Donation ethics – donation in life and after death

Donating organs in life or after death not only requires important medical assessments but also psycho-social and ethical considerations that are of equal importance.

The work with organ donation and transplantation is dependent on a multi professional cooperation, which is reflected in this research group: the professions represented are transplant surgeon, social worker/counsellor with background within the transplantation field, microbiologist with extensive experience of working with patient organizations, social welfare and health care policies. The Group also has a wide network of partners, both nationally and internationally, consisting of ethicists, social workers, ethnologists, patient representatives, physicians and nurses who – among other things – represent renal medicine, intensive care and transplant surgery. The intention is to have a close collaboration with representatives of the entire donation process, whether it's donation in life or after death.

The group is conducting both quantitative and qualitative research. Some of the current projects explore:

· The process of finding a living donor. The project highlights the role and the responsibility of the medical health care in this process – how is the request to become a donor handled? Who should ask the question? How informed is the consent of the donors? How voluntary is a next-of-kin’s donation?

· Organ trafficking. Generally, the need for organs far exceeds the organs that actually are donated. Consequently, this sometimes leads to organ trade and to poor and vulnerable people being exploited in some parts of the world. This is another priority area for the research group. In addition to conducting research within this area, the group is also participating in the international work aiming at developing and implementing policies to minimize organ trade and trafficking.

· The medical treatment aiming at making organ donation possible. Organ donation after death requires consent. A question that the research group poses is what an individual believes to have agreed to, when saying "Yes" to organ donation: has the individual also consented to the continuation of medical treatment when there no longer is any hope for one's own survival, in order to allow organ donation? And who should really determine when the deceased has not expressed his/her willingness during lifetime?

In addition to the research carried out in the group, the members have clinical experience of working with organ donation and transplantation. The group also continuously interact with patient representatives and clinicians involved in all the phases of the donation process. This collaboration is important bearing on both the choice of research questions, as well as for the improvement of the clinical organ donation process.

Annika Tibell
Adjungerad professor
Karolinska Institutet
LIME, CHE, Forskargruppen för Donationsetik

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