be dealt with when it comes, wouldn't you say?
Quoting Cobra
Now you are saying that this is the question:
Quoting Cobra
The two are not only non-equivalent, but they can't even be reconciled.
I would rather answer the first question you asked. Please give a definition of moral action. I eagerly await.
I don't know if its me or you, or what's going on, but I just don't understand what you're asking or what the issue is, or how they are unrelated. They aren't supposed to be equivalent people.
Just use your own definition or something.
Let's assume that the two people are equal medical-wise, meaning they're both good candidates for the transplant. But the first person had a dark past, he hurt another individual, the second person is a law-abiding citizen. The first person is next in line, so he gets the transplant.
This is the reason why there are rules! If the rule for transplant is that, it doesn't look at your past, only that you're a good candidate for transplant and you're next in line to receive it, no one could deny you that opportunity. Looking at his past is changing the rules. Now ask yourself, would you like the rules changed in another situation? Blame the rule-makers if you must.
I also don't like thinking about it, that a bad person got to extend his life due to the genius of science, while a good person must wait longer for the next opportunity, but I am also for following rules.
I am anticipating the objection to this is, I no longer think morally for myself but taking the easy way out of this conundrum by pointing to the rules. But look at the bigger picture, expand your horizon -- what if this happens in another situation where you are involved, or your loved ones are involved.
The penalty for various crimes is laid out by law, and it almost never includes the forfeit of the right to medical care. And nor should it. The connection with the death penalty is obvious - it is a death penalty with a random element added. And the same problem arises, that convictions can be overturned and found to have been wrong.
Quoting Cobra
So if the man is later exonerated, this woman is responsible for the death of an innocent man. Should she in turn forfeit her right to treatment? Let's not go there.
We make these calculations then take such risks often. It's a fallible system, but I don't see how fallibility necessarily negates reliability and better outcomes from the system.
The death penalty is only fallacious and get's flack, rightfully so, because it is irreversible under a fallible system.
In the case of organ transplant, the "good patient" or "better candidate" didn't kill anyone, nor is the bad guy being denied medical treatment or a transplant.
I have a brother in Prison for truly horrific reasons I won't mention, with a history of recidivism. Having grown up witness to him, I am comfortable saying he is exactly where he belongs. He is actually what inspired me to go to law school. I doubt he cares about preserving lives, or mine for that matter.
I am not saying he shouldn't get a transplant, but I am not going to argue he should be first in line or something over demonstrably better candidates with a known pattern of attentiveness to the well-being of others.
A law is a law, true. But laws can be bad, get remade, revised, and overturned. Rules are made to be broken, bent, and challenged. There is leeway and alternative.
But this is a bit off topic, I just want to know thoughts on whether or not in accordance to the various ethical systems where this type of situation would fall. I already know the legality aspect and whatever.
It's not the people whom I called non-equivalent. It's the questions.
1. You asked to make a moral judgment.
2. Then you said that that is not the question.
All I ask, read it carefully, please: Define morality for me, and then we can make a moral judgment. Tell me what is moral in its essence.
I don't have that definition. I doubt that you do, or that anyone else does.
That was my point. I won't make a decision based on something undefinable.
Sorry to know about it. But good for you for having the wisdom.
I still don't know what in the world you're talking about. You're asking me to read carefully, yet you didn't read my post, seemingly at all. You quote something I said that is not a question, clearly, because the actual question soon follows, as stated as so.
Then you speak in vague whatever that I don't get instead of just stating it plainly, like in the second post. You don't know the answer and don't think I do either. There are many definitions of morality and ethical systems and theories. Just use those. You're the only one that hasn't answered the post adequately, the other users have understood the assignment.
Then what's the point going back and forth with me and asking me to "read carefully and answer the question"? Just move on if you think so. What's the big deal?
The big deal is that you asked a question that is impossible to answer. Why ask questions that are impossible to answer? talking about them won't answer them. No way you can answer them. So what's the point of asking questions that are impossible to answer? This is a rhetorical question, this last one, not something I expect an answer to.
The other big deal is that people often refer to "morality" as a principle to follow, yet they can't define the principle itself. I find it an empty rhetoric, and a false defensive offensive. They push the word "moral" down your throat, and then they ask you to explain yourself or to defend yourself. I can't abide with that. Leave morality out of the sphere when you want emotional justification. NOT YOU personally, but people. That is the big deal.
