Living Organ Donation Is Still Ethically Acceptable

Spital, Aaron

doi:10.1001/archinte.1993.00410040089014

Cited by 2 publications

(1 citation statement)

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“…Such views reflect an understanding of nonmaleficence as an absolute duty, rather than a prima facie obligation (10). Absolute duties demand adherence in all circumstances.…”

Section: Nonmaleficence In Living Kidney Donationmentioning

confidence: 99%

What Are the Harms of Refusing to Allow Living Kidney Donation? An Expanded View of Risks and Benefits

Allen

Abt

Reese

2014

American Journal of Transplantation

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Recent Organ Procurement and Transplantation Network policies relating to living kidney donation (LKD) warrant renewed attention to the ethics of transplantation from living donors. These policies focus on risks related to potential donor evaluation, informed consent and follow‐up. The ethical basis of living donation is a favorable risk/benefit ratio for the donor, but regulations and research have given less attention to the benefits of donation. Relatedly, the transplant field has also failed to consider potential harms from denying patients the opportunity to donate. These harms may be substantial in the setting of directed kidney donation to a spouse/partner, sibling or child. We argue that complete assessment of donor risks and benefits demands consideration of not only the risks and benefits of donation, but also those of refusing a donor. In contrast to the ever‐expanding literature on risks of donation, there are no data describing outcomes for individuals who were turned down as kidney donors. We consider factors contributing to this omission in the transplant literature, argue that current regulations may perpetuate a narrow understanding of relevant risks and benefits in LKD, and identify areas for improvement in research and clinical practice.

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“…Such views reflect an understanding of nonmaleficence as an absolute duty, rather than a prima facie obligation (10). Absolute duties demand adherence in all circumstances.…”

Section: Nonmaleficence In Living Kidney Donationmentioning

confidence: 99%

What Are the Harms of Refusing to Allow Living Kidney Donation? An Expanded View of Risks and Benefits

Allen

Abt

Reese

2014

American Journal of Transplantation

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Taking values seriously: Ethical challenges in organ donation and transplantation for critical care professionals

Aulisio

DeVita

Luebke

2007

Critical Care Medicine

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Last year, >28,000 people received organ transplants from >14,000 donors in the United States. Unfortunately, the wait list now tops 91,000, with the gap between recipient needs and available donor organs at around 60,000. This has motivated a host of efforts to increase organ supply, including driver's license and donor registry initiatives, educational and advertising campaigns, and "required request" and mandatory Organ Procurement Organization notification when a patient's death is imminent. Other more controversial efforts to increase the donor pool include expanded criteria for cadaveric donors, such as older or sicker donors and so-called non-heart-beating donation, now referred to as donation after cardiac death. Perhaps the most controversial of all efforts to address the organ shortage have focused on increasing the number of living organ donors, which in 2001 for the first time exceeded the number of cadaveric donors. Critical care professionals know the sad reality behind the statistical scarcity of organ supply. They must manage anxious patients and family members who may be waiting for an organ that never comes, triage patients into and out of the intensive care unit, and work through the propriety of shifting goals from cure to comfort when those same patients deteriorate to the point that transplant may no longer be an appropriate medical option or when a transplant fails. Equally significant ethical challenges arise on the donor side, whether it is working through difficult end-of-life decisions, identifying when to call the organ procurement organization, caring for brain-dead patients, managing a candidate for donation after cardiac death, or caring for a living donor postoperatively. This article discusses some of the difficult ethical challenges raised by organ donation and transplantation for critical care professionals, focusing on end-of-life decision making, donation after cardiac death, and living organ donation.

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Living Organ Donation Is Still Ethically Acceptable

Cited by 2 publications

References 5 publications

What Are the Harms of Refusing to Allow Living Kidney Donation? An Expanded View of Risks and Benefits

What Are the Harms of Refusing to Allow Living Kidney Donation? An Expanded View of Risks and Benefits

Taking values seriously: Ethical challenges in organ donation and transplantation for critical care professionals

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