Ethical, Psychological and Social Un/certainties in the Face of Deemed Consent for Organ Donation in England.

IF 1.8 3区 哲学 Q2 ETHICS Health Care Analysis Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI:10.1007/s10728-024-00492-0
Laura L Machin, Elizabeth Wrench, Jessie Cooper, Heather Dixon, Mark Wilkinson
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Abstract

Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant's 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals' perspectives on deemed consent, drawn from interview data with 24 healthcare professionals in an NHS Trust in England, prior to the introduction of the legislation. Whilst participants supported deemed consent in principle, they were concerned that it would present a threat to the nature of donation as a 'gift'; the notion of informed consent (or non-consent); and the autonomy of donors, their relatives, and their own roles as health professionals, posing dilemmas for practice. We argue that healthcare professionals present themselves as guardians of potential (non)donors and thus as having ethics and integrity in their own practice. We draw conclusions around the values and principles that matter to healthcare professionals when contemplating consent in deceased donation which will be useful for organ donation committees and ethics forums.

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在英格兰,面对器官捐献的 "视为同意",伦理、心理和社会方面的不确定性。
英国于 2020 年引入了已故器官捐献的 "视为同意 "立法,该立法被视为英国国家医疗服务系统血液与移植部门新十年战略的重要组成部分,旨在提高器官捐献的同意率。尽管该立法包含保护公众的保障措施,但 "视为同意 "的引入给医护专业人员的实践带来了伦理、心理和社会方面的不确定性。在本文中,我们通过对英国国家医疗服务系统(NHS)一家信托机构的 24 名医护专业人员的访谈数据,深入探讨了医护专业人员对 "视为同意 "的看法。虽然参与者原则上支持 "视为同意",但他们担心这会对捐赠作为 "礼物 "的性质、知情同意(或非同意)的概念、捐赠者及其亲属的自主权以及他们作为医疗专业人员的角色构成威胁,从而给实践带来两难境地。我们认为,医护专业人员是潜在(非)捐献者的监护人,因此在其自身的实践中应遵守职业道德和诚信。我们围绕医护专业人员在考虑同意死者捐献时所关注的价值观和原则得出结论,这将对器官捐献委员会和伦理论坛有所帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
3
期刊介绍: Health Care Analysis is a journal that promotes dialogue and debate about conceptual and normative issues related to health and health care, including health systems, healthcare provision, health law, public policy and health, professional health practice, health services organization and decision-making, and health-related education at all levels of clinical medicine, public health and global health. Health Care Analysis seeks to support the conversation between philosophy and policy, in particular illustrating the importance of conceptual and normative analysis to health policy, practice and research. As such, papers accepted for publication are likely to analyse philosophical questions related to health, health care or health policy that focus on one or more of the following: aims or ends, theories, frameworks, concepts, principles, values or ideology. All styles of theoretical analysis are welcome providing that they illuminate conceptual or normative issues and encourage debate between those interested in health, philosophy and policy. Papers must be rigorous, but should strive for accessibility – with care being taken to ensure that their arguments and implications are plain to a broad academic and international audience. In addition to purely theoretical papers, papers grounded in empirical research or case-studies are very welcome so long as they explore the conceptual or normative implications of such work. Authors are encouraged, where possible, to have regard to the social contexts of the issues they are discussing, and all authors should ensure that they indicate the ‘real world’ implications of their work. Health Care Analysis publishes contributions from philosophers, lawyers, social scientists, healthcare educators, healthcare professionals and administrators, and other health-related academics and policy analysts.
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