scholarly journals Organ Donation and the Ars Moriendi

2019 ◽  
Vol 86 (4) ◽  
pp. 327-334
Author(s):  
Stephen Doran
Keyword(s):  
Organ Donation ◽  
Human Person ◽  
Organ Donor ◽  
Third Party ◽  
Organ Donors ◽  
Potential Organ Donor ◽  
Ars Moriendi ◽  
Dying Patients ◽  
Donation Process ◽  
The Impact

Organ donation is rightly understood as a gift that is a genuine act of love. Organ donation as an act of love requires it to be an act of freedom that honors the integrity of the human person who is in the process of dying. However, the process of organ donation, by necessity, inserts a third party of interest whose primary aim is to assist someone other than the dying person. Caregivers can become “organ focused” instead of “patient focused.” The procurement of organs potentially results in the commodification of the potential organ donor. Furthermore, death is not a momentary event but rather an ontological change in the person where the union of body and soul becomes divided. This Catholic understanding of death is important to assess the impact of organ donation on the process of dying. Family members of organ donors often have traumatic memories associated with the organ donation process, potentially overshadowing the ars moriendi—the art of dying. Summary: While organ donation is an act of love, the donation process can be distraction from the care of the dying patient, who may be treated differently than other dying patients who are not organ donors. A Catholic understanding of death is helpful in assessing the impact of the organ donation process.

Chaplain “DOs and DON’Ts” on Organ Donation

2018 ◽  
Vol 43 (7) ◽  
pp. 1-2
Author(s):  
Jozef Zalot ◽  
Keyword(s):  
Organ Donation ◽  
Organ Procurement ◽  
Family Members ◽  
Organ Donor ◽  
Organ Donors ◽  
Vital Organ ◽  
Course Of Action ◽  
Donation Process ◽  
Organ Procurement Organizations ◽  
The Relationship

This guide was developed in collaboration with LifeCenter Organ Donor Network (Cincinnati, OH) to offer chaplains a framework for the best possible course of action when they provide spiritual care to family members of patients who are potential vital organ donors. Some organ procurement organizations (OPOs) may want to control the donation process. They are thus hesitant to invite in—let alone collaborate with—any “outsiders” who they believe might undermine the likelihood of procuring vital organs. So how should a chaplain respond when ministering to potential vital organ donors and their families? Should they speak with family members about donation? What should they say? Do OPOs want chaplains to speak with family members? Should there be limits to these conversations? This can be a touchy area, because vital organ donation necessarily entails the death of the patient. This makes the relationship between chaplains and OPOs sometimes strained.

scholarly journals Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Paola Frati ◽  
Vittorio Fineschi ◽  
Matteo Gulino ◽  
Gianluca Montanari Vergallo ◽  
Natale Mario Di Luca ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Donor ◽  
Legal Framework ◽  
Organ Donors ◽  
Organ Perfusion ◽  
Medical Mission ◽  
Legal Implications ◽  
Legal Context ◽  
Successful Transplantation ◽  
Italian Context

A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. “Elective ventilation” (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation.

scholarly journals Real-Time Healthcare Intelligence in Organ Transplantation

2018 ◽  
pp. 128-152
Author(s):  
Bruno Fernandes ◽  
Cecília Coimbra ◽  
António Abelha
Keyword(s):  
Decision Making ◽  
Organ Transplantation ◽  
Organ Donor ◽  
Decision Making Process ◽  
Organ Donors ◽  
Potential Organ Donor ◽  
Critical Areas ◽  
Deceased Donors ◽  
End Stage ◽  
Donor Criteria

Organ transplantation is the best and often the only treatment for patients with end-stage organ failure. However, the universal shortage of deceased donors results in a worrying situation that must be addressed. Brain dead donors constitute the largest share of organ donors, but identifying a patient that may progress to brain death can be a complex task. Therefore, the urgent need of intelligent solutions to support the decision-making process is crucial in critical areas as the organ transplantation is. This work aims at acquiring knowledge on the potential organ donor criteria for further detection and implementing a platform to assist the process of identification of potential organ donors at Centro Hospitalar do Porto – Hospital de Santo António. The developed system is currently implemented and displays a steady and competent behavior providing consequently a way to have more control of the information needed for the decision-making process

