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Ethical guidelines for organ transplantation from deceased donors submission

Submission ID: 
5
This submission reflects the views of
Organisation Name: 
DonateLife WA
Please identify the best term to describe the Organisation: 
Health service
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Submission - Option 1. Online submission
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General Comments: 

 

 

 

NHMRC draft Ethical Guidelines for Organ Transplantation from Deceased Donors

 

Public Consultation

 

Submission

 

From: DonateLife WA

Date:  20 February 2015

 

 

The Draft Guidelines in General

 

Comment 1.

The document reads well. The definitions and case studies are helpful and easy to understand

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The Role of the Draft Guidelines in Relation to other Current Documents

 

Comment 2.

There are currently (February 2015) two NHMRC documents on ethical guidelines; this 2015 draft Ethical Guidelines for Organ Transplantation from Deceased Donors and the 2007 Organ and Tissue Donation After Death, for Transplantation – Guidelines for Ethical Practice for Health Professionals. Two other NHMRC documents, the 2007 Making a Decision about Organ and Tissue Donation after Death and the 2007 Making a Decision about Living Organ and Tissue Donation address organ donation.  There is another document, the TSANZ Organ Transplantation from Deceased Donors: Consensus Statement on Eligibility Criteria and Allocation Protocols (version 1.3; 8 January 2014, “Consensus Statement”).  Five guideline documents on organ and tissue donation and transplantation can be daunting and confusing.

 

The draft Ethical Guidelines for Organ Transplantation from Deceased Donors document states that its final version and “a new version of Clinical Protocols to be developed by TSANZ” will supersede the TSANZ document. The new Clinical Protocols will presumably refer to organ-specific transplantation, being recipient eligibility, organ suitability, and organ allocation.  Thus the draft Ethical Guidelines for Organ Transplantation from Deceased Donors address ethical principles in organ and tissue transplantation.  The document does not address the process of organ donation (“Scope of Ethical Guidelines” page 5), but will make recommendations on the currency of the documents Organ and Tissue Donation After Death, for Transplantation – Guidelines for Ethical Practice for Health Professionals and Making a Decision about Organ and Tissue Donation after Death (Terms of Reference, Appendix A).

 

The 2007 Organ and Tissue Donation After Death, for Transplantation – Guidelines for Ethical Practice for Health Professionals document outline ethical principles in the process of organ donation, including a comprehensive section on consent. The documents Making a Decision about Organ and Tissue Donation after Death and Making a Decision about Living Organ and Tissue Donation consider ethical issues and informed decisions on organ donation.  These documents on the process of organ donation complement transplantation that will be provided by the final Ethical Guidelines for Organ Transplantation from Deceased Donors document and the new Clinical Protocols.

 

Recommendation 1.

The documents Organ and Tissue Donation After Death, for Transplantation – Guidelines for Ethical Practice for Health Professionals (2007), Making a Decision about Organ and Tissue Donation after Death (2007) and Making a Decision about Living Organ and Tissue Donation (2007) should be retained after adoption of the draft 2015 Ethical Guidelines.   They could be updated and incorporated into a single document on ethical issues and informed decisions relating to organ donation.

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Glossary, page 3 - Risk Criteria

Risk criteria of organs, as Standard risk or Higher risk, are defined in the Glossary (page 3). Their clinical criteria are explained “as set out in the Consensus Statement”, which will become superseded.

 

Recommendation 2.

The clinical criteria of Standard and Higher risk of organs for donation, as currently outlined in the Consensus Statement, should be presented in the final Ethical Guidelines for Organ Transplantation from Deceased Donors and also in the new Clinical Protocols, for consistency and clarity.   

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Section 2.2. Application of ethical principles and values to organ transplantation

2.2.1, page 10. Donation of organs is an act of altruism and solidarity that provides significant benefits to those in medical need.

Line 9.  “While reasonable compensation of expenses is ethically acceptable,…”

 

Question 1.

What is “reasonable compensation”?

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2.2.6, page 12          Privacy

“Health professionals and institutions must respect the privacy of donors and recipients, and their families” and “have a responsibility to counsel and advise recipients and their families about the potential consequences of releasing information about the procedure (e.g. via social media). Recipients have a responsibility to respect the privacy of the donor and his or her family”. 

 

These principles are vitally important, and should also apply to donor families. 

 

Recommendation 3.

To add “donor families have a responsibility to respect the privacy of organ recipients and their families, and to not release information that would potentially identify recipients”.

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Section 3 Ethical Practice

3.1, page 13             Discussing Transplantation

“Discussions about transplantation (with potential recipients) should commence well before an organ becomes available”.

 

Comment 3.

A good practice that should be promoted

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Deceased Directed Donation, page 20

 

Comment 4.

The guidelines and case studies are helpful.

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Appendix B Further sources of information

Legislation and regulatory frameworks, page 25

 

The list of guardianship laws of each State and Territory are helpful.

 

Recommendation 4.

Listing the organ and tissue donation and transplantation Acts of each State and Territory would be helpful.

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Submission - Option 2. Upload submission (Microsoft Word document preferred)

Page reviewed: 8 April, 2016