Russell S, Jacob R G
Patient Educ Couns. 1993 Jun;21(1-2):89-99. doi: 10.1016/0738-3991(93)90063-3.
New procedures for segmented organ transplantation of the lung and liver have again brought to public attention the issue of live organ donation. To provide a context for understanding the dilemmas faced by potential donors, the body of literature over the last 40 years regarding living-related organ donation with kidneys was reviewed. Results indicated that while psychological side effects have been reported including depression and family conflict these risks are generally under-emphasized. Risk factors for negative psychological consequences include high age, lack of social support, and organ rejection in the recipient. Instantaneous decision-making in favor of donation is generally described. However, researchers have neglected to consider social desirability factors when assessing donor motives. Furthermore, lack of awareness has been shown concerning the coercive processes involved in moral decision-making. Health professionals should be aware that merely raising the issue of live organ donation may instigate powerful psychological processes beyond the potential donor's voluntary control and leave little room for refusal without psychological cost. Implications for treatment are discussed with these circumstances in mind.
肺和肝的分段器官移植新程序再次引起了公众对活体器官捐赠问题的关注。为了提供一个理解潜在捐赠者所面临困境的背景，我们回顾了过去40年里关于亲属活体肾捐赠的文献。结果表明，虽然有报道称存在包括抑郁和家庭冲突在内的心理副作用，但这些风险通常未得到充分重视。负面心理后果的风险因素包括年龄较大、缺乏社会支持以及受者的器官排斥。一般描述的是瞬间做出支持捐赠的决定。然而，研究人员在评估捐赠者动机时忽略了考虑社会期望因素。此外，对于道德决策中涉及的强制过程缺乏认识。卫生专业人员应该意识到，仅仅提出活体器官捐赠问题可能会引发潜在捐赠者无法自主控制的强大心理过程，并且在没有心理代价的情况下几乎没有拒绝的余地。考虑到这些情况，我们讨论了对治疗的影响。
