مطالعه بایدهای اخلاقی و موانع اخذ رضایت آگاهانه در اهدای عضو
مجله اخلاق پزشکی - علمی پژوهشی,
دوره 11 شماره 41 (1396),
26 October 2017
,
صفحه 77-90
https://doi.org/10.22037/mej.v11i41.19220
چکیده
زمینه و هدف: رضایت آگاهانه از قواعد مهم اخلاق پزشکی است که توجه به آن قبل از آغاز هر اقدام تشخیصی و یا درمانی، فرایند درمان و مراقبت را تسهیل خواهد کرد. این مطالعه، با هدف بررسی بایدهای اخلاقی و موانع اخذ رضایت آگاهانه در اهدای عضو انجام شد.
مواد و روشها: در این مطالعه مروری، جستجوی نظاممند برای مقالات انگلیسی زبان، دارای متن كامل و قابل دسترس، در بازه زمانی سالهای 2010 تا 2016 با واژگان کلیدی «Organ Donation» و «Informed Consent» در پایگاههایPubMed ، Science Direct و Google Scholar صورت گرفت. از میان 126 مقاله یافت شده، 16 مقاله مرتبط، مطالعه و تحلیل گردید.
ملاحظات اخلاقی: صداقت و امانتداری در گزارش متون، استناددهی به منابع، پرهیز از هر گونه سوگیری رعایت گردید.
یافتهها: بایدهای اخذ رضایت آگاهانه به دو دسته مربوط به اهداکننده و مربوط به رضایتگیرنده و کادر درمان دستهبندی شد. اکثر مطالعات، آگاهی از خطرات اهدا، اطمینان از صلاحیت و قاطعیت دهنده عضو را از موارد مرتبط با اهداکننده میدانستند. ارزیابی کامل پزشکی، دادن اطلاعات و ایجاد درک کافی از موارد مرتبط با رضایت گیرنده میباشند. موانع در سه دسته مربوط به اهداکنندگان، خانوادههای آنها و رضایت گیرنده قرار گرفت. از مهمترین موانع اخذ رضایت آگاهانه آموزشهای حرفهای ناکافی در اهداکنندگان زنده و عدم درک صحیح از مرگ مغزی و فشار برای اهدای عضو در خانوادههای اهداکنندگان دچار مرگ مغزی میباشند.
نتیجهگیری: بیماران مایل به دریافت اطلاعات مهم، به ویژه در زمینه خطرات پیوند بوده و محرومیت از چنین اطلاعاتی، مانعی اساسی برای رضایت آگاهانه است. یافتهها نشاندهنده ضرورت بازنگری روند رضایت آگاهانه به منظور انتقال اطلاعات مربوط به اهدای عضو، به طور مؤثر و ارزیابی درک اهداکننده است.
- بایدهای اخلاقی؛ اهدای عضو؛ رضایت آگاهانه
ارجاع به مقاله
مراجع
Baligh N. In Translation of Muted Consent. Edited by Vojcic J. Tehran: Iranian Center for Research of Medical Ethics and History; 1994. [Persian]
Parsapour A, Parsapour M, Larijani B. Informed consent, contents, conditions and practical methods. Iran J Diabet Lipid Dis 2005; 5: 1-14. [Persian]
Beauchamp TL, Childress JF. Principles of biomedical ethics. 7th ed. New York: Oxford University Press; 2013.
Abecassis M, Adams M, Adams P, Arnold R, Atkins C, Barr M, et al. Consensus statement on the live organ donor. JAMA 2000; 284(22): 2919-2926.
Pier M. Medical ethics: Patients’ rights. Translated by Khazanedari S. Tehran: Education Development Center of Shahid Beheshti University of Medical Sciences; 2003. p.81-93. [Persian]
Linin G. Comparative study on patients’ right in European countries. Tehran: Ahoura; 1999. p.45-71.
