Organ Donation and Religious Beliefs Chan, Lik Hang Nick Course title: Contemporary Bioethics, offered by the School of Public Health and Community Medicine Date: August 2007 These days, donation of blood is generally accepted but donation of non-regenerative tissues and organs often causes dispute. One reason to fight against the donation of those organs is, usually due to religion, that a body should remain intact after death. Both pros and cons of this issue will be discussed in this essay. This essay is organised as follow. Beauchamp and Childress's principles as fundamental proposition, namely beneficence, non-maleficence, autonomy and justice, will be described. Then, a case study concerning Miriam's decision to be an organ donor, with reference to Beauchamp and Childress's four principles, will be discussed. Next, the author's view will be presented. This view will then be compared with Miriam, the individual concerned and the religious people, as part of the society. The argument in this essay stands with Miriam's decision, she should be an organ donor. Her family's religious based opposite view will be rejected. The problem of organ donation is a practical bioethics issue. Before discussing the issue of organ donation, principles of ethics should be introduced. What is bioethics or medical ethics in the first place? Aristotle states that good is our aim in every discipline and particularly health is the end of medical art (1995, p.1729). There are dozens of principles proposed by several modern and contemporary ethicists, and some of them are similar. Since distinguishing different principles is beyond the scope of this essay, only one framework will be mentioned. Ethicists Beauchamp and Childress (cited in Berglund, 2007) espouse four principles: beneficence, non-maleficence, autonomy and justice. Beneficence is the principle to care for others by doing good. Non-maleficence is the principle of not doing harm to others, or minimizing harm. Autonomy is the principle of allowing individuals to make their own decisions about their lives. Justice is the principle of aiming to distribute resources fairly (p.12). This frame of principles will be elaborated further in Miriam's case. Miriam, a fit and well young driver, decided if she were to die in unexpectedly then she would donate her organs. Her family opposes her decision due to strong religious beliefs, which have an idea that a body should remain intact when buried. In this case, the term beneficence can be referred to Miriam's will to help others by donating her organ after death. In contrast, her family's beliefs may be contradictory to the principle of non-maleficence. By donating, Miriam almost certainly helps others; while in the case of not donating, Miriam makes no direct harm to others. However, doing no direct harm does not imply that there is no harm at all. This is similar to the issue of killing versus letting die. This issue can be illustrated with euthanasia as an example. The meaning of euthanasia can be traced back to the ancient Greek, literally euthanasia means good or happy death (Berglund, 2007, p.143; Holland, 2003, p.85). To be more precise, euthanasia is an intentional action to hasten one's death for the benefit of one (Holland, 2003, p.85). There are two kinds of euthanasia: active and passive. As an analogy, active euthanasia may be regard as killing and passive euthanasia may be treated as letting die. "Passive euthanasia is performed by someone who doesn't do what they could to keep a patient alive" (Holland, 2003, p.86). Whether or not certain action is passive euthanasia may be ambiguous, such uncertainly is not discussed here because those arguments lie outside the key focus of this essay. The family's view against donation fit into the category of letting die. So, doing nothing is possibly harmful to others. Next, the autonomy principle can be referred to Miriam's decision. She has the right on deciding the usage of her body after death. Last, the justice principle has least relation to Miriam's case. One argument may be pointed out. Miriam's will to become donor allows fair use. Gill and Sade argue "healthy people should be allowed to sell one of their kidneys while they are alive" (2002, p.17). In such case, the distribution may not be fair. Selling organs is another topic and will not be discussed here. Having discussed the principles, the author's dissection of the problem will be presented. It often happens that when one asks a religious person "why", one will hear the reason like "because the God say so". Consider the conversation between Socrates and Euthyphro, as described in Plato's dialogue: Socrates: And what do you say of piety, Euthyphro? Is not piety, according to your definition, loved by all the gods? Euthyphro: Certainly. Socrates: Because it is pious or holy, or for some other reason? Euthyphro: No, that is the reason. Socrates: It is loved because it is holy, not holy because it is loved? (cited in Koukl, 2002) Consequently, religious people merely follow what the God says without examining the action itself. They do good because the God say so, not because they think the action itself is good. Bertrand Russell also expresses similar point