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Lauerer, Michael ; Kaiser, Katharina ; Nagel, Eckhard:
Organ Transplantation in the Face of Donor Shortage : Ethical Implications with a Focus on Liver Allocation.
In: Visceral Medicine.
Bd. 32
(2016)
Heft 4
.
- S. 278-285.
ISSN 2297-4725
DOI: https://doi.org/10.1159/000446382
Abstract
BACKGROUND:
Transplantation medicine is associated with several ethical issues related to the lack of organs. Major questions concern the regulations for giving permission for organ removal, informing the public about organ donation, setting of organ allocation priorities, waiting list access, and strategies to counteract scarcity.
METHODS:
This contribution is based on analyses of legal regulations, guidelines of self-regulatory bodies, administrative data, and literature from medical, normative, and empiric disciplines. It addresses the above-mentioned issues descriptively with a focus on Germany and liver transplantation.
RESULTS:
The basic principle of beneficence justifies a shift from voluntariness towards an obligation to document one's decision regarding organ donation. Organ allocation is obviously tangent to fundamental values and concepts of justice. At that, there is no consistent agreement on whether to prioritize the sickest patient or to maximize the overall health benefit. Restrictions relating to waiting list access are the subject of controversies. The reasons for denial of access are largely related to high demands on the prospect of success. Strategies to counteract organ scarcity partly conflict with the respect for autonomy, non-maleficence, beneficence, or justice.
CONCLUSION:
We propose to focus on recent most promising strategies to counteract scarcity in the short-term: demanding a documented decision on organ donation and an orientation towards the Spanish model of organization. Concepts for waiting list access should constantly be reviewed considering all medical evidence and must not be based on moralism. Moreover, we suggest to consider public preferences for organ allocation and strengthen the confidence in transplantation medicine.
Weitere Angaben
| Publikationsform: | Artikel in einer Zeitschrift |
|---|---|
| Begutachteter Beitrag: | Ja |
| Institutionen der Universität: | Fakultäten > Rechts- und Wirtschaftswissenschaftliche Fakultät > Lehrstuhl Medizinmanagement und Gesundheitswissenschaften > Lehrstuhl Medizinmanagement und Gesundheitswissenschaften - Univ.-Prof. Dr. Dr. Dr. h.c. Eckhard Nagel Fakultäten Fakultäten > Rechts- und Wirtschaftswissenschaftliche Fakultät Fakultäten > Rechts- und Wirtschaftswissenschaftliche Fakultät > Lehrstuhl Medizinmanagement und Gesundheitswissenschaften |
| Titel an der UBT entstanden: | Ja |
| Themengebiete aus DDC: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit |
| Eingestellt am: | 11 Mai 2020 08:16 |
| Letzte Änderung: | 11 Mai 2020 08:16 |
| URI: | https://eref.uni-bayreuth.de/id/eprint/54370 |