Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)最新文献_第2页

The "noncompliant" transplant patient: a persistent ethical dilemma. “不服从”的移植病人:一个持续的伦理困境。

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.7182/prtr.1.9.4.el05lu6406242u54

S S Edwards

引用次数: 9

Ethical assessments of brain death and organ procurement policies: a survey of transplant personnel in the United States. 脑死亡和器官获取政策的伦理评估:对美国移植人员的调查。

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.7182/prtr.1.9.4.n174j3r4687606q8

J M DuBois

{"title":"Ethical assessments of brain death and organ procurement policies: a survey of transplant personnel in the United States.","authors":"J M DuBois","doi":"10.7182/prtr.1.9.4.n174j3r4687606q8","DOIUrl":"https://doi.org/10.7182/prtr.1.9.4.n174j3r4687606q8","url":null,"abstract":"The Questionnaire on Prolonging and Shortening Life was developed to assess the views of medical personnel regarding brain death, organ procurement policies, and related issues. The questionnaire was completed by 189 transplant physicians, 197 clinical coordinators, 150 medical students, and 70 nursing students. Ninety-five percent supported the so-called dead donor rule. What this rule means in practice appeared unclear among the population. More than 60% supported procuring organs from anencephalic and \"higher brain-dead\" patients, although patients in both groups are not dead by current legal standards. Performance on items relating to so-called non-heart-beating organ donation suggested that 75% of the group do not support non-heart-beating organ donation without assurance that the donors are brain-dead before procurement begins. Given that current recommendations to increase organ donation look to non-heart-beating organ donation rather than to anencephalic patients and those in a persistent vegetative state, these findings suggest that further ethical discussion and analysis are urgently needed.","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 4","pages":"210-8"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21731368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

Ethical dilemmas in living donor organ transplantation. 活体器官移植的伦理困境。

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.7182/prtr.1.9.4.p724081835344u31

M T Nolan

{"title":"Ethical dilemmas in living donor organ transplantation.","authors":"M T Nolan","doi":"10.7182/prtr.1.9.4.p724081835344u31","DOIUrl":"https://doi.org/10.7182/prtr.1.9.4.p724081835344u31","url":null,"abstract":"Living related donors are an increasing source of organs for transplantation. Although the use of this type of donation is widespread in the United States, the practice of placing donors at risk for injury or illness without physical benefit can create ethical dilemmas for health professionals dedicated to healing and avoiding harm. It is important for transplantation professionals to be familiar with the risks and benefits associated with living donation within their own specialty area. Placing living donation within an ethical framework can allow for careful consideration and guide decision making in each individual case. Drawing upon the literature for examples from several of the transplantation specialty areas, this article reviews some of the risks and benefits associated with living donation and identifies the limits of the utilitarian and casuistic ethical framework in guiding decision making in living donation. An ethical framework of virtue-principlism is offered as one which is grounded in an understanding of what it is to be human and in the nature of the health professional-patient relationship.","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 4","pages":"225-9; quiz 230-1"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21731370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

The “Noncompliant” Transplant Patient: A Persistent Ethical Dilemma “不服从”移植病人:一个持续的伦理困境

