Tag: organ donors

Bioethics News

Organ donation from euthanized patients. The practice is controversial and currently only allowed in Belgium an Netherlands

In 2015, 2023 patients were euthanized only in Belgium.  Organ donation from euthanized patients These patients could, in theory, be organ donors; however, 926 (45.8%) were excluded because they were over 75 years old.

A total of 684 organs were eventually useful for donation in Belgium. But, in Belgium and Netherlands, the countries that this practice is permitted, it is rarely performed; as of August 2016, 43 patients undergoing euthanasia had donated organs. The same year, 1288 Belgian patients were on transplant waiting lists (See HERE).  It is clear that, although the organs from euthanized subjects could in some measure reduce transplant waiting lists, the fact that they are obtained from euthanized patients presents unquestionable ethical difficulties.

La entrada Organ donation from euthanized patients. The practice is controversial and currently only allowed in Belgium an Netherlands aparece primero en Bioethics Observatory.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Organ donation for transplantation in children with cardiac arrest and dying person dignity

Premortem interventions before donation in circulatory arrest in children could have objective ethical problems 

(See our special reports about criterion of death and organs transplantation HERE)

Up until a few years ago, performing medical interventions in end-of-life situations had been proposed as actions centered on the best interests of the dying patient.

The growing demand for organs for transplantation has created a need to increase the number of organ donors (see HERE).

Since the number of brain-dead donors is currently insufficient to meet the needs of patients on the transplant waiting list, medical procedures have been developed in the last decade aimed at ensuring that the organs from donors in cardiac arrest are also suitable for successful solid organ transplantation (see HERE our article about the relation between excellent figures of organ donation and organ donors with cardiac arrest in Spain).

Nevertheless, in order to achieve sufficient organ viability in donors with cardiac arrest, a series of medical procedures need to be performed that have the main aim of reducing the warm ischaemia time to which these organs are subjected, in order to increase the chances of post-transplant success.

An article has recently been published in the Journal of Medical Ethics (1“Premortem interventions in dying children to optimise organ donation: an ethical analysis”, whose authors Joe Brierley and David Shaw analyze the ethical and legal aspects of premortem interventions performed in dying children, aimed at optimizing organ donation for transplantation following cardiac arrest.

Premortem interventions in pediatric patients for organ donation from an ethical perspective

This article examines the legislative aspects (specific to the United Kingdom), and also gives a description and analysis of the elements that, from an ethical perspective, might support – or contradict – the performance of premortem interventions in pediatric patients for organ donation.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

My Sister’s Keeper: An Assessment of Living Organ Donation among Minors

by Alex Fleming

The 2009 film My Sister’s Keeper, based on Jodi Picoult’s 2004 New York Times bestselling novel which bears the same name, is among other things, a controversial story about a young girl (Anna Fitzgerald) who sues her own parents in order to obtain legal rights to the use of her body. For as long as she can remember, Anna has unwillingly been providing blood and bone marrow to her older and critically ill sister, Kate. As the story unfolds, tension within the family arises as the 13 year-old Anna Fitzgerald becomes fully aware of her reason for existence, so to speak, which is to prevent the death of her older sister by providing a regular supply of blood and bone marrow, which she has done regularly for several years. Later on, as Kate’s condition worsens and her renal function begins to fail, the parents naturally turn to Anna to provide what could be a life-saving kidney transplant for her older sister. The climax of the story begins as Anna confidently and heroically refuses. The story raises a slew of bioethical issues which are beyond the scope of this essay; however, the story sheds light on a topic worthy of discussion: living organ donation among minors.

As the supply of organs suitable for transplantation decreases and the demand for them increases, the question of living organ donation among those yet of age has become a question of greater concern, primarily among those who point to the various ethical implications which such a procedure creates.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Nudges and Reasoning

Back in what now seems like a previous age, when David Cameron was prime minister, there was quite a lot of attention paid to his so-called ‘nudge unit’. Nudges, named after Thaler and Sunstein’s well-known book, are ways of getting people to make better choices by making these options more salient or less effortful for them. For example, you can (apparently) nudge people to save more for retirement by changing the default option for retirement plans: when the default is a higher proportion of income people save more than when it is lower. Similarly, you can increase the proportion of organ donors by making the system opt out rather than opt in, and you can nudge people to eat healthier by ensuring that fruit, and not crisps or chocolate, is at eye level in the queue for the register in the lunch room.

