Living liver donation: Attitudes of the general public and general practitioners in Scotland

In April 2006, the Scottish Liver Transplant Unit in Edinburgh became the first NHS transplant unit in the UK to offer adult-to-adult living donor liver transplantation (LDLT). This procedure allows a healthy individual to donate part of their liver to someone with end-stage liver disease. With donations from the deceased in short supply, this procedure has the capacity to save lives. The aim of this study was to explore the attitudes of the general public and general practitioners (GPs) towards LDLT, before its implementation. A total of 1041 members of the Scottish general public and 155 GPs working in Scotland completed a short questionnaire devised for this study. The majority of participants supported the option of LDLT, but frequency counts showed that only 34% of the general public wish to donate their organs following death compared to 85% of GPs. With regards to an acceptable risk of death before volunteering to donate, 25% of GPs would accept a 1 in 20 risk of death, whereas 50% of the general public either could not make a decision or selected ‘No risk’. The question of how well people understand the concept of risk was again highlighted in this study.     

情绪和框架效应对个体捐赠决策影响的实验研究

本研究采用双因素被试间实验具体考察了特定即时情绪和框架效应对于捐赠决策的影响,结果发现存在显著的主效应和交互作用。悲伤情绪能够增加捐赠者的捐赠意愿,快乐情绪会降低捐赠者的捐赠意愿;损失框架能够增加捐赠者的捐赠意愿,幸存框架会降低捐赠者的捐赠意愿;快乐情绪的捐赠者的捐赠决策受框架效应的影响要弱于中性情绪和悲伤情绪的捐赠者,捐赠者在幸存框架下的捐赠决策受情绪的影响比在损失框架下受情绪的影响更小。     

The Seminal Contribution of Rabbi Moshe Feinstein to the Development of Modern Jewish Medical Ethics

The purpose of this essay is to show how, on a wide variety of issues, Rabbi Moshe Feinstein broke new ground with the established Orthodox rabbinic consensus and blazed a new trail in Jewish medical ethics. Rabbi Feinstein took power away from the rabbis and let patients decide their treatment, he opened the door for a Jewish approach to palliative care, he supported the use of new technologies to aid in reproduction, he endorsed altruistic living organ donation and recognized brain death (thus laying the groundwork for Orthodox Jewish acceptance of heart transplantation), he downplayed the value of social worth in triage decisions, and was a fierce defender of the rights of the fetus. I develop broader theological principles from Rabbi Feinstein's ethical positions and compare them to those of his Jewish and Christian contemporaries.     

Legal and Ethical Considerations for Requiring Consent for Apnea Testing in Brain Death Determination

Abstract

The past decade has witnessed escalating legal and ethical challenges to the diagnosis of death by neurologic criteria (DNC). The legal tactic of demanding consent for the apnea test, if successful, can halt the DNC. However, US law is currently unsettled and inconsistent in this matter. Consent has been required in several trial cases in Montana and Kansas but not in Virginia and Nevada. In this paper, we analyze and evaluate the legal and ethical bases for requiring consent before apnea testing and defend such a requirement by appealing to ethical and legal principles of informed consent and battery and the right to refuse medical treatment. We conclude by considering and rebutting two major objections to a consent requirement for apnea testing: (1) a justice-based objection to allocate scarce resources fairly and (2) a social utility objection that halting the diagnosis of brain death will reduce the number of organ donors.     

From a terror management perspective: The efficacy of self-affirmation on organ donation-related thoughts and intentions in China

ABSTRACT

In 2015, the Chinese government officially abolished the practice of harvesting organs from executed prisoners. However, the voluntary donor registration rate among the Chinese population is approximately 2% as of January 2020. Guided by self-affirmation theory and terror management theory, the present investigation examined a number of variables that may be related to donor registration intentions and a method to mitigate death thoughts and misconceptions. An online experiment was conducted in which 352 Chinese participants were randomly assigned to either a self-affirmation (i.e., affirming values that are important to the participants) or a no-affirmation condition. Results revealed that self-affirmation lowered death thoughts among the participants, which in turn were positively related to organ donation misperceptions. Inconsistent with terror management theory, the level of death thoughts was not directly related to participants’ intentions to register as organ donors. Instead, the relationship between the two was mediated by misperceptions toward organ donation.