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Martinelli V, Lumer ELL, Chiappedi M, Politi P, Gregorini M, Rampino T, Peri A, Pietrabissa A, Fusar-Poli L. Ethical Issues in Living Donor Kidney Transplantation: An Update from a Psychosocial Perspective. Healthcare (Basel) 2024; 12:1832. [PMID: 39337173 PMCID: PMC11431117 DOI: 10.3390/healthcare12181832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
Living donor kidney transplantation (LDKT) currently represents the treatment of choice for patients with end-stage renal failure. LDKT is a serious event with profound psychological, interpersonal, familial, and social implications. Over the last few years, there has been an exponential growth in living donation programs involving genetically and emotionally related donors, as well as people who donate to an unrelated and unknown subject. The implementation of paired exchange programs, Samaritan donation, and preemptive transplantation raise further ethical issues, which are inextricably linked to the unique psychosocial context of both the donor and the recipient. The present narrative review aims to provide an update on the main ethical challenges related to LDKT. We conducted a comprehensive literature search in PubMed/Medline. The results of the most relevant studies were narratively synthesized from a psychosocial perspective around the four principles of biomedical ethics: autonomy, beneficence, non-maleficence, and justice. Finally, we discussed the potential future directions to provide an effective, patient-centered, and ethical psychosocial assessment and follow-up of living donors and recipients that underwent LDKT.
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Affiliation(s)
- Valentina Martinelli
- General Surgery Unit 2, IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (A.P.); (A.P.)
- Harvey Medical Course, Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Estella L. L. Lumer
- Harvey Medical Course, Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Matteo Chiappedi
- Child Neurology and Psychiatry Unit, ASST Pavia, 27029 Vigevano, Italy;
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (P.P.); (L.F.-P.)
| | - Marilena Gregorini
- Nephrology, Dialysis and Transplant Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (M.G.); (T.R.)
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Teresa Rampino
- Nephrology, Dialysis and Transplant Unit, IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (M.G.); (T.R.)
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Andrea Peri
- General Surgery Unit 2, IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (A.P.); (A.P.)
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Pietrabissa
- General Surgery Unit 2, IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (A.P.); (A.P.)
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Laura Fusar-Poli
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (P.P.); (L.F.-P.)
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Wilkinson D. Implications of identity-relative paternalism. JOURNAL OF MEDICAL ETHICS 2023; 49:417-418. [PMID: 37197926 DOI: 10.1136/jme-2023-109209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023]
Affiliation(s)
- Dominic Wilkinson
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Biomedical Ethics, National University of Singapore Yong Loo Lin School of Medicine, Singapore
- Newborn Care, Oxford University Hospitals NHS Foudnation Trust, Oxford, UK
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