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Stock PG, Nagral S, Rondeau E, Gawronska S, Groverman J, Barbari A, Coates PT, Domínguez-Gil B, Fadhil R, Malyszko J, Niño Murcia A. Transplantation in the Context of Migration and Refugees: A Summary of the DICG and TTS Ethics Committee Workshop, Buenos Aires, Argentina, September 2022. Transplantation 2024; 108:1476-1487. [PMID: 38383953 DOI: 10.1097/tp.0000000000004918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Global conflicts and humanitarian crises have resulted in an unprecedented number of refugees and migrants. This challenges the limited resources of health care systems and jeopardizes the availability of transplant care for these deserving migrants and refugees. This was the basis for a workshop held during the Congress of the Transplantation Society (Buenos Aires, 2022). We elaborate on the proceedings of the workshop entitled "Transplantation in the Context of Migration and Refugees," organized by the Ethics Committee of The Transplantation Society and Declaration of Istanbul Custodian Group. Transplant providers from around the world shared strategies of how each region has responded to providing access to care for refugees and migrants in need of transplant services. The potential exploitation of this vulnerable group leading to illicit organ removal was addressed for each region. The Transplantation Society, Declaration of Istanbul Custodian Group, and global transplant community should continue to focus on the status of refugees and migrants and collaborate on strategies to provide access to transplant care for this deserving population. Global cooperation will be essential to provide vigilant oversight to prevent exploitation of this vulnerable population.
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Affiliation(s)
- Peter G Stock
- Department of Transplant Surgery, University of California San Francisco, San Francisco, CA
- Ethics Committee of The Transplantation Society, Montreal, QC, Canada
| | - Sanjay Nagral
- Department of Surgical Gastroenterology, Jaslok Hospital and Research Centre, Mumbai, India
- Declaration of Istanbul Custodian Group (DICG), Montreal, QC, Canada
| | - Eric Rondeau
- Declaration of Istanbul Custodian Group (DICG), Montreal, QC, Canada
- Soins intensifs nephrologiques et Rein aigu, hôpital Tenon, Paris, France
| | - Sylwia Gawronska
- United Nations Office on Drugs and Crime (UNODC), Regional Office for Southeast Asia and the Pacific (ROSEAP), Bangkok, Thailand
| | | | - Antoine Barbari
- Department of Nephrology, Rafik Hariri University Hospital, Beirut, Lebanon
| | - P Toby Coates
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Faculty of Health and Medical Sciences, University of Adelaide, SA, Australia
| | - Beatriz Domínguez-Gil
- Ethics Committee of The Transplantation Society, Montreal, QC, Canada
- Organización Nacional de Trasplantes, Madrid, Spain
| | - Riadh Fadhil
- Ethics Committee of The Transplantation Society, Montreal, QC, Canada
- Qatar Organ Donation Centre, Hamad Medical Corporation, Doha, Qatar
| | - Jolanta Malyszko
- Declaration of Istanbul Custodian Group (DICG), Montreal, QC, Canada
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Alejandro Niño Murcia
- Ethics Committee of The Transplantation Society, Montreal, QC, Canada
- Department of Transplantation Surgery, Colombiana de Trasplantes, Bogotá, Colombia
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Ghazi M, Saleh A, Abdallah M, El Masri D, El Masri J, El Ayoubi LM, Hawi J, Jurjus A. Barriers toward xenotransplantation in Arab World. Xenotransplantation 2024; 31:e12852. [PMID: 38526015 DOI: 10.1111/xen.12852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/26/2024]
Abstract
Organ transplant is a crucial therapeutic strategy offering a life-saving and transformative medical intervention. It provides an opportunity to improve their quality of life and increase their lifespan. The shortage of organs remains a critical global challenge, leading to a prolonged waiting times for organ receivers, which contributes to an increase in morbidity and mortality rates. Hence, xenotransplantation offered a promising solution to the global shortage of organs through the use of animal organs, leading to an increase in donor availability, reducing waiting times, minimizing organ trafficking, improving genetic engineering advancements, and driving scientific innovation. Even though xenotransplantation has many benefits in the clinical setting, it has many barriers that are hindering its achievements and constraining its occurrence. Some barriers to xenotransplant are general, such as the immunological barrier, while others are specific to certain regions due to local causes. The Arab region exhibits disparities in clinical settings compared to the global context, marked by the huge economic crisis and a shortage of trained healthcare professionals. Considering the huge resources and advancements needed in the field of xenotransplantation, this review aims to explore the specific barriers toward xenotransplantation in the Arab countries, highlighting the challenges to overcome these barriers.