It's not impossible to answer, there just aren't right or wrong answers to the question. It is open ended, hypothetical and imaginative not definite. The users have answered just fine. This isn't a scientific or a legal question. Just because I don't like the answers doesn't mean the question itself wasn't adequately answered.
So you're having some kind of personal issue with answering the question, what do you want me to do about it?
This is what I wish you will do about it: define morality. By providing positive, inclusive, and sufficiently delineating parameters.
Why do I ask it? because you asked us to do a moral judgment applied to a scenario. If the criteria (morality) is not definite, then the entire discussion that follows is meaningless. It may be diversified, open-ended, hypothetical and imaginative, but completely meaningless. Talking about a topic from a point of view that nobody knows what it is, by way of a lack of an agreed or even approximate definition, is meaningless.
Why in the world would I do that? You've said in your posts multiple times, no one knows what they're talking about regarding the principle of morality, no one knows the definition of morality, and those that have gave definitions, you find to be false and empty rhetoric. You're literally just meaninglessly bugging me.
No. No definitions have been given. You are not right here.
I am not meaninglessly bugging you. I am showing you that the entire discussion is meaningless. That action by me is not meaningless.
So, just leave the thread and stop blabbering on like a supposed smart ass. What's the matter with you? You just look like a fool.
There are two ways to answer to your question, but I think that you'll find both of them unsatisfactory:
1. Yes, it's in our best interest to prolong the life of the latter man. It's a simple answer, but the reality is much more complicated. There are millions of ways to challenge this answer by introducing new variables to the equation.
2. You should refer to the existing clinical and ethical guidelines for organ transplantation. The problem of morality of organ transplantations is relatively old and incredibly complex. Luckily for us, there are guidelines that have been developed through extensive time and effort. It's very difficult to challenge them in a way that they haven't been challenged already.
I'll offer an answer that I personally find satisfactory. Why not give both men a new heart? It seems like the novelty of the transplantation described in the OP is that we can genetically modify pig hearts and offer them to the people who otherwise wouldn't receive a hearth. Sounds like a win for everyone. We should celebrate this.
In a separate article the New York Times revealed that the xenotransplant patient had a record of assault (stabbing the victim multiple times).
Ethical Question: What moral justification did the editors of the New York Times have for revealing this highly prejudicial (but irrelevant) information? What public good did the NYT article serve? In my opinion it didn't serve any public good.
On any given day, the number of organs available for transplant fails to meet the need by a very wide margin. It is hoped that xenotransplant from pigs (which are genetically modified to reduce the likelihood of organ rejection) would solve the problem. People could help solve the problem by making organs available for transplant in the event of their timely/untimely demises, but they don't do so often enough.
The implantation of a properly obtained organ poses no ethical issue with respect to the history of the recipient.
We could, of course, require transplant donors and recipients to be of unblemished sterling character. Fortunately for everyone concerned, we don't.
He deserves credit for his willingness to receive the xenotransplant. There is only so much one can learn in an experimentation lab. Eventually, new techniques need to be tried in vivo -- real life.
I might be mistaken, but my understanding is that there was no competition for the pig heart. After all, fresh pigs can be conveniently provided -- pigs grow a lot faster than we do.
I go with unenlightened's answer and Caldwell's. Medics are not judges. We cannot know the future and we also cannot judge the merit of one's life. At least that is not the reasoning doctors should employ. They are in the business of curing people not in the business of judging whether someone lived rightly or wrongly. The sentiments of the woman in your example are understandable, but should not become a basis of choosing what kind of medical action to perform.
The question actually does become salient in times of the pandemic. Many hosipitals, states and countres have drawn up criteria of what needs to be done when there are more patients than ventilator machines for instance. Determining moral worth is universally rejected I think, but other criteria such as age or perhaps whether the patient has dependents on them are not so clear cut. There is a good question in there, but I would be loathe to weigh the values of a human life.
I respect very much, your will to share the harrowing story of your brother. I find your rendition of it very disturbing, when I try to imagine myself in your place, having the same experience. I hope you gain some catharsis from the sharing.
I think your question then, at a personal level, becomes, is your brother worthy of a heart transplant?
