Ethics Of Transplantation Research Articles

Ethics and the Acquisition of Organs * The Ethics of Transplants: Why Careless Thought Costs Lives

Ethics and the Acquisition of Organs * The Ethics of Transplants: Why Careless Thought Costs Lives

Transplant ethics under scrutiny – responsibilities of all medical professionals

In this text, we present and elaborate ethical challenges in transplant medicine related to organ procurement and organ distribution, together with measures to solve such challenges. Based on internationally acknowledged ethical standards, we looked at cases of organ procurement and distribution practices that deviated from such ethical standards. One form of organ procurement is known as commercial organ trafficking, while in China the organ procurement is mostly based on executing prisoners, including killing of detained Falun Gong practitioners for their organs. Efforts from within the medical community as well as from governments have contributed to provide solutions to uphold ethical standards in medicine. The medical profession has the responsibility to actively promote ethical guidelines in medicine to prevent a decay of ethical standards and to ensure best medical practices.

The Ethics of Organ Transplantation

The Ethics of Organ Transplantation

The Ethics of Organ Transplantation ed. by Steven J. Jensen

The Ethics of Organ Transplantation ed. by Steven J. Jensen

Virtual Municipal Banks of Cell Donors - An innovative concept to promote Education for Donation in Transplantation and Disease Prevention

The North Histocompatibility Centre - Portugal in partnership with the Municipal Council of Penafiel, created in the North of Portugal an innovative concept of civil society participation to promote cell and organ donation. The organization of virtual municipal banks of Bone Marrow Donors in close relationship with the North Histocompatibility Centre has involved the basic municipal structures in the country organization. Villages and small cities have official municipal services collaborating in cell, tissue, organs and cord blood donation promotion. 40 cities and villages started the project this year. In the city halls and official local buildings there are informative flyers, posters, educational DVDs about donation, newspapers with information about transplantation, papers to register as a donor, lists to register as a potential donor, information about collection dates to Bone Marrow donors in the city, neighboring towns or villages. In that municipal buildings can be found people who participated in educational meetings to be able to give local information about cell, tissue, organs donation and transplantation, web sites and educational material locally available. This innovative concept to mobilize civil society around transplantation and donation has also the implicit component of Education for Health in order to prevent diseases leading to the need for transplantation. Apealing to people to donate implicitly carries the responsibility to teach those same people to avoid diseases that lead to the need for transplantation. So, the second part of this partnership with local communities involves Schools. Teachers of Biology and Philosophy from the basic and medium schools are recruited to teach cell biology, concepts about diseases needing transplantation and ethics in transplantation. Local universities, especially higher education courses related to health are involved to collaborate in school teachers courses about these subjects. The Portuguese Transplantation Society supports these initiatives and educational material developed. The schools include in their curriculum the subject of donation and transplantation and develop discussions and free works with groups of students that are interested in the subject. The program in the schools has a fix part and a free one where students can do blogs, web sites, paintings, sculptures, meetings, poems, theatre, study visits to transplantation units or to the labs, etc The involvement of local communities in this way is much more creative and creates a stronger connection between health institutions and citizens. Local political power is much more effective mobilizing citizens than central governments. Using municipal councils to mobilize society around transplantation and donation we can reach the locals of proximity of those populations. The expected secondary achievement of this innovative concept it is not only increase donors but also reduce patients needing transplantation in the next years teaching healthy life styles. To reduce governmental budgets to transplantation by reducing patients is the financial desired achievement in the future.

The ethics of transplants: why careless thought costs lives

1. Introduction 2. Procurement from the living 3. Methodological models 4. Procurement from the dead 5. Penumbral problems 6. Conclusion

Self-Sufficiency or Autarkeia? Introducing an Aristotelian Perspective on Organ Transplantation Ethics