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Affiliation(s)
- Maya Ghazi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Aalaa Saleh
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Malak Abdallah
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Diala El Masri
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Jad El Masri
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | | | - Jihad Hawi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abdo Jurjus
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Wasti SP, Shrestha A, Atteraya MS, GC VS. Migrant workers' health-related research in Nepal: A bibliometric study. DIALOGUES IN HEALTH 2023; 3:100147. [PMID: 38515805 PMCID: PMC10954020 DOI: 10.1016/j.dialog.2023.100147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 03/23/2024]
Abstract
Background In recent years, the health of migrants has become an important global public health issue. However, less is known about the current status of research activity among Nepalese migrants' health. This study aimed to assess the current status of research activity by analysing published peer review literature on Nepalese migrants' health. Methods A systematic search of published literature on Nepalese migrant workers' health was conducted in Scopus, Medline, CINAHL, Embase, PsycINFO and Web of Science, and a bibliometric analysis methodology was used. The search of databases retrieved 520 records, and a total of 161 papers were included in the analysis. Bibliometric analyses were performed in R and VoSViewer to create visualisation maps. Results The retrieved documents were published in the last three decades, and a total of 533 researchers originating from 24 countries contributed to the literature. A large proportion of papers (n=22) were published in a single year, in 2019, and the number of authors per journal ranged from one to 14. The topmost preferred journals for publications in Nepalese migrants' health were PLoS One (n=9), followed by the Journal of Immigration and Minority Health (n=6). The retrieved articles received 2425 citations, with an average of 15.1 citations per article. The study identified nine overlapping research domains (thematic areas) - infectious disease, non-communicable diseases, health and lifestyle, sexual and reproductive health, access to health services, workplace safety, maternal health, gender-based violence, and health system and policy. Conclusion The present bibliometric study fills an analytical gap in the field of migrat's health research in Nepal and provides evidence and insights to advocate the formulation of strategies to promote the migrants' health vulnerabilities often associated with individual-related hazards such as working in 'difficult, dirty, and dangerous (3Ds) working conditions.
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Affiliation(s)
- Sharada P. Wasti
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | | | - Madhu Sudhan Atteraya
- Department of Social Welfare, College of Social Science, Keimyung University, South Korea
| | - Vijay S. GC
- School of Human and Health Sciences, University of Huddersfield, Huddersfield, United Kingdom
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Popa E, Zawiła-Niedźwiecki J, Zabdyr-Jamróz M. Policy change without ethical analysis? Commentary on the publication of Smajdor. THEORETICAL MEDICINE AND BIOETHICS 2023; 44:379-385. [PMID: 37420106 DOI: 10.1007/s11017-023-09631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/08/2023] [Indexed: 07/09/2023]
Affiliation(s)
- Elena Popa
- Interdisciplinary Centre for Ethics, Jagiellonian University, Kraków, Poland.
| | | | - Michał Zabdyr-Jamróz
- Health Policy and Management Department, Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland
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Yaneva A, Shopova D, Bakova D, Mihaylova A, Kasnakova P, Hristozova M, Semerdjieva M. The Progress in Bioprinting and Its Potential Impact on Health-Related Quality of Life. Bioengineering (Basel) 2023; 10:910. [PMID: 37627795 PMCID: PMC10451845 DOI: 10.3390/bioengineering10080910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
The intensive development of technologies related to human health in recent years has caused a real revolution. The transition from conventional medicine to personalized medicine, largely driven by bioprinting, is expected to have a significant positive impact on a patient's quality of life. This article aims to conduct a systematic review of bioprinting's potential impact on health-related quality of life. A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, Google Scholar, and ScienceDirect databases between 2019 and 2023. We have identified some of the most significant potential benefits of bioprinting to improve the patient's quality of life: personalized part production; saving millions of lives; reducing rejection risks after transplantation; accelerating the process of skin tissue regeneration; homocellular tissue model generation; precise fabrication process with accurate specifications; and eliminating the need for organs donor, and thus reducing patient waiting time. In addition, these advances in bioprinting have the potential to greatly benefit cancer treatment and other research, offering medical solutions tailored to each individual patient that could increase the patient's chance of survival and significantly improve their overall well-being. Although some of these advancements are still in the research stage, the encouraging results from scientific studies suggest that they are on the verge of being integrated into personalized patient treatment. The progress in bioprinting has the power to revolutionize medicine and healthcare, promising to have a profound impact on improving the quality of life and potentially transforming the field of medicine and healthcare.
