Neither Ethical nor Prudent: Why Not to Choose Normothermic Regional Perfusion
In transplant medicine, the use of normothermic regional perfusion (NRP) in donation after circulatory determination of death raises ethical difficulties. NRP is objectionable because it restores the donor's circulation, thus invalidating a death declaration based on the permanent cessation of...
Authors: | ; ; ; ; ; |
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Format: | Electronic Article |
Language: | English |
Check availability: | HBZ Gateway |
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Fernleihe: | Fernleihe für die Fachinformationsdienste |
Published: |
Wiley
2024
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In: |
The Hastings Center report
Year: 2024, Volume: 54, Issue: 4, Pages: 14-23 |
Further subjects: | B
donation after circulatory determination of death
B normothermic machine perfusion B Organ Transplantation B trust in medicine B dead donor rule B normothermic regional perfusion B clinical ethics B ethical parsimony |
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Volltext (kostenfrei) Volltext (kostenfrei) |
Summary: | In transplant medicine, the use of normothermic regional perfusion (NRP) in donation after circulatory determination of death raises ethical difficulties. NRP is objectionable because it restores the donor's circulation, thus invalidating a death declaration based on the permanent cessation of circulation. NRP's defenders respond with arguments that are tortuous and factually inaccurate and depend on introducing extraneous concepts into the law. However, results comparable to NRP's—more and higher-quality organs and more efficient allocation—can be achieved by removing organs from deceased donors and using normothermic machine perfusion (NMP) to support the organs outside the body, without jeopardizing confidence in transplantation's legal and ethical foundations. Given the controversy that NRP generates and the convoluted justifications made for it, we recommend a prudential approach we call “ethical parsimony,” which holds that, in the choice between competing means of achieving a result, the ethically simpler one is to be preferred. This approach makes clear that policy-makers should favor NMP over NRP. |
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ISSN: | 1552-146X |
Contains: | Enthalten in: Hastings Center, The Hastings Center report
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Persistent identifiers: | DOI: 10.1002/hast.1584 |