Bosek Marcia Sue Dewolf, Sargeant Isabelle L
Department of Nursing, University of Vermont, Burlington, VT 05405, USA.
JONAS Healthc Law Ethics Regul. 2012 Jan-Mar;14(1):19-26; quiz 27-8. doi: 10.1097/NHL.0b013e318247689b.
: In 2007, the Centers for Medicare & Medicaid Services mandated that kidney transplant programs establish a living donor advocate program to ensure safe care and support for living organ donors. This quality improvement project assessed the impact of establishing a living donor advocate program and identified the ethical commitments and threats living kidney donors perceive throughout the donation process.
: This quality improvement project reflects a mixed-methods methodology. Qualitative as well as quantitative data were generated through the donor-advocate consultation sessions and the written Living Donor Satisfaction Survey. Thirteen living donors participated.
: No threats to donor rights were identified by either the donor or the advocate. Nonrelated donors were motivated by altruism, whereas related donors were motivated by a sense of family. A majority of donors reported being changed emotionally and spiritually by the act of serving as a living donor. The living kidney donors were overwhelmingly extremely satisfied with their decision to donate and perceived the living donor advocacy program as being very good.
: Questions have been raised about what role the donor's spouse should have during the informed consent process. Further research is needed to better understand the role and power of an advocate when threats to the donor's rights are noted.
2007年，医疗保险和医疗补助服务中心规定肾脏移植项目要设立活体捐赠者倡导项目，以确保为活体器官捐赠者提供安全的护理和支持。这个质量改进项目评估了设立活体捐赠者倡导项目的影响，并确定了活体肾脏捐赠者在整个捐赠过程中所感受到的道德承诺和威胁。
这个质量改进项目采用了混合方法。通过捐赠者倡导咨询会议和书面的活体捐赠者满意度调查收集了定性和定量数据。13名活体捐赠者参与其中。
捐赠者和倡导者均未发现捐赠者权利受到威胁的情况。非亲属捐赠者的动机是利他主义，而亲属捐赠者的动机是家庭责任感。大多数捐赠者表示，作为活体捐赠者的行为在情感和精神上改变了他们。活体肾脏捐赠者对自己的捐赠决定极其满意，并且认为活体捐赠者倡导项目非常好。
关于捐赠者的配偶在知情同意过程中应扮演什么角色的问题已经出现。当发现捐赠者权利受到威胁时，需要进一步研究以更好地理解倡导者的角色和权力。
