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[Ethical and social problems posed by organ transplantation]
1Hôpital de la Pitié, Paris.
Bulletin De L'Academie Nationale De Medecine
|October 1, 1992
Summary
Organ transplantation faces a critical organ shortage despite medical advances. Addressing family refusal and legal frameworks is key to increasing organ donation rates and saving lives.
Area of Science:
- Transplantation medicine
- Medical ethics
- Public health policy
Context:
- Organ transplantation has evolved from a scientific possibility to a social reality.
- Graft tolerance is achievable, but organ availability remains a significant limitation.
- Living donation is restricted due to ethical concerns like coercion and commercialization.
Purpose:
- To highlight the disparity between organ transplant demand and supply.
- To identify the primary barriers to organ retrieval.
- To explore potential solutions for increasing organ donation.
Summary:
- Post-mortem donation, particularly from brain-dead donors, is crucial for organs like the liver, heart, and lungs.
- High success rates (70-80% 10-year survival) have increased demand, outstripping donor organ availability.
- Reasons for organ scarcity include donor age, transmissible diseases, inadequate medical resources, and family refusal.
Impact:
- The organ shortage leads to increased patient mortality (10% of waiting list) and prolonged waiting times.
- Deterioration of patient health and reduced transplant success rates are consequences of delayed transplantation.
- Family refusal, often stemming from the sensitive circumstances of requesting donation after brain death, is a major obstacle.