Transplantation Flashcards
Why do we need donated bodies
Transplantation
Scientific research
Medical education
The benefit to all of these is significant both to individuals and society more generally
The more donations the greater the benefit
What Is the ethical issue
Is there is a resource available which can be put to good use often life saving should we not use it
If bodies or their parts are not donated they will be buried or burned - waste?
Fundamental principle - making the most of the resources available is one consideration but not the only one
Consent - most of the U.K. Operates an opt in system apart from wales
Choose whether you want in or not
Next of kin decides finally if they agree with your decision
Donation will not go ahead without consent
If donations brings so much good why worry about consent
Respect for autonomy - people expect to have control over bodily integrity while alive so why not whine dying or dead - coercion is often considered unacceptable esp in medical context
Respect for individuals values and beliefs - people may have religious objections to donations or believe their body needs to be kept intact
Concern for people still alive- it may distress relatives to know that organs or whole bodies are being donated and used without consent
Alder hay scandal
Removal of organs from dead children without their parents consent.
Given consent for post mortems but had asked to keep organs together or not been told about removal
Resulted in public outcry, immensely distressing for parents, damages reputation of NHS and donation
Resulted in the HTA 2004
Human tissue act 2004
Came into force 15th November 2004
Replaced the HTA 1961 and anatomy act 1984 -and human organ act 1989
HTA make a fundamental principe
Consent
What is HTA concerned with
Deals with the removal, storage and use of human bodies, parts and organs
What are the 3 parts to the HTa
Part 1 - consent and organ transplantation
Part 2- human tissue authority
Part 3- misc
What is part 1 S2
Appropriate consent - children
What does part 1s2 concern
Children and
Live organ donation
Children who are competent can give consent
Competent = gillick competent
If the child is not competent then someone with parental responsibility can give consent but has to be in their best interests
This can become contentious
Deceased organ donation
Children who are competent can give consent: advanced declaration for their organs to be used for transplantation
If the child is nor competent then someone with parental responsibility can give consent
Part 1 s3 concerns
Appropriate consent adult Live organ donation Adults must give consent Deceased organ donation Adults can give prior consent: advanced declaration, for their organs to be used for transplantation
What happens according to P1s3 if there is no advanced declaration
Consent can be obtained from a nominated person to make decisions after their death
If the person didn’t nominate a named representative - next Of kin
HtA part 2
Sets up the human tissue authority
Part 2 human tissue authority 3 parts
1 remit - licensing
2 issues codes of practice
3 regulates the transplants between living persons and prohibits commercial dealing in human material
HTA part 3 section 43
It is lawful for hospital authorities to take minimum sets or preserve organs of deceased persons whilst the appropriate consent to transplant is sought
What is the most important part of the changes
Getting consent
What should be an overriding factor
Competent person have given consent
But practice has always been to ask the next of kin, regardless of any advance declaration made by the donor
Role of public opinion in transplantation should we worry what people think about organ donation, organ allocation, how bodies and their parts are used more generally after death
These are moral views and we all probably have views on them
E.g. Organ allocation
Organs are scarce should be put to good use but what is good use Preventing deaths Providing good QOL Providing food quantity of life Providing equal access to treatment Prioritising certain people - children Research
Who’s views should count
Balance all views as they are all important
Why do we need or balance all views
Doctors and scientists know about tissue typing and likely risks and benefits
Bioethicists know about key ethical principles and what they require
The public may be less likely to donate if they find the donation system to be objectionable
