Ethics of organ procurement from the unrepresented patient population

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase t...

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Bibliographic Details
Published in:Journal of medical ethics 2019-11, Vol.45 (11), p.751-754
Main Authors: Raho, Joseph A, Brown-Saltzman, Katherine, Korenman, Stanley G, Weiss, Fredda, Orentlicher, David, Lin, James A, Moreno, Elisa A, Nuri-Robins, Kikanza, Stein, Andrea, Schnell, Karen E, Diamant, Allison L, Weiss, Irwin K
Format: Article
Language:English
Subjects:
Bioethics
Blood & organ donations
Brief report
Health care access
Heart
Homeless people
Hospitals
Informed consent
Medical ethics
Patients
Transplants & implants
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Summary:The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act (RUAGA) of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion.
ISSN:0306-6800
1473-4257
DOI:10.1136/medethics-2019-105584