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Martin DE, Cronin AJ, Dalle Ave A, van Haren FMP, Locke JE, Miñambres E, Oniscu GC, Parent B. Addressing ethical confusion in deceased donation and transplantation research: the need for dedicated guidance. Transpl Int 2021; 34:2459-2468. [PMID: 34516693 DOI: 10.1111/tri.14108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/10/2021] [Accepted: 09/10/2021] [Indexed: 12/13/2022]
Abstract
Innovative research in deceased donation and transplantation often presents ethical challenges for researchers and those responsible for ethical governance of research. These challenges have been recognized as potential barriers to the conduct of research. We review the literature to identify and describe ethical considerations that may cause confusion or uncertainty in the context of research involving potential deceased donors or deceased donor transplantation. We normatively examine these considerations and discuss their implications for the ethical conduct of research. In addition to the complexities of research involving critically ill, dying or recently deceased individuals, uncertainty may arise regarding the ethical status of various individuals who may be involved in research aimed at improving availability and outcomes of organ transplantation. Consequently, routine ethical guidelines for clinical research may fail to provide clear guidance with regards to the design, conduct and governance of some deceased donation or transplantation studies. Ethical uncertainty may result in delays or barriers to research, or neglect of important ethical considerations. Specific ethical guidance is needed to support research in deceased donation and transplantation as the ethical considerations that arise in the design and conduct of such research may not be addressed in the existing guidelines for human research.
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Affiliation(s)
| | - Antonia J Cronin
- Department of Nephrology and Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Kings College London, London, UK
| | - Anne Dalle Ave
- Ethics Unit, University Hospital of Lausanne, Lausanne, Switzerland
| | - Frank M P van Haren
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia.,Intensive Care Unit, St George Hospital, Sydney, NSW, Australia
| | - Jayme E Locke
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eduardo Miñambres
- Transplant Coordination Unit and Service of Intensive Care, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.,School of Medicine, University of Cantabria, Santander, Spain
| | - Gabriel C Oniscu
- Edinburgh Transplant Centre, Royal Infirmary of Edinburgh, Edinburgh, UK.,Department of Clinical Surgery, University of Edinburgh, Edinburgh, UK
| | - Brendan Parent
- Division of Medical Ethics, New York University School of Medicine, New York, NY, USA
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Prabhu A, Parker LS, DeVita MA. EPR and uDCDD: A Response to Commentaries. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2017; 17:W1-W3. [PMID: 28661729 DOI: 10.1080/15265161.2017.1332696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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