Introduction: This paper explores parallels between Aristotle's ethics and emerging themes in organ transplantation policy, in particular the pursuit of national self-sufficiency. No longer confined by an individualized conception of altruism and organ donation as a supererogatory act, the ethos of transplantation is evolving as communities and governments recognize the nature of donation and transplantation as a necessarily public concern. Methods: Recent literature concerned with organ donation and allocation ethics is reviewed in conjunction with Aristotle's accounts of economy, self-sufficiency and civic virtue in The Politics. Aristotle's theories are explored in the context of contemporary ethical issues in organ transplantation in order to identify common themes, challenges and suggestions for future ethics research and policy making. Results: Solidarity, reciprocity, justice and even civic duty have become potential rationales for donation policies, in particular those which encourage nations or regions to strive to meet their own needs for transplantation without reliance on foreign outsourcing, thus achieving self-sufficiency. These values reflect key themes in Aristotle's Politics and suggest that an Aristotelian perspective of current debates in transplantation ethics offers a valuable source for future examination, in particular with respect to emerging conceptions of national self-sufficiency in organ donation and transplantation. Conclusion: Aristotelian ethics have long been neglected as a source of guidance in transplantation ethics. Future work in this area will benefit greatly from an examination of the ancient past.

The Ethics of Organ Transplantation

The Ethics of Organ Transplantation

History and ethics of hand transplants

Hand transplantation is a form of composite tissue allotransplantation, whereby the hand of a cadaveric donor is transferred to the forearm of an amputee. The aim of such a procedure is to achieve better outcomes in terms of functionality and appearance when compared with prosthetics. The microsurgical techniques required have been well established for many years. In addition, advances in immunosuppressive therapy have meant that hand transplantation is a feasible therapeutic option. However this is not a life-saving procedure, requiring lifelong antirejection treatment with potentially serious side-effects. Hand transplantation is therefore a controversial concept with ethical, financial and psychological implications that need careful consideration. Before this treatment can be fully accepted, further research is still required; this should be directed towards achieving immunological tolerance, while minimizing costs and potential side-effects of post-transplant therapy.

Transplantation Ethics: Are We Approaching the Crossroads?

Ethical issues of organ transplantation are of extreme importance to involved physicians and to society. The basic principle is that the donor cannot be considered as a commodity; financial incentives must not occur. Regarding deceased-donor organ transplantations, ethical issues are related to the consent for donation, determination of death, and principles of organ allocation. Living donors should be healthy, giving free consent after being fully informed about the risks of the procedure. Transplant professionals have a double responsibility because they must remember about the rights of the organ recipient as well as of the donor. Because of the organ shortage we commonly use organ recovery from donors after cardiac arrest and extend the living-donor pool, practices that may influence some important ethical principles. A proper detailed determination of donor death is of utmost importance. The dead donor rule must be preserved. However category III non–heart-beating donors (so-called controlled cardiac arrest) raise doubts as to the time of the decision to transfer the dying (not yet dead) patient to the operating room to withhold supportive treatment. In certain centers, not quite healthy living donors are being used; they are called extended-criteria or complex donors. Although organ trade is condemned, some workers agree to use as complete strangers donors, obviously believing in pure altruistic motivation of such donors without the additional incentives. Finally, is the trend to consider utility in organ allocation justified? It seems that quite soon we may need a new transplantation ethics code that is not totally directed by transplant professionals exclusively to the needs of potential recipients.

The Ethics of Transplants – Why Careless Thought Costs Lives Janet Radcliff e Richards The Ethics of Transplants – Why Careless Thought Costs Lives Oxford University Press £278pp £16.99 978 0 1995 7555 8 9780199575558

The Ethics of Transplants – Why Careless Thought Costs Lives Janet Radcliff e Richards The Ethics of Transplants – Why Careless Thought Costs Lives Oxford University Press £278pp £16.99 978 0 1995 7555 8 9780199575558

The Ethics of Transplants – Why Careless Thought Costs LivesThe Ethics of Transplants – Why Careless Thought Costs Lives

The Ethics of Transplants – Why Careless Thought Costs LivesThe Ethics of Transplants – Why Careless Thought Costs Lives