Sheikhtaheri A, Farzandipour M. Informed consent process: inpatients competency and admission clerks’ performance in teaching hospitals in Kashan. J Inform Manage 2009; 6(2): 96-104. [Persian]
Hajavi A, Piri Z, Shahmoradi L, Asadi N, Kheradmandi S, Oveisi M, et al. A survey on completeness of inpatient informed consent forms in the three treatment-teaching centers in Iran University of Medical Sciences (IUMS). J Health Adm 2008; 11(32): 55-62.
United Nations Educational, Scientific and Cultural Organization (UNESCO), Report of the International Bioethics Committee (IBC) on consent. Available at: www.unesdoc.unesco.org/images/E.pdf. Accessed October 10, 2009. Report No.
Caplan A. Must I be my brother’s keeper? Ethical issues in the use of living donors as source of liver and other solid organs. Transplant Proc 1993; 25(2): 1997-2000.
Glannon W. Underestimating the risk in living kidney donation. J Med Ethics 2008; 34(3): 127-128.
Ali Akbaei Babukani E, Shakeri M, Shamli N. The Last Will and Consent of the Next of Kin in Removing Organs. J Manage Syst 2012; 10(29): 197-233. [Persian]
Levine R. The National Commission’s ethical principles, with special attention to beneficence. Edited by Childress J, Meslin E, Shapiro H. Washington: Georgetown University Press; 2005. p.126-135.
Kazemian A, Parsapour A. Study on physician’s point of view about right telling to terminal patients. Ethics Sci Technol 2006; 1(1): 61-67. [Persian]
Bernard l. Resolving ethical dilemmas: A guide for clinicians. USA: Lippinicott; 2000.
Vincent A, Logan L. Consent for organ donation. Br J Ansaeth 2012; 108(1): 80-87.
Nowak E, Pfitzner R, Koźlik P, Kozynacka A, Durajski L, Przybyłowski P. Organ Donor Cardsd Concepts Versus Reality: A Study Among Academic Students in Poland. Transplant Proc 2014; 46(8): 2519-2529.
Arianpur N, Tofighi E, Roozegar R. Investigating the role of substitution of satisfactory buttocks with organ satisfaction in organ donation after brain death. 2nd conference on the study of religious standards in medicine. Tehran: AJA University of Medical Sciences; 2013. [Persian]
Albright CL, Wong LL, Cruz MRD, Sagayadoro T. Choosing to be a designated organ donor on their first driver's license: actions, opinions, intentions, and barriers of Asian American and Pacific Islander adolescents in Hawaii. Transplant Prog 2010; 20(4): 392-400.
Miranda B, Matesanz R. International issues in transplantation: setting the scene and flagging the most urgent and controversial issues. Ann N Y Acad Sci 1998; 2(1): 129-143.
Abouna G. Organ shortage crisis: problems and possible solutions. Transplant Proc 2008; 40(1): 34-41.
Beaulieu D. Organ donation: the family's right to make an informed choice. J Neurosci Nurs 1999; 31(1): 37-42.
West R, Burr G. Why families deny consent to organ donation. Aust Crit Care 2002; 15(1): 27-32.
Martinez J, Lopez J, Martıin A, Martin M, Scandroglio B, Martin J. Organ donation and family decision-making within the Spanish donation system. Soc Sci Med 2001; 53(4): 405-425.
Randhawa G, Brocklehurst A, Pateman R, Kinsella S, Parry V. Opting-in or opting-out?’ The views of the UK’s faith leaders in relation to organ donation. Health Policy 2010; 96(1): 36-44.
Abbasi Z, Peyman A. Brain death and organ donation in Iran. Med Law J 2012; 6(20): 43-54. [Persian]
Barber K, Falvey S, Hamilton C, Collett D, Ru dge C. Potential for organ donation in the United Kingdom: audit of intensive care records. BMJ 2006; 332(7550): 1124-1130.
Siminoff L, Mercer M, Graham G, Burant C. The reasons families donate organs for transplantation: implications for policy and practice. J Trauma 2007; 62(4): 969-978.
