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ORGAN DONATION AND ALLOTRANSPLANTATION

ORGAN DONATION AND ALLOTRANSPLANTATION. HEALTH LAW AND BIOETICS Helena Pereira de Melo 23 April , 2014 Szilvia Szabó - 003903. ORGAN DONATION AND ALLOTRANSPLANTATION Introduction. Organs and tissues for donation heart , kidneys , liver , lungs , pancreas , intestine , thymus

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ORGAN DONATION AND ALLOTRANSPLANTATION

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  1. ORGAN DONATION AND ALLOTRANSPLANTATION

    HEALTH LAW AND BIOETICS HelenaPereira de Melo 23 April, 2014 Szilvia Szabó - 003903
  2. ORGAN DONATION AND ALLOTRANSPLANTATIONIntroduction Organs and tissuesfordonation heart, kidneys, liver, lungs, pancreas, intestine, thymus Bones, cornea, skin, heartvalves Nervesand veins… Most of kidneys>liver>heart Cultureinrelationtotransplant Human rightsinrelation Justicerights Beneficerights
  3. ORGAN DONATION AND ALLOTRANSPLANTATIONIntroduction – Human rights Mr. George Olds is a 76-year-old nonsmokingretired business executivewithend-stageheartfailure. He has goodpulmonary and renalfunctionand is notdiabetic;thus he is medically a goodcandidateforahearttransplant. His life expectancywithout a transplant is 1 mouth. He has a lovingfamily, withtheresourcestopaythe $100,000 cost of procedure. Mr. Matt Younger is a 46-year-old divorced man who is unemployed, havinglosthisjobas an autoworker 3 yearsago. He has a history of smoking and alcoholuse. He suffers a heartattack, developsintractableheartfailure, and will die within 1 mouthwithout a hearttransplant. He has goodpulmonary and renalfunctionand is notdiabetic, makinghim a goodcandidatefortheprocedure. Whoshouldreceiveit? 1984 National OrganTransplaltationActdesignedthe United Network forOrganSharing (UNOS)
  4. ORGAN DONATION AND ALLOTRANSPLANTATIONHistory – before modern society
  5. ORGAN DONATION AND ALLOTRANSPLANTATIONHistory – 19 century 1818 first human – to – humanbloodtransfusion 1831 Mary Shelley publishes Frankenstein 1878 firstsuccessful human – to – humanbonetransplant 1881 firstreporteduse of skingraft 1896 firstattemptsatbonemarrowtransplant
  6. ORGAN DONATION AND ALLOTRANSPLANTATIONHistory – 20 century 1900-1902 bloodgroupsdiscovered 1902-1908 CarrelDevelopsTechniqueforconnectingblood 1905 firstsuccessfulcorneatransplant 1908 firsttransplant of a knee 1909 firstrecordedkidneytransplant, animalto human 1913 researchescreatethefirstartificialkidney
  7. ORGAN DONATION AND ALLOTRANSPLANTATIONHistory – 21 century 2000-2002 Population of kidneyfailurepatiensgrows Tissue and bloodbanksrespondto terror attack Number of livingdonorspassescadavericdonors Patientslivingwithorgan and tissuetransplantsnumbersintheMillions 2003 Eighteenpeople die eachdayonthewaitinglist 2004 50th anniversary of thefirstkidneytransplant 2004 and beyond The future of transplantation
  8. Deathbymedicalsience Clinicaldeath: The circulation, breathingand brainfunctiontemporarilysuspended. Reversible! 2. Biologicaldeath: The body’sviability is irreversiblyterminated. 3. Braindeath: The brain– includingthebrainstem – complete and irreversiblecessation. The sameasthetraditionalsense of invidual’sdeath
  9. LegalDeath – A statutorydefinition of death? The Criminal Law RevisionCommittee (1980): acknowledgetheexistence of thebraindeath. Totakeplacein a statuewould be toorestrictive. Intheothersidewouldpromotedistrust. Main questions: What is human death? Howcanwedeterminethat is has occured? The currentmainstreamview– thewhole-brainapproach (irreversiblececassion of brain and brainstream) The progressivealternative – thehigher-brainapproach(irreversiblececassion of consciousness) 2.1. essence of human persons 2.2. personalidentity 2.3. thedefinition of death is a moralissue
  10. Braindeath
  11. Deathoralive?The case of anencephalicnewborns 95 % of which die withinthefirstpostnatalweek ‚Organsobtainedfromtheseanencephalicnewbornscouldmake a substantialcontributiontothesupply of infantorgans’ ‚Theywouldprovide a significantproportion of transplantableorgans’ US Uniform Determination of DeathAct (1980) alsorequiresthatanencephalicslikeallorgandonorsmeetestabilishedcriteriaforbraindeath, icludingcessation of brainstemactivity, beforetheyareusedasdonors.
  12. Transplantation’sinterspecies Allotransplantation is thetransplantation of cells, tissues, ororgansto a recipientfromageneticallynon-identical donor onthesame species. Autotransplantation is thetransplantation of organs, tissuesorproteinsfromone part of the body to an otherinthesameinvidual. Xenotransplantation is thetransplantation of livingcells, tissuesororgansfromone species toanother(pigs – human) Isograft is a graft of tissuebetweentwoinvidualswhoaregeneticallyidentical. (i.e. Monozygotictwinswherethetransplantrejectionneveroccur)
  13. Transplantation Live donor transplants Cadavertransplantation FoetalTissueTransplantation 2.1 Opting/Contractingincountries: USA, UK, Canada, Germany, The Netherlands, Switzerland, New Zeland, Australia, Japan, South Korea, Thailand, Ireland, South-America, and in most Arab countries 2.2 Opting/Contractingoutcountries: Austria, CzehRepublic, Poland, Denmark, Portugal, Finland. Somecountriescanchoosetogiveopportunitytoaskthefamily (France, Italy, Spain)
  14. TransplantationfromLiveDonors Wholeorgans (kidneys) Organmaterials (liverorbonemarrow) 2 cases Parentsconceived a childinthehopethatthebaby’sbonemarrowcellswouldsavethe life of a teenagedaughterdying of leukemia. 3 years old one of twin’sbonemarrowrequestdbythefather of theirhalf-brotherinthefaceoftheirmother’sobjection ‚thelawalonecannotprovideall of theanswerstomattersof human relation’ (Curran 1991)
  15. FoetalTissueTransplantation Fromabortedfoetus (may be infectedordefective) ‚secondpatient’ ?Independent fromthewoman? Usefulness: Itseemstohavethegreatesttherapeuticpotentialsuchas - Parkinsonism, Treatment of diabetes and immunodeficiencydisorders, Anaemiapatients, Immunesystemresearch. Inthe US researchsouldcontinue, onpoliticalgroundstoo (=wintheanti-abortionmovement). Modification:allowresearchonspontaneouslyabortedfoetuses and embryos, andwillprobably be overturnedintime.
  16. FoetalTissueTransplantation The Council of Europe (1986) ‚evenwhendeadtheembryo of foetusretainsits human character and … respectfor human dignityrequiresthat anycommercialorindustrial use must be prohibited’ BeneficeRightsinFoetalTransactions (US National OrganTransplantAct 1983; United StatesniformAnatomicalGiftAct 1983)
  17. FoetalTissueTransplantation Howtoprovideequitableacesstothesescaretissues? Howtoprotectthe right of couplesorwomentoproducefoetaltissuetohelplovedones? Howtoavoidthepossibleexploitation of poorwoman?
  18. https://www.youtube.com/watch?v=uXulTMrNI4M Organtheftin Kosovo
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