Restless Feelings: Desiring Direct Contact After Postmortem Organ Donation

2018 ◽  
Vol 82 (1) ◽  
pp. 42-62
Author(s):  
Sophie H. Bolt ◽  
Marloes Witjes ◽  
Barbara van den Ende

This article investigates the emergence of a growing demand in the Netherlands: the wish of organ donor families and organ recipients to establish contact. Such direct contact transgresses both the anonymity and privacy long considered by many to be fundamental to organ donation. Legislation prescribes that privacy should be safeguarded, but the parties involved increasingly manage to find each other. Research is needed to provide insight into the ramifications of direct contact, which may inform mourning counseling and psychosocial support. Drawing on qualitative interviews with donor’s relatives, we analyze the reasons for the desire to have direct contact. We seek to understand how meanings are constructed and contested through organs at the margins of life and death in the individualized and secularized society of the Netherlands. We find that relatives struggle with persistent restless feelings after postmortem organ donation and may develop a level of personal attachment and assign inalienability to human body parts.

2017 ◽  
Vol 27 (3) ◽  
pp. 266-272 ◽  
Author(s):  
Eva-Maria Merz ◽  
Katja van den Hurk ◽  
Wim L.A.M. de Kort

Introduction: In the Netherlands, there is a constant shortage in donor organs, resulting in long waiting lists. The decision to register as organ donor is associated with several demographic, cultural, and personal factors. Previous research on attitudes and motivations toward blood and organ donations provided similar results. Research Question: The current study investigated demographic, cultural, and personal determinants of organ donation registration among current Dutch blood donors. Design: We used data from Donor InSight (2012; N = 20 063), a cohort study among Dutch blood donors, to test whether age, gender, religious and political preferences, donor attitude, and altruism predicted organ donor registration among current blood donors. Results: Organ donors were more often represented in the blood donor population compared to the general Dutch population. Women showed a higher propensity to be registered as organ donor. Higher education as well as higher prosocial value orientation, prosocial behavior, that is, doing volunteer work, and awareness of need significantly associated with being registered as organ donor. Religious denomination negatively predicted organ donation registration across all faiths. Discussion: Results are discussed in light of cultural context, and possible implications for improving information provision and recruitment are mentioned.


2019 ◽  
pp. 169-196
Author(s):  
Stanley Finger

Gall’s skull and cast collections served as his research “library.” He had a large one in Vienna, and he built a second one starting with some of his prized earlier pieces after settling in Paris in 1807, though he left a great number of pieces behind. Since the Renaissance, people had been collecting specimens from the natural world, amassing them in “cabinets of wonder” and even publishing catalogues of their pieces. In the Netherlands, Frederik Ruysch had not only collected a large number of fetuses and human body parts by the 1690s, but had incorporated some of them into artistic panoramas that even the laity craved to see. Gall fit into this collecting tradition with the skulls and casts he obtained from hospitals, asylums, and places of execution, and with those purchased, traded for, or gifted to him by friends and admirers. Nonetheless, there was also considerable grave robbing (resurrectionism) by overly zealous phrenologists in this era, worrying people and casting a dark shadow over his collecting endeavors. Parts of Gall’s Vienna collection can be seen in the Rollett Museum near Vienna, whereas his second collection and own skull are now in the Musée de l’Homme (Paris).


