Consequence Map

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Consequence Map by Mind Map: Consequence Map

1. Health Canada (Government)

1.1. Scientific Consequences

1.2. Social Consequences

1.3. Ethical/Legal Consequences

1.4. Economic Consequences

1.5. Personal Consequences

2. Social Consequences

2.1. Can either DIVIDE a group of people or BRING TOGETHER a group of people

2.1.1. An organ donor's family (after death) may decide to connect with the recipient, or vice versa (the recipient may choose to send a thank-you letter to the donor's remaining family. Sense or soul of a person may "live on" in another individual.

2.1.2. Regardless of whether the Seinfeld family chooses to donate Aurora's heart to her sister, or if they choose not to, they are at a loss. Either daughter may potentially die or both. This entire situation divides family bonds and relationships due to its premise in personal value and belief systems.

2.1.3. Practice of organ donation differs based on the religion you follow and the culture you belong too. Our case study did NOT address the religion or culture of the Seinfelds.

2.1.3.1. Groups of people who, for the most part, are AGAINST organ donation:

2.1.3.1.1. Amish are forbidden from using modern medical services (i.e. surgery is not possible)

2.1.3.1.2. Gypsies. Belief of afterlife impedes the process of manipulating the body.

2.1.3.1.3. Shinto. Dead bodies considered impure/dangerous. To injure a dead body is a serious crime.

2.1.3.2. Arbitrary groups with no clear position. The people within the groups may themselves be divided in opinion.

2.1.3.2.1. Jehovah's Witnesses. Belief against blood transfusion means that all blood must be removed from the organs/tissues before being transplanted.

2.1.3.2.2. Judaism. Have rules concerning the treatment of a dead body however some Rabbis' argue that transplantation does not show a lack of respect for the dead and any delay in the burial process to facilitate organ donation may be respectful of the decedent.

2.1.3.3. Religions IN FAVOUR of organ donation (or who leave it up to individual decision): Buddhism, catholicism, christianity, episcopal, Greek orthodox, Hinduism, Evangelical, Islam, Lutheran, Mennonite, Moravian, Mormons (require confirmation through prayer to receive an organ), Pentecostal, Presbyterian, Seventh Day Adventist, Southern Baptist Convention, Quakers, Unitarian Universalists, United Church of Christ, United Methodist. **This list is not exhaustive**

2.2. Doctors and medical professional receive job prestige and networking opportunities

2.3. Those who donate set an example for others to donate which ultimately creates common good for society at large

2.4. The recipient of the organ/tissue requires time away from school and/or work and deals with some lifestyle changes (due to medicine, doctor visits, maintenance of health)

2.4.1. Donor Families will have difficulty transitioning back to work, school and every day life, for this reason TGLN has specific support for making such transitions easier.

2.5. The recipient is the stakeholder who benefits MOST because they receive a new chance at life (transplantation significantly increases lifespan)

2.6. The process of becoming an organ donor depends on the location in which you reside in

2.6.1. In Canada, the registration process is based on a provincial or territorial level which allows for variation in the numbers of registered donors. If Canada had a united approach across the country, research believes the % of citizens who are organ donors may increase.

2.6.1.1. Ontario has a high percentage of registered donors when compared to the rest of the 9 provinces / 2 territories.

2.7. Donor remains unaffected overall

2.7.1. For live donation: the donor does not face any benefit in Canada, nor any serious repercussion. The donor is very altruistic in nature and may gain the gratification of helping another in need (whether that be a family member or a stranger)

2.7.2. After death donation: The donor family may feel that in donating their relatives organs a part of their soul may live on in another human being. This may help their grieving process.

2.8. Heart Donations have caused several confusions. Specifically when the patient is "brain dead" but might still have a beating heart. Individuals might view this case not appropriate for donation.

2.9. 1/3rd of Ontarians are registered as donors even though 85% are in favor of donation.

2.10. Individuals who live in rural areas will have less available organ donations due to available donations within their radius. As a result they might have to move to a closer distance to the hospital during this process.

2.10.1. For children, this will affect their school, and for parents it will affect their work. As a result the mental health of the family will be influenced.

3. Ethical/Legal Consequences

3.1. Under the TGLN Act, one must be 16 years of age to be able to register as a donor.

3.2. One individual can donate up to 8 organs, thus saving up to 8 people. With benefit to 75 more if donating tissue.

3.2.1. Take 1 life i.e. Aurora, to save her sister's life. Does it work like this? What level is humanity reaching that we theoretically kill a person to save 7 more...

3.3. Valuing one life over another

3.3.1. Explicitly in terms of valuing one daughter over the other

3.3.2. The waiting list to receive an organ depends on a variety of factors. In theory, this ranks recipients in order of need and availability

3.3.3. In countries where the number of organ donors are scarce in relation to individuals needing a transplant, illegal activity may occur to harvest those organs.

3.4. Parents in a dilemma 1. Can pull the plug on Aurora (to then harvest her heart) for the sister Katie2. Wait it out, and potentially risk lives of both daughters (coma and critical condition) 3. Aurora may live, and Katie may die

3.4.1. Some may argue that a life in a comatose state is not worth living and she may never wake up from it again (i.e. theoretically she may be very close to death already)

3.4.2. Do the daughters have a choice in the matter? Or only the parents?

3.5. In Canada, families are counselled upon the death of their relative to consider donating their love one's organs/tissues EVEN IF a person had not registered as a donor in their lifetime.

