Tag: organ procurement

Bioethics Blogs

Brain Death – 3rd Edition by Wijdicks

This third edition introduces new research in the intensive care unit, newly unearthed historical data on important US-UK differences, a thorough discussion of US guidelines and how it is used in hospital practices, and compares guidelines used elsewhere in the world. In this incisive work, the many complexities of diagnosis and management of brain death are examined but it also illuminates cultural beliefs and bioethical problems, highlights the nature of conferences with family members, and captures several organ procurement issues. The book also includes 30 commonly asked practice problems to resolve diagnostic uncertainties and conflicts along with 12 video clips to assist in neurological evaluation.  

Chapter 1: History of Brain Death

A New Comatose State Appears

Defining Neurologic Criteria for Death in Us

Chapter 2: Neurology of Brain Death

The Pathology of Brain Death

Clinical Examination in Adults

The Clinical Determination of Brain Death in Children

Documentation

Teaching Brain Death Determination

Errors and Alleged Recoveries

Legal Definitions and Obligations

Chapter 3: International Criteria of Brain Death

Guidelines in the United Kingdom

Guidelines World Wide

Consensus for a Uniform World Wide Standard

Chapter 4: Beliefs About Brain Death

Religious Beliefs

Cultural Views

Religious Conflict Resolution

Chapter 5: Critics and Brain Death

The Uncertainty of Death

Emerging Controversies

Critique

Chapter 6: Procurement After Brain Death 

Transitioning to Organ Donation

Organ Procurement Organizations

Organ Donation Requests

Preparation for Determining Organ Suitability

Donation Protocols

Medical Management of the Organ Donor

Chapter 7: Clinical Problems in Brain Death and Organ Donation

1. The Qualifications of the Examiner

2. Clinical Mimics

3.

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 News

Organ Trafficking Claims from Vietnam Renew Questions about Abuses in China

March 7, 2017

(The Epoch Times) – Such “violations of the law” may come in the form of abducting innocent individuals and murdering them to sell their organs, according to revelations from Vietnam last year that have not previously been documented in English. In July 2016, Vietnam police issued internal circulars regarding Chinese kidnappers harvesting the vital organs of vulnerable people in a border province, according to documents obtained by Epoch Times. In October, state television aired investigative reports on China’s underground organ procurement operations, partly targeting Vietnamese.

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 Transplants in the US Are on the Rise, but the Reason Why Means It’s Not Exactly a Public Health Triumph

January 10, 2017

(Quartz) – Organ transplants in the United States reached a record high for the fourth consecutive year. In 2016, more than 33,600 organ transplants were performed in the US, according to preliminary data from the Organ Procurement and Transplantation Network (OPTN). The total number of transplants increased nearly 9% from the year prior and a whopping 20% since 2012, when around 28,000 transplants were performed.

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

Transplant doctors clash over Chinese organ donor system

Criticism of alleged forced organ harvesting in China reached fever pitch this week as the 26th International Congress of The Transplantation Society convened for the first time on Chinese soil.

The Congress, which opened in Hong Kong on Wednesday, features a number of presentations from Chinese researchers, including former Vice-Minister for Health Huang Jiefu, and marks the end of a longstanding Transplantation Society (TTS) embargo on research from China.

Despite claims from Chinese officials that organs will no longer be harvested from executed prisoners, experts from around the world have slammed TTS for this year’s Congress, saying it implies implicit endorsement of current and past organ harvesting practices in China.

In an article published on Wednesday in the American Journal of Transplantation, a day before the Congress opened in Hong Kong, doctors and members of a non-governmental medical organization questioned the “veracity of the announced changes”:

“It is noticeable that China has neither addressed nor included in the reform a pledge to end the procurement of organs from prisoners of conscience, nor have they initiated any legislative amendments…Until we have independent and objective evidence of a complete cessation of unethical organ procurement from prisoners, the medical community has a professional responsibility to maintain the academic embargo on Chinese transplant professionals.”

Current TTS president Philip O’Connell and past president Jeremy Chapman, both Australian doctors based in Sydney, have been heavily criticised for ongoing collaboration with researchers from Chinese hospitals.

Despite having expressed grave concerns about China’s practices as late as December 2013, Jeremy Chapman told the Sydney Morning Herald earlier this year that he believes China has ended the use of organs from executed prisoners. 

