GESTIÓN EN SALUD PÚBLICA: Organ donation and recipient information

domingo, 1 de octubre de 2017

Organ donation and recipient information

Organ donation and recipient information

Bioedge

Organ donation and recipient information

by Xavier Symons | 30 Sep 2017 |

How can we solve the shortage of organ donors?

Clearly there’s no easy answer. But two bioethicists have a very practical suggestion: why not provide more detailed information to potential donors about those who need an organ transplant?

Writing in the Journal of Medical Ethics, David Shaw (University of Basel) and Dale Gardiner (Nottingham University NHS Trust) argue that providing real-life stories of the benefits of organ donation could greatly increase the likelihood of donation; the researchers propose that a detailed leaflet be given to patients and families who are making decisions about organ donation. This would help to overcome the moral distance between donors and recipients, and increase an awareness of the variety of benefits that organ donation yields:

“Providing more detailed information about recipients...may increase the consent rate by helping to reduce [the] moral distance from those who might benefit from donation...This information could include a description of what it is like to wait for an organ, how donation benefitted them and also stories from families of those who donated. Providing this information could also help heighten awareness among staff of the importance of donation. We would not propose providing details of the actual recipients of organs from a given patient, but instead providing a representative sample of those who could benefit, or have benefited.”

Shaw and Gardiner are not unaware of the risks of coercion that come with providing emotive information to patients and families; these individuals are already in a distressed state and may feel pressured by information that implies an obligation to donate. Yet the authors suggest that generic exemplar cases would not induce distress as much as details of people currently on the waiting-list would.

Most of us have an ambivalent attitude towards drug addicts. Can they stop? No, their will power is shot to pieces. Will you invite one home to dinner? No, he’s a drug addict. However inconsistent it might be, we manage to dismiss addiction as morally serious and stigmatize them at the same time.

The Massachusetts Supreme Court is due to hear a case on drug addiction which could have wide-ranging consequences. Julie Eldred, an addict, relapsed while on parole and was jailed. (See story below.) But jailing her was wrong, according to the Massachusetts Medical Society, because opioid use is a chronic illness, not a character defect.

The opposite point of view is represented by 11 addiction experts in an amicus curiae brief. They argue that “Most addicts quit and do so on their own. Addiction seems to be among the most spontaneously ‘remitting’ of all the conditions termed major mental disorders, which is a very inconvenient fact for the position that addiction is a ‘chronic and relapsing brain disease.’”

The outcome of the argument will have immense legal and social consequences. If the addict is helpless in the grip of his or her disease, punishment makes no sense. The whole criminal law would change. To be continued....