Faculty of Nursing, University of Edinburgh, UK.
Bioethics, Regina Apostolorum Pontifical University, Italy.
New Bioeth. 2022 Dec;28(4):341-349. doi: 10.1080/20502877.2022.2095714. Epub 2022 Jul 8.
This paper looks at the ethics of opt-in vs. opt-out of organ donation as Scotland has transitioned its systems to promote greater organ availability. We first analyse studies that compare the donation rates in other regions due to such a system switch and find that organ increase is inconclusive and modest at best. This is due to a lack of explicit opt-out choices resulting in greater resistance and family override unless there are infrastructures and greater awareness to support such change. The paper then looks at the difference between informed consent of the opt-in vs. presumed consent in the opt-out approaches. Patient autonomy and dignity are better reflected with informed consent. Eighteen months have passed since the new organ donation policy has come into effect, this paper recommends more research into organ donors' psychological motivations to help governments and the healthcare profession obtain more organs for transplantation.
本文探讨了苏格兰将其器官捐赠系统从选择加入转变为默认选择后，选择加入与选择退出的伦理问题，以提高器官可用性。我们首先分析了比较其他地区因这种系统转换而导致的捐赠率的研究，发现器官增加的结果并不明确，最多也只是适度增加。这是由于缺乏明确的选择退出选择，导致更大的阻力和家庭否决，除非有基础设施和更大的意识来支持这种变化。本文还探讨了选择加入和选择退出方法中知情同意和默认同意之间的区别。知情同意更能体现患者的自主性和尊严。新的器官捐赠政策生效已经过去了 18 个月，本文建议对器官捐献者的心理动机进行更多研究，以帮助政府和医疗保健专业人员获得更多可用于移植的器官。
