A tragic accident involving a fire cracker 13 years ago left Matthew Scott without his left hand. Through advances in transplant technology, Scott received the first hand transplant  in the United States. He received the hand on January 24 and by the 27th he was able to wiggle his fingers. This was made possible because the donor's family consented to the transplant while their loved one's heart was still beating despite his complete lack of brain function. Getting family consent can be controversial. When the potential donor's wishes are known, it is highly likely that the individual's organs will be used for transplantation. However, when the issue had not been discussed previously, there is less than a 50% chance that the organs will be donated.

    The class reaction to the hand transplant was a mixture of disgust and amazement. One student objector exclaimed, "Nasty! I don't know where his hand has been!" Questions also arose whether this procedure was worth the many risks involved, such as the massive amounts of anti-rejection drugs and the possibility of weakening the immune system, and also with this patient's history of diabetes. Supporters of the hand transplant mentioned that if the ability of the hand transplant exists, then one should make use of this procedure to improve the quality of his/her life. This discussion generated various thoughts and opinions concerning organ donation in general.

    The majority of the class revealed that they are organ donors. They believe that it is important to help others in need when it is in their power to do so. The thought of themselves living on in someone else was appealing to them. Moreover, they felt a moral obligation to prolong the lives of others. Among the non-donors, we found that the majority used common myths regarding organ donation to justify their position. One member felt that a family might not get the sense of closure that comes when family members are able to view the body of the deceased. However, organ donation does not harm the outward appearance of the body and therefore does not prevent an open casket funeral. Others felt deeply connected with their physical concept of self, wanting it to remain whole and united in death. Moreover, the entire class was confused about the differences between donating organs and donating one's body to science. They did not understand that they can specify how they want their bodies to be used.

    Several social psychological principles can be used to help understand both sides of the organ donation issue. The principle most discussed was altruism.  Altruism refers to an act performed voluntarily to help someone else when there is no expectation of receiving an award in any form (Taylor, Peplau, & Sears, 1997). There was a debate whether organ donation fits this definition of altruism.

    A few students felt that it is altruistic because the donor cannot receive a benefit after death, while others held that the donor is not sacrificing any necessary resources because he/she no longer has a use for the organs. There is a similar debate concerning live donors. Because they are not deceased when they donate their organs there could be some underlying self-serving motivations. In fact, some researchers believe that there is no purely altruistic act and that some sort of self-benefit is always the motivation. Helping someone else is only accomplished while striving to reach that personal goal (Hatfield, Walster, & Piliavin, 1978). Another concept used to explain why someone would donate is reciprocation. One classmate felt that if she was willing to donate her organs, another person would in turn donate their own organs if she was in need. This is what Jones (1964) called "generalized reciprocity," that what we give to the world will be given back to us equally.

    These two principles, altruism and reciprocation, were the two pro-donation ideas that were mentioned by the class and are supplemented by our own research. More principles supporting organ donation that we found are the norm of social responsibility, empathy, self-presentation, and self-relevance.

    The concept mentioned by the class that underlies the decision not to donate was the bystander effect (See Section 3). This is the idea that when other people are present, it is less likely that any one person will offer help to a stranger in distress (Taylor, Peplau, & Sears, 1997). Relating this to organ donation, knowing that there are so many people in the world to donate their organs may lead an individual person to feel less responsible to donate their own organs. Evolutionary theory can also be used to further support the decision not to donate. It holds that traits that dispose you to help strangers are eliminated by the process of natural selection and that those disposing you to help family members will survive. Therefore, one would be more likely to donate organs to perpetuate their own genes rather than those of an anonymous recipient. Another concept is the just-world hypothesis. Many people may believe that personal religious beliefs would be a major factor for not donating organs, but evidence shows that the vast majority of religions encourage or support organ donation. Another controversial issue is racial discrimination or preference when deciding who gets donated organs.

    As you can see there are many issues, thoughts and concerns regarding organ donation. Social norms, conventions, and ethics will continue to be challenged as advancing technology provides the opportunity to better and save the lives of those in need.

References

    Hatfield, E., Walster, G.W., & Piliavin, J.A. (1978). Equity theory and helping relationships. In L. Wispe (Ed.), Altruism, sympathy, and helping: Psychological and sociological principles (pp. 115-139). New York: Academic Press.

Jones, E.E. (1964). Ingratiation. New York: Appleton-Century-Crofts.

Taylor, S.E., Peplau, L.A., & Sears, D.O. (1997). Social Psychology (9th ed.). New Jersey: Prentice-Hall, Inc.