Alternate Choice Organ Counselling in Altruistic Non-Directed Solid Organ Donation: An Ethical Analysis

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Richard C. Armitage
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引用次数: 0

Abstract

Introduction

Currently, recruitment of non-directed altruistic (NDA) kidney and liver lobe donors in the UK regards these individuals as potential NDA donors of the particular organ type they initially express an interest in donating. Conceptualising these individuals instead as potential NDA donors of either a kidney or a liver lobe would require them to be counselled on both kidney donation and liver lobe donation. This can be referred to as ‘alternate choice organ counselling’.

Methods

This paper conducts an ethical analysis of alternate choice organ counselling using the ethical framework of Principlism, and suggests changes to current policy and practice, accordingly.

Findings

This paper finds multiple strong ethical reasons to carry out alternate choice organ counselling for potential NDA donors of kidneys or liver lobes: the duty to respect autonomy requires alternate choice organ counselling such that the potential donor's decision to become a NDA donor of a particular organ type is fully informed; the duty of non-maleficence requires alternate choice organ counselling such that the harm subjected to the donor through living donation can be minimised (although such counselling might generate serial NDA donors, which would expose them to greater total harm); the asymmetry in the degree to which the living kidney and living liver lobe donation mechanisms promote justice requires alternate choice organ counselling for potential donors who wish to maximise the utility of their single NDA donation; finally, alternate choice organ counselling is likely to promote beneficence in potential NDA donors.

Discussion

This paper finds ethical reasons for potential NDA donors to be conceptualised as potential NDA donors of either a kidney or liver lobe, and for these individuals to be provided with alternate choice organ counselling. Suggestions on how this might be delivered in practice are offered, and the necessary further quantitative and qualitative research outlined.

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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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