Ahmad Samera, Vong Gerard, Pentz Rebecca D, Dixon Margie, Davis Keenan W, Khalifa Yousuf M
School of Medicine, Emory University, Atlanta, GA.
Center for Ethics, Emory University, Atlanta, GA.
Cornea. 2020 Oct;39(10):1207-1214. doi: 10.1097/ICO.0000000000002296.
To describe the ethical attitudes of corneal surgeons and eye bank leadership toward for-profit entities in corneal donation, processing, and distribution.
Fifty postfellowship corneal surgeons practicing in the United States and 25 eye bank leaders (eg, eye bank directors, CEOs, or presidents) for the Eye Bank Association of America-accredited eye banks completed a 22-question interview, focusing on corneal donation industry changes, including the entry of for-profit institutions.
Most participants in both study groups agreed that they have concerns with the entry of for-profit businesses into eye banking (62% corneal surgeons, 68% eye bank leadership), although physicians partnered with a for-profit corneal processor were significantly more likely to have no concerns with the entry of for-profits into eye banking than corneal surgeons partnered with a nonprofit processor (P = 0.04). The most frequently identified concerns with the entry of for-profit businesses into corneal banking were the hypothetical loss of donor trust (56% corneal surgeons, 64% eye bank leadership, P = 0.04) and the potential exploitation of donor generosity (72% corneal surgeons, 60% eye bank leadership). Qualitative theme analysis suggests that both study groups may view increased research/innovation as a potential benefit (64% corneal surgeons, 66% eye bank leadership) of for-profits in eye banking.
Key stakeholders in eye banking do hold relevant ethical beliefs toward recent industry changes, and these attitudes should be considered in the future creation of the ethical corneal donation policy. Further research is needed to assess the attitudes of potential donors and donor families.
描述角膜外科医生和眼库领导层对角膜捐赠、处理和分配中的营利性实体的伦理态度。
在美国执业的50名研究员后角膜外科医生和美国眼库协会认可的眼库的25名眼库领导(如眼库主任、首席执行官或总裁)完成了一次包含22个问题的访谈,重点是角膜捐赠行业的变化,包括营利性机构的进入。
两个研究组的大多数参与者都同意他们对营利性企业进入眼库行业存在担忧(62%的角膜外科医生,68%的眼库领导层),尽管与营利性角膜处理商合作的医生对营利性企业进入眼库行业不担忧的可能性明显高于与非营利性处理商合作的角膜外科医生(P = 0.04)。对营利性企业进入角膜库最常提到的担忧是假设的捐赠者信任丧失(56%的角膜外科医生,64%的眼库领导层,P = 0.04)和对捐赠者慷慨的潜在利用(72%的角膜外科医生,60%的眼库领导层)。定性主题分析表明,两个研究组都可能将增加的研究/创新视为眼库中营利性企业的潜在好处(64%的角膜外科医生,66%的眼库领导层)。
眼库行业的关键利益相关者对近期行业变化确实持有相关的伦理信念,在未来制定伦理角膜捐赠政策时应考虑这些态度。需要进一步研究以评估潜在捐赠者和捐赠者家庭的态度。