Experience of ethical dilemmas among professionals working in pediatric transplantation: An international survey

Abstract

With solid organ transplantation now being the gold standard treatment for end-stage organ disease, the possibility of successful transplantation is among the most important interventions within modern medicine. The process of obtaining and fairly allocating organs has led to the rise of complex ethical dilemmas. [1][2][3] The occurrence of these ethical issues is mostly an unavoidable consequence of the pervasive challenge of organ shortage. 4 Ethical issues are likely to remain commonplace in transplantation

To feel or not to feel: a scoping review and mixed-methods meta-synthesis of moral distress among surgeons

“…Interpersonal factors were also explored in relation to the moral distress among surgeons (3,(5)(6)(7)(8)(9)(25)(26)(27)(31)(32)(33)(34)(35)(36)(37)(38)(39). In some instances, these interpersonal factors arose in connection to the care provided, such as having unclear or inconsistent goals of care (7,25,34,37), discordance among and between teams or families (3,5,8,26,38), disruptions to the doctorpatient relationship (32), providing life prolonging intervention for terminally ill patients (3,(6)(7)(8)(9)25,33,34,37,39) and pressure from others to drive care (7,8,25,26,33,34,37). In studies assessing surgeons, interpersonal factors' impact on moral distress appear to differ based on surgeon roles.…”

“…Practice environment was found to influence moral distress among surgeons (2)(3)(4)(6)(7)(8)24,25,27,30,(32)(33)(34)(35)(36)38,39). While some studies focused on the type of setting (e.g., intensive care units, Veterans Affairs hospitals, private practice) (2,8,33) others focused on the influence of subspecialty (33), and differences based on patient population (e.g., pediatric vs. adult) (36,38).…”

Resilience or denial? Handling ethical dilemmas in the pediatric transplantation community

“…1 In this issue of Pediatric Transplantation, Arslan et al present their study reviewing the results of a questionnaire that was sent to the membership of the International Pediatric Transplant Association (IPTA) regarding ethical dilemmas in pediatric transplantation. 2 The authors report both the results of the survey and those of a focus group they convened in the United Kingdom to discuss and analyze the results of the survey. The authors sought to determine the differences between the experiences of transplant professionals around the world and to give direction to medical organizations and authorities regarding issues most in need of addressing for our community.…”

“…The overall rate of pediatric transplant professionals experiencing ethical dilemmas was surprisingly low (38% of respondents had experienced an ethical dilemma in the prior 2 years) 2 . Ethical concerns were more common regarding living donor donation as compared to deceased donor donation and more commonly reported by surgeons compared to physicians.…”

“…In this issue of Pediatric Transplantation , Arslan et al present their study reviewing the results of a questionnaire that was sent to the membership of the International Pediatric Transplant Association (IPTA) regarding ethical dilemmas in pediatric transplantation 2 . The authors report both the results of the survey and those of a focus group they convened in the United Kingdom to discuss and analyze the results of the survey.…”