3.5.1. Families will choose the option that they feel their relative would appreciate HOWEVER the person (Aurora) is dead and ultimately has no say as to whether or not their organs get donated. It may be strictly against their wishes to donate but their family could not know and donate anyways.

3.6. Organ donation in some countries is not strictly regulated leading to organs being sold on the black market or doctors/medical professionals cutting ethical corners.

3.6.1. In Iran it is legal to sell kidneys thus creating a socioeconomic status divide amongst potential recipients.

3.6.2. Doctors may submit to monetary payment to ensure that an organ is transplanted to a wealthy recipient

3.7. In Canada: Recipients are given fair chance to an organ in relation to their gender, religion, race, etc.

3.8. Spouse, children, parents, relatives, then the administrative head of hospital can give consent for an individual that has passed or is too ill to make the correct decision.

3.8.1. This power might violate the rights of those individuals who do not have close relations with their relatives, which might result in the relative not knowing personal values of the individual.This is also true for those that might be homeless.

3.8.1.1. This is also the case for Aurora, who is in a coma and has had the chance to discuss these discussions due to her age.

3.9. When applying to be a donor, you are able to specify if you do not want to donate a specific body part.

3.10. Under the TGLN Act the hospitals are responsible for having Routine Notifications to TGLN notifying if a donation is possible. This Notice and Consent gives donors the ability to request more information as well to have support during the process. This communication prevents any illegal activities.

4. Economic Consequences

4.1. No financial cost/burden to complete the transplant surgery to the family

4.1.1. Donor registration is free

4.2. Depending on the amount of health care insurance the Steinfelds have, they may or may not incur financial expenses due to the time spent in hospital (i.e. to keep Aurora in her comatose state) and to care for Kate

4.3. Medical professionals will always have jobs in demand due to human existence.

4.3.1. Doctors who complete transplant surgeries depends mostly on the size of the hospital

4.4. The Steinfeld parents are taking time off work to care for their daughters

4.5. Donation will not affect economic divides, due to the process being dependent on the severity of the illness, and the waiting list.

4.6. Following transplantation, the patient must take several different mediation on a daily basis, which creates a large population for pharmaceutical companies to target.

5. Scientific Consequences

5.1. The daily medications that one must take after transplantation might cause complications for their other organs.

5.2. Many donations, such as heart, and liver do not make it to their recipients due to the current transportation of the organ.

5.2.1. Currently, there is a trail technology 'TransMedics' that is able to keep a heart beating and a lung breathing artificially outside the human body. This technology has allowed the transpiration time of the organ to double

5.3. There can be medical complications during the transplant surgeries

5.3.1. The body of the recipient may reject new organ/tissue

5.3.2. Misinformation/medical error (i.e. wrong person scheduled for surgery)

5.4. One is able to make financial donations to TGLN for scientific research as they are a registered Canadian Charity.

5.5. Time is critical. Errors in time will result in faulty transplants

5.5.1. The heart specifically requires less than 6 hours of transport time between bodies to be functionally optimal.

5.6. Due to medical research and academic study, the process of organ donation is being refined with higher rates of success

5.6.1. The donor candidate (Aurora) may choose to donate all 8 of the possible organs - saving 8 lives and benefiting up to 75 different people from their generosity.

5.6.2. Specific to heart donations, the donor is usually a brain-dead patient due to trauma to the head. The donor's other organs are all pretty well functional.

5.7. Donation of organs/tissue to research/study is also an option

5.7.1. "Research" may include surgery practice for medical students in university, the study of an organs shape and composition in order to create artificial organs to help save lives, the study of effects on organs due to various health reasons (i.e. smoke conditions, alcohol, etc.)

5.8. Although medical professionals are able to install devices of various material (i.e. animal organs, metal, plastic, etc.) into recipient's body. The best chance of survival and longevity comes with transplantation of a live, human organ because it is the closest resemblance to their own.

5.9. Biologically, the Seinfeld sisters are a perfect match for organ donor to recipient. They have compatible blood types, are relatively similar in size, and are in close proximity.

6. Personal Consequences

6.1. The Seinfeld's are faced with a hard decision. Any option they select their future is impacted. Required them to question their set of beliefs, integrity, and whole value-system. Family will face a lot of hardship & grief.

6.1.1. If Aurora is unplugged from her comatose state, she will die. The parents lose a daughter. Katie will feel guilty/remorseful the rest of her life.

6.1.1.1. Katie will receive an organ & live. Potential medical complications in the future? Full lifestyle change.

6.1.2. If Aurora is left in her comatose state, she has the possibility to gain consciousness & continue her life.

6.1.2.1. How long she remains in comatose remains a mystery

6.2. Aurora or Katie may die

6.2.1. Trauma to family, coping with loss

6.3. Studies have showed that following a transplant the recipient patient as well as the Donor Family might have depression.

6.4. TGLN recognizes the personal difficulties the Donor Family will face during and following the process of donation. For this reason TGLN provides unique support for each Donor Family.

6.5. The recipient must take several different medications on a daily basis to make sure that the body does not reject the donation.

6.6. Doctors work around the clock performing critical, time-sensitive transplant surgery. This may affect their personal life at home i.e. relationships with significant others or children. May also result in a lack of sleep.