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.1177/090591999900900403

S. S. Edwards

{"title":"The “Noncompliant” Transplant Patient: A Persistent Ethical Dilemma","authors":"S. S. Edwards","doi":"10.1177/090591999900900403","DOIUrl":"https://doi.org/10.1177/090591999900900403","url":null,"abstract":"Journal of Transplant Coordination, Vol. 9, Number 4, December 1999 (eg, throwing) potentially infectious blood or body fluids, or even attacking providers and/or other patients. The negative effects of these types of behaviors may be minimal, moderate, or severe; however, in most instances, the effects are felt not only by the patient but by those around the patient as well. When patients act in ways that healthcare providers find undesirable or counterproductive, the provider’s initial impression may be that the patient is simply choosing to be difficult. However, it is important to consider the potential causes for the patient’s behavior. For instance, a patient who is not taking medication properly may have forgotten the doctor’s instructions. A patient may not be able to read and may be too embarrassed to ask anyone else for assistance, or may choose not to take the medication in the way it was prescribed (or at all) because of the unpleasant side effects it causes. A heart patient may not be following the prescribed “heart healthy” diet because of certain social or cultural norms in the community. Perhaps the prescribed diet is too expensive in light of the fact that the rest of the family won’t eat it and the patient cannot afford to buy additional food. In some cases, the problem may have more to do with distrust of the healthcare system or of specific providers; patients may simply not believe what the physician or other provider has told them or may be worried that they are being lied to or taken advantage of by the provider. And, of course, it is always possible that in The “noncompliant” transplant patient: a persistent ethical dilemma","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"202 - 208"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65466861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethical Assessments of Brain Death and Organ Procurement Policies: A Survey of Transplant Personnel in the United States 脑死亡和器官获取政策的伦理评估:美国移植人员的调查

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.1177/090591999900900404

J. DuBois

{"title":"Ethical Assessments of Brain Death and Organ Procurement Policies: A Survey of Transplant Personnel in the United States","authors":"J. DuBois","doi":"10.1177/090591999900900404","DOIUrl":"https://doi.org/10.1177/090591999900900404","url":null,"abstract":"Journal of Transplant Coordination, Vol. 9, Number 4, December 1999 These attacks on whole brain death criteria for diagnosing death are likely reinforced by two things. First, brain-dead bodies do reveal many signs of life—even if this life is no longer regarded as the life of a human being. These signs can include maintaining a spontaneous heartbeat, fighting infections, digestion, demonstrating spinal reflexes, and, in some spectacular cases, sustaining a pregnancy.2,8,9 Second, popular media reports sometimes speak of brain death as a disorder rather than as the biological and legal death of a person. For example, nearly a decade after the Uniform Determination of Death Act, one headline announced “Brain-dead woman gives birth, then dies” (San Francisco Chronicle, August 4, 1993). The effects of these skeptical concerns about brain death are ambiguous. On the one hand, these challenges have not led to any mainstream, concerted efforts to change the Uniform Determination of Death Act or organ procurement policies. Policy proposals that seriously consider skeptical views regarding brain death quite frequently move in a more liberal, rather than a more conservative, direction. A common conclusion following from denials that Ethical assessments of brain death and organ procurement policies: a survey of transplant personnel in the United States","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"210 - 218"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65466925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Ethical analysis of organ recovery denials by medical examiners, coroners, and justices of the peace. 法医、验尸官和治安法官拒绝器官恢复的伦理分析。

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.7182/prtr.1.9.4.q022hjm60630w514

T J Shafer, L L Schkade, L A Siminoff, T A Mahoney

{"title":"Ethical analysis of organ recovery denials by medical examiners, coroners, and justices of the peace.","authors":"T J Shafer, L L Schkade, L A Siminoff, T A Mahoney","doi":"10.7182/prtr.1.9.4.q022hjm60630w514","DOIUrl":"https://doi.org/10.7182/prtr.1.9.4.q022hjm60630w514","url":null,"abstract":"Context: Despite its pivotal nature, until the early 1990s the role of medical examiners, coroners, and justices of the peace was largely ignored in discussions of the critical shortage of organs for transplantation in the United States. These officials have the right to determine, from a medico-legal perspective, whether a deceased person can be an organ donor. Thus, they play an important role in the donation process. Using a principles-based ethical framework, this article examines the problem of nonrecovery of life-saving organs for transplantation in the United States because a medical examiner or other official denies recovery.Objective: The goals of organ donation and the collection of forensic evidence are not mutually exclusive. An analysis of the ethical principles and obligations of beneficence, respect for autonomy, and justice reveals that medical examiners and other officials could probably, after appropriate review, release all cases under their jurisdiction for organ donation.Conclusion: Medical examiners, coroners, and justices of the peace could assume a leadership role, working together on public policy with medical, social, and legal groups, spearheading efforts to stop the loss of organs due to official denials, up to and including state and federal regulation and legislation. Beyond their professional obligations, as agents of a social institution, medical examiners and other officials have the more general ethical responsibility of promoting the public health and welfare and of reinforcing societal consensus that transplantation is a social good which should be optimized through formal and informal activities.","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 4","pages":"232-49"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21731371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Ethical Analysis of Organ Recovery Denials by Medical Examiners, Coroners, and Justices of the Peace 法医、验尸官和治安法官拒绝器官恢复的伦理分析

