尸体器官采购的同意程序:它是如何工作的? 如何改善它? 如何改善它?
1Department of Clinical Bioethics, Bldg 10, Room 1C118, National Institutes of Health, Bethesda, MD 20892, USA. wendler@nih.gov
JAMA
|February 15, 2001
概括
器官采购组织 (OPO) 在遵循已故个人或近亲的愿望方面表现出显著的差异. 持久的医疗保健授权书可以改善器官捐赠同意过程.
科学领域:
- 医学伦理 医学伦理
- 移植手术 移植手术
- 公共卫生政策 公共卫生政策
背景情况:
- 器官移植至关重要,但仍然存在供体短缺.
- 了解器官采购组织 (OPO) 的同意做法是提高捐赠率的关键.
- 目前的OPO同意实践缺乏全面的数据.
研究的目的:
- 确定在器官采购过程中,OPO优先考虑谁的愿望 (已故或近亲).
- 评估是否提前指令和注册表可以增强器官捐赠同意过程.
主要方法:
- 在61个器官采购组织 (OPO) 进行了全国性的电话调查.
- 该调查包括49个关于不同捐赠情景中的同意实践的问题.
- 数据是在1999年6月至8月期间收集的.
主要成果:
- 在OPO同意实践中存在显著的分歧,31%的人遵循已故的愿望,31%的人遵循近亲的愿望.
- 伦理上的分歧导致了OPO之间的不同同意政策.
- 持久授权权 (DPOA) 显著影响了决策,56%的OPO可能会根据DPOA同意获得器官,当家人反对捐赠时.
结论:
- 加强医疗保健持久委托书的法律范围可能会对器官采购率产生重大影响.
- 扩大对器官捐献偏好的活体遗嘱可能对采购产生最小的影响.
- 需要进行国家对话,以解决OPO同意实践中的伦理差异.
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