Ethical considerations underpinning the donation of live,non-regenerative organs

The recent donation of a kidney to one of Australia's most prominent citizens by a long-time friend and employee has brought to attention the problems of access facing patients who require renal transplantation as a life-saving measure. The lack of availability of cadaver organs, the improved techniques available to minimise tissue rejection and the potential to genetically engineer tissue-compatible individuals for future organ donation have generated an interest in the ethical and legal considerations that underlie live organ donation.     

Ethical criteria for procuring and distributing organs for transplantation

This article provides an ethical analysis and assessment of various actual and proposed policies of organ procurement and distribution in light of moral principles already embedded in U.S. institutions, laws, policies, and practices. Evaluating different methods of acquisition of human body parts--donation (express and presumed), sales, abandonment, and expropriation--the author argues for laws and policies, including required request, to maintain and facilitate express donation of organs by individuals and their families. Such laws and policies need adequate time for a determination of their effectiveness before society moves to other major alternatives, such as a market. In organ allocation and distribution, which have close moral connections with organ procurement, the author defends the judgment of the federal Task Force on Organ Transplantation that the community should have dispositional authority over donated organs, that professionals should be viewed as trustees and stewards of donated organs, and that the public should be heavily involved in the formation of policies of allocation and distribution. Concentrating on policies being developed in the United Network for Organ Sharing, the author examines the point system for cadaveric kidneys, the access of foreign nationals to organs donated in the U.S., and the multiple listings of patients seeking transplants. He concludes by identifying two major problems of equitable access to donated organs that will have to be addressed by social institutions other than UNOS: access to the waiting list for donated organs and the role of ability to pay in extrarenal transplants.     

Bioethical and legal considerations in increasing the supply of transplantable organs: from UAGA to "Baby Fae"

In the last 35 years, organ transplant technology has advanced greatly. The major problem associated with organ transplantation is organ availability, and not surgery-related mortality. This article examines current organ procurement procedures and technologies, legislative responses to the scarcity of transplantable organs, as well as the psychological barriers to organ donation. Issues of fairness in the allocation of scarce economic and social resources, the role of religion and ethics in organ donation and transplantation decision, and the impact of the media are also considered.     

澳门有关人体器官和组织捐献、摘取及移植的法律制度

随着现代医学的发展,器官移植作为一种行之有效的医疗手段已越来越多地应用于临床医学,无偿捐献器官在一些国家已被视为是一种社会进步和文明的表现, 但随之也出现了一些社会问题,如怎样尊重死者的遗愿和家属愿望等.同时,在一些非洲国家 ,人体器官的国际交易已成为危害当地社会安全的重要犯罪.我国内地这方面的立法还很不健全,但在澳门却有一套严密而细致地规范人体器官和组织捐献及移植的法律制度.澳门回归后,这一法律制度由于不抵触澳门特别行政区基本法已延伸到特别行政区有效,这一法律制度对内地的相关立法有一定的借鉴意义.澳门2/96/M号法律对器官捐献、摘取和移植规定了以下几方面的内容:     

澳门有关人体器官和组织捐献、摘取及移植的法律制度

随着现代医学的发展 ,器官移植作为一种行之有效的医疗手段已越来越多地应用于临床医学 ,无偿捐献器官在一些国家已被视为是一种社会进步和文明的表现 ,但随之也出现了一些社会问题 ,如怎样尊重死者的遗愿和家属愿望等。同时 ,在一些非洲国家 ,人体器官的国际交易已成为危害当地社会安全的重要犯罪。我国内地这方面的立法还很不健全 ,但在澳门却有一套严密而细致地规范人体器官和组织捐献及移植的法律制度。澳门回归后 ,这一法律制度由于不抵触澳门特别行政区基本法已延伸到特别行政区有效 ,这一法律制度对内地的相关立法有一定的借鉴意义。…     

Ethical, professional and legal regulation of medical practice

Moral or ethical codes of practice represent one of the oldest forms of medical regulation. Legislation such as the Medical Practice Act 1992 (NSW) enables regulatory bodies to create codes of practice for medical practitioners. Such codes can become an important aspect of disciplinary proceedings by providing the yardstick against which practitioners' conduct is evaluated. An important aspect of the New South Wales Board's Code of Professional Conduct 2005 is the obligation for doctors to report adverse events which reflect on the performance or conduct of colleagues. This is part of an increasing impetus to report adverse events in the interest of public safety. In the long- term this is a constructive development as it is likely to lead to improvements in identification of risks and hazards and thereby to result in better service provision and community health.     

Ethical and legal dilemmas surrounding bio-banking

The interaction of medical technology and advancements in human life and biological tissue offers many possibilities and issues, for example the area of assisted conception and the identification and treatment of disease. However, hand-in-hand with these, ethical dilemmas arise. The overarching ethical issue surrounding cryo-preserved embryos is： Should an embryo be accorded the status of ＇life＇ or should it be labeled nothing more than ＇property＇？ This question is the interaction between frozen embryos and divorce, adoption, research and terminal incidents; it is a legal and ethical quagmire that cannot be readily resolved. This issue is of particular moral importance when one contemplates the fact that the scientific definition of life is dealt with on a continuum ranging from the metabolic view to the emergence of self-consciousness. The question must become property versus life or, in essence, sale or destruction of property versus sale or destruction of life. As this paper will show, the underlying attitudes of the progenitors involved in cryogenics can be driven by the darker side of our species; that side being the possible exploitation of those individuals or those capable of becoming individuals for personal and community gain while denying or rationalizing that point of view to society as a whole.     

Ethical and legal issues in suicide research

Moralist, libertarian and relativist ethical positions concerning suicide and its prevention are presented in order to clarify premises upon which ethical issues in suicide research may be resolved. Ethical concerns are differentiated from legal considerations and the implications of the vulnerability of suicidology research participants are discussed. Specific issues that arise in design, choice of participants, interpretation, diffusion of results and evaluative research are treated. These include: experimental methodologies, obtaining informed consent, deception and disclosure, studying innovative and unproven interventions, unknown consequences of participation, rescue criteria, disclosure of information to third parties, research with special populations, risks in publicizing results and measuring the value of human life. When specific legal obligations are lacking, ethical premises concerning the acceptability of suicide and obligations to intervene may influence research protocols.     

Physician-assisted suicide: legal and ethical considerations

As medicine's technical limits have become increasingly clear, Americans seem more willing to address end-of-life decisionmaking. A major development during the 1990s was physician assistance in dying: physician-assisted suicide in Michigan, Oregon's Death with Dignity Act, and developments in Europe, most notably The Netherlands. This evolution toward recognizing the appropriateness of assistance in dying raises legal and ethical issues for physicians and healthcare institutions such as nursing facilities and acute care hospitals. These issues include the effects on providers' values systems, the trust between patient and provider, and the "slippery slope" that voluntary, active assistance in dying will become involuntary, active assistance. This Article addresses the policy issues that institutions must confront in a changing environment.     

法医学鉴定实践中的伦理考量

法医学鉴定的对象是人及与人相关材料,因此在法医学检案实践中需要考虑伦理问题。基于法医学鉴定中的公平正义、尊重、真相告知三大基本原则,进一步衍生出法医学检案实践活动的具体伦理要求,即法医学鉴定的称职性、对鉴定涉及案件及其当事人伦理考虑、如何处理案件检材。然而当前法医学鉴定却存在部分法医鉴定人不称职、重技术轻程序、鉴定机构选择出现争议、利益输送与利益冲突等问题。笔者针对以上问题提出相应对策,并重点讨论三大矛盾,保证法医学鉴定称职性。