Sunstein and Thaler promote nudges as both respectful of individual autonomy and as welfare promoting. They advocate ‘libertarian paternalism’: paternalism, because nudges are ways of making it more likely that people act in their own interests, in cases in which they would not otherwise do so, but libertarian because nudges don’t prevent people from acting as they like. If you want to buy crisps and not fruit, go right ahead (the crisps are there if you look). If you want to opt out of being an organ donor, all you have to do is say so. No real constraints are imposed by nudges after all. But nudges are controversial nevertheless.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Ethical questions about mitochondrial replacement in humans. Three parents babies

We thus consider it necessary to establish a moratorium on their use in humans, at least until more is known about these aspects. If this knowledge is obtained, ethical questions would still remain to be resolved, among which we consider the most relevant to be those related to the dignity and identity of the human embryo.

Children with two mothers and a father

In January 2017, the prestigious scientific journal Bioethics published a special edition dedicated to the ethical aspects of nuclear transfer techniques aimed at preventing the transmission of mitochondrial diseases, a topic that we have extensively addressed in our Observatory (see HERE).

Its editorial, Ethics of mitochondrial replacement, starts by referring to the recent birth of the first baby resulting from these techniques (see HERE). It then provides a brief description of the main characteristics of mitochondrial diseases, which are inherited exclusively from the mother. It explains that mothers who carry mutations in their mitochondrial DNA (mtDNA) face the uncertainty of not knowing if their genetic children will or will not inherit a serious mitochondrial disease. However the emergence of mitochondrial replacement techniques (MRT) offers these mothers hope, as healthy mitochondria from a donor are used to replace those of the mother. These techniques are maternal spindle transfer (MST) and pronuclear transfer (PNT), which consist, respectively, in removing the nucleus from a healthy egg or zygote, which will keep its mitochondria. The nucleus of the mother’s oocyte (patient or carrier of the mutation) or of another zygote obtained by fertilising the mothers egg is then transferred into the enucleated oocyte or zygote.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Vatican Defends China Invite to Organ Trafficking Summit

February 9, 2017

(BBC) – The Vatican has defended its decision to invite China to a conference on organ trafficking despite its record of using executed inmates as organ donors. The head of the Pontifical Academy of Sciences (PAS) admitted he did not know whether the practice was continuing but said he hoped to encourage change. Human rights groups say China is still using executed prisoners as a source of organ transplants. Beijing says forced organ harvesting ended in 2015.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Why Don’t More African Americans Become Organ Donors?

February 7, 2017

(BBC) – In 2016, African Americans accounted for 30% of the overall organ donation waiting list, and 33% of the kidney list, despite being only 13% of the US population. A black organ recipient doesn’t have to have a black donor. But they would be more likely to have a successful match – based on certain genetic markers and antibodies – if more black donors were available. The percentage of black Americans who donate organs has risen since 1988, but there is still an outsized need.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The lure of human-animal chimera research

Andrew Fenton and Letitia Meynell call for moral reflection on the primacy of capacities for determining the moral status of non-human animals used in human-animal chimera research.

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Last week Nature and Cell published research that takes us closer to creating non-human animal hosts for growing human organs. According to their Nature article, Tomoyuki Yamaguchi and colleagues modified rats to grow mouse pancreata that were then used to successfully treat diabetic mice. According to their Cell article, Jun Wu and colleagues modified embryonic pigs and allowed them to develop long enough to confirm that human cells could be successfully integrated into their tissues and organs.