Howlader M, Dhanji A, Uppal R, Magee P, Wood A, Anyanwu A. Patients' views of the consent process for adult cardiac surgery: questionnaire survey. Scand Cardiovasc J 2004; 38(6): 363-370.
Tarighat Saber G, Zare S, Etemadi A, Mohammadi M, Shams G. Assessment of Knowledge And Satifaction of Information Given in Cancer Patients Referred to Imam Khomeini Hospital 1382-1383 and Its Assossiation with Anxiety and Depression in These Patients. Tehran Univ Med J 2006; 64(2): 165-171. [Persian]
Hammami M, Abdulhameed H, Concepcion K, Eissa A, Hammami S, Amer H, et al. Consenting options for posthumous organ donation: presumed consent and incentives are not favored BMC Med Ethics 2012; 13: 32-46.
Murray L, Miller A, Dayoub C, Wakefield C, Homewood J. Communication and Consent: Discussion and Organ Donation Decisions for Self and Family. Transplant Proc 2013; 45(1): 10-12.
Tumin M, Abdul Talib Abdul Mutalib M, Mohd Satar N, Abdullah N, Chong C, Ng K, et al. A comparison of donor and control group quality of life. Ann Ransplant 2014; 19: 112-118.
Lenzi J, Sarlo R, Assis A, Ponte M, Paura P, Araújo C, et al. Family Informed Consent to Organ Donationd Who Performs Better: Organ Procurement Organizations, In-Hospital Coordinators, or Intensive Care Unit Professionals? Transplant Proc 2014; 46(6): 1672-1673.
Gordon E, Mullee J, Skaro A, Baker T. Live liver donors’ information needs: A qualitative study of practical implications for informed consent. Surgery 2016; 160(3): 671-682.
Gordon E, Rodde J, Skaro A, Baker T. Informed consent for live liver donors: A qualitative, prospective study. J Hepatol 2015; 63(4): 838-847.
Midolo E. The Legislation on Living Organ Donation in Western Europe: Legal and Ethical Analysis and Impact on Clinical Practice. Transplant Proc 2013; 45(7): 2576-2579.
Petrini C. Ethical Issues With Informed Consent From Potential Living Kidney Donors. Transplant Proc 2010; 42(4): 1040-1042.
Rowinski W, Paczek L. Transplantation Ethics: Are We Approaching the Crossroads? Transplant Proc 2012; 44(7): 2171-2172.
Shardlow E, Twamley H. Ethics of transplantation. Anaesth Intensive Care Med 2012; 13(6): 278-280.
Gordon E. Informed Consent for Living Donation: A Review of Key Empirical Studies, Ethical Challenges and Future Research. Am J Transplant 2012; 12(9): 2273-2280.
Joffe A, Carcillo J, Anton N, deCaen A, Han Y, Bell M, et al. Donation after cardiocirculatory death: a call for a moratorium pending full public disclosure and fully informed consent. Philo, Ethics Humanit in Med 2011; 6: 17-37.
Wojcik J. Muted consent. Tehran: Iranian Center for Research of Medical Ethics and History; 1994.
U.S. Department of Health and Human Services, Advisory Committee on Organ Transplantation. Recommendations 1-18. Availavle at: http://www.organdonor.gov/legislation/acotrecs118.html. Accessed December 29, 2011.
Cotler S, Cotler S, Gambera M, Benedetti E, Jensen D, Testa G. Adult living donor liver transplantation: perspectives from 100 liver transplant surgeons. Liver Transpl 2003; 9(6): 637-644.
Hester M. Why must we leave our organs to others. Am J Bioeth 2006; 6: 23-28.
Miller C. Regulation and oversight of adult living donor liver transplantation. Liver Transpl 2003; 9(10): 69-72.
Glazier A. The principles of gift law and the regulation of organ donation. Transpl Int 2011; 24(4): 368-372.
- چکیده مشاهده شده: 693 بار