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Affiliation(s)
- Antoniya Yaneva
- Department of Medical Informatics, Biostatistics and eLearning, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria;
| | - Dobromira Shopova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University, 4000 Plovdiv, Bulgaria
| | - Desislava Bakova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Anna Mihaylova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Petya Kasnakova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Maria Hristozova
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
| | - Maria Semerdjieva
- Department of Healthcare Management, Faculty of Public Health, Medical University, 4000 Plovdiv, Bulgaria; (D.B.); (A.M.); (P.K.); (M.H.); (M.S.)
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Sun G, Li L, Zhang X. A visualized and scientometric analysis of research trends of weight loss in overweight/obese children and adolescents (1958-2021). Front Public Health 2022; 10:928720. [PMID: 36339176 PMCID: PMC9632180 DOI: 10.3389/fpubh.2022.928720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
Background Weight loss is an appropriate approach to reduce the health risks associated with overweight/obese children and adolescents, and the optimal method of weight loss requires further research. This study systematically explores scientific co-operation, disciplinary interaction, hotspots and trends in the field of weight loss in overweight/obese children and adolescents (WLOCA), and provides references for further research. Methods Citespace 5.8.R1 (64-bit) was adopted to conduct a comprehensive visualization analysis of the literature on WLOCA from Web of Science Core Collection, including publication, institution, country/region, author, journal, keywords and reference. Results 2,513 papers were found in the Web of Science Core Collection, and the annual number of papers published has increased significantly since 2003. Cincinnati Children's Hospital is the institution with the largest number of publications, while Washington University plays a pivotal role in the collaboration network. In terms of nations, USA has made greater contributions than the rest in terms of the number of publications and global co-operation research. The most influential authors in this field are Thomas H. Inge, Thomas Reinehr, Todd M. Jenkins, Epstein LH, Ogden CL, etc. The most active journals are "Obesity," "International Journal of Obesity," "Obesity Surgery," "Pediatrics," etc. which are characterized by interdisciplinary interactions. Research hot topics mainly include "assessment of obesity and pathophysiological mechanism," "comprehensive intervention," and "bariatric surgery," and there's a gradual shift from "lifestyle intervention" and "pathophysiological mechanism" to "clinical surgical application." In addition, disciplinary integration and comprehensive research, targeted intervention and treatment, and prospective research are the future research trends. Conclusion The overall trend in WLOCA study is positive. The main contribution of this study is to reveal the overall picture of the research in this field with visual maps and detailed data by combining quantitative with qualitative approaches, which can provide valuable references for relevant researchers to quickly understand the status of studies on WLOCA, to seek co-operation, and grasp research hotspots and frontier trends.
