Altruism in terminal cancer patients and rapid tissue donation program: does the theory apply?

Abstract

Rapid Tissue Donation (RTD) is an advancing oncology research procedure for collecting tumors, metastases, and unaffected tissue 2 to 6 hours after death. Researchers can better determine rates of progression, response to treatment, and polymorphic differences among patients. Cancer patients may inquire about posthumous body donation for research to offer a personal contribution to research; however, there are barriers to recruiting for an RTD program. Physicians must reassure the patient that their treatment options and quality of care will not be compromised due to participating in RTD. In this commentary we discuss how theories of altruism may explain cancer patients’ desire to participate in an RTD program, the ethical concerns of health care professionals and patients and the use of altruism as a recruitment strategy. We offer recommendations for examining the cultural and ethical climate of the institution prior to initiating such a program such as examining the relationship of healthcare professionals and patients, identifying ethical concerns, and examining ways to promote acceptance and buy-in across professionals, patients, and families.

Effect of Cannabis Use on Human Immunodeficiency Virus DNA During Suppressive Antiretroviral Therapy

“…There were 48 men who have sex with men (MSM) coenrolled in the San Diego Primary Infection Resource Consortium [9,10] and in the Translational Methamphetamine Acquired Immunodeficiency Syndrome (AIDS) Research Center cohort [11]. The estimated duration of infection (EDI) was determined using serologic and virologic parameters [12].…”

Can research at the end of life be a useful tool to advance HIV cure?

“…In our ‘Last Gift’ model, we propose that some HIV-infected individuals with a non-AIDS related advanced illness would be willing to participate in such research. Examples of non-AIDS related diseases relevant for a Last Gift cohort include solid cancers, cardiovascular disease, and neurodegenerative diseases [33, 34]. Participants would be eligible for our Last Gift cohort when they are certified as being terminally ill by a physician and having a prognosis of 6 months.…”

“…The proposed research model has been useful for cancer research [33]. In particular, cancer research has greatly benefited from rapid autopsy programs by allowing a better understanding of cancer disease mechanisms and how various therapies have impacted these mechanisms [33, 37].…”

“…In particular, cancer research has greatly benefited from rapid autopsy programs by allowing a better understanding of cancer disease mechanisms and how various therapies have impacted these mechanisms [33, 37]. Characterization of these mechanisms has involved samples collected from rapid autopsies and state-of-the-art laboratory techniques like proteomics, genomics, metabolomics, etc.…”

Patient, caregiver and physician perspectives on participating in a thoracic rapid tissue donation program

“…[9] Discomfort from the healthcare team is not uncommon as some staff may be uncomfortable broaching the topic feeling it sends a negative message to the patient. [10, 11]…”