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Sablone S, Musajo Somma C, Ruta F, Bellino M, Ciciriello T, Saracino M, Attimonelli Petraglione R, Michelangeli G, Gianelli Castiglione A, Cardillo M, Introna F, Gesualdo L. Organ procurement in forensic deaths: A retrospective analysis of the Italian context with a focus on the Puglia Region virtuous experience. J Forensic Leg Med 2024; 102:102657. [PMID: 38387233 DOI: 10.1016/j.jflm.2024.102657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/14/2023] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
Organ transplantation is one the most important contributions of modern medicine to society since it provides a unique therapy for terminal organ failure. However, the development of this therapeutic approach is hindered by the limited organ supply. In Italy, organ procurement requires a multidisciplinary medical-surgical approach in which legal medical doctors (LMDs) are generally tasked with ascertaining the reality of death. Sometimes, a medico-legal report is required when the deceased's family deny their consent to the organs and tissues removal from a potential deceased donor. LMDs can also be appointed by law to carry out post-mortem examinations of potential deceased donors. In these cases, the public prosecutors' interest in preserving the corpse integrity for forensic purposes seems to conflict with the ethical-humanitarian interest in promoting, at most, the opportunity to donate; however, a LMD can act as a mediator and allow both goals. This paper aims to illustrate the Apulia Region experience in reconciling the justice interests with those of a culture promoting deceased organ and tissue donation. It has been pursued by analyzing the virtuous regional organ procurement trend in forensic deaths before and after a crucial 2015 initiative, comparing the results with the national ones, and contextualizing them in the relevant literature to show systemic strengths and weaknesses and inform future Italian policy development.
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Affiliation(s)
- Sara Sablone
- Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
| | - Chiara Musajo Somma
- Puglia Regional Transplant Center (CRT Puglia), Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
| | - Federico Ruta
- Health Agency BAT, General Direction, 76121, Andria (BT), Italy.
| | - Mara Bellino
- Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
| | - Tommaso Ciciriello
- Section of Anesthesia, Intensive Care and Pain Unit, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
| | - Michele Saracino
- Puglia Regional Transplant Center (CRT Puglia), Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
| | | | | | | | - Massimo Cardillo
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy.
| | - Francesco Introna
- Section of Legal Medicine, Interdisciplinary Department of Medicine, Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
| | - Loreto Gesualdo
- Puglia Regional Transplant Center (CRT Puglia), Bari Policlinico Hospital, University of Bari, 70124, Bari, Italy.
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