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MED-105 Medical Ethics ✅ > 10: Organ Donation ✅ > Flashcards

10: Organ Donation ✅ Flashcards

1
Q

Organ transplantation types

A

Auto-grafts

Allo-grafts

Xeno-grafts

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2
Q

Auto-grafts

A

Come from the recipients

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3
Q

Allo-grafts

A

Transplants between genetically non-identical individuals

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4
Q

Xeno-grafts

A

Tissues or organs transplanted from one species to another

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5
Q

Living donations

A

Living related: donated to a family member

Living unrelated: donated to a non-family member

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6
Q

Deceased donation

A

Donation after brain death: death diagnosis on neurological criteria

Donation after circulatory death: non-heart beating donation
-often after withdrawal of mechanical ventilation

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7
Q

Brain death

A

Irreversible loss of BRAINSTEM function

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8
Q

Criteria for brain death

A

Unconscious

Fail to respond to outside stimuli

Heartbeat and breathing can only be maintained using a ventilator

Clear evidence that serious brain damage has occurred and it cannot be cured

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9
Q

Issues with brain death

A

Notions of personhood:
-where is it located in the human body
-UK approach: a person seizes to exist when they have lost the capacity to have consciousness

Cultural and Religious Orders
-different views regarding death
-death rituals and ways of attending to the dead body
->e.g. burial or cremation

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10
Q

Paired donation

A

A and B are in a relationship but not genetically compatible

C and D in same situation

A compatible with C, B compatible with D.

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11
Q

Pooled donation

A

More than 2 pairs involved in a swap

Aka paired donation but more pairs

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12
Q

Types of organ donation

A

Non-directed

Directed

Conditional
-UK: all conditional deceased donation should be prohibited
-US: LifeSharers- allows people to register as donors and request their organs offers to members of the organization first

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13
Q

Ethical issues of living organ donation

A

Many more people are willing to receive organs than are willing to donate them

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14
Q

Issues relating to Cadaveric organ donation

A

Issues relating to the:
-definition of death
-ownership of the body

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15
Q

Issues relating to Xenotransplantation

A

A concern with mixing of species

Risk of transfer of diseases from animal to human

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16
Q

Legal framework of organ donation

A

Opt-in and opt-out system

People must actively register and remove themselves from the system

17
Q

Other systems of organ donation

A

Mandated choice
-people must record their choice at some point in their lives

Benefits in kind
-offering reimbursement, health insurance or priority

18
Q

UK: Deemed Consent Bill

A

All adults are considered potential donors unless they have recorded a decision not to donate and if:

-under 18
-lack mental capacity to understand the new arrangements
-visitors to England
-people who have lived in England for less than 12 months before their death

19
Q

Issues to consider with organ donation

A

Ethical considerations
- autonomy
- beneficence and non-maleficence
- decision-making

Legal Issues
- organ donation system
- donor registry
- opt-in or Opt-out system

Family Involvement
- soft or hard system

Organ Market

20
Q

Priority and Reimbursement System

A

In Israel

People who sign up for organ donation are given:
-priority on transplant list
-financial reimbursement for any medical expenses and lost work

21
Q

Organ markets

A

Organ trafficking and transplant tourism

Violate the principles of equity, justice and respect for human dignity

22
Q

Allocation of organs for transplantation

A

Restrictive selection for transplantation

-conditions associated with positive outcome

-clinical criteria

-co-morbidities

23
Q

Key factors for the allocation of organs

A

Urgency

Chance of success

Age of donor

Difference in age/size between donor and recipient

Proximity of medical centre

24
Q

Ethical principles relating to the allocation of organs

A

Utility = an action is to be right if it promotes more benefit than any alternative action

-allocation should maximise the estimated overall good adjusted for potential accompanying harms
-consider:
->patient survival,
->graft survival,
->quality of life,
->availability of alternative treatments and
->age
-social acceptance that we dont include socioeconomic status, career, race or education in determining who ought to recieve an organ

Justice = equality and distributive justice

-all people should have an equal right to the benefits of transplantation
-not only the good of the outcome but the good with the distribution

25
Q

Key ethical principles in LIVING donor kidney transplantation

A
  1. Altruism - selfless gift to others without expectation of remuneration
  2. Autonomy - valid consent
  3. Beneficence - actions that serve the best interest of patients
  4. Dignity - special status of the body
  5. Non-maleficence - do no harm
  6. Reciprocity - providing benefits or services to another as part of a mutual exchange
26
Q

Should Doctors encourage organ donation of a kidney?
Arguments for:

A

(Antonia Cronin)

A good thing to offer a gift

Medical good of society
-“If something is not wrong to do but is actually a good thing, then it cannot be wrong to encourage the doing of it”

27
Q

Arguments against doctors encouraging organ donation of a kidney

A

(Walter Glannon)
Do no harm

Secondary duty, not primary to promote organ donation

Act in best interests of patients and respect their autonomy

May be seen as coercion due to power imbalance

28
Q

GMC’s procedures for doctors to potential organ donors

A

Follow national procedure for identifying potential organs

Take account of the requirements in any relevant legislations when speaking with the patient

Make clear that any decisions about whether the patient would be a potential donation candidate is made by the transplant coordinator/team and not yourself

MED-105 Medical Ethics ✅ (8 decks)

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