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Answered: - Living Donor Organ Transplantation IMA STUDENT INDIANA WESLEYAN
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Living Donor Organ
Transplantation
IMA STUDENT
INDIANA WESLEYAN UNIVERSITY
What are the ethical considerations?
Ross?s Ethics
Rawls?s Theory of Justice
Duties of Beneficence: helping to
better the condition of others
Everyone has equal right to equal
basic liberties
Duties of Non-maleficence: avoiding
or preventing injury and harm to
others
Natural duty to help others in need or
in jeopardy
A person has the right to determine
what risks he is willing to take with
his own life and health
Voluntary consent required
We must learn the facts of the case
and explore the possible
consequences of our actions
We must guide our actions by what is
right, rather than by what is useful
(Munson, 2009, p. 876-885)
What are the moral responsibilities in
this situation?
Act for the benefit of others
Act in a way to bring about the greatest benefit and least
amount of harm
Our actions are the result of our own choices and decisions
based on our own moral values and beliefs
?Above all, do no harm?
(Munson, 2009, p. 891-904)
?
My command is this: Love each
other as I have loved you. Greater
love has no one than this, that he
lay down his life for his friends.
JOHN 15:12-13
It is an act of love to give an organ so that someone else
might live or experience an improvement in his life. Jesus
gave sacrificially and we should follow His example.
?
Patient Rights
Informed Consent:
Your Rights:
The informed consent process should
help you understand all aspects of
the donation process, including the
risks and benefits. Your consent to
become a donor is completely
voluntary. You should never feel
pressured to become a donor. You
have the right to delay or stop the
donation process at any time.
Living donation: Information you need to know (2014,
August 21). Retrieved from http://www.unos.org/doc/LivingDonation.pdf
You have the right to be informed about the
care you will receive
You have the right to make decisions about
your care
You have the right to give free and informed
consent to be an organ donor
You have the right to receive full disclosure of
the risks, alternatives, and outcomes
You have the right to be listened to
You have the moral and legal rights to privacy
Know your rights (2014, August 21) Retrieved from
http://www.jointcommission.org/assets/1/6/Know_Your_Right
s_brochure.pdf
Medical Research
A variety of strategies are being
researched and developed to
help the immune system accept
organ transplants
Researchers are exploring how to
grow new organs from stem cells
Clinical Trials for Extracorporeal
Liver Assist System (ELAD)
Drug researchers are trying ways
to block or deplete the genes
that attack donor organs
McClellan, M. (2003). Organ and tissue transplants: Medical miracles and challenges. Berkeley Heights, NJ:
Enslow
Advanced Directives
Advanced directives are written, legal instructions regarding your
preferences for medical care if you are unable to make decisions
for yourself. Advance directives guide choices for doctors and
caregivers if you are terminally ill, seriously injured, in a coma, or
near the end of life.
Do Not Resuscitate Order (DNR)
Living Will
Durable Healthcare Power of Attorney (DHCPOA)
?As iron sharpens iron, so one person
sharpens another? Prov 27:17 (NIV)
It is important to seek out godly people to consider your
decisions with. Others in the body of Christ may see
where we are blind.
Reproductive Decisions
Pregnancy in post-transplant patients is common
Increased risk for preeclampsia, hypertension, and renal
insufficiency
Increased risk for low birth weight
(Surti, Tan, & Saab, 2008)
Medical Technology
Adult
Stem Cell therapies
Tissue Regeneration
3-D printing of organs
(Sarfarti, 2014) (Wong, 2013) (?Miniature human liver,? 2013) (Akhter, Ali Aziz, & Al Ajlan,
2011)
End of Life Care
Palliative Care
Pain Control
Anxiety Control
Depression control
Withdrawal of nutrition and fluids
Advance Directives
(Kahn, Lazarus, & Owens, 2003) (Wright, Pape, Ross, Campbell, & Bowman, 2007) (Munson, 2012, p. 582-583)
Spiritual Care
?Death
has been swallowed up in victory.? ?Where, O death, is your
victory? Where, O death, is your sting?? The sting of death is sin,
and the power of sin is the law. But thanks be to God! He gives us
the victory through our Lord Jesus Christ? (1 Cor. 15:54-57)
What are your religious and spiritual needs?
