Ethics of Organ Donation

April 25, 2013
nuffieldorgan

Activities to teach about the ethics of donation of bodies for medicine and research are the latest resources developed by the Education Advisory Group

It’s about 18 months since the release of the Nuffield Council on Bioethics reports on the donation of human bodies for medicine and research. In the intervening period the Council’s Secretariat and Education Advisory Group (of which I am a member) have been refining a series of resources for teaching about the ethics of human tissue usage.

On this occasion the resources have been targeted primarily for students at KS4 (GCSE).  The materials have, however, been provided in both PDF and Word formats precisely to allow for adaptation should anyone wish to use them in a slightly different context. Issues covered include: terminology, altruistic donation, prioritisation of different uses of human tissue, and an intervention ladder to determine how best to increase the shortfall in available organs in an ethically-appropriate way.


Headline Bioethics: Change to organ donation law in Wales?

January 9, 2013

[A printable version of this Headline Bioethics Commentary is available via this link]

OptOutMediumAuthor: Christopher Jones

Clip: Will Wales change organ donation law?

Date of story: 8th November 2011

Summary of story: The Welsh government’s has published a White Paper Proposals for Legislation on Organ and Tissue Donation: A Welsh Government White Paper in which they outline their intention to change the law regarding organ donation. In keeping with the rest of the UK, Wales current has an “opt-in” system, in which a person has to actively indicate (e.g. by signing organ donor register) that they give consent for their organs to be used by the NHS. Under the proposed system of presumed consent, all adults resident in Wales will automatically be placed upon the register; if anyone wishes to withdraw their consent they must actively remove themselves from the list. Many countries already operate this “opt-out” system; including, in Europe, such countries as France, Spain, Austria, Belgium, Norway and Sweden. In the news coverage, Glyn Davies MP state his opposition to the proposal, highlighting concerns about both the efficacy of the new system, and whether adequate consideration will be given to ethical aspects of the change.

Discussion of ethical issues: One ethical argument against presumed consent suggests that it violates the patient’s right to make an informed decision, and so does not uphold respect for their autonomy (Gillon, 1994). The specific purpose of informed consent is to protect a patient’s right to autonomy, as made clear by both the Universal Declaration on Bioethics and Human Rights (UNESCO, 2005) and the Declaration of Helsinki (World Medical Association, 2008). Enforcing presumed consent would remove the need for informed consent, and as such would be “a violation of an individual’s autonomy” (Kurosu, 2008).  Presumed consent, it is argued, forces patients either to become donors, or to state their wish to not become donors; in both instances the patient’s autonomy is violated, as  “compelling patients is unethical” (Kurosu, 2008). This deontological argument suggests a move to presume consent in Wales would be intrinsically unethical. Similarly, Kennedy et al. (1998) consider that a government body “assuming possession of our body parts” would be “a step too far”. Read the rest of this entry »


Bioethics videos: Class of 2011

June 13, 2011

For the past few years, Second year Medical Biochemistry students at the University of Leicester (and Medics taking the relevant module as a special studies course) have been asked to produce short videos on a bioethical topic. It seemed a shame not to make their excellent videos more widely available, so we’ve started to post some to YouTube. Topics covered this time around included: organ trading, egg donation, brain imaging and public health initiatives.

The team looking at the ethics of organ trading based their video around a woman seeking a privately-organised transplant for her daughter. This issue is highly topical at the moment, with the recent publication of Scott Carney’s book The Red Market: On the Trail of the World’s Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers.

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Whose cells are they anyway?

December 24, 2010

Rebecca Skloot's book has received critical and popular acclaim in 2010

In hundreds of research labs around the world, including within my own Department, scientists carry out experiments using a human cell line known as “HeLa”. Most cells die after a defined period of time, but mutations within the HeLa cells have allowed them to continue dividing outside of these normal contraints, and as such they are said to be “immortal”. The original tissue sample from which HeLa cells are derived was taken from the cancerous cervix of an African-American woman Henrietta Lacks (the name of the cell line being an abbreviation of her name).

The Immortal Life of Henrietta Lacks, a captivating account of the human story behind these amazing cells, has recently won many plaudits, including the prestigious Wellcome Trust Book Prize.

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Forensic uses of DNA

December 10, 2010

For the past three years we have been asking second year students to produce a short film on a bioethical topic as an assessed activity. This task allows the students to demonstrate their knowledge in creative ways. I have finally got around to posting some of their films on our own YouTube channel. The first of these focusses on the use of DNA in forensics and as well as the students’ own CSI-style story it also features an interview with Alec Jeffreys. More videos will be posted shortly.


Private Practice: Acting ethically at the Wellness Center?

July 1, 2009

(Warning – contains plot spoilers!) Private Practice is a spin-off from Seattle hospital drama Grey’s Anatomy in which Dr Addison Montgomery (Kate Walsh) moves from Seattle Grace to join the staff of the Ocean Wellness Center in Los Angeles.

I have to admit that I tired of Grey’s Anatomy during Season 1 and although I was aware it has spawned another series I had no desire to watch. All this changed, however, following an excellent talk on the programme, given by Dublin Doctor Audrey Dillon at the 4th Postgraduate Bioethics Conference (Belfast, June 2009).

The writers of Private Practice, headed by Shonda Rhimes, have made a conscious decision to incorporate ethical issues into the storylines (see ‘Private Practice’ explores bioethics questions). This means, therefore, that the series may well throw up some interesting case studies as discussion starters.

At the time of writing, Living TV (UK) has just started transmission of Season 2 (see here for Episode guide). A Family Thing, the first programme of the series, was aired on 25th June 2009 (TRILT code 00FC042B). True to promise, it contained two subplots featuring ethical dilemmas.

Saviour siblings – a donor by design?

In the first (starting 7 minutes in), Molly and Eric Madison present at the clinic demanding that the staff deliver their baby daughter that day, despite the fact that she is only 27 weeks gestation. The girl, it transpires, has been conceived following Pre-implantation Genetic Diagnosis, to be a ‘saviour sibling’ for her older brother, Jason.  The boy has leukaemia and has had his own bone marrow wiped out in preparation for a transplant from a donor who has now fallen unwell with pneumonia. He is therefore immunocompromised and urgently needs umbilical stem cells courtesy of the new child.

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Blood & Guts – A History of Surgery: Fixing Faces

February 16, 2009
Michael Mosley performing a facial surgery technique on a Mannequin/dummy

Michael Mosley performing facial surgery on a mannequin/dummy

In the fourth part of the BBC 4 Blood and Guts series, Fixing Faces looks at the evolution of plastic surgery. True to form, Michael Mosley presents a graphic account of how brutal attempts to reconstruct patients’ diseased or damaged faces have led to a modern medical speciality which is now believe to be on the eve of the first full face transplant. This episode describes and illustrates the history of this area of surgery: showing the work of the 16th century Italian doctor Gasparis Taliacotii (00:05:06 – 00:18:02); the beginning of the Botox era (00:18:02 – 00:30:00); and the work of Sir Harold Gillies and Sir Archibald Mclndoe, who developed both surgical techniques and the need for psychological support for patients undergoing reconstructive facial surgery (00:30:00 – 00:50:00) (Please see this Student BMJ article – ‘A brief histoy of plastic surgery’).

This episode highlights two main ethical topics for discussion: functional Magnetic Resonance Imageing (fMRI) and Neuroethics (00: 01:54 – 00:05:06); and face transplants or facial allograft transplantation (00:50:00 – End).

Read the rest of this entry »


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