E-Locus - Institutional Repository of the University of Crete - Μεταμοσχεύσεις από πτωματικούς δότες : μια βιοηθική προσέγγιση

Home Μεταμοσχεύσεις από πτωματικούς δότες : μια βιοηθική προσέγγιση

Results - Details

[Add to Basket]

Identifier

000353341

Title

Μεταμοσχεύσεις από πτωματικούς δότες : μια βιοηθική προσέγγιση

Author

Κονιδάκη, Αικατερίνη-Φραντζέσκα

Thesis advisor

Φιλαλήθης, Αναστάσιος

Reviewer

Μολύβας, Γρηγόρης
Μάλλιος, Ευάγγελος

Abstract

Transplantation which is one of the most important acquisitions of medicine allows the rehabilitation of body’s functions that have been lost or in some cases have been partly replaced by an automatic mechanical method. The technical success evolved in parallel with the development of surgical techniques for the procurement of all organs from a donor. The donation of organs, tissues and cells predicates the process of transplantation and consequently it is crucial to yield the idea of donating organs, tissues and cells to public in order to get accustomed with this practice. One of the most important subjects in the field of transplantation is brain death which is determined as the irreversible impairment of the brain function with a permanent loss of all the functions of brain stem. In no case a person with a sustaining coma or persistent vegetative or non cognitive state can be characterized as brain dead and more importantly to be defined as a potential organ donor. The standards for the determination of death are very rigorous and medically and legally acceptable in order to acquire the right to set the request for organ donation. During the medical chronicles there is not even one case of a brain dead person’s revival. The death of brain stem is considered as a sufficient and necessary condition in order to define a whole brain death as it is determined by the 9th decision of the 21st plenum of the Central Council of Health that took place in 20-3-1985. The majority of organs for transplantation come from persons that have been diagnosed as brain dead and their cardiorespiratory function is maintained artificially. Since the diagnosis of brain death has been completed the person is labeled as dead and any further medical support considers being useless. Every policy for the reassurance of transplants must take into account the sensitive side of the subject particularly in regard to respect the dead. The law 2737/1999 has been orientated to sensitize society foreseeing various movements to activate them, namely the development and establishment of the transplant coordinator. The institution of transplant coordinator is very important and attention must be paid to its complete and proper application which could have as a result the sensitization and diffusion of the organ donation idea and consequently the increase of cadaveric transplants. The real key of this case is the network of transplant coordinators that are responsible for the search, the recognition and record of potential donors, the information of the donors’ family and the discussion with them about 113 organ donation while in parallel they participate in the development of programs concerning the spread of idea of organ donation. The policy of presumed consent seems to be attractive in order to encounter the problems that arise from the shortage of organ transplants and the difficulty in finding transplant donors. Nevertheless the potential establishment of this policy for the saving of transplants from cadaveric donors probably would encumber rather than facilitate this goal. The emphasis at the methods of consent that are finally applied should aim to keep a balance between respect to the wishes of the dead and he mood to offer life. The information and sensitization of the public about organ donation is one of the most nodal subjects that state should pay attention rather than the adoption of systems like explicit refusal which is the other aspect of consent, in particular to consider as potential donor anyone who hadn’t expressed his denial for posthumous donation during his life. The procurement of organs from dead persons stimulates the philosophical brainstorming and particularly puts forward the question if we could harm the dead and ignore his will. A retrospection of the philosophical arguments for the adoption of the aspect about posthumous harm and posthumous interests occupies a significant part of our ethical philosophy and tries to justify the posthumous respect of the wishes of the dead. The maintenance of the concept of harm in our ethical and legal system consists one of the most effective and powerful ways to ensure respect not only to the dead but mainly to the jurisdiction of the living for the body of the dead. The idea we have about transplantations nowadays can and should change. On this account it is essential to formulate a constant and accountable cooperation between all the involved agents and organizations, a meaningful dialogue, an exchange of views and an expression of responsible and reliable proposals with ultimate end to sensitize society. The substantial cooperation of public with the organs that coordinate and manage the transplantation system as well as the respect they show to the persons that are related to the dead are considered to be a prerequisite in order to ground transplantations in people conscience so as to give a social consent which will accrue much more transplants than any other form of presume consent.

Language

Greek

Subject

Bioethical Issues

Brain Death

Cadaver

Ethics, Medical

Human Body

Organ Transplantation

Patient Rights

Tissue Donors

Δεοντολογία, Ιατρική