Ethical analysis of organ recovery denials by medical examiners, coroners, and justices of the peace

Shafer, Teresa J.; Schkade, Lawrence L.; Siminoff, Laura A.; Mahoney, Timothy A.

doi:10.7182/prtr.1.9.4.q022hjm60630w514

Cited by 20 publications

(14 citation statements)

References 105 publications

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“…In the case of physician MEs, they in effect fulfill an ethical and a moral obligation every time they release an organ for transplantation (37). Investigating deaths can have a noble purpose for both the deceased, as well as living persons whose lives could be saved.…”

Section: Discussionmentioning

confidence: 99%

Vital Role of Medical Examiners and Coroners in Organ Transplantation

Shafer¹,

Schkade

Evans

et al. 2004

American Journal of Transplantation

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Many people die owing to the shortage of donor organs. Medical examiners and coroners (MEs/Cs) play a vital role in making organs available for potential recipients. Medical examiners'/coroners' case data were collected using a structured confirmatory-recorded methodology for calendar years 2000-01 and were linked and analyzed with donor and transplant data from the United Network for Organ Sharing, predicting the nature and extent of the loss of donor organs. Nearly seven percent of ME/C cases were denied recovery during 2000-01. Because 353 and likely, 411 potential organ donors (PODs) were denied, as many as 1400 persons on transplant waiting lists did not receive organs because of ME/C denials. Problematically for pediatric patients awaiting transplantation, nearly half of all ME/C denials occurred in pediatric patients. Eighteen percent of PODs aged five or less and 44.2% of child abuse PODs were denied recovery by the ME/C. There were no (zero) denials in three of the five largest U.S. cities and in four states. Since 1994, two states have enacted legislation restricting the circumstances of ME/C denials, resulting in an 83% decrease in ME/C denials. Release of all organs from ME/C cases is needed urgently to protect the lives of those persons awaiting transplantation. Medical examiners and coroners deserve recognition for their efforts in advocating methods and/or regulation/legislation designed to achieve 100% release of life-saving organs for transplantation.

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Section: Discussionmentioning

confidence: 99%

Vital Role of Medical Examiners and Coroners in Organ Transplantation

Shafer¹,

Schkade

Evans

et al. 2004

American Journal of Transplantation

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“…La Unión Europea ha emitido una recomendación sobre la autopsia médico-legal que es más estricta que nuestra legislación (Recomendación nº(99) 3 del Consejo de Ministros de los Estados Miembros, para la Armonización Metodológica de las Autopsias Médico-Legales) 8 :…”

Section: Discussionunclassified

“…No son pocos los facultativos que opinan que los objetivos de la donación de órganos y la recolección de pruebas forenses no son mutuamente excluyentes. Un análisis de los principios y obligaciones éticos de beneficencia, el respeto por la autonomía de la Justicia junto a la comprensión de los problemas que se le plantean, unido a un afán de colaboración adecuado, por ambas partes, pueden disminuir el número de negativas 3 .…”

Section: Introductionunclassified

Autorización de la extracción de órganos a fallecidos: una incidencia más del Juzgado de Guardia

Martínez-García

Pérez-Crespo

2015

Cuad. med. forense

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El trasplante de órganos es una de las aportaciones modernas más importantes de la Medicina a la sociedad, y en el curso de este procedimiento interactúan con frecuencia los médicos del equipo de trasplantes (MET) y los médicos forenses (MF), estableciéndose en ocasiones cuestiones o controversias poco comprendidas por el otro colectivo. Así, vemos que algunos MET piensan que aunque el número de negativas judiciales en la extracción de órganos sea pequeño, su trascendencia en el número de receptores es importante, pudiéndose establecer dudas sobre la justificación ética a que una posible sobreprotección de los procedimientos judiciales impida salvar vidas. También se da la circunstancia contraria: algunos MF opinan que el explante de órganos puede imposibilitar la determinación de la causa de la muerte en determinados casos. No son pocos, sin embargo, los facultativos de ambos equipos que opinan que los objetivos de la donación de órganos y la recolección de pruebas forenses no son mutuamente excluyentes. La comprensión de los problemas que se plantean, a una y otra parte, unido a un afán de colaboración adecuado, pueden disminuir el número de negativas. También, la inclusión del MF en los MET podría suponer una significativa mejora en el proceso, tanto médico como judicial, de la extracción y el trasplante de órganos, disminuyendo la negativa judicial de explante de órganos. Palabras clave: Muertes judiciales. Autopsia forense. Trasplante de órganos de cadáver. Especialista en Medicina Legal.

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“…Clinical results of organ transplantation are excellent for most recipients of transplant organs [4,5], and indeed transplantation has been described as a "social good" [6]. Does it follow, however, that organ donation is necessarily a social good?…”

Section: Utilitarian Rationalismmentioning

confidence: 99%

Untitled

Streat

2004

Crit Care

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The objective of the present article is to review moral assumptions underlying organ donation in the intensive care unit. Data sources used include personal experience, and a Medline search and a nonMedline search of relevant English-language literature. The study selection included articles concerning organ donation. All data were extracted and analysed by the author. In terms of data synthesis, a rational, utilitarian moral perspective dominates, and has captured and circumscribed, the language and discourse of organ donation. Examples include "the problem is organ shortage", "moral or social duty or responsibility to donate", "moral responsibility to advocate for donation", "requesting organs" or "asking for organs", "trained requesters", "pro-donation support persons", "persuasion" and defining "maximising donor numbers" as the objective while impugning the moral validity of nonrational family objections to organ donation. Organ donation has recently been described by intensivists in a morally neutral way as an "option" that they should "offer", as "part of good end-of-life care", to families of appropriate patients. In conclusion, the review shows that a rational utilitarian framework does not adequately encompass interpersonal interactions during organ donation. A morally neutral position frees intensivists to ensure that clinical and interpersonal processes in organ donation are performed to exemplary standards, and should more robustly reflect societal acceptability of organ donation (although it may or may not "produce more donors").

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Ethical analysis of organ recovery denials by medical examiners, coroners, and justices of the peace

Cited by 20 publications

References 105 publications

Vital Role of Medical Examiners and Coroners in Organ Transplantation

Vital Role of Medical Examiners and Coroners in Organ Transplantation

Autorización de la extracción de órganos a fallecidos: una incidencia más del Juzgado de Guardia

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