L13: Organ Transplantation Flashcards
What are the 3 types of donor donation
Brain stem death
Circulatory death
Living donor
What is brainstem death
Brainstem is not functioning but heart is beating
What is circulatory death
Heart is not beating
What organs can living donors donate
Kidney
Part of liver
To become a donor where do you have to die
In a controlled manner i.e in the hospital
What is the organ numbers like
Organ shortage
What should a good donation system enable
- maximise organs for transplant
- improve or extend lives
- utilitarian approach i.e greatest good for the greatest number
To maximise the number of organs donated what can we do
Make organ donation compulsory
What is the act called for organ transplant in the U.K.
Human tissue act 2004
What areas does the human tissue act 2004 cover
Anatomical examination Determining cause of death Public display Education Transplantation
In addition to the human tissue act 2004 what other guidelines are available that provide info an how to apply the act to clinical practice
Code of practise
In order to become a donor what needs to be obtained from the patient
Consent
What was the old U.K. organ donation system called
Opt in system
What is the opt in system
If you want to become a donor you have to sign up
What does the opt in system allow
- respect autonomy
- certainty that the person wanted it
What is the current U.K. organ donation system called
Opt out system
What are the disadvantages of opt in
- people who want it never get to to sign up
- doesn’t provide enough organs
- autonomous is not respected if the person has not joined
What is the opt out system
People who do not want to become a donor have to take action, those who do not take action is presumed that they want to become a organ donor
What are the advantages of opt out system
- more organ donation
- still allows people for a choice and respects autonomy
- consequentialist (consequence matter even if the act is bad)
What are the disadvantages of the opt out system
- people are unaware of the new organ donation system
- makes it look organ donation is compulsory
- people may want to opt out but never get the opportunity
- people may change their mind
What is the soft opt out system
- Relatives are asked if the patient would of wanted the organ donation to proceed
- If relative think that they patient did not want it then if they provide the evidence organ donation would not go ahead.
What is the hard opt out sytem
Whatever the organ register says is the final say, you do not ask the relatives.
What are the ethical issues with the opt out system
- is presumed consent really consent as consent requires capacity and voluntariness
- consent requires decision, if someone has not decided are they giving consent ?
- people know little about it
- presumed consent makes it look like your are forcing the patients
Is presumed consent sufficient for whole body donation
No
What type of consent is required for whole body consent
Appropriate valid consent
Who can only give the consent for whole body donation
Person donating their body only
What does the consent have to be for whole body donation
Written consent
What can the written consent be
- signed by one person and with 1 witness
Or - contained in the will of that person
What is the basic tennant of fairness model
Those who freely cause bad consequence should carry the burden of them i.e people who opt out should have low priority if they need organ donation
Which factors are considered for organ allocation
Likely benefit of waiting
Fairness
Tissue matching
What are the pros of basic tennnant of fairness
You can help yourself if you becomes an organ donor
Increases number of donors
What are the cons of the basic tenant of fairness
- this model is odd within the NHS policy as NHS does not base allocation on past behaviour
- problem cases where people could never donate their organs anyway