Intimate Borders: The Ethics of Human Organ Transplantation in Contemporary Film

The image of the intruder is central to human organ transplantation rhetoric. The external, fleshy other crosses a supposedly definitive and divisive line by traversing and settling inside the epidermal layer of an other's self. While transplant teams make a putative claim that grafting is essential to the continued survival of critically ill patients, they also stress the dangers of rejection, wherein the originary body attacks the unfamiliar presence of an other's organs. The organicity of the rejection process—that the body resists incorporating organs from an other—seemingly shows how the skin marks the limit of the self, making the peaceful cohabitation of self and other an impossibility. The immune system is figured as an army always ready to attack any outside intrusion that may threaten the integrity, and therefore the survival, of the self. Here, outsiders pose risks and should be managed, surveilled, and even destroyed for the sake of protecting the sanctity of the wholesome, healthy body. Yet, in order for the transplant recipient to survive, there must be a repression of this system of defence; it must be weakened to let the other do its life-saving work of pumping vitality into the otherwise waning body. Highly toxic immunosuppressive pharmaceutics prevent the immune system from performing its militaristic duties, allowing the organ of an other to labor away at its everyday functions of keeping the other/self alive. In this article, I examine three contemporary films that bring together histories of transnational racism and ethical quandaries regarding organ donation: Miguel Sapochnik's Repo Men (2010 Sapochnik , M. (Dir.) ( 2010 ). Repo Men [DVD]. USA: Universal. ), David Moreau's The Eye (2008 Moreau , D. (Dir.) ( 2008 ). The Eye [DVD]. USA: Lionsgate. ), and Stephen Frears' Dirty Pretty Things (2002 Frears , S. (Dir.) ( 2002 ). Dirty Pretty Things [DVD]. UK: Miramax. ). These films are diverse in genre and diegesis, and yet, I argue, they all share a preoccupation with how the biotechnological imperative to cut through bodily borders is intimately tied to state control, surveillance, and protection of geopolitical boundaries. The Eye and Repo Men are popular Hollywood productions designed to appeal to a mass audience through their emphasis on the spectacle of fear, stereotypical gendered and raced characterizations, and gory, violent visualities. The Eye is an American adaptation of a Hong Kong production (Pang and Chung 2002 Pang , D. and Chun , O. P. ( 2002 ). Gin gwai (The Eye) [DVD]. Hong Kong : Palm Pictures . ), which was originally concerned less with romantic self-discoveries and more with the deeply disturbing (and very scary) ways in which transplants haunt our imaginaries. In contrast, Dirty Pretty Things attempts to paint a more complex picture of precariously legal migrants in London through the social realist genre. Using a grainy visual effect to emphasize the lack of “gloss,” and thus the focus on reality, in these migrants' lives, the film nevertheless borrows from Hollywood sensationalism with its images of bloody body parts, scenes of violence toward women, and largely stereotypical national and racialized representations. However, Dirty Pretty Things is the sole film on which this article focuses that is, arguably, driven by a political agenda. It is openly concerned with the politics of race and gender in contemporary Britain—a subject that has been of some interest to Frears throughout his career—and with transnational inequalities. Although the other two films may not offer overt political messages, I suggest that slippages between bodily and geopolitical borders open up a critical and political space where the viewer can engage with the intersecting issues of biotechnologies and transnational migrations. I further argue that all three films convey a politics of belonging deeply invested in ethics, and thus in a concern with hospitality. Organ donation is currently carrying the weight of cultural anxieties not only regarding divisions between self and other, but also concerning national boundaries of belonging and whether “different others” are to be welcomed or expulsed.

Use of Standardized Patients to Teach Medical Students about Living Organ Donation

Educators routinely use standardized patients to teach medical students a variety of clinical concepts. Standardized patients have also been used to teach students about medical ethics and deceased organ donation. Not reported before, however, is the use of standardized patients to educate medical students about the ethical issues in living organ donation. It seems important to fill this gap because in the United States, roughly 45% of organ donors are living donors, and these patients will visit physicians throughout their lifespan, not just with the occurrence of donation. This article reports an experience teaching concepts in living donation and transplant ethics to second-year osteopathic medicine students using a standardized patient and supplementary instructional materials (eg, film, panel discussion, reading list). Specifically, a transplant ethics module was created that included an actor portraying a living donor candidate who had a number of case variables pertaining to medical and psychosocial matters. Instructional themes included informed consent, altruism, patient selection criteria, organ vending, and post-donation support systems.

The Ethics of organ transplantation

The Ethics of organ transplantation

The ethics of organ transplantation: how comprehensive the ethical framework should be?