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

The Difficult Ethics of Organ Donation from Living Donors

June 28, 2016

(The Wall Street Journal) – Earlier this year, an Organ Procurement and Transplantation Network and UNOS working committee wrote a report about the ethical considerations of a type of “imminent-death donation,” in which a living donor through a surrogate donates an organ before the planned withdrawal of ventilator support. The committee found that, under certain circumstances, the practice may be ethical, but some people who read the report expressed significant enough concerns that the committee determined, for now at least, that it didn’t want to move forward with trying to change UNOS policy. The report is expected to be posted soon for public comment.

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

Public Education and Misinformation on Brain Death in Mainstream Media

The results of this study in Clinical Transplantation should come as no surprise.  Mainstream media provides poor education to the public on brain death. 

The authors argue that because public understanding of brain death impacts organ and tissue donation, it is important for physicians, organ procurement organizations, and transplant coordinators to improve public education on this topic.

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

China’s Terrible Transplant Secret

Guest Post by Wendy Rogers
Earlier this year, a Malaysian politician, Datuk Bung Moktar Radin, travelled to China to receive a kidney transplant.  The details are scanty. There is no mention of the source of the kidney that the Malaysian MP received.  Reports of foreigners travelling to China for transplants rarely make the media, yet they may be an important link in trying to untangle the secrets of China’s secretive transplant system.

Back in the early to mid-2000s, Chinese hospitals brazenly advertised on the internet for foreign customers, offering kidney, liver and heart transplants with astonishingly short waiting times of 2-4 weeks.  In contrast, patients in countries like Australia, the UK, and the US typically wait years, with many dying before an organ becomes available.  Despite initial denials, Chinese officials eventually admitted that virtually all their organs were sourced from executed prisoners.  Using executed prisoners as organ donors is uniformly considered unethical because of concerns that prisoners may be manipulated or coerced rather than being genuine volunteers.  Voluntary donation is at the heart of most transplant programs world-wide, although there are exceptions.

Violating this ethical principle by selling organs from executed prisoners to foreign (and Chinese) patients might seem enough to make China a pariah in the international transplant community.  But this is only one part of China’s terrible transplant secret. Reputable international investigators have gathered evidence that Chinese prisoners of conscience, mainly Falun Gong practitioners, Uyghurs, house Christians and Tibetans, are murdered for their organs.  Falun Gong practitioners, who make up the bulk of the millions of Chinese citizens in “re-education through labour (laojiao)” camps, are subject to medical tests to examine the health of their transplantable organs.

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

Facial Recognition Software and Improved Organ Donor Matching

Linda Wright briefly explains “hoped-for” GeneSetMatch technology and highlights problems for informed consent and public trust.

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Progress requires imagination. New ideas on how to find more organs for transplantation bring welcome hope of extending more lives. Some initiatives use science to improve the medical acceptability of more organs, whilst others, such as social media, reach out to more people to increase the chance of finding more organ donors.

Organ donation cannot succeed without public trust. Recent controversies about unfair access to transplantation by those using social media to find donors has had a negative impact on the public’s perception of the transplant system. This strategy has also found suitable organs donors, however.

GeneSetMatch is a new research idea. The developers hope to apply science and bioinformatics to explore possible ways of using facial recognition to find living organ donors. They want to develop software to link facial features with HLA types. The goal is to identify persons likely to have immune system genes that match someone who needs an organ transplant. This technology could potentially identify more potential living donors. As living donation is the best treatment for most people needing a kidney transplant, this could be exciting.

Simultaneously, the technology being developed by GeneSetMatch raises interesting questions about how people relate to each other, and about the application of science in the modern world. Will this technology (or something similar) be seen as a major breakthrough? Or, will such technology result in another controversy similar to that with the use of social media to find organ donors?

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

Record Number of Organ Transplants Performed in US Last Year

By Kaitlyn Schaeffer
Last year 30,973 transplants were performed in the US, setting a record for the procedure, according to the Organ Procurement and Transplantation Network. This number represents nearly a 5% increase from 2014.
“This landmark achievement is a testament to the generosity of the American public to help others through donation, and their trust in the transplant system to honor their life-saving gift,” said Betsy Walsh, president of the Organ …

The post Record Number of Organ Transplants Performed in US Last Year appeared first on 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.