尊重活体肾供者的自主权:放宽活体肾供者接受标准的论点。

IF 1.6 Q2 ETHICS
Monash Bioethics Review Pub Date : 2023-12-01 Epub Date: 2022-12-09 DOI:10.1007/s40592-022-00166-4
Alison C Weightman, Simon Coghlan, Philip A Clayton
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引用次数: 1

摘要

出于对捐赠者健康的考虑,医生通常会拒绝患有某些合并症(如糖尿病或肥胖)的活体肾脏捐赠者的捐赠。尽管肾移植持续短缺,活体供体肾移植的性能优于已故供体肾移植,但这种拒绝仍在发生。在本文中,我们认为医生这种家长式的拒绝是不合理的,在一定范围内,应该更多地接受这种捐赠。我们首先描述当前保守的捐助者接受指导方针和做法的可能的弱和强家长式的理由。然后,我们通过概述这种捐赠经常被低估的好处和通常被高估的危害来证明我们的立场,然后讨论尊重具有某些合并症的自愿捐赠者的自主权的必要性。最后,我们回应了一些可能反对我们建议更自由的肾脏捐赠者接受标准的意见。我们以澳大利亚的情况作为案例研究,但我们的论点适用于世界各地的类似情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Respecting living kidney donor autonomy: an argument for liberalising living kidney donor acceptance criteria.

Doctors routinely refuse donation offers from prospective living kidney donors with certain comorbidities such as diabetes or obesity out of concern for donor wellbeing. This refusal occurs despite the ongoing shortage of kidney transplants and the superior performance of living donor kidney transplants compared to those from deceased donors. In this paper, we argue that this paternalistic refusal by doctors is unjustified and that, within limits, there should be greater acceptance of such donations. We begin by describing possible weak and strong paternalistic justifications of current conservative donor acceptance guidelines and practices. We then justify our position by outlining the frequently under-recognised benefits and the routinely overestimated harms of such donation, before discussing the need to respect the autonomy of willing donors with certain comorbidities. Finally, we respond to a number of possible objections to our proposal for more liberal kidney donor acceptance criteria. We use the situation in Australia as our case study, but our argument is applicable to comparable situations around the world.

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来源期刊
CiteScore
2.70
自引率
6.20%
发文量
16
期刊介绍: Monash Bioethics Review provides comprehensive coverage of traditional topics and emerging issues in bioethics. The Journal is especially concerned with empirically-informed philosophical bioethical analysis with policy relevance. Monash Bioethics Review also regularly publishes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. Produced by the Monash University Centre for Human Bioethics since 1981 (originally as Bioethics News), Monash Bioethics Review is the oldest peer reviewed bioethics journal based in Australia–and one of the oldest bioethics journals in the world. An international forum for empirically-informed philosophical bioethical analysis with policy relevance. Includes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. One of the oldest bioethics journals, produced by a world-leading bioethics centre. Publishes papers up to 13,000 words in length. Unique New Feature: All Articles Open for Commentary
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