Organ transplantation is one of the major medical achievements of the twentieth century (Mancuso 2006:138). The discovery of effective immunosuppressive drugs in the late 1970s was an important step towards increasing the success rate of organ transplants and thus paved the way for organ transplantation to become a medical routine affair in the twenty-first century (Schmidt 2003: 319). The current prevalence of organ transplantation was clearly to see in a recently published study which assembled worldwide data on living kidney transplantation. The study showed steady rise of living kidney transplantation in most regions of the world. According to statistics given by this study, ‘‘The number of living kidney donor transplants grew over the last decade, with 62% of countries reporting at least a 50% increase. The greatest numbers of living donor kidney transplants, on a yearly basis, were performed in the United States (6435), Brazil (1768), Iran (1615), Mexico (1459), and Japan (939). Saudi Arabia had the highest reported living kidney donor transplant rate at 32 procedures per million population (pmp), followed by Jordan (29), Iceland (26), Iran (23), and the United States (21)’’ (Horvat et al. 2009:1088). When a medical treatment, like organ transplantation, becomes so prevalent and manages to achieve impressive success rates in improving the quality of patients’ lives worldwide then intriguing ethical questions will be raised by default. The main thesis of this thematic issue is that the ethical framework of organ transplantation should be as comprehensive as possible and thus should not be confined to conventional set of ethical questions related to the donor–recipient relationship. The first article in this thematic issue argues that media ethics should be incorporated in this ethical framework. The second article asks for more critical consideration to the requirement of consent, which underlines the authority of people in regard to their bodies. The third article speaks of a need to offer pyschological care to the living kidney transplantation partners before and after transplantation. The fourth and fifth articles elaborate on the need to involve the religious aspects in the ethical discourse on organ donation.

Life, Transferable: Questioning the Commodity-Based Approach to Transplantation Ethics

Abstract Some bioethicists have proposed a legalized market in human organs as a solution to transplant waiting lists and global poverty. Solutions to organ procurement problems that are solely market-based would unfairly shift the burdens of medical procedures onto developing nations. Market advocates base their claims on the understanding of organs as property, a position that should be problematized. Instrumentalizing people in this way is part of the broader commodification of animals and the environment. Combating the market mentality requires a return to the holistic view of bioethics that led to the founding of the field.

Transplant research and deceased donors: laws, licences and fear of liability

Transplantation research on samples and organs from deceased donors in England, Wales and Northern Ireland is under threat. The key problems relate to difficulties encountered in gaining consent for research projects, as distinct from consent to donation for clinical transplantation. They are due partly to the terms of the Human Tissue Act 2004 (the 2004 Act), and partly to its interpretation by the Human Tissue Authority (HTA). They include excessive interaction with donor representatives regarding ‘informed consent’ to research projects, uncertainty as to the scope and duration of a donor's ‘authority’ over an organ, and restrictions caused by the apparent need for licensing of transplantation research under the 2004 Act, combined with lack of certainty, or guidance, as to the distinction between ‘research’, which requires a licence, and ‘service development’, which does not. In our view this confusion hinders and deters Specialist Nurses for Organ Donation in approaching donor representatives and discussing possible research projects with them. It has also, as we have reported elsewhere, led to abandonment of research projects for fear of liability, despite both Research Ethics Committee (REC) approval and donor consent. Such problems do not seem to occur under the transplant laws of most other comparable jurisdictions. The Transplantation Ethics Symposium, ‘The ethics of organ retrieval: goals, rights and responsibilities’, hosted by the MRC Centre for Transplantation at King's College London in December 2010, revealed that many senior clinicians and researchers, administrators, and lawyers are both unclear and in disagreement concerning the effects of the 2004 Act and the extent to which it is adhered to or ignored in practice. In this paper we examine the difficulties encountered and suggest solutions based on a less restrictive interpretation of the 2004 Act, or, more probably, a regulatory change under its authority. We propose that, in the long term, a law which includes consent for REC-approved research within the general consent for organ donation and transplantation seems preferable to the present system, both ethically and in practical terms.

Advanced Practice Nursing and the Ethics of Transplant

Advanced Practice Nursing and the Ethics of Transplant

Probing Transplant and Living Donor Candidates about Their Participation in Organ Vending

The selling of human organs for transplant is illegal in the United States and in most countries; however, such transactions still occur. Transplant hospitals and their personnel have multiple ethical duties, including (1) protecting the safety of their living donors and transplant recipients and (2) protecting the integrity of living donation and transplantation as clinical practices. To date, few psychosocial screening tools exist that pertain specifically to a person's risk or intent of pursuing organ vending (buying or selling). This article presents a series of transplant ethics case consultations that spawned the creation of a set of behavioral prompts for teams to probe with regard to organ vending when screening candidates about their suitability for participation as living donors or transplant recipients.