of view (Koukl, 2002). To challenge them, several questions can be raised. If the God had created everything and does good, why does evil exist? How many people were killed in earthquake, tsunami, volcanic eruption, typhoon and all other natural disasters? Are these disasters good and approved by God? Moreover, as Hauser and Singer point out, "there are no moral principles that are shared by all religious people" (2006, internet). Lots of religions exist in the world, and some of them claim that their God is the only God who created the world and set up certain rules for people to follow. There is an obvious contradiction. If the God from certain religion created the world, the God from other religions must be counterfeit. The proposition of any religion that God exist is hypothetical and precarious. There is no universal agreement on which religion makes a true claim. Thus, the question on the existence of God shall remain open, due to limited knowledge. No assumption has been made to deny the existence of God. Rather than seeking approval of God, rational reasons are used throughout this essay. Furthermore, eliminating religion is not the aim of this essay. Sometimes, religion, as Lebacqz claims, may be insightful to bioethical discussion (2006, p.260). Going back to Miriam's case. The argument of her family, that a body should remain intact after death, is religious. This argument cannot be supported by rational reasoning. Apart from the family's belief, keeping the death body intact has no benefit to anyone else. The next question is, is there anything outweigh the family's feeling? The answer is positive. By donating her organs, Miriam saves others' life, she does good to others. Doing good is her ultimate goal. One may claim that she may not do good. Since the receiver is unknown, what if Miriam saves someone's life and it turns out that he is a bad guy, a serial killer, say? Such claim is imprudent if we assume everyone have equal rights to live. Otherwise, what makes a particular person has more right to live than others? Does Stephen Hawking have more rights to live because he is smart? Does Bill Gates have more rights to live because he is rich? Does Paris Hilton have more rights to live because some people think she is hot? Does Avril Lavigne have more rights to live because some people think she can sing? None of these reasons are plausible. Treating everyone fairly, whenever possible, is preferred. If Beauchamp and Childress's principles are applied, Miriam should become an organ donor. This is because, as mentioned above, being an organ donor is an action that helps others, and Miriam has the right to make decision about her body. On the other hand, her family's argument is not well supported, and interrupting Miriam to be an organ donor may decrease the chance of organ seekers to get help. In the sense of consequentialism, Miriam's decision is preferred, because the consequence of donating organs helps others and saves lives, is good for those who receive her donation. It is also good for Miriam because donating organs voluntarily and she is happy to do so. Now the situation is clear, Miriam, the individual, is willing to care about others, to save lives, and she has right to do so; while her family, in contrast with Miriam, feel that she should not do so because of religious beliefs. As can be seen from the discussion above, Miriam's decision that to be an organ donor willingly outweighs her family’s view. To conclude, issues of bioethics have been outlined. In particular, Beauchamp and Childress's principles: beneficence, non-maleficence, autonomy and justice, have been stressed. As an example, Miriam's case has been studied. It is believed that her decision to be an organ donor is desired because this action does good to others and she is capable to make decision and has right about her life. With that said, her action satisfies the beneficence and autonomy principles. Her family's view, which is based on their religious beliefs, has also been examined and it is considered to be unsound. Even worse, it possibly contradicts the non-maleficence principle. Doing good is one of key aspects of ethics, and donating organs is beneficial to others. After all, donating organs after death should be persuaded.   Bibliography Aristotle (1995) Nicomachean Ethics (trans. Ross, W.D.). In Barnes, J. (ed.) The Complete Works of Aristotle. New Jersey: Princeton University Press. Berglund, C. (2007) Ethics for Health Care. (3rd ed.) Melbourne: Oxford University Press. Gill, M.B. and Sade, R.M. (2002) Paying for Kidneys: The Case against Prohibition. Kennedy Institute of Ethics Journal. Vol.12, No.1, p.17-45. Hauser, M. and Singer, P. (2006) Godless Morality. Project Syndicate. Retrieved August 16, 2007, from http://www.project-syndicate.org/commentary/hausersinger1 Holland, S. (2003) Bioethics: A Philosophical Introduction. Cambridge, U.K.: Polity Press. Koukl, G. (2002) Euthyphro's Dilemma. Stand to Reason. Retrieved August 17, 2007, from http://www.str.org/site/News2?page=NewsArticle&id=5236 Lebacqz, K. (2006) Philosophy, Theology, and the Claims of Justice. In Guinn, D.E. (ed.) Handbook of Bioethics and Religion. New York: Oxford University Press.