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.1177/090591999900900407

T. Shafer, L. Schkade, L. Siminoff, T. Mahoney

{"title":"Ethical Analysis of Organ Recovery Denials by Medical Examiners, Coroners, and Justices of the Peace","authors":"T. Shafer, L. Schkade, L. Siminoff, T. Mahoney","doi":"10.1177/090591999900900407","DOIUrl":"https://doi.org/10.1177/090591999900900407","url":null,"abstract":"Journal of Transplant Coordination, Vol. 9, Number 4, December 1999 criteria,133 1 45 including the use of organs from non–heart-beating donors.158-167 Despite its pivotal nature, until the early 1990s the role of medical examiners, coroners, and justices of the peace (ME/C/JPs) in the organ shortage was largely ignored, with a few notable exceptions.158-160 ME/C/JPs have the right to determine, from a medicolegal perspective, whether a deceased person can be an organ donor. In medical examiner jurisdictions, the medical examiner (who is a physician) must give permission for organ recovery to proceed. In coroner or justice of the peace jurisdictions where there is no medical examiner system, the coroner or justice of the peace must give permission for organ recovery to proceed. “In effect, the [ME/C/JP’s] decision to allow procurement surgery is a sine qua non for organ transplantation.”184 Thus, as can be seen, ME/C/JPs play an important role in the donation process, reviewing Ethical analysis of organ recovery denials by medical examiners, coroners, and justices of the peace","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"232 - 249"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65466712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

The Dilemma of Too Few Hearts 红心太少的困境

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.1177/090591999900900413

N. Long, A. Borkon

引用次数: 0

Book Review: The Multi-Organ Donor: Selection and Management 书评:《多器官捐赠者:选择与管理》

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.1177/090591999900900415

S. Dunn

引用次数: 0

Financial incentives: alternatives to the altruistic model of organ donation. 经济激励:器官捐赠利他模式的替代方案。

Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO) Pub Date : 1999-12-01 DOI: 10.7182/prtr.1.9.4.g5070676r738l7lq

L A Siminoff, M D Leonard

{"title":"Financial incentives: alternatives to the altruistic model of organ donation.","authors":"L A Siminoff, M D Leonard","doi":"10.7182/prtr.1.9.4.g5070676r738l7lq","DOIUrl":"https://doi.org/10.7182/prtr.1.9.4.g5070676r738l7lq","url":null,"abstract":"Improvements in transplantation techniques have resulted in a demand for transplantable organs that far outpaces supply. Present efforts to secure organs use an altruistic system designed to appeal to a public that will donate organs because they are needed. Efforts to secure organs under this system have not been as successful as hoped. Many refinements to the altruistic model have been or are currently being proposed, such as \"required request,\" \"mandated choice,\" \"routine notification,\" and \"presumed consent.\" Recent calls for market approaches to organ procurement reflect growing doubts about the efficacy of these refinements. Market approaches generally use a \"futures market,\" with benefits payable either periodically or when or if organs are procured. Lump-sum arrangements could include donations to surviving family or contributions to charities or to funeral costs. Possibilities for a periodic system of payments include reduced premiums for health or life insurance, or a reciprocity system whereby individuals who periodically reaffirm their willingness to donate are given preference if they require a transplant. Market approaches do raise serious ethical issues, including potential exploitation of the poor. Such approaches may also be effectively proscribed by the 1984 National Organ Transplant Act.","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 4","pages":"250-6"},"PeriodicalIF":0.0,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21730755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13