Ethical and legal issues in minor children organ transplantation

Darovanje organov je danes dobro uveljavljena kirurška medicinska praksa. Predstavlja učinkovit način zdravljenja poškodb organov, ki so posledica hudih prometnih nesreč, težkih bolezni in današnjega načina življenja, saj bolnikom s presajenimi organi omogoča živeti kvalitetnejše in daljše življenje kot če novega organa nebi prejeli. V zadnjih desetletjih je bila v evropskem prostoru uspešno vzpostavljena transplantacijska mreža t. i. Eurotransplant za namene izmenjave in oskrbe držav z organi za potrebe transplantacij. Eurotransplant deluje na podlagi načela solidarnosti. Tudi Slovenija je postala njegova članica in obenem ustanovila še svojo nacionalno mrežo Slovenija Transplant. Idejna zasnova mednarodne izmenjave organov je izjemno uspešna, saj zagotavlja veliko verjetnost čakajočim bolnikom, da bodo potrebovani organ tudi prejeli. Donorstvo organov temelji na visoki stopnji samozavedanja in altruizma posameznika. V splošnem pa darovalcev organov primanjkuje, medtem ko se število prejemnikov nesorazmerno povečuje. Darovalci so lahko odrasle osebe, izjemoma tudi otroci, mladoletni ob izpolnjevanju strogih pogojev, saj so manj primerni zaradi svoje telesne in duševne nerazvitosti. Številne tuje raziskave poročajo tudi o dolgotrajnih posledicah darovanja organov otrok, ki jih ta pusti v razvoju otroka. Vendar pa so otroci v določenih primerih najprimernejši darovalci. To je, kadar kateri izmed njihovih živečih sorojencev boleha za resno dedno genetsko boleznijo. V takšnih primerih bi bili otroci v svoji zgodnji starosti ustrezni darovalci za uspešno zdravljenje sicer neozdravljivih bolezni sorojencev. Govorimo o t.i. »saviour sibling« otrocih. Ker se v takšnih primerih biomedicina poslužuje posegov v genetiko človeka, se pojavljajo številna etična in pravna vprašanja, kje so meje poseganja v telo človeka in kakšni so dopustni nameni? Ali bomo lahko določili tudi spol in druge osebne lastnosti človeka? Nekatere države iz omenjenih dvomov zavračajo takšne biomedicinske posege, s katerimi bi sicer preprečili nastanek neozdravljivih bolezni. Treba se je vprašati, ali je mogoče, da bi bile takšne biomedicinske metode lahko med drugim sredstvo za izvrševanje človekovih pravic. Odgovori na takšna vprašanja bi najverjetneje bili povsem drugačni, če bi se v takšnih situacijah znašel vsak sam. Menim, da sta pravo in medicina ustvarjena zaradi ljudi. Z nekim naravnim namenom, da omogočata razvoj človeka. In kot je družba začela odprto razmišljati o občutljivih temah, kot je smrt in evtanazija, menim, da bi lahko začeli na enak način razmišljati tudi o rojstvu človeka. Današnja medicina uspešno sledi izzivom človekovega razvoja. Vendar pa miselnost družbe mnogokrat trči v etične dileme. Pojavljajo se dvomi o možnostih zlorab znanstvenega raziskovanja, vendar pa v kolikor so meje jasno določene in protipravna ravnanja ustrezno sankcionirana je tudi takšne dvome mogoče preseči. Navsezadnje, je skrb in temeljno vodilo znanosti in medicine blagor bolnika že od obstoja Hipokrata naprej.Organ transplantation is a phrase that even nowadays causes mixed feelings despite the exceptional social progress. The first thought that comes to mind is that someone is in great distress, wherein every minute of their life is one hundred percent dependent on some usually unknown person, who will (perhaps) at some point react with an almost unreasonably high moral determination or altruism and thus save someone’s life. At the same time, it quickly becomes clear to us that human life, despite all technological advances, is still so vulnerable that at some point even the most modern devices cannot save us. In short, when technology fails, we are left with only what is peculiar to all, essential and self-evident for only rare individuals. Donation of one\u27s own body. However, it should be emphasized that it is by no means permissible to judge an individual\u27s decision for or against donation neither from a medical point of view, nor from a legal point of view, least of all from an ethical and moral point of view. Regardless of the stated, organ donation raises several legal issues and dilemmas when minors find themselves in the role of a donor or recipient, whose will and reason are stated possible by diametrically opposed decisions to the interests of their parents and relatives. We talk about the medical diagnoses in which we have to unwillingly face difficult ethical dilemmas. In most of the cases, these are the deepest existential human questions. At the same time, we must be aware that every single individual, from the legal perspective, is a real and completely individual subject who is offered various spectra of legal protection by law, which also protects their most fundamental rights they have as a human being. We talk about the right to life and the right to the personal integrity as well as numerous other individual’s rights. Since people worldwide are aware of and very well accept donation, I want to polemicize the donation from the perspective whether we as the society can allow ourselves to go as further as to objectify the human body to the extent that it serves only as a consumable biological material to save our (pre-selected) loved ones. The public has often been made aware of the suspected abuses in the field of organ donation around the world, which means that this area is extremely legally sensitive. In most of the cases it is necessary to properly (legally) regulate and thus provide the most optimal solutions for numerous patients, both potential recipients of organs whose lives are counted in minutes, as well as potential donors. It is important that in such circumstances organ donation procedures are implemented by people being emotionally distant from the clinical case and possess professional medical and legal knowledge with which they form sound decisions. Groups of such professionals form the so-called Ethics Commission for Transplantations. As a result and thanks to the extreme attention of the media and social networks, public is in detail daily introduced to the different forms of serious genetic diseases and organ damage, the only solution to which is donation and genetic material analysis. In order to avoid or prevent occurrence of such diseases, we also talk about the so-called “saviour sibling” that encompasses medical methods of analysis acting preventive and at the same time they open numerous morally ethical issues and dilemmas. At the same time, we realize that top achievements in medicine open up new legal questions