Wanted Dead or Alive: Organ Donation and Limitations on Surrogate Consent for Non-competent Living Donors

Education is critical in decision making and the informed consent process in prospective living donors. Little has been written about how and what living donors should be taught. This article describes a multidisciplinary program for living donor education at the University of Virginia. The goals of the program are to impart information needed for prospective donors to make an informed decision and to independently evaluate donors' medical and psychosocial suitability. A partnership between the transplant department and an independent donor advocacy team establishes an environment conducive to education. By embracing independence, transparency, partnership, and advocacy, our program permits bidirectional education. This partnership facilitates unbiased understanding and appreciation of this education and considers each individual's unique circumstances when making informed decisions. Likewise, prospective donors educate the team about their circumstances, which helps the team safeguard the prospective donor and may enhance the safety of prospective donors and the perceived integrity of living organ donation.

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Ethics of Surrogate Consent for Living Organ Donation

JAMA ◽

10.1001/jama.292.14.1684-c ◽

2004 ◽

Vol 292 (14) ◽

pp. 1684

Keyword(s):

Organ Donation ◽

Living Organ Donation ◽

Surrogate Consent

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The Ethics of Organ Donation in Patients Who Lack the Capacity for Decision Making

Creative Nursing ◽

10.1891/1946-6560.24.3.186 ◽

2018 ◽

Vol 24 (3) ◽

pp. 186-190 ◽

Cited By ~ 1

Author(s):

Lauren Lee

Keyword(s):

Health Care ◽

Decision Making ◽

Organ Donation ◽

Health Care Providers ◽

Consensus Statement ◽

Organ Procurement ◽

Well Being ◽

Living Donors ◽

Care Providers ◽

Best Interest

Free and informed consent is the legal and ethical basis for organ donation from living donors, and is a requirement for making an autonomous health decision. In clinical practice, health-care providers are required to respect four bioethical principles: respect for autonomy, beneficence, non-maleficence, and justice (Beauchamp & Childress, 2012), with the best interest of their patients in mind. Yet there are bioethical concerns behind organ procurement from living donors who have never attained capacity, do not yet have the capacity, or have permanently lost the capacity for decision making. A consensus statement by the Live Organ Donor Consensus Group (Abecassis et al., 2000) protects these donors’ well-being and autonomy, but there still is a need to raise ethical awareness about the decision-making process regarding vulnerable potential donors. Health-care providers who are staff members in transplant clinics should be aware of the current consensus statement, commit to essential bioethical principles surrounding organ donation, and advocate for vulnerable living donors.

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Lethal Organ Donation: Would the Doctor Intend the Donor’s Death?

The Journal of Medicine and Philosophy A Forum for Bioethics and Philosophy of Medicine ◽

10.1093/jmp/jhz008 ◽

2019 ◽

Vol 44 (4) ◽

pp. 442-458 ◽

Cited By ~ 2

Author(s):

Ben Bronner

Keyword(s):

Organ Donation ◽

Living Donors

Abstract Lethal organ donation is a hypothetical procedure in which vital organs are removed from living donors, resulting in their death. An important objection to lethal organ donation is that it would infringe the prohibition on doctors intentionally causing the death of patients. I present a series of arguments intended to undermine this objection. In a case of lethal organ donation, the donor’s death is merely foreseen, and not intended.

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Kidney to Share

10.7591/cornell/9781501755439.001.0001 ◽

2021 ◽

Author(s):

Martha Gershun ◽

John D., MD Lantos

Keyword(s):

Kidney Transplantation ◽

Organ Donation ◽

Living Donor ◽

Living Donors ◽

Body Parts ◽

Economic Policies ◽

Complex Process ◽

Major Operation ◽

History Of ◽

Healthy Body

This book tells the story of the author's decision to donate a kidney to a stranger. The book takes readers through the complex process by which such donors are vetted to ensure that they are physically and psychologically fit to take the risk of a major operation. The story is also placed in the larger context of the history of kidney transplantation and the ethical controversies that surround living donors. The book helps readers understand the discoveries that made transplantation relatively safe and effective as well as the legal, ethical, and economic policies that make it feasible. The book explores the steps involved in recovering and allocating organs. It analyzes the differences that arise depending on whether the organ comes from a living donor or one who has died. It observes the expertise — and the shortcomings — of doctors, nurses, and other professionals and describes the burdens that we place on people who are willing to donate. It asks us to consider just how far society should go in using one person's healthy body parts in order to save another person. The book provides an account of organ donation that is both personal and analytical. A combination of perspectives leads to a profound and compelling exploration of a largely opaque practice. The book pulls back the curtain to offer readers a more transparent view of the fascinating world of organ donation.

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