If he were my brother my answer would be NO! F*** NO! and I don't F****** care what anyone else says, Damn them and damn their ethical/moral arguments.
After I had cooled down, maybe I could be reasoned with more and could start to listen to some of the very reasonable points made in this thread regarding the legality and morality of the OP but from knowing my own personality and my own moral code. I don't think I would change my mind in regards to what would then be, the example of my own personal case. I would still not what the transplant, for such a brother, to happen.
On the general question of should morality, ethics, background of the patient, etc be considered when it comes to life-saving organ transplants. Probably not, but I think its a good idea, not to tell too many people that the life of a 'bad person' was just saved instead of the life of a 'good person,' regardless of what they may become after the event because some will take actions based on their own sense of morality.
There have been many drama's depicting this conflict. An example is an episode of Babylon 5.
A character called 'The black rose killer' is a serial killer who was caught and 'mind-wiped.'
A new personality is then uploaded into his brain with full historical memories, all the way back to birth. He then joins a religious group who become stationed on Babylon 5. He is now a delightful chap who only wants to help others. He is then stalked by a group of people who are the relatives of some of his victims. They employ a telepath to secretly cause him to remember that he was the black rose killer. They then catch up with him, torture him and kill him. The main characters on Babylon 5 are very angry at this and Captain Sheridan wants to beat up the main torturer. In the end, the main torturer gets mind-wiped, joins the same religious group and takes over as the delightful chap who he killed.
Poetic justice eh?
I could give you my own definition of morality, as I conceive/perceive it, and I will do so, if you want me to. But others will be easily able to punch holes in it. A single objective morality that is perfectly applicable in all perceivable scenarios requires perfection. Humans don't like perfection because it is a concept which is beyond us and in my opinion, does not exist. We may even crucify you if you claim to be such.
Why should a theist have a problem with this? I'm one but I have no problem with it. Is it playing god somehow?
Your Theism seems to be on a shoogly peg. From your Thanatos and Hypnos commentary,(you believe in them....you don't believe in them) to your (I am theist but.... fingers to the gods)
Read back on your own comments......
Many theists considered a pig to be a filthy animal. I cant see an orthodox Islamist accepting a pig heart, even to save his/her life. Even if it's been 'modified.'
Many versions of the Yahweh myth or Islamic myths or other myths such as Elah Yisrael or Elah Elahin, etc or the various versions of Christianity will not even have a tattoo as they believe it is against God never mind replacing parts of yourself with bits of modified animal so that you can stick around Earth longer, instead of joining your God in his heavenly paradise! For eternity!
I really appreciate you taking time to answer, I think this answer is pretty level-headed. I am not in the medical profession, so I'm not entirely familiar with all the guidelines they follow. I did read a bit of the doctors oath. What ethical theories do you fall in line with?
I guess for me, I still think both men should get a heart. I just think it rubs people the wrong way sometimes when we prolong, ignore, or increase the chance of suffering to be "fair". For example, a child dying because they were next in line behind a serial killer/rapist with no regard for human life.
5 or even 10 years is a wink, goes by in a flash. You just retuned yourself (hopefully become a better person) after a transplant and declare to the world "meet the new me!" and it's already time for a priest to give you your last rites!
Oops! Went off on a tangent!
At least in the past, convicted felons were not rarely used in medical experiments. It's how they can be useful to society. This practice is nothing new.
This recent xenotransplant wasn't a standard heart transplant, but an experimental one, so the situations aren't actually comparable. (Who payed for the pig heart transplant? Surely not an insurance company.)
The actual dividing line here isn't between who is more deserving of a life saving medical procedure and who isn't, but where the line is between an experimental medical procedure and a standard medical procedure (and who pays for these things).
Importantly, also, we're talking with the benefit of hindsight: In this case, the man with the pig heart is still alive. Had he died during or soon after surgery, many people who are currently opposed to him getting the pig heart, would then feel vidicated and would view the situation differently.
There are already criteria in place for selecting recipients of organ transplants. There is an official waiting list and a board of doctors who decide on a case by case basis.
Also, do you know what is the actual probability that in the same region, at the same time, there are two or more people who need the same new organ, and they also have the exact same medical predispositions for it?
How many prospective recipients does any particular donor organ have at any given time?
IOW, how often does the type of situation you describe in the OP actually happen?