Introducing an Organ Donor Registry is Saskatchewan

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Amy Zarzeczny ◽  
◽  
Luiza Radu ◽  
Keyword(s):  
Organ Donation ◽  
Public Interest ◽  
Public Awareness ◽  
National Level ◽  
Organ Donor ◽  
Organ Donors ◽  
Media Campaign ◽  
Organ Donations ◽  
Paper Form ◽  
Evaluation Metric

On 3 September 2020, Saskatchewan launched an organ donor registry that allows participants 16 years and older to register their intent to be an organ donor either online or using a paper form. Saskatchewan has historically performed poorly at a national level with low rates of organ donations. Saskatchewan's new registry is intended to increase the numbers of organ donors in the province, while also helping to modernize its organ donation system and ease donation conversations with families. Saskatchewan's introduction of this registry brought the province in line with other provinces and territories across Canada that use similar systems, and provided a response to the surge in public interest around organ donation that followed the Humboldt Bronco bus crash tragedy and related ``Logan Boulet Effect.'' The 2019-2020 and 2020-2021 provincial budgets included dedicated funding for the development and launch of the registry, which was accompanied by a media campaign to increase public awareness. Though it is too early to evaluate the success of the registry, early indications suggest donation rates will be a key evaluation metric. Registries are commonly thought to help increase public awareness of, and support for, organ donation, but improving Saskatchewan's organ donation rates will likely also require companion measures to strengthen the culture and practice of donation in the province.

Abstract 16: Sex Disparities in Organ Donation: Finding an Equal Donor Pool

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Erika Yee ◽  
Seyedeh Maryam Hosseini ◽  
Bianca Duarte ◽  
Shannon Knapp ◽  
Nancy K Sweitzer ◽  
...  
Keyword(s):  
Organ Donation ◽  
Family Member ◽  
Family Members ◽  
Organ Donor ◽  
Medical Mistrust ◽  
Organ Donors ◽  
Donor Pool ◽  
Men And Women ◽  
Willingness To Donate ◽  
Amazon's Mechanical Turk

Introduction: The majority of living organ donors are women, and the majority of deceased organ donors are men. This poses a problem for transplant candidates who have worsened survival with sex mismatched organs. The objective of this study was to identify reasons for disparities in organ donation between sexes and identify strategies to increase organ donors. Methods: We conducted a fifteen question survey using a crowdsourcing marketplace, Amazon’s Mechanical Turk, in September 2019. The survey assessed how participants make decisions about becoming an organ donor. The survey was distributed to U.S. adult participants, including eight write-in questions and two Likert scale questions. Qualitative descriptive analyses were used to understand reasons for and against becoming an organ donor. Quantitative results were compared with t test. Results: Among the 667 eligible participants representing 49 states, 54.9% were women and 63.1% were in the 18-40 age group. The majority of men (64.8%) and women (63.4%) were registered organ donors. Among men and women donors, three themes guided their willingness to donate: desire to help others, personal experience with organ donors/recipients, and believing organs would have no use to the donor once dead. Among men and women non-donors, decisions were guided by three themes: no reason, medical mistrust, considering becoming a donor. Themes varied by sex when considering whether to donate organs of a deceased family member. Women were guided equally by two themes: family member’s wishes and believing the deceased family member had no further use for organs. Men had similar themes but valued the family member’s wishes more. Women’s willingness to donate their own organs to family members (p=0.03) and strangers (p=0.02) was significantly higher than men. Among non-donors, both sexes would consider becoming organ donors if more information was provided. Conclusion: In a national survey of adults, women and men had similar reasons for becoming and not becoming an organ donor. However compared to men, women were more willing to donate their organs and more altruistic in the donation of family members’ organs. Women’s deceased organ donation may increase with further communication of women’s wishes before death and by improved public education about organ donation.

scholarly journals A global pandemic is not a good time to introduce ‘opt-out’ for organ donation

2020 ◽  
Vol 20 (2) ◽  
pp. 155-166
Author(s):  
Jordan A. Parsons ◽  
Greg Moorlock
Keyword(s):  
Organ Donation ◽  
Media Coverage ◽  
Public Awareness ◽  
Good Time ◽  
Organ Donors ◽  
Resuscitation Orders ◽  
Global Pandemic ◽  
Opt Out ◽  
The Impact ◽  
New System