Clergy involvement
We are made in God?s image; therefore all human life, irrespective of an individual?s
ability or gifts, is precious and holy.
(Engelhardt & Smith, 2005)
(Kahn, Lazarus, & Owens, 2003)
Duty To Treat
Four Pillars of the
Hippocratic Oath:
Beneficence
Non-Maleficence
Autonomy
Justice
(Voors, 2000, p. 642-643)
Individual Responsibility
Keep yourself as healthy as possible
Follow all pre-op and post-op instructions
Adhere to treatment plans
Take your medication as prescribed
Schedule and keep all follow up appointments
(Estelle-Brazzell Horton, 2014)
The United Network for Organ
Sharing
UNOS is responsible for transplant organ distribution in the U.S. UNOS
oversees the allocation of many different types of transplants, including
liver, kidney, pancreas, heart, lung, and cornea.
Receive data from hospitals and medical centers regarding adults and
children who need organ transplants
Criteria have been developed to ensure that all people on the waiting
list are judged fairly as to the severity of their illness and the urgency
of receiving a transplant
People in most urgent need are placed highest on waiting list and are
given first priority
(Liver Transplantation, n.d.)
?
From everyone who has been
given much, much will be
demanded; and from the one
who has been entrusted with
much, much more will be asked.
LUKE 12:48 (NEW INTERNATIONAL VERSION)
?
References
Akhter, J., Ali Aziz, A., & Al Ajlan, A. (2011). Stem cells and liver disease. Internet Journal of Medical Update, 6(2), p. 6975. Retrieved from http://ebscohost.com
Engelhardt H. T. , & Smith A. (2005). End-of-life: The traditional Christian view. Retrieved on September 14, 2014 from
http://www.asu.edu/clubs/bioethics/christian.pdf
Estelle-Brazzell Horton, S. (2014). What is personal health responsibility? ABNF Journal, 25(1), 5-9. Retrieved from
http://ebscohost.com
Freund, L. (2010). Creating a culture of accountability. Ethics is the key to sharing healthcare stewardship. Healthcare
Executive, 25(1), 30. Retrieved from http://ebscohost.com
Kahn, M., Lazarus, C., & Owens, D. (2003). Allowing patients to die: Practical, ethical, and religious concerns. Journal of
clinical Oncology: Official Journal of the American Society of Clinical Oncology, 21(15), 3000-3002. Retrieved from
http://ebscohost.com
Know your rights (2014, August 21) Retrieved from
http://www.jointcommission.org/assets/1/6/Know_Your_Rights_brochure.pdf
Liver transplant (n.d.). Retrieved from http://www.uchospitals.edu/online-library/content=P00677
Living donation: Information you need to know (2014, August 21). Retrieved from http://www.unos.org/doc/LivingDonation.pdf
McClellan, M. (2003). Organ and tissue transplants: Medical miracles and challenges. Berkeley Heights, NJ:
Enslow
Miniature human liver grown from stem cells: Tissue implanted in mice became functioning organ hope for
treatments to end reliance on donors (2013, July4). Guardian, p. 14. Retrieved from
http://galegroup.com.oak.indwes.edu
Munson, R. (2012). Intervention and reflection: Basic issues in Bioethics. Boston, MA: Wadsworth.
Sarfati, J. (2014, July 10). Stem cells and Genesis. Retrieved on August 29, 2014 from
http://creation.com/stem-cells-and-genesis
Surti, B., Tan, J., & Saab, S. (2008). Pregnancy and liver transplantation. Liver International, 28(9), 12001206. doi:10.1111/j.1478-3231.2008.01871.x
Voors, M. (2000). The duty to treat: Ethics and HIV/AIDS. Physiotherapy, 86(12), 640-644. Retrieved from
http://ebscohost.com
Wong, S. C. (2013). Stem cells news update: A personal perspective. Balkan Journal of Medical Genetics,
16(2), 7-15. doi:10.2478/bjmg-2013-0025
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