亲属活体供体活体移植的伦理考虑。[e] [e] [e] [e]。

Pediatrie Pub Date : 1993-01-01
L Sann
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引用次数: 0

摘要

本文就父母活体供体肝移植的主要伦理原则进行了探讨。看来,这种移植方法是提供给患者的一种新的可能性,不能在不干扰他们自由的情况下从父母的选择中减去。此外,有一种社会决断力来确保提供这种选择,但这种选择受到实现条件、时间和父母个人情况的限制。对供体和受者之间的风险、利益、优势和偏见的考虑表明,只要尊重适当的医学指示,这类移植是有利的平衡。然而,心理成本和负担的考虑值得特别注意,并在本文中详细说明,特别是关于动机和对捐助者的长期影响。无效和道德的普遍性检查赞成这样的程序。道德正义通常会得到尊重。考虑到需要捐助者同意的局势压力,需要特别注意自治问题。同意应该根据不同的情况进行适当的征求:捐赠者是明确明确地想捐献他的部分肝脏,还是只需要提供信息。过度招揽父母参与捐肝是合格的“强迫选择”;在某些情况下,父母不能有效地拒绝他们的参与,家长式的行为在道德上是可以接受的。提出了一种一般程序,以确保对供体和受者的心理、法律和道德保护。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Ethical considerations on live transplantation from living related donors. Le conseil d'éthique de l'hôpital Debrousse].

This review examines the ethical problems of liver transplantation from living parental donors regarding the main ethical principles. It appears that this method of transplantation is a new possibility offered to patients that cannot be subtracted from the parents' choice without interfering with their liberty. Moreover, there is a social decisiveness to ensure the offering of this option which is limited by the conditions of realisation, timing and personal situations of the parents. The considerations of risks, benefits, advantages and prejudices between donor and recipient show a favourable balance for this type of transplantation provided that adequate medical indications are respected. However, the considerations of psychological cost and burden deserve special attention and are detailed in this paper especially regarding the motivations and the long-term effects on the donor. Futility and ethical generalisation examinations favour such a procedure. Moral justice will generally be respected. The consideration of autonomy required special attention owing to the situation pressure upon the donor's consent. Consent deserves adapted solicitation according to variable situations: whether the donor explicitly specifically wanted to donate part of his liver or only required information. Excessive solicitation of parents' participation to liver donation represents qualified "forced choice"; in some situations where the parents cannot effectively refuse their participation, paternalistic action is ethically acceptable. A general procedure is proposed to ensure the psychological, legal and ethical protection of the donor and recipient.

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