Patients could be kept alive solely so they can become organ donors, hearts could be retrieved from newborn babies for the first time, and body parts could be taken from high-risk donors as part of an urgent medical and ethical revolution to ease Britain's chronic shortage of organs, doctors' leaders say.
This paper explores the issue of donation of organs from deceased donors for transplantation into a specified recipient. It argues that proper account should be taken of the principles underlying the Human Tissue Act 2004, which grant the donor a form of proprietary control. Three hypothetical scenarios are then used to draw out the implications of these principles for existing regulatory policy and the common law response to excised human organs. The paper concludes that the law should be understood as recognising ownership in organs removed from living and deceased persons and as offering opposition to the prohibition of directed donation that can only be coherently removed by reform of the 2004 Act.
The number of patients in Israel who die while waiting for a transplant rose last year, and the number of transplantations fell by 20%, the annual report of the Ministry of Health’s National Transplant and Organ Donation Centre has said. As a result the shortage of organs has become more acute. Rafi Biar, chairman of the centre’s steering committee and director of the Rambam Medical Centre in Haifa, said that the main cause of the decrease is a new law that changed the protocol for defining “brain death” after discussions with the Chief Rabbinate. According to Jewish law death can be determined only after cardiopulmonary failure, and until recently the Chief Rabbinate had prohibited organ donation, as it did not recognise brain stem death. However, in 2008 the Israeli parliament passed a law that defines “brain respiratory” death as an indication of death for all legal purposes and also outlined the procedure that should be carried out to ensure that death had occurred.
Some doctors are set to argue against moves towards an organ donation system of presumed consent in the UK. Under presumed consent all people are assumed to be willing to donate their organs unless they have opted out. No part of the UK has introduced such a system yet, although the Welsh assembly favours the idea. However, delegates at the British Medical Association's annual conference in Cardiff will debate later whether the move could damage trust in doctors. Those in favour of presumed consent, which has been supported by the BMA for the last 10 years, believe it would help boost UK donation rates, which, despite recent improvements, still lag behind many other countries.
Britain’s Orthodox Jews have been plunged into the centre of an angry debate over medical ethics after the Chief Rabbi ruled that Jews should not carry organ donor cards in their current form. London’s Beth Din, which is headed by Lord Jonathan Sacks and is one of Britain’s most influential Orthodox Jewish courts, caused consternation among medical professionals earlier this month when it ruled that national organ donor cards were not permissible under halakha (Jewish law). The decision has now sparked anger from within the Orthodox Jewish community with one prominent Jewish rabbi accusing the London Beth Din of “sentencing people to death”.
An investigation is under way into how two transplant patients were given kidneys from a donor with a rare and aggressive form of cancer. The incident at the Royal Liverpool University hospital involved organs from a woman who died at another hospital, and was later found to have had a hard-to-identify disease called intravascular B-cell lymphoma. Both patients had been preparing for live transplants from their sisters but accepted the donor kidneys instead. The recipients are now receiving chemotherapy treatment. Although cancer transmission is a known risk of transplantation among clinicians, the case raises questions about guidance to patients and whether sufficient checks are made. One senior of
EU prosecutors have accused seven people, including doctors and a health official, of trafficking kidneys through a clinic in Kosovo. International trafficking allegedly took place in 2008 at the Medicus clinic in the capital, Pristina. Kidney "donors" and recipients were of different nationalities, prosecutors said in a press release. The prosecutors form part of the EU's law and order mission, Eulex, in the breakaway Serbian province.
The father of a woman who died after a double lung transplant said she would have been "horrified" to discover the organs were from a smoker of 30 years. Cystic fibrosis sufferer Lynsey Scott, of Wigan, died months after surgery at Wythenshawe Hospital last year. Allan Scott said she was not told that the donor smoked and is calling for patients to be given more information.
Cash incentives and the payment of funeral expenses are two ideas being put forward to encourage people to donate human organs and tissue. The Nuffield Council on Bioethics is asking the public if it is ethical to use financial incentives to increase donations of organs, eggs and sperm. Paying for most types of organs and tissue is illegal in the UK. The public consultation will last 12 weeks and the council's findings will be published in autumn 2011.
US scientists have created working liver grafts in the lab, and say the research could one day allow the growth of livers for transplant. There is a shortage of liver donors, but so far it has been difficult to grow replacement organs. In the work, published in Nature Medicine, a team from Massachusetts General Hospital, created successful grafts using rat cells. A UK expert said it was "a big step in the right direction".
A distraught Newtownards father is today set to take his battle for a liver transplant for his severely ill son to the High Court. But while his legal team argue for a judicial review of a rule requiring alcoholics to be off drink for six months before being considered for a life-saving transplant, devoted dad Brian Anderson will travel to King’s Hospital in London to see his son Gareth.
Objectives To examine the impact of a system of presumed consent for organ donation on donation rates and to review data on attitudes towards presumed consent. Conclusion Presumed consent alone is unlikely to explain the variation in organ donation rates between countries. Legislation, availability of donors, organisation and infrastructure of the transplantation service, wealth and investment in health care, and public attitudes to and awareness of organ donation may all play a part, but their relative importance is unclear. Recent UK surveys show support for presumed consent, though with variation in results that may reflect differences in survey methods.
Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.
While clearly a lot of work had gone into producing this report, a major concern for the British Medical Association is the way the report itself, and members of the Taskforce in presenting the report, discussed the evidence about the impact of presumed consent on donation rates.