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Affiliation(s)
- Guotao Sun
- School of Physical Education, Chengdu Sport University, Chengdu, China,College of Education and Sports Science, Yangtze University, Jingzhou, China
| | - Long Li
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China,School of Physical Education, Xichang University, Xichang, China
| | - Xiaolin Zhang
- Sport Research Office, Chengdu Sport University, Chengdu, China,*Correspondence: Xiaolin Zhang
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Fatima S, Hussain Z, Hamid S, Idrees Z, Mansoor M, Idrees T. Donatio organorum- reluctance to organ donation medical students; a cross-sectional descriptive study. Ann Med Surg (Lond) 2022; 83:104534. [PMID: 36389197 PMCID: PMC9661651 DOI: 10.1016/j.amsu.2022.104534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Organ donation is the act of removing an organ or tissue from a donor and transplanting the said organ/tissue to a recipient. Despite being the only definitive treatment for end-organ failure, there is a lot of hesitation surrounding the practice of organ donation. Even among medical students, who are more aware of the benefits of organ donation than the general public, this reluctance is widespread. Therefore, we conducted this research to determine the basis of this skepticism, so that the root causes can be identified and eradicated. Our research sought to ascertain the overall attitudes of Rawalpindi Medical University, Pakistan's students towards organ donation, the associated factors that influenced this attitude (religious devotion, gender, age, year of study) and the reasons for the hesitance. Methods A cross-sectional study targeting the students of first to final year MBBS was conducted at Rawalpindi Medical University, Pakistan in the year 2022. The sample size was calculated using OpenEpi software, and came out to be 292. The students enrolled at Rawalpindi Medical University during the year 2021–2022 were made a part of the study. A self-structured questionnaire that was developed after substantial research was used to collect the data using a non-random convenience sample technique. Chi Square test was used to determine significance after data analysis using SPSS-22. Results A total of 290 students participated in the study, 58 from each year. All of the participants were Muslim. A very strong correlation was found between high devoutness and willingness towards organ donation (p = 7.4252E-13). Only 9/290 (3%) of people in Pakistan have joined The Transplantation Society of Pakistan; the main cause of this low ratio is that very few people were aware that such a group even existed (according to 62% of the responders). The mistrust of doctors and the belief that appropriate efforts would not be done to resuscitate patients who have signed up for organ donation is a significant factor in the anxiety surrounding organ donation. Conclusions There are several reasons why people are reluctant to donate their organs, including a lack of understanding of religious perspectives on the subject, mistrust of medical professionals and medical administration, and general public ignorance. We can make a significant progress toward closing the gap between the demand for and supply of organ donations if these problems are remedied. The most effective strategy to stop organ trafficking is through organ donation. Through seminars, conversations, and workshops, we need to raise awareness about organ donation. We found a positive correlation between religious devoutness of Muslim students and willingness to donate. The main reason for reluctance was the fear of being premature pronounced dead in the hope of harvesting their organs. Only 3% of the study participants had joined the transplantation society of Pakistan. The most effective strategy to stop organ trafficking is through organ donation.
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Affiliation(s)
- Sumia Fatima
- 4 Year MBBS Student at Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan
| | - Zainab Hussain
- 4 Year MBBS Student at Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan
| | - Sidra Hamid
- Department of Physiology at Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan
| | - Zainab Idrees
- 4 Year MBBS Student at Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan
| | - Maryam Mansoor
- 4 Year MBBS Student at Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan
| | - Tayyaba Idrees
- 4 Year MBBS Student at Rawalpindi Medical University, Rawalpindi, Punjab, Pakistan
- Corresponding author. H# 458, St# 03, Hazrat Bilal Block, Bareen Road Kotha Kalan, near Morgah, Rawalpindi, 46600, Punjab, Pakistan.
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Alhajji L, Martinez-Sosa N, Hadjikyriakou M, Potter JE, Padilla V. Letter to the editor: Organ trafficking: A primer for psychiatrists. Gen Hosp Psychiatry 2022; 78:128-129. [PMID: 35534284 DOI: 10.1016/j.genhosppsych.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Lujain Alhajji
- Department of Psychiatry & Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, United States of America.
| | - Natalie Martinez-Sosa
- PGY-5 Forensic Psychiatry Fellow, Department of Psychiatry & Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, United States of America
| | - Maria Hadjikyriakou
- PGY-5 Consultation-Liaison Psychiatry Fellow, Department of Psychiatry & Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, United States of America
| | - JoNell Efantis Potter
- Director of the Division of Research and Special Projects, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami Leonard M. Miller School of Medicine, United States of America
| | - Vanessa Padilla
- Department of Psychiatry & Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, United States of America
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Abstract
The genetic modification of pigs as a source of transplantable organs is one of several possible solutions to the chronic organ shortage. This paper describes existing ethical tensions in xenotransplantation (XTx) that argue against pursuing it. Recommendations for lifelong infectious disease surveillance and notification of close contacts of recipients are in tension with the rights of human research subjects. Parental/guardian consent for pediatric xenograft recipients is in tension with a child's right to an open future. Individual consent to transplant is in tension with public health threats that include zoonotic diseases. XTx amplifies concerns about justice in organ transplantation and could exacerbate existing inequities. The prevention of infectious disease in source animals is in tension with the best practices of animal care and animal welfare, requiring isolation, ethologically inappropriate housing, and invasive reproductive procedures that would severely impact the well-being of intelligent social creatures like pigs.
