AUTONOMY OF THE DONOR
Organ and tissue donation is a voluntary event entirely at the discretion of the live donor, The principle of autonomy is fully in play here.
For example, a 35-year-old-man is dying of hepatic failure. His brother is fully HLA rnatched and a highly compatible donor. There are no other donors at this time and the patient will likely not survive long enough to find another donor. You are screening the brother for the donation, but hc is not willing to undergo the surgery for the partial donation. What should you do?
There is nothing you or anyone-including a court of law can do to compel a person to donate an organ or tissue if he clearly chooses not to do so. The need of the recipient has no impact on mandatin€l a donor to donate. This is true even if the donation is uncomplicated for the donor and the recipient will die without it.
ORGAN DONOR NETWORK ASKS FOR CONSENT FOR DONATION
For example, a 30-year-old woman is your patient in the intensive care unit for respiratory failure. The patient has had a motor vehicle accident and has sustained a massive intracranial hemorrhage. The patient is brain dead and will be removed from the ventilator. You know that there are numerous patients in your hospital waiting for organs. The family of the patient is with you. You have an excellent relationship with the family and they trust you. What should you do about the donation?
Only the organ donor neturcrk or uniform network for organ sharing shoulci obtain con_ sent for an organ donation. The medical tcant taking care of the patient shoukl not ask for the donation. Even if your relationship witr.r the familv is excelent, the organ donor network has an enormously greater success rate in obtaining consent. physicians that ask for consent for organ donatiolr are far rnore likely to be refused. Because a greater number .f refusals would lead to a loss of potentiar organs for donation when the shortage statute of available organs is critical, it is against the raw f.r doctors to obtain this consent. By legal statute, only those specifically trained to obtain consent for orqan donation should approach the family for this consent.
In addition, there is thc perception of an enormous conflict of interest on the part of the family n’hen a caregiver attempts to obtain consent. {4ren a caregivcr asks for consent, it leads some families to believe that the health-care team is not doing everything possible to preserve the lifc of the paticnt. This makes it scer’ that the priority of the health-care team is to obtain organs. It is essentiar for the hcarth-care teanl to preserve its reration ship rvith thc family as the advocates for prcserving the rife of the patient. In addition, the organ donation network has a much greater chancc of obtaining colscnt, so if the primarv health care team tries to obtain consent, it cor.rld lcad to a loss of needed orsans.
PAYMENT FOR DONATIONS
With the exception of renewatrle tissues such as spermr unfertilizcd eggs, and blood, pay_ n.rcnt for organs is considered ethicarly unacceptable. peoplc must not bc in the busincss of selling organs. The economic aspects of organ clonation must be ninimizecl so that pcople believe that the patients who need organs the most w I get them, not that the rvealthv will get preferential treatment. It is, howeveq acceptable to cover the cost to the donor of donatior.r. ‘l here is a diff’erence betwecn reimbursing the donor for the cost of donation and creating a finalcial incentivc for pcople to,sell’, organs.
ORGAN DONOR CARDS Although an organ donor card gives an indication of a patient’s wishcs for donation, fam ily consent is still necessary for donation. Family objection can overrule the or gan donor Only the organ donor neturcrk or uniform network for organ sharing shoulci obtain con_ sent for an organ donation. The medical tcant taking care of the patient shoukl not ask for the donation. Even if your relationship witr.r the familv is excelent, the organ donor network has an enormously greater success rate in obtaining consent. physicians that ask for consent for organ donatiolr are far rnore likely to be refused. Because a greater number .f refusals would lead to a loss of potentiar organs for donation when the shortage statute of available organs is critical, it is against the raw f.r doctors to obtain this consent. By legal statute, only those specifically trained to obtain consent for orqan donation should approach the family for this consent.
In addition, there is thc perception of an enormous conflict of interest on the part of the family n’hen a caregiver attempts to obtain consent. {4ren a caregivcr asks for consent, it leads some families to believe that the health-care team is not doing everything possible to preserve the lifc of the paticnt. This makes it scer’ that the priority of the health-care team is to obtain organs. It is essentiar for the hcarth-care teanl to preserve its reration ship rvith thc family as the advocates for prcserving the rife of the patient. In addition, the organ donation network has a much greater chancc of obtaining colscnt, so if the primarv health care team tries to obtain consent, it cor.rld lcad to a loss of needed orsans.
PAYMENT FOR DONATIONS
With the exception of renewatrle tissues such as spermr unfertilizcd eggs, and blood, pay_ n.rcnt for organs is considered ethicarly unacceptable. peoplc must not bc in the busincss of selling organs. The economic aspects of organ clonation must be ninimizecl so that pcople believe that the patients who need organs the most w I get them, not that the rvealthv will get preferential treatment. It is, howeveq acceptable to cover the cost to the donor of donatior.r. ‘l here is a diff’erence betwecn reimbursing the donor for the cost of donation and creating a finalcial incentivc for pcople to,sell’, organs.
ORGAN DONOR CARDS Although an organ donor card gives an indication of a patient’s wishcs for donation, fam ily consent is still necessary for donation. Family objection can overrule the or gan donor