Max Planck Institute of Neurobiology, Martinsried, Germany
Graduate School of Systemic Neurosciences, Ludwig Maximilian University of Munich Faculty of Biology, Martinsried, Germany.
J Med Ethics. 2021 Sep;47(9):618-622. doi: 10.1136/medethics-2019-105999. Epub 2020 Feb 14.
Given the dramatic shortage of transplantable organs, demand cannot be met by established and envisioned organ procurement policies targeting postmortem donation. Live organ donation (LOD) is a medically attractive option, and ethically permissible if informed consent is given and donor beneficence balances recipient non-maleficence. Only a few legal and regulatory frameworks incentivise LOD, with the key exception of Israel's Organ Transplant Law, which has produced significant improvements in organ donation rates. Therefore, I propose an organ procurement system that incentivises LOD by allocating additional priority points to the living donor on any transplant waiting list. I outline benefits and challenges for potential recipients, donors and society at large, and suggest measures to ensure medical protection of marginalised patient groups.
鉴于可移植器官的严重短缺,通过针对死后捐献的既定和预想中的器官获取政策无法满足需求。活体器官捐献(LOD)是一种具有吸引力的医学选择,如果获得知情同意并且捐赠者的善行与受赠者的不伤害相平衡,则在伦理上是允许的。只有少数几个法律和监管框架鼓励 LOD,其中关键的例外是以色列的器官移植法,该法律使器官捐赠率有了显著提高。因此,我提议建立一个器官获取系统,通过在任何移植等待名单上为活体捐献者分配额外的优先点来鼓励 LOD。我概述了对潜在受赠者、捐赠者和整个社会的好处和挑战,并提出了确保边缘化患者群体得到医疗保护的措施。