2018 ◽  
Vol 87 (2) ◽  
pp. 153-168
Author(s):  
Eberling Elisabeth

Zusammenfassung: In Deutschland sterben im Durchschnitt pro Tag drei Menschen, die vergeblich auf eine Organspende warten, so die Deutsche Stiftung Organtransplantation. In diesem Beitrag wird die Wirksamkeit eines Nudges mit der Einstellung des Defaults „Organe werden gespendet“ (Widerspruchslösung) diskutiert. Nachgegangen wird der Frage, ob dieser Nudge zu signifikant höheren Organspenderaten führt als der Default „Organe werden nicht gespendet“ anhand von Daten der acht Mitgliedsländer der Organisation Eurotransplant. Anhand der Analysen kann ausgeschlossen werden, dass eine höhere Organspenderate lediglich auf eine höhere Sterberate zurückzuführen ist. Separat vorgestellt werden zudem Ergebnisse für die Länder Deutschland, Niederlande, Belgien und Österreich. Diese Länder weisen ähnliche sozioökonomische Merkmale auf. Erörtert werden Einflussfaktoren auf die Organspenderaten und mögliche Probleme und Verzerrungen der Raten. Darüber hinaus wird diskutiert, inwiefern ein Nudge im Bereich der Organspende ethisch zu legitimieren ist. Das Ergebnis der Analysen: In Ländern mit Widerspruchsregelung ist die Organspenderate signifikant höher als in Ländern ohne entsprechende Regelung; die gesetzliche Regelung ist aber nicht eindeutig als Ursache isolierbar. Summary: According to the German Foundation for Organ Transplantation, on average, three people die each day in Germany while waiting for an organ donation. This article discusses the effectiveness of a nudge to the default setting “organs are donated” (presumed consent). It is explored whether this nudge leads to significantly higher organ donation rates than the default setting “organs are not donated“ based on data from the eight member countries of the Eurotransplant organization. The analysis shows that higher organ donation rates are not driven by higher mortality rates alone. The results for Germany, the Netherlands, Belgium and Austria are presented separately. These countries share similar socio-economic characteristics. Factors influencing organ donor rates are discussed as are possible problems and distortions of the donation rates. In addition, it is discussed to what extent a nudge in the field of organ donation can be ethically legitimized. The analyses show that, in countries with presumed consent, organ donation rates are significantly higher than in countries without this rule. However, it was not possible to identify the legal regulation as the sole cause of this difference.


2019 ◽  
Vol 17 (1) ◽  
pp. 95-107 ◽  
Author(s):  
Paweł Łuków

AbstractThe article argues that altruistic giving based on anonymity, which is expected to promote social solidarity and block trade in human body parts, is conceptually defective and practically unproductive. It needs to be replaced by a more adequate notion which responds to the human practices of giving and receiving. The argument starts with identification of the main characteristics of the anonymous altruistic donation: social separation of the organ donor (or donor family) from the recipient, their mutual replaceability, non-obligatoriness of donation, and non-obligatoriness of reciprocation on the recipient’s part. Since these characteristics are also central to typical market relations, anonymous altruistic donation not only cannot promote solidarity but may encourage proposals for (regulated) markets of transplantable organs. Thus, transplant ethics needs to be reframed. It needs to be rooted in, rather than promote, the practices of giving and receiving known to human societies. As the basis for such reframing, the idea of sharing in another’s misfortune is proposed. It relies on the human practices of giving and receiving and, with appropriate regulatory safeguards, can provide a better conceptual basis for blocking commercial exchanges of human body parts.


Author(s):  
Anna Koval ◽  

he end of the twentieth century and the beginning of the twentyfirst century has begun the rapid development of scientific researches in the biological and medical fields. This process is associated with using of fundamentally new methods, which are primarily aimed at the disease prevention, as well as the introduction into the treatment of human diseases with the latest scientific and innovative technologies, methods and techniques of their application. These opportunities in the development of scientific technologies in the field of biology and medicine have led to the emergence of such a direction of scientific activity as "biotechnology". The proposed article notes that using of biomedical technologies has caused a number of new problems in the field of law and ethics. Legal arrangement in the field of the health protection have become much more complicated. Thanks to new opportunities, today these relations regulate rights and responsibilities of a fairly large number of people. Modern relations in the field of medical services and medical care lead to the emergence of new approaches to their regulation by both legal and ethical norms. In the past, relations in the field of the health protection were usually between two subjects, a doctor and a healthcare consumer. Nowadays, in a medical practice, relations in the field of the health protection involve: a health-care consumer, his family members (e.g., in the case of hereditary diseases diagnosis, blood and organ donation etc.) and third parties (e.g., organ donation, reproductive cell donation, surrogacy etc.). In the general doctrinal concept, biotechnology is the industrial use of living organisms or their parts (microorganisms, fungi, algae, plant and animal cells, cellular organs, enzymes etc.) for product producing or modifying, improving plants and animals, and in medical practice - in relation of the individual human organs (or body as a whole) functioning. These circumstances require improving the legal regulation of modern medicine public relations, bringing them into line with emerging realities. Moreover, the specifics of relations in this field determines the specifics of their legal regulation. The application of new medical technologiesin relation to human treatment has given rise to a significant number of moral and ethical problems that could not be solved within the framework of medical ethics and deontology alone. In connection with this, the way out of the current situation could be the consolidation of bioethics as an interdisciplinary field of knowledge, as a science, which makes it possible to explain moral, ethical and legal aspects of the medicine. This, for example, determines the allocation of medical law in an independent branch of law in some Western countries and Ukraine. The article focuses on biomedical ethics, which is a component of the medical activities system regulation. In the context of considering the levels of social regulation of medical activities, bioethics (biomedical ethics) is an interdisciplinary science that studies moral and ethical, social and legal problems of medical activities in the context of human rights protection. Bioethics should create a set of moral principles, norms and rules that are binding on all mankind and delineate the limits of scientific interference in the nature of the human body, the transition through which is unacceptable.


