MO-083   Mini-Oral – Ethical, legal and psychoscial aspects of transplantation                                  Background...
Mini-Oral – Ethical, legal and psychoscial aspects of transplantation                      ImplicationsNeed for new strate...
Mini-Oral – Ethical, legal and psychoscial aspects of transplantation                         Dilemma. Pros and cons Optio...
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New ways of dying create new ethical challenges for the spanish model

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New ways of dying create new ethical challenges for the spanish model

  1. 1. MO-083 Mini-Oral – Ethical, legal and psychoscial aspects of transplantation BackgroundFactors associated to high Recent drop of Spanish organorgan donation rates in Spain donation rates. Explanatoryin the past, include factors:- Identification and maintenance - Less traffic and labor accidents of brain damaged patients - Improved management of with potential to evolve into cerebral infarctions brain dead donors - More request of withdrawal of- Few requests to withdraw life respiratory support by families support in the past of brain damaged potential donors
  2. 2. Mini-Oral – Ethical, legal and psychoscial aspects of transplantation ImplicationsNeed for new strategies to maintain high OD rates:• Living donation• Uncontrolled donation after cardiac death (uDCD)• Controlled DCD (cDCD) – A policy maker dilemma: How can severely brain damaged patients become organ donors while paying the smallest ethical cost?
  3. 3. Mini-Oral – Ethical, legal and psychoscial aspects of transplantation Dilemma. Pros and cons Option a) Maintaining life support to Option b) Withdrawing life support enable donation after brain death to enable controlled DCD- Maximizes the # of organs - Avoids futility, instrumentalization- Accepted practice - Respects family wishes regarding- Deceiving families about the aim of maintaining life support involves EOL options futile, expensive interventions and uncertainty of results (f. refusals) - Loss of organs- Alternatively, transparency obliges to discuss with families the - Lack of explicit consent donation options before patients - Major conflicts of interest are dead, which subordinates the treatment received to the willingness to donate and may involve undue inducement

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