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You Y, Min L, Tang M, Chen Y, Ma X. Bibliometric Evaluation of Global Tai Chi Research from 1980-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116150. [PMID: 34200236 PMCID: PMC8201343 DOI: 10.3390/ijerph18116150] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/24/2022]
Abstract
While studies on the health benefits of Tai Chi have sprung up over the past four decades, few have engaged in collecting global data, estimating the developing trends, and conducting reviews from the perspective of visualization and bibliometric analysis. This study aimed to provide a summary of the global scientific outputs on Tai Chi research from 1980 to 2020, explore the frontiers, identify cooperation networks, track research trends and highlight emerging hotspots. Relevant publications were downloaded from the Web of Science Core Collection (WoSCC) database between 1980 and 2020. Bibliometric visualization and comparative analysis of authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords were systematically conducted using CiteSpace software. A total of 1078 publications satisfied the search criteria, and the trend of annual related publications was generally in an upward trend, although with some fluctuations. China (503) and Harvard University (74) were the most prolific country and institution, respectively. Most of the related researches were published in the journals with a focus on sport sciences, alternative medicine, geriatrics gerontology, and rehabilitation. Our results indicated that the current concerns and difficulties of Tai Chi research are “Intervention method”, “Targeted therapy”, “Applicable population”, “Risk factors”, and “Research quality”. The frontiers and promising domains of Tai Chi exercise in the health science field are preventions and rehabilitations of “Fall risk”, “Cardiorespiratory related disease”, “Stroke”, “Parkinson’s disease”, and “Depression”, which should receive more attention in the future.
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Affiliation(s)
- Yanwei You
- Division of Sport Science & Physical Education, Tsinghua University, Beijing 100084, China; (Y.Y.); (L.M.)
| | - Leizi Min
- Division of Sport Science & Physical Education, Tsinghua University, Beijing 100084, China; (Y.Y.); (L.M.)
| | - Meihua Tang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China;
| | - Yuquan Chen
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China;
| | - Xindong Ma
- Division of Sport Science & Physical Education, Tsinghua University, Beijing 100084, China; (Y.Y.); (L.M.)
- Correspondence:
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Etheredge HR. Assessing Global Organ Donation Policies: Opt-In vs Opt-Out. Risk Manag Healthc Policy 2021; 14:1985-1998. [PMID: 34012308 PMCID: PMC8128443 DOI: 10.2147/rmhp.s270234] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/20/2021] [Indexed: 12/17/2022] Open
Abstract
This paper argues that there is little difference between opt-in and opt-out organ donation systems for increasing donor numbers when used in isolation. Independently diverting to an opt-out system confers no obvious advantage and can harm efforts to bolster donations. Rather, it is essential to address barriers to organ donation on several levels along with a switch in system. Moreover, for many countries, it may be more beneficial to adequately capacitate the donation system already in place, rather than entertain a significant change with its attendant resource requirements. For decades, the international transplant community has been involved in vigorous debate as to the merits of moving from default opt-in systems to opt-out policies to grow organ donor numbers and better meet the ever-increasing demand for lifesaving transplants. Opt-out is certainly en vogue, with Wales, England and Nova Scotia recently switching over, Scotland due to become opt-out in March 2021 and Northern Ireland and Canada seriously considering a similar move. Thanks to several countries making the switch from opt-in to opt-out over the last 20-30 years, there are sets of robust longitudinal data that aid in analysing the efficacy of donation systems. However, these data are often contradictory and largely inconclusive, suggesting other factors may be in play. This paper reviews some emerging trends in opt-in versus opt-out organ donation policies and considers recent data that elucidates some of the main contentions across each. Ethical frameworks underpinning donation systems, such as informed consent, trust and transparency, are discussed in detail. Substantial time is also devoted to opt-in vs opt-out systems in developing countries, which tend to be excluded from many analyses, and where the challenges faced are magnified by socio-economic constraints. This constitutes a major gap in recently published literature, as developing countries often lag far behind their developed counterparts in donor and transplant numbers.
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Affiliation(s)
- Harriet Rosanne Etheredge
- Wits Donald Gordon Medical Centre, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Steve Biko Centre for Bioethics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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