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Ethische Relevanz und faktische Mängel in der Kommunikation von Spezifika der Organspende nach Kreislaufstillstand

Ethical relevance and factual deficiencies in the communication of specifics of organ donation after circulatory determination of death

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Zusammenfassung

In zahlreichen Ländern nimmt die Zahl von Organspenden nach Kreislaufstillstand (donation after circulatory determination of death, DCDD) zu, obwohl in der Medizinethik verschiedene Aspekte der DCDD kritisch diskutiert werden. In unserer Arbeit identifizieren wir ethisch relevante Aspekte der DCDD basierend auf einer umfassenden Literaturanalyse. Wir fokussieren dabei insbesondere auf zwei Aspekte: vorbereitende Maßnahmen und Irreversibilität des Todeskriteriums. Danach untersuchen wir in einer weltweit durchgeführten Auswertung von Webseiten von Organspende-Organisationen und einer begleitenden Umfrage, inwieweit diese ethisch relevanten Aspekte von DCDD in der Information potenziell spendewilliger Personen eine Rolle spielen. Es zeigt sich, dass in der Mehrheit der Webseiten der Organisationen auf die Thematik DCDD nicht oder kaum eingegangen wird, die befragten Verantwortlichen der Organisationen aber die Wichtigkeit der Aufklärung bei spendewilligen Personen betonen. Wir diskutieren diese Diskrepanz und weisen auf zentrale Punkte hin, über welche spendewillige Personen informiert werden sollen, wenn diese Form der Organspende in ihrem jeweiligen Land praktiziert wird. Zudem plädieren wir dafür, dass das Todeskriterium und die Prozeduren zur Todesfeststellung in der Transplantationsmedizin einheitlich sein sollen, um kritisch diskutierte Aspekte im Kontext der DCDD entschärfen zu können.

Abstract

Introduction

In many countries, the number of organ donations after circulatory determination of death (DCDD) is increasing, although various aspects of DCDD are critically discussed in medical ethics. In our work, we identify ethically relevant aspects of the DCDD—in particular regarding preparatory measures and the irreversibility of the death criterion—and we investigate to what extent persons interested in becoming organ donors are informed about those issues.

Methods

We performed a comprehensive literature review on ethical issues of DCDD. Subsequently, we conducted a worldwide evaluation of organ donation organisations’ websites and an accompanying survey to investigate the extent to which ethically relevant aspects of DCDD play a role in the information of persons interested in becoming organ donors.

Results

We find that a majority of the organisations’ websites do not deal with the subject of DCDD, whereas the responsibles of the organisations surveyed emphasised the importance of education for potential donors.

Conclusion

We point out central issues about which persons willing to become organ donors should be informed if DCDD is practiced in their respective countries. In addition, we advocate that the criteria and the procedures for determining death in the context of transplantation medicine should be uniform in order to defuse some of the critically discussed aspects in the context of DCDD.

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Abb. 1

Notes

  1. Siehe www.irodat.org (letzter Zugriff am 1. Aug. 2018).

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Danksagung

Wir danken Tanja Krones, Leitende Ärztin Klinische Ethik und Geschäftsführerin Klinisches Ethikkomitee des Universitätsspitals Zürich, für ihre Ratschläge bei der Gestaltung der Umfrage.

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  1. Institut für Biomedizinische Ethik und Medizingeschichte, Winterthurerstrasse 30, 8006, Zürich, Schweiz

    Markus Christen & Martina Gloor

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  1. Markus Christen
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  2. Martina Gloor
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Correspondence to Markus Christen.

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M. Christen und M. Gloor geben an, dass kein Interessenkonflikt besteht.

Ethische Standards

Das Projekt inkl. der Befragungen wurde im Einklang mit nationalem Recht durchgeführt. Das Einverständnis aller Teilnehmer wurde eingeholt.

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Christen, M., Gloor, M. Ethische Relevanz und faktische Mängel in der Kommunikation von Spezifika der Organspende nach Kreislaufstillstand. Ethik Med 30, 343–361 (2018). https://doi.org/10.1007/s00481-018-0501-0

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