PROFESSIONALISM Flashcards
What does the Human Tissue Act 2004 do?
It regulates the removal, storage and use of human tissues for research, pt treatment, post-mortem examination, anatomical examination, surgical training and display in public
Its primary aim is to ensure that these activities are conducted with proper consent, respect for the individual, and regard for public health and safety.
What are the rules with taking material from the deceased under the HTA?
Consent can be given from the individual whilst they are alive and have capacity to consent
If the individual did not indicate this then those close to them can be asked whether a nominated representative was appointed. If not then a person in a qualifying relationship can make the decision
What is the Human Tissue Authority?
The independant regulatory body that oversees compliance with the Human Tissue Act
Ethical issues surrounding the use of human tissue
Informed consent
Respect for autonomy, dignity
Cultural considerations
Confidentiality and data protection
What are independant assessors for organ donation?
These are people that gather information about the donor and recipient during a statutory interview and submits their report to the HTA who will make the final decisions to go ahead with the donation
What is the purpose of independent assessors?
To prevent donors being forced against their will or coerced
That no reward has been offered
That the donor has capacity to make an ifnromed decision
What are the conditions for the living donor?
Donor is competent and over 18
Risk to donor is low - may be to do with comorbidities or smoking etc
Decisions are fully informed
Decision must be voluntary and not coerced or incentivised
Transplant must have a good chance of a successful outcome
What are directed and non-directed organ donations?
Directed Donation is when the donor names a specific person who will receive the kidney. It is the most common type of living donation. Directed donations are often between blood relatives, like parents, siblings, or children. They can also happen between people with close personal relationships, such as a spouse, friend, or coworker.
Non-directed donation is when a person donates anonymously to someone in need. They usually do not have any kind of relationship with the person who gets their donated kidney. Other names for a non-directed donor include an altruistic or “good Samaritan” donor.
What is taken into consideration when transplantation decisions made?
Urgency status
Blood group and HLA matching
Weight and height of donor compared to recipient
Geography
How long pts have waited for
Life expectancy - note age itself should not be used to restrict transplantations according to the Age Discrimination Act 1975
Who manages blood and transplantation services to the UK?
NHS Blood and Transplant
What is Donation after Circulatory Deatg?
The retrieval of organs for the purpose of transplantation from patients whose death is diagnosed and confirmed using cardio-respiratory criteria
What are controlled and uncontrolled Donation after Circulatory death?
Uncontrolled - organ retrieval after a cardiac arrest that is unexpectated and from which the pt cannot or should not be resuscitated
Controlled - after a death which follows the planned withdrawal of life-sustaining treatments that have been considered to be of no overall benefit to a critically ill pt on ICU or in ED
What is donation after Brainstem Death?
This is retrieval of organs from patients whose death has been confirmed using neurological criteria where Brian injury is suspected to have cause irreversible loss of the capacity for consciousness and respiration before terminal apnoea has resulted in hypoxic cardiac arrest and circulatory standstill i.e. only possible in pts on mechanical ventilation
These organs are usually in better condition than DCD!
Allocation process for donation after circulatory death and donation after brainstem death?
DCD - typically allocated regionally to reduce time between organ retrieval and transplantation = improves success rates
DBD - typically allocated nationally via the National Allocation Scheme = allows organs to be matched with the most suitable recipients across the country’s
Law on organ donation in the UK?
Since March 2020 England operated under an opt-out system known as “deemed consent” or “Max and Keiras law”
Note if you do not opt out then the family is always involved before donation takes place
If someone is under 18 then the family will be asked to make the decision and provide consent. Other people excluded are those who lack the mental capacity to understand the changes for a significant period before their death and those who have not loved in England for at least 12 months before their death
Why was it important for the UK to change to an opt-out organ donation system?
80% of people in ENgland support organ donation but only 38% had opted in so families were often left with a difficult decision when a loved one died
There is a shortage of donors and last year 408 pts died on the transplant waiting list - aim to increase organ donation numbers
There are over 5000 people waiting on the organ transplant list
ethics of opt in vs opt out organ donation
Opt in system respected autonomy by requiring explicit consent whereas opt-out is presumed consent
Opt-in system may lead to lower donation rates due to lack of awareness or encouragement which can limit the number of organs. Opt-out systems tend to increase organ donation rates which can save more lives (promotes beneficence)
Issues with family members decisions conflicting with the individual’s stated wishes
For the opt-out system to work ethically it requires high levels of public awareness and education. It must ensure it does not disproportionately affect certain groups e.g. some groups of people may have limited access to information
The opt-out system can challenge public trust if they perceive it as infringing on personal freedom
Opt-out system can overcome many traditional barriers to organ donation e.g. lack of education or transplant awareness
What is a deductive argument?
An argument where the conclusion logically follows from the premise is.e. If the premises are true then the conclusion must also be true
“All humans are mortal. Socrates is human. Therefore, Socrates is mortal”
What is an inductive argument?
An argument where the conclusion is likely to be true if the premises are true but it is not garunteed
“Most Greeks eat olives. Socrates is a Greek. Therefore Socrates eats olives”
What make an argument valid?
If all of its premises were true then the conclusion would have to be true
(The conclusion must follow on from the premise and its impossible for the conclusion to be false if the premises are true)
Note that validity says nothing about whether or not any of the premises are true - it’s more about the form of an argument than the truth of the argument
What make an argument sound?
When it is valid AND all the premises are true
What is the straw man fallacy?
the logical fallacy of distorting an opposing position into an extreme version of itself and then arguing against that extreme version. In creating a straw man argument, the arguer strips the opposing point of view of any nuance and often misrepresents it in a negative light.
What is the Ad hominem fallacy?
argumentative strategies that involve criticizing an opponent’s character, motive, background, or other personal attributes instead of their argument’s content.
What is the appealing to emotion fallacy?
An informal fallacy characterized by the manipulation of the recipient’s emotions in order to win an argument, especially in the absence of factual evidence.
What is the begging the question fallacy?
an informal fallacy that occurs when an argument’s premises assume the truth of the conclusion
“People have known for thousands of years that the earth is round. Therefore, the earth is round.”
What is the argument from fallacy?
The formal fallacy of analyzing an argument and inferring that, since it contains a fallacy, its conclusion must be false
How do you check if an argument is valid?
- Check whether it is possible for the premises to be true while the conclusion is false -> if not possible the argument is valid
How do you check if an argument is sound?
- Check its valid: is it impossible for the premises to be true whilst the conclusion is false?
- Assess whether the premises are true
If both conditions met then argument is sound
