Week 10 - Organ Donation & Transplantation ethics Flashcards
What is organ transplantation?
Organ transplantation = surgical replacement of a malfunctioning organ by another organ
–> transfer of human cells, tissues or organs from a donor to recipient with the aim of restoring functions in the body
What are auto-grafts?
A transfer which originates from recipients themselves
What are allo-grafts?
Transplants between genetically non-identical individuals
What are Xeno-grafts?
The transfer of living animal organs/ tissues to humans
What are the two types of organ donation?
- Living donation = living patient consents to donate a single/ part of a organ
–> Living related = donating to a family member
—> Living unrelated = donating to non-family member
= sometimes as part of paired/ polled donation - Deceased donation = donation after death =cadaveric donation
–> Donation after brain death = death diagnosis on neurological criteria
=Irreversible loss of brainstem function
–> Donation after circulatory death = non-heart beating donation
= diagnosis on cardiovascular criteria
= usually after withdrawal of mechanical ventilation
What is the NHS criteria for diagnosing brain death?
- a person must be unconscious and fail to respond to
outside stimulation - a person’s heartbeat and breathing can only be
maintained using a ventilator - there must be clear evidence that serious brain
damage has occurred and it cannot be cured
What is the NHS criteria for diagnosing brain death?
- a person must be unconscious and fail to respond to
outside stimulation - a person’s heartbeat and breathing can only be
maintained using a ventilator - there must be clear evidence that serious brain
damage has occurred and it cannot be cured
What are the issues with deceased donation?
- Notions of personhood:
- The human organism only dies when it ceases to function in an integrated way - Culture and religious order:
- Diff. views regarding death
- Death rituals and ways of attending dead body to ensure “good death”
What is the difference between paired donation and pooled (donation chain)?
- Paired donation = Potential donor A and
potential recipient B are in
a relationship but are not
genetically compatible.
Potential donor C and
potential recipient D are
in the same position. A is
compatible with D and C is
compatible with B. Thus A
gives to D and C gives to B. - Pooled donation = like paired, but more than 2 pairs involved in swap
What is non-directed, directed, conditional donation?
- Non-directed = a person who offers to donate an organ to anyone who might benefit
- Directed = when a person agrees to donate organs, but only to a specific recipient
- Conditional = a person agrees to donate organs on the condition that they are allocated to a SPECIFIC TYPE of recipient
What are the ethical issues surrounding each type of organ transplant?
❑ Living organ donation – many more people are willing to receive
organs rather than they are to donate
❑Cadaveric organ donation – issues relating to the definition of death
and ownership of the body
❑ Xenotransplantation – a concern with mixing of the species;
risk of transfer of diseases from animal to human
What are the types of system for organ donations?
*Opt-in system
–>People must actively join the register
*Opt-out system (“presumed consent”)
–>People must actively remove themselves from register
*Other systems:
1. Mandated choice
–> People must record their wishes regarding organ donation after
death at some stage(s) in their lives
*Benefits in kind
–> Offering reimbursement or health insurance or priority
* Market
What are the issues to consider regarding organ transplant?
- Ethical considerations
1. Autonomy
2. Beneficence and non-maleficence
3. Decision-making - Legal Issues
1. Organ donation system
2. Donor registry
3. Opt-in or opt-out system - Family involvement
1. Soft or hard system (Soft; where family’ input will be sought in
determining patient’s wishes)
What ethical principles are affected by organ transplantation?
- Utility
- Justice
What are the key ethical principles in living kidney transplantation?
- Altruism
* has been the basis of organ donation in the UK;
* as a selfless gift to others without expectation of remuneration - Autonomy;
* Valid consent required by living donor before an organ can be removed - Beneficence
* actions that serve the best interests of patients. - Dignity
* inherent dignity or special status of the human body;
* dignity & price are mutually incompatible - Non-maleficence
* ‘doing no harm’ - Reciprocity
* providing benefits or services to another as part of a mutual exchange.
(i.e. paired/pooled LDKT)
SAMPLE SBA
