Organ donation after euthanasia in children: Belgian and Dutch perspectives

Bollen, Jan; Hoopen, Rankie ten; Hoeven, M.A.H.B.M. van der; Shaw, David; Brierley, Joe; Ysebaert, Dirk; Heurn, L. W. Ernest van; Mook, Walther N. K. A. van

doi:10.1136/archdischild-2018-315560

Cited by 13 publications

(28 citation statements)

References 18 publications

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“…5,10,12,21,28,37,40,41,43,52,53,56,62,81,82,86,91,94,95 Some authors expressed the opinion that, in places where there is existing legislation to permit this combined procedure, the patient's wish should not be denied. 27,69 An important aspect in respecting the patient's wish for donation is the comfort the patient gets from knowing that their death will help other people through transplantation, 4,25,27,37,40,41,43,57,63,72,75,77,82,83,86,87,91 and for the families to know that the last wish of their loved one was granted. 25,75,87 Some authors 73 also stated that other ethical and logistical issues that are currently preventing patients from donating as many organs as possible (eg, death determination, directed donation, desire for MAiD at home) should be further investigated in order to respect patient wishes and autonomy.…”

Section: Ethics Dilemmas and Consensusmentioning

confidence: 99%

Organ donation following medical assistance in dying, Part I: a scoping review of legal and ethical aspects

Silva

Rochon

et al. 2023

JBI Evidence Synthesis

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Objective: The objective of this review was to collate and summarize the current literature on what is known about organ donation following medical assistance in dying (MAiD). Additionally, for this part I of a two-part series scoping review, the focus is on legal and ethical considerations regarding organ donation following MAiD. Introduction: Organ donation following MAiD is a relatively new procedure that has sparked much debate and discussion. A comprehensive investigation into the legal and ethical aspects related to organ donation following MAiD is needed to inform the development of safe and ethical practices. Inclusion criteria: In this review, we included documents that investigated legal and/or ethical issues related to individuals who underwent organ donation following MAiD in any setting (eg, hospital or home) worldwide. We considered quantitative and qualitative studies, text and opinion papers, gray literature, and unpublished material provided by stakeholders. Methods: This scoping review followed JBI methodology. Published studies were retrieved from databases, including MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (Ovid), Web of Science: Science Citation Index and Social Science Citation Index, and Academic Search Complete (EBSCOhost). Gray and unpublished literature included reports from organ donation organizations in Canada, The Netherlands, and Belgium. Two independent reviewers screened all reports (both by title and abstract and by full text) against the inclusion criteria, extracted data, and completed a content analysis. Disagreements between the 2 reviewers were resolved through discussions among the reviewers and the first author. Results: We included 121 studies for parts I and II of our scoping review, 88 of which are included in part I. The majority of the 88 documents were discussion papers published in English (79.5%) and in Canada (39.7%) from 2019 to 2021. In the content analysis, we identified 4 major categories regarding ethical and legal aspects of organ donation following MAiD: i) legal definitions, legislation, and guidelines; ii) ethics, dilemmas, and consensus; iii) consent and objection; and iv) public perceptions. We identified the main legislation regulating the practices of organ donation following MAiD in countries where both procedures are permitted, the many ethical debates surrounding this topic (eg, eligibility criteria for organ donation and MAiD, disclosure of donors’ and recipients’ information, directed organ donation, death determination in organ donation following MAiD, and ethical safeguards for organ donation following MAiD), as well as the public perceptions of this process. Conclusions: Organ donation following MAiD has raised many legal and ethical concerns regarding establishing safeguards to protect patients and families. Despite the ongoing debates around the risks and benefits of this combined procedure, when patients who request MAiD want to donate their organs, this option can help fulfill their last wishes and diminish their suffering, and this should be the main reason to offer organ donation following MAiD.

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Section: Ethics Dilemmas and Consensusmentioning

confidence: 99%

Organ donation following medical assistance in dying, Part I: a scoping review of legal and ethical aspects

Silva

Rochon

et al. 2023

JBI Evidence Synthesis

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“…At international medical conferences in 2018 and 2019, I listened as transplant and critical care physicians discussed "donation after death". This refers to the rapidly expanding scenario in Canada [6] and some Western European countries [7] whereby a person dies by euthanasia, with a legalized lethal injection that she or he requested, and the body is then operated on to retrieve organs for donation [5]. At each meeting, the conversation unexpectedly shifted to an emerging question of "death by donation"-in other words [8], ending people's lives with their informed consent by taking them to the operating room and, under general anesthesia, opening their chest and abdomen surgically while they are still alive to remove vital organs for transplantation into other people.…”

Section: Cause Of Death: Organ Donation?mentioning

confidence: 99%

Death by organ donation: euthanizing patients for their organs gains frightening traction

Ely

2019

Intensive Care Med

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“…Shifting or removing the line between life and death for the purpose of organ donation opens the possibility of transforming longheld ethical standards in the United States, such as those articulated in the principles in the 1997 IOM report: prohibition against active euthanasia and not killing in retrieving organs (IOM, 1997). In contrast, in some countries in Western Europe, notably Belgium and the Netherlands, organs may be removed for donation after circulatory death from patients (including children) whose lives are ended through euthanasia (Algahim & Love, 2015;Bollen et al, 2018). Removing the Dead Donor Rule to allow organ donation following euthanasia or physician-assisted death has been proposed by bioethicists in the United States (Coons & Levin, 2011;Verheijde et al, 2009) and is presently legal in Canada (Allard & Fortin, 2017).…”

Section: Implications For Practice Research and Policymentioning

confidence: 99%

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

Tantillo

González

Ortega

2019

Policy, Politics, & Nursing Practice

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Scientific advances have enabled thousands of individuals to extend their lives through organ donation. Yet, shortfalls of available organs persist, and individuals in the United States die daily before they receive what might have been lifesaving organs. For years, the legal foundation of organ donation in the United States has been known as the Dead Donor Rule, requiring death to be defined for organ donation purposes by either a cardiac standard (termination of the heartbeat) or a neurological one (cessation of all brain function). In this context, one solution used by an increasing number of health care facilities since 2006 is donation after circulatory death, generally defined as when care is withdrawn from individuals who have known residual brain function. Despite its increased use, donation after circulatory death remains ethically controversial. In addition, some ethicists have advocated forgoing the Dead Donor Rule altogether and allowing donation before or near death in certain circumstances. However, nurses and other health professionals must carefully consider the practical and ethical implications of broadening the Dead Donor Rule—as may be already occurring—or removing it entirely. Such changes could harm both the integrity of the health care system as well as efforts to secure organ donation commitments from the public and are outweighed by the moral and pragmatic cost. Nurses should be prepared to confront the challenge posed by the ongoing scarcity of organs and advocate for ethical alternatives including research on effective care pathways and education regarding organ donation.

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Organ donation after euthanasia in children: Belgian and Dutch perspectives

Cited by 13 publications

References 18 publications

Organ donation following medical assistance in dying, Part I: a scoping review of legal and ethical aspects

Organ donation following medical assistance in dying, Part I: a scoping review of legal and ethical aspects

Death by organ donation: euthanizing patients for their organs gains frightening traction

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

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