Following several international examples, England introduced a system of deemed consent for organ donation in May 2020. This had been planned for over a year. However, the unprecedented circumstances of the COVID-19 pandemic raise issues that make the timing of this change unfortunate. The planned public awareness campaign has thus far been overshadowed by media coverage of the pandemic, and will likely continue to be, creating a situation in which a significant portion of the population may be unaware of having become potential organ donors. Further, the immediate impact of the new policy is likely to be significantly weakened by the suspension of the majority of organ donation and transplant activity. In this article, we first outline the details of the new model introduced in England, before considering the impact of the pandemic on transplantation services. We put forward three ethical reasons why, given the unprecedented circumstances, the change should have been postponed. We argue that (1) COVID-19 dominating headlines will prevent widespread awareness of the change, thereby undermining the autonomy of those who do not wish to be donors; (2) a lack of transplant activity during the pandemic will make the impact of the change difficult to measure; and (3) trust in the new system may be damaged given controversial decisions regarding Do Not Attempt Cardiopulmonary Resuscitation orders and the allocation of scarce intensive care resources. These reasons combined make for a shaky start at best and present a risk of the new system failing to achieve its desired and essential effect of increasing the number of voluntary organ donors.

Illinois Department of Motor Vehicle Customers’ Reasons for (Not) Registering as an Organ Donor

2019 ◽  
Vol 29 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Tobias Reynolds-Tylus ◽  
Brian L. Quick ◽  
Andy J. King ◽  
Miriam Moore
Keyword(s):  
African Americans ◽  
Organ Donation ◽  
Motor Vehicle ◽  
Organ Donor ◽  
Organ Donors ◽  
Biological Sex ◽  
Negative Beliefs ◽  
Personal Experiences ◽  
Promotional Efforts ◽  
Promotional Messages

Context: Organ donation campaigns are maximized when promotional messages address salient issues among the intended audience. A diverse sample (N = 1573) was recruited to identify the reasons for (not) registering as an organ donor. Objective: Relying on an established coding scheme, an updated explanation for why individuals register (or not) as organ donors is provided. Moreover, registration trends with respect to race, biological sex, and age is presented. Method: Participants exiting Department of Motor Vehicle offices (N = 12) were surveyed to understand their reasons for registering and not registering as organ donors. Results: Benefits of donation followed by prior registration, rational arguments, and personal experiences represented nearly 90% of the coded responses for registering. Conversely, negative beliefs, decisional uncertainty, perceived disqualification, no reason, general fear/disgust, and lack of opportunity constituted nearly 90% of the coded responses for not registering as an organ donor. Whites and Latinx individuals were more likely to register as organ donors compared to African Americans. Participants in the lower (18-24) and upper (65+) age brackets had the lowest donor registration rates. Conclusion: Promotional efforts should continue to target younger and older audience segments with information about organ donation as well as African Americans. Results from the current study suggest emphasizing the benefits of organ donation as well as overcoming negative beliefs, decisional uncertainty, and perceived disqualifications.

scholarly journals Short-term impact of introducing a soft opt-out organ donation system in Wales: before and after study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025159 ◽  
Author(s):  
Jane Noyes ◽  
Leah McLaughlin ◽  
Karen Morgan ◽  
Philip Walton ◽  
Rebecca Curtis ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Donor ◽  
P Value ◽  
Short Term ◽  
Consent Rate ◽  
Potential Organ Donor ◽  
Opt Out ◽  
Significant Difference ◽  
Before And After ◽  
Donor Numbers