Both studies represent advances in what is known as chimera research. Chimeras are animals (human or otherwise) possessing cells containing a genetic identity distinct from their parents and sometimes from their own species. Human-animal chimera research is largely motivated by shortages in human organs available for transplant. The hope is that in the not too distant future, part-human chimeric animals will grow what are effectively human organs to make up for the shortfall.

Cardiac muscle cells. Photo Credit: David C. Zebrowski, Felix B. Engel

This research is receiving a good deal of media attention. Some scientists express cautious excitement about the breakthroughs while other scientists and ethicists express worries about the use of non-human animals in such invasive research and question its legitimacy.

Ethical confusion is understandable. The non-human animals typically used in this research – mice, rats, pigs and cows – don’t have a high moral status in our society.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

JHU Projects Explore Ethical Challenges

Hub Staff Report/Crossposted from the HUB

 


 

“Why is it that most of the university’s focus on contemporary ethical issues is concentrated on health care, public health, and the biomedical sciences? Surely other professions and other disciplines also face important real world ethical issues—shouldn’t Hopkins faculty, staff, and students be addressing these issues as well?”

 

That question, posed by Johns Hopkins University trustee Andreas Dracopoulos to the Berman Institute of Bioethics, helped inspire and drive the JHU Exploration of Practical Ethics program, a grant program to fund research into interdisciplinary fields of ethics.

 

“IT IS EASY FOR US TO STAY AWAY FROM ISSUES LIKE WHAT WE’RE TALKING ABOUT TODAY. BUT IT IS IMPORTANT FOR US TO GRAPPLE WITH THESE ISSUES IN A THOUGHTFUL WAY, AND TO HAVE OUR OWN THOUGHT LEADERS COME TOGETHER.”

Sunil Kumar, JHU provost

The program provided funds for nine projects—some of which are still under way—that examine issues relating to criminal justice, higher education, economics, and environmentalism. At a symposium Tuesday, those projects were presented to members of the university community.

 

“Andreas’ provocative question—and it was provocative—set in motion a process of exploration among university leadership initiated by [JHU] President [Ronald J.] Daniels,” said Ruth Faden, the former director of the Berman Institute, in her remarks opening the symposium. “The goal of this process is to assess whether the university should expand its footprint beyond the traditional territories of bioethics and take on the full range of ethical challenges facing society.”

 

     Jon Spaihts, screenwriter of Passengers, and Prometheus, hosts the symposium

 

Some of the projects centered on ethical dilemmas surrounding climate change and pollution.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Organ Donation in France: A Move to the Opt-Out System

Legislation has recently come into effect in France that now presumes consent to organ donation. France’s previous policy required doctors to consult relatives in cases where deceased individuals had no clear directives regarding organ donation, and relatives refused in almost one third of the cases. The new policy means that all citizens will be organ donors unless they sign up on a ‘refusal register’. This legislation comes in the wake of persistent organ shortages and ever-growing transplant waiting lists. The hope is that an opt-out program will help alleviate this problem. Some have suggested that the opt-out system will increase donation rates through reducing next-of-kin vetoes, while others have claimed that more people will donate because it will now be the status quo.

 

Read more here and here

Other Posts


Organ Donation in France: A Move to the Opt-Out System





2017-01-05T23:01:54+00:00

Legislation has recently come into effect in France that now presumes consent to organ donation. France’s previous policy required doctors to consult relatives in cases where deceased individuals had no clear directives regarding organ donation, […]

  • Dr. Bruce Gelb

GBI excited to ​announce new President, Dr. Bruce Gelb





2016-12-13T01:59:15+00:00

Global Bioethics Initiative is pleased to announce the election of Dr. Bruce Gelb, M.D., F.A.C.S, as President of the Board of Directors. Dr. Gelb is an Assistant Professor of Surgery at NYU Langone Medical Center, […]


​​​The future of ​b​ioethics under President-elect Trump: Professor ​​Moreno​’s Thoughts​





2016-11-17T01:14:11+00:00

It is difficult to predict the fate of bioethics in the coming years under the new President-elect Trump, states Professor Jonathan Moreno, an Advisory Board member of Global Bioethics Initiative.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.