Guiding ethical principles in transplant candidate selection committees: A scoping review protocol

Area of Science:

• Medical Ethics
• Transplant Surgery
• Public Health Policy

Background:

• Ethical considerations are integral to all stages of organ transplantation, including recipient selection.
• Existing literature inadequately details the ethical insights guiding transplant candidate selection committees.
• Ethical frameworks could enhance equity in the organ allocation and recipient selection processes.

Purpose of the Study:

• To conduct a scoping review of published literature on ethical principles for solid-organ transplant candidate selection committees.
• To identify existing research on ethical decision-making in transplant candidate selection.
• To provide recommendations for improving ethical practices in selection committees.

Main Methods:

• Comprehensive literature search across PubMed, EMBASE, APA PsycInfo, SCOPUS, and CINAHL (1960-2024).
• Inclusion of full papers and abstracts in English focusing on transplant candidate selection.
• Two independent reviewers screened articles, with a third resolving conflicts; data extracted using Covidence.

Main Results:

• The review identified a paucity of studies specifically addressing the ethical principles guiding transplant candidate selection committees.
• Analysis revealed that the definition of a "right decision" in selection is not consistently elucidated.
• Systematic bias and discrimination in selection processes remain significant concerns.

Conclusions:

• There is a critical need to examine transplant candidate selection processes for potential biases and discrimination.
• Improving ethical frameworks and decision-making in selection can enhance fairness and equity.
• Addressing these issues is crucial for fostering public trust in organ transplantation.