ObjectivesTo determine the short-term impact of a soft opt-out organ donation system on consent rates and donor numbers.DesignBefore and after observational study using bespoke routinely collected data.SettingNational Health Service Blood and Transplant.Participants205 potential organ donor cases in Wales.InterventionsThe Act and implementation strategy.Primary and secondary outcomesConsent rates at 18 months post implementation compared with 3 previous years, and organ donor numbers 21 months before and after implementation. Changes in organ donor register activity post implementation for 18 months.ResultsThe consent rate for all modes of consent was 61.0% (125/205), showing a recovery from the dip to 45.8% in 2014/2015. 22.4% (46/205) were deemed consented donors: consent rate 60.8% (28/46). Compared with the 3 years before the switch there was a significant difference in Welsh consent rates (χ2 p value=0.009). Over the same time period, rest of the UK consent rates also significantly increased from 58.6% (5256/8969) to 63.1% (2913/4614) (χ2 p value<0.0001), therefore the Wales increase cannot be attributed to the Welsh legislation change. Deceased donors did not increase: 101 compared with 104. Organ donation registration increased from 34% to 38% with 6% registering to opt-out.ConclusionThis is the first rigorous initial evaluation with bespoke data collected on all cases. The longer-term impact on consent rates and donor numbers is unclear. Concerns about a potential backlash and mass opting out were not realised. The move to a soft opt-out system has not resulted in a step change in organ donation behaviour, but can be seen as the first step of a longer journey. Policymakers should not assume that soft opt-out systems by themselves simply need more time to have a meaningful effect. Ongoing interventions to further enhance implementation and the public’s understanding of organ donation are needed to reach the 2020 target of 80% consent rates. Further longitudinal monitoring is required.

A Qualitative Study of Turning Points or Aha! Moments in Older Adults’ Discussions About Organ Donation

2018 ◽  
Vol 28 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Kimberly Downing ◽  
Linda L. Jones
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Organ Donation ◽  
Organ Procurement ◽  
Turning Points ◽  
Age Groups ◽  
Organ Donor ◽  
Younger Age ◽  
Donation Process ◽  
Dialogue Process

Introduction: Older adults (50-70 years old) have lower organ donor registration rates than younger adults. Older adults have different informational needs and donor registration behavior than younger age groups. Objective: The objective of this qualitative study was to understand insights of older adults about organ donation to effectively address the barriers to becoming an organ donor. This study identified turning points as “Aha!” moments that occurred during a dialogue intervention where older adults discussed benefits, barriers, and process to organ donation. Setting and Participants: Dialogues were held with small groups of older adults in 11 communities in a Midwestern organ procurement organization service area. Participants were positive to organ donation, but not registered as an organ donor. Methods/Approach: Qualitative analysis of verbatim comments from the dialogue and a follow-up survey were used to examine turning points or “Aha!” moments of participants’ decision-making about organ donation and organ donor registration. Findings: Twenty-one separate in-depth dialogues were conducted with 198 participants, with mean age of 60.57 years. There were 2757 separate comments coded with 465 of the comments (17%) identified as providing Aha! moments during the dialogue. Three themes include benefits of organ donation (30%), barriers about organ donation (39%), and organ donation process (31%). Discussion: The research identified moments in the dialogue where possible learning about organ donation may have occurred. After participation in the dialogue process, there was an increase in intent to register to be an organ donor, organ donation discussion with family and friends, and organ donor registration.

Transparent Vessels?: What Organ Donors Should Be Allowed to Know about Their Recipients

2013 ◽  
Vol 41 (1) ◽  
pp. 323-332
Author(s):  
Richard H. Dees
Keyword(s):  
Consensus Statement ◽  
Organ Donor ◽  
Hiv Positive ◽  
Organ Donors ◽  
Live Donor ◽  
Transplant Center ◽  
Donation Process ◽  
Pertinent Information ◽  
Risk And Benefit

After a long search, Jonathan has finally found someone willing to donate a kidney to him and thereby free him from dialysis. Meredith is Jonathan's second cousin, and she considers herself a generous person, so although she barely knows Jonathan, she is willing to help. However, as Meredith learns more about the donation process, she begins to ask questions about Jonathan: “Is he HIV positive? I heard he got it using drugs. Has he been in jail? He's already had one live donor, so what happened to the first kidney? Did he forget to take his drugs or something?” The transplant center must, then, decide if Meredith is, in fact, entitled to answers to these kinds of questions. According to the Consensus Statement on the Live Organ Donor, “It is incumbent on the transplant center to provide full and accurate disclosure to potential donors of all pertinent information regarding risk and benefit to the donor and recipient.” But whether answers to the Meredith's questions count as “pertinent information regarding the risk and benefit” is the issue at hand.

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