Author(s):  
Justine Pila

This chapter surveys the current legal position concerning property in bodies and bodily materials. Of especial relevance in the current age of advanced genetic and other bio technologies, it looks beyond property in bodies and their materials ‘as such’ to consider also (a) the availability of rights of personal and intellectual property in objects incorporating or derived from them, and (b) the reliance on quasi-property rights of possession and consent to regulate the storage and use of corpses and detached bodily materials, including so-called ‘bio-specimens’. Reasoning from first principles, it highlights the practical and conceptual, as well as the political and philosophical, difficulties in this area, along with certain differences in the regulatory approach of European and US authorities. By way of conclusion, it proposes the law of authors’ and inventors’ rights as simultaneously offering a cautionary tale to those who would extend the reach of property even further than it extends currently and ideas for exploiting the malleability of the ‘property’ concept to manage the risks of extending it.


RMD Open ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e001183 ◽  
Author(s):  
Aurélie Najm ◽  
Alessia Alunno ◽  
Francisca Sivera ◽  
Sofia Ramiro ◽  
Catherine Haines

ObjectivesTo gain insight into current methods and practices for the assessment of competences during rheumatology training, and to explore the underlying priorities and rationales for competence assessment.MethodsWe used a qualitative approach through online focus groups (FGs) of rheumatology trainers and trainees, separately. The study included five countries—Denmark, the Netherlands, Slovenia, Spain and the United Kingdom. A summary of current practices of assessment of competences was developed, modified and validated by the FGs based on an independent response to a questionnaire. A prioritising method (9 Diamond technique) was then used to identify and justify key assessment priorities.ResultsOverall, 26 participants (12 trainers, 14 trainees) participated in nine online FGs (2 per country, Slovenia 1 joint), totalling 12 hours of online discussion. Strong nationally (the Netherlands, UK) or institutionally (Spain, Slovenia, Denmark) standardised approaches were described. Most groups identified providing frequent formative feedback to trainees for developmental purposes as the highest priority. Most discussions identified a need for improvement, particularly in developing streamlined approaches to portfolios that remain close to clinical practice, protecting time for quality observation and feedback, and adopting systematic approaches to incorporating teamwork and professionalism into assessment systems.ConclusionThis paper presents a clearer picture of the current practice on the assessment of competences in rheumatology in five European countries and the underlying rationale of trainers’ and trainees’ priorities. This work will inform EULAR Points-to-Consider for the assessment of competences in rheumatology training across Europe.


2021 ◽  
pp. 026975802110106
Author(s):  
Raoul Notté ◽  
E.R. Leukfeldt ◽  
Marijke Malsch

This article explores the impact of online crime victimisation. A literature review and 41 interviews – 19 with victims and 22 with experts – were carried out to gain insight into this. The interviews show that most impacts of online offences correspond to the impacts of traditional offline offences. There are also differences with offline crime victimisation. Several forms of impact seem to be specific to victims of online crime: the substantial scale and visibility of victimhood, victimisation that does not stop in time, the interwovenness of online and offline, and victim blaming. Victims suffer from double, triple or even quadruple hits; it is the accumulation of different types of impact, enforced by the limitlessness in time and space, which makes online crime victimisation so extremely invasive. Furthermore, the characteristics of online crime victimisation greatly complicate the fight against and prevention of online crime. Finally, the high prevalence of cybercrime victimisation combined with the severe impact of these crimes seems contradictory with public opinion – and associated moral judgments – on victims. Further research into the dominant public discourse on victimisation and how this affects the functioning of the police and victim support would be valuable.


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