Conflicts of interest in the context of end of life care for potential organ donors in Australia

Haren, Frank M.P. van; Carter, Angus; Cavazzoni, Elena; Chapman, Michael; D’Costa, Rohit; Jones, Sarah L.; McGee, Andrew; Moodie, Stewart; Nunnink, Leo; O’Leary, Michael J.; Opdam, Helen; Radford, Sam; Turner, Andrew; Martin, Dominique

doi:10.1016/j.jcrc.2020.06.016

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…Professional probity cannot and should not be simplified to concerns around conflicts of interest and their mitigation via transparent disclosure. 49 , 50 A 2015 Canadian publication drew an important distinction between disclosure and institutional trustworthiness in managing conflicts of interest. 51 Automatic and insensitively timed disclosure of roles or interests may be potentially harmful to a family or patient, especially when the motivation to disclose is professional protection rather than information sharing of relevance to a healthcare decision.…”

Section: Discussionmentioning

confidence: 99%

Baseline Ethical Principles and a Framework for Evaluation of Policies: Recommendations From an International Consensus Forum

Gardiner¹,

McGee²,

Simpson³

et al. 2023

Transplantation Direct

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Background. To maintain public trust and integrity in organ and tissue donation and transplantation (OTDT), policymakers, governments, clinical leaders, and decision-makers must ensure that policies proposed to increase donation and transplant activity satisfy baseline ethical principles established by international agreement, declaration, and resolution. This article describes the output of the Baseline Ethical Domain group of an international forum designed to guide stakeholders in considering these aspects of their system. Methods. This Forum was initiated by Transplant Québec and co-hosted by the Canadian Donation and Transplantation Program partnered with multiple national and international donation and transplantation organizations. The domain working group members included administrative, clinical, and academic experts in deceased and living donation ethics and 2 Patient, Family, and Donor partners. Identification of internationally accepted baseline ethical principles was done after literature reviews performed by working group members, and a framework for consideration of existing or novel policies was completed over a series of virtual meetings from March to September 2021. Consensus on the framework was achieved by applying the nominal group technique. Recommendations. We used the 30 baseline ethical principles described in World Health Organization Guiding Principles, Declaration of Istanbul, and Barcelona Principles to generate an ethical framework—presented graphically as a spiral series of considerations—designed to assist decision makers in incorporating these ethical principles into practice and policy. We did not seek to determine what is ethical but instead described a method of evaluation for policy decisions. Conclusions. The proposed framework could be applied to new or existing OTDT policy decisions to facilitate the transformation of widely accepted ethical principles into practical evaluations. The framework includes adaptation for local contexts and could be applied broadly internationally.

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Section: Discussionmentioning

confidence: 99%

Baseline Ethical Principles and a Framework for Evaluation of Policies: Recommendations From an International Consensus Forum

Gardiner¹,

McGee²,

Simpson³

et al. 2023

Transplantation Direct

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“…Efforts to increase the chances of successful organ donation following VAD may sometimes appear to be in tension with goals of end‐of‐life care, especially those relating to the location of death and provision of palliative care. However, such tensions – and related conflicts of interests in professional roles – can often be resolved, as shown in the context of regular donation after the circulatory determination of death 22 . In dVAD, the location of death may be a particular concern for individuals who wish to die at home.…”

Section: Ethical Considerationsmentioning

confidence: 99%

“…However, such tensionsand related conflicts of interests in professional rolescan often be resolved, as shown in the context of regular donation after the circulatory determination of death. 22 In dVAD, the location of death may be a particular concern for individuals who wish to die at home. When the dying process begins outside the clinical setting, a longer period of organ ischaemia and, hence, reduced viability for transplantation is likely.…”

Section: Ethical Considerationsmentioning

confidence: 99%

Missed opportunities: saving lives through organ donation following voluntary assisted dying

Ray

Martin

2023

Internal Medicine Journal

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Organ donation after voluntary assisted dying (VAD) in Australia may potentially increase organ transplant rates. Despite significant international experience with donation after VAD, there has been little discussion of this in Australia. We review potential ethical and practical concerns relating to donation after VAD and advocate action to establish programmes in Australia that ensure safe, ethical and effective donation after VAD.

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“…This is understandable as, given death has already occurred, there is less potential for donation considerations to influence end‐of‐life decision‐making and so less actual or perceived conflict of interest for both clinicians and family. Greater concern regarding conflating decisions about proceeding to end‐of‐life care and those about donation exist in the situation of DCD, where a clear separation in the decision about withdrawal of treatment from that of donation is generally recommended [11].…”

Section: Early Sn‐od Involvementmentioning

confidence: 99%

Understanding the organ donation conversation landscape in the UK

Opdam

Radford

2021

Anaesthesia

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Conflicts of interest in the context of end of life care for potential organ donors in Australia

Cited by 12 publications

References 24 publications

Baseline Ethical Principles and a Framework for Evaluation of Policies: Recommendations From an International Consensus Forum

Baseline Ethical Principles and a Framework for Evaluation of Policies: Recommendations From an International Consensus Forum

Missed opportunities: saving lives through organ donation following voluntary assisted dying

Understanding the organ donation conversation landscape in the UK

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