Mr. Ahmad had a fall at work consequently suffered from an intracerebral hemorrhage. Mr. Ahmad was declared brain-dead on his 3rd postoperative day after undergoing craniotomy surgery. Leaving his wife and 2 teenage children. His wife was informed by his doctor and transplant coordinator of the plan to remove his kidneys, heart, liver, and corneas for transplant. When Mr. Ahmad was alive, he did not discuss with his family about organ donation and they did not opt-out of the human organ transplant act (HOTA) program. His wife questioned the doctor if he is sure that Mr. Ahmad is dead. As a Muslim, she then discussed with his elderly parents nevertheless, they had requested to continue treatment till his heart stops beating and also rejected orjugan donation. This essay will delve into the ethical principles of autonomy, beneficence, fidelity, non-maleficence, and justice. Non-maleficence and beneficence have been viewed as a primary obligation ('Everything you need to know about organ transplants', 2019). This essay will apply the ethical decision-making process to resolve the issue between law and ethics, and it will discuss the implications for nursing practice.
The first ethical dilemma is between beneficence and respecting the patient’s autonomy. Autonomy means to respect the individual’s right of thought, intention, and when making decisions on their healthcare treatments. Mr. Ahmad did not discuss with his family about donating his organs neither has he signed the Human Organ Transplant Act opt-out form to the removal of his body after his death. It is stated that if a person passes away in the hospital, their body parts will be donated. If Mr. Ahmad were to not donate his organs it can prolong his pain and suffering, from his relative’s point of view they want to prolong the treatment in the sense that they are unsure if Mr. Ahmad will recover, hence not wanting to donate his organs. However, being consistent with the law will help end his suffering and pain. Hence, the healthcare team should consider educating Mr. Ahmad’s wife and parents on his condition and on the benefits of donating his organs.
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The medical team should uphold the ethical principle of fidelity by being faithful and loyal to our patients, and act as the patient's advocate. As an advocate, you would want to state facts and advocate for the good of the patient. According to the Human Organ Transplant Act, Mr. Ahmad did have a choice to opt-out but he did not, and the wife has no knowledge of Mr. Ahmad wanting to transplant his organs, as a nurse we should inform the patients wife about his current situation and get an Ustad, also known as religious teacher, to inform her about the spiritual benefits, for example, it will be counted as an act of good deed where rewards occur even after passing on, it is also stated in (Majlis Ugama Islam Singapore, 2019) that it is permissible for Muslims to donate their organs for the following reasons, organ transplant and donation by the deceased is allowed in Islam because, Islam calls for the seeking of cure and treatment for illnesses, and for certain organ failure, the most effective treatment is to receive a new organ. it also states that the “Syariah” is built upon values such as care and compassion, calling for mankind to help one another and to contribute to alleviating human suffering and pain. As a nurse advocate, it is important to seek the best treatment for your patient and it can also benefit other families because other families may have difficulties having to go through financial and emotional distress while waiting for organ donors for their relatives.
The principle of justice dictates that it would be fair to the patient and family. He would pass on peacefully without any treatment and it would not prolong his suffering. As for the donee of the organ, they would get a second chance at life, and a chance to live healthily. The medical team should also be fair to both patient and family and distribute reliable resources keeping the continuation of treatment for Mr. Ahmad in the plan.
Mr. Ahmad’s Family is worried about going against their beliefs of donating his organs but, according to Majlis Ugama Islam Singapore, the fatwa committee says that it is permissible for Muslims to be included in Human Organ Transplant Act because, as mentioned in the Quran: “…and whoever saves one life, then it is as though he has saved the whole of humanity” (al-Maidah: 32) (MUIS,2007). Hence, donating his organs would be an act of Amal Jariyah (continuous charitable deed) which also supports the ethical principle of beneficence because the medical team should do good to the patient and donate his organs so more lived can be saved. Therefore, his family should not be worried about going against their religion because it is beneficial for Mr. Ahmad’s spiritual and afterlife.
We can also educate Mr. Ahmad’s wife about how organ transplant works, by explaining to her that a person who has an organ that is working very poorly, needs an organ transplant. Going through with an organ transplant can lengthen someone's life and allow people with chronic illnesses to live a longer and more normal lifespan (Medical News Today, 2019).
Conclusion
Donating Mr. Ahmad’s organs poses many legal and ethical issues that require some serious consideration. To deal with ethical dilemmas, nurses need to be well educated on the nursing code of ethics and ethical and legal principles. They can educate the wife on possible outcomes like hospice for the patient, but the complications could be infections, depending on the outcome of the wife’s decision. In conclusion, we should donate because, Mr. Ahmad did not sign the opt-out form. In any point of his life this means it is taken as a mandated choice, meaning competent people are required to indicate yes or no. The Human Organ Transplant Act was established in 1994 he was already over the age of 21 and has the choice to but he did not opt-out, nor did he discuss with his family about donation of organs. Donating his organs can help him complete a last good deed by donating his organs and possibly saving another patient (Nursing Ethics: across the curriculum and into practice, 2019).
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