Organ Donation, Brain Death and the Family: Valid Informed Consent

Iltis, Ana S.

doi:10.1111/jlme.12254

Cited by 15 publications

(11 citation statements)

References 48 publications

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“…One study has shown that OPO Web sites “predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process” (Woien et al 2006 ). Then, the importance of informing the public about the organ donation process was even further marginalized by changing the donor registration language from “consent” to “authorization” (Iltis 2015 ). The Organ Procurement and Transplantation Network (OPTN) describes the term “authorization” as “[t]he act of granting permission for a specific act.…”

Section: Implications Of Neuroscientific Findings On the Debatementioning

confidence: 99%

Neuroscience and Brain Death Controversies: The Elephant in the Room

2018

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The conception and the determination of brain death continue to raise scientific, legal, philosophical, and religious controversies. While both the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in 1981 and the President’s Council on Bioethics in 2008 committed to a biological definition of death as the basis for the whole-brain death criteria, contemporary neuroscientific findings augment the concerns about the validity of this biological definition. Neuroscientific evidentiary findings, however, have not yet permeated discussions about brain death. These findings have critical relevance (scientifically, medically, legally, morally, and religiously) because they indicate that some core assumptions about brain death are demonstrably incorrect, while others lack sufficient evidential support. If behavioral unresponsiveness does not equate to unconsciousness, then the philosophical underpinning of the definition based on loss of capacity for consciousness as well as the criteria, and tests in brain death determination are incongruent with empirical evidence. Thus, the primary claim that brain death equates to biological death has then been de facto falsified. This conclusion has profound philosophical, religious, and legal implications that should compel respective authorities to (1) reassess the philosophical rationale for the definition of death, (2) initiate a critical reappraisal of the presumed alignment of brain death with the theological definition of death in Abrahamic faith traditions, and (3) enact new legislation ratifying religious exemption to death determination by neurologic criteria.

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Section: Implications Of Neuroscientific Findings On the Debatementioning

confidence: 99%

Neuroscience and Brain Death Controversies: The Elephant in the Room

2018

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“…Ethically troublesome cases and the potential for conflict between transplant team or hospital and OPO evidence the need for a process change. Much of our assessment has been previously considered by Iltis (2015b); until her more extensive remedies can occur, we suggest the following immediate, practical steps forward as a solution to help circumvent these conflicts.…”

mentioning

confidence: 98%

Informing Consent for Organ Donation

Nash

Thiele

2016

HEC Forum

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“…39 True informed consent assumes the requestor has disclosed relevant information, authorized decision makers have decisional capacity, information is in language they can understand such that they can appreciate the implications of the decision, and the communication takes place under circumstances that allow them to make and communicate a free and voluntary informed choice. 40 The American Medical Association's policy on presumed consent affirms that "donations under presumed consent would be ethically appropriate only if it could be determined that individuals were aware of the presumption that they were willing to donate organs and if effective and easily accessible mechanisms for documenting and honoring refusals to donate had been established." 41 Whether these standards are met under presumed consent depends on the exact method in which it is implemented.…”

Section: Autonomymentioning

confidence: 99%

Presumed Consent for Organ Donation: Principlism Opts Out

Marquardt¹

2017

BFP

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The number of available organs for transplant each year falls woefully short of the number of patients in need of donated organs in the United States. While approval numbers are very high for organ donation, the number of registered donors is much smaller. A commonly proposed solution to increase the pool of organ donors is to replace the current explicit consent policy with a presumed consent system, where everyone is considered to have consented as a donor unless they have opted out by joining a non-donor registry or by some other method. This proposal raises many ethical questions that must be examined in light of standard medical ethics principles before implementation of such a policy should be supported. On a practical level, the evidence for the results of putting presumed consent policy in place should first be analyzed. Careful consideration of such evidence reveals that implementation of presumed consent in the United States may raise donor rates, but this result is not at all as guaranteed as many proponents claim. Under principlism, a common ground bioethics approach, presumed consent is morally questionable at best. Examination with regards to the four pillars of principlism, beneficence, non-maleficence, justice, and autonomy, reveals considerable ethical difficulties that all but disqualify presumed consent from consideration. While it is possible that such a system would increase organ donation rates, it increases the potential for discrimination in the donation process, is likely to subvert doctor-patient trust in some cases, and undermines the concept of true informed consent in medicine.

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Organ Donation, Brain Death and the Family: Valid Informed Consent

Cited by 15 publications

References 48 publications

Neuroscience and Brain Death Controversies: The Elephant in the Room

Neuroscience and Brain Death Controversies: The Elephant in the Room

Informing Consent for Organ Donation

Presumed Consent for Organ Donation: Principlism Opts Out

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