Donation after brain circulation determination of death

BMC Medical Ethics 2017 18:15
Authors: Anne L. Dalle Ave, James L. Bernat
“In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation may resume after the determination of death; 3] complete circulatory cessation is verified; and 4] the cessation of brain function is permanent and complete. Death should be determined by the confirmation of the cessation of systemic circulation; the use of brain death tests is invalid and unnecessary. Because this concept differs from current standards, consensus should be sought among stakeholders. The patient or surrogate should provide informed consent for organ donation by understanding the basis of the declaration of death.”
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When organ donation isn’t a donation

BMJ 2017;356: j1028
Author: Margaret McCartney
“The rest of the UK requires consent for organ donation, either by the dead person having pre-empted the decision by joining the donor register or by family consent. Wales uses a “soft” opt-out, meaning that it’s not intended to be legally enforced and that potential situations where doctors remove organs for transplant directly against the surviving family’s wishes will not occur.”
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Human rights violations in organ procurement practice in China

BMC Medical Ethics 2017 18:11
Authors: Norbert W. Paul, Arthur Caplan, Michael E. Shapiro, Charl Els, Kirk C. Allison, Huige Li
“Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China’s organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained.”
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Uneasy About the Ethics of Egg Donation

The Atlantic, 17 January 2017
Author: Chris Bodenner
“The following reader tells the story of her long battle with infertility that culminated with the successful use of donated eggs. But despite the happy ending, she struggles with uneasy questions about the ethics of the donor industry and the “massive resentment” she harbors toward her husband.”
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Navigating social and ethical challenges of biobanking for human microbiome research

BMC Medical Ethics, 11 January 2017
Authors: Kim H. Chuong, David M. Hwang, D. Elizabeth Tullis, Valerie J. Waters, Yvonne C. W. Yau, David S. Guttman, Kieran C. O’Doherty
“Biobanks are considered to be key infrastructures for research development and have generated a lot of debate about their ethical, legal and social implications (ELSI). While the focus has been on human genomic research, rapid advances in human microbiome research further complicate the debate.”
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France introduces opt-out policy on organ donation

The Guardian, 3 January 2017
Author: Kim Willsher
“France has reversed its policy on organ donations so that all people could become donors on their death unless they join an official register to opt out. The new law presumes consent for organs to be removed, even if it goes against the wishes of the family. Until 1 January, when the legislation took effect, unless the person who had died had previously expressed a clear wish for or against donation, doctors were required to consult relatives who, in almost a third of cases, refused.”
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Egypt busts organ trading racket, arrests 45 people

Reuters, 6 December 2016
Author: Mahmoud Mourad, Lin Noueihed
“Egypt has uncovered a network accused of illicit international trafficking in human organs, arresting 45 people and recovering millions of dollars in a dawn raid on Tuesday, the health ministry said. Among those held were doctors, nurses, middlemen and organ-buyers, involved in what the ministry described as the largest organ-trafficking network exposed in Egypt to date.”
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Rethinking the Ban — The U.S. Blood Supply and Men Who Have Sex with Men

NEJM, November 16, 2016
Authors: Chana A. Sacks, Robert H. Goldstein, Rochelle P. Walensky
“The ban on donations from men who have sex with men was instituted at a time of public health panic and vast uncertainty, but 31 years later, scientific advances in testing and in understanding of disease transmission offer new tools and better ways than a sweeping ban to minimize the risk of transfusion-related HIV. Thousands of people died from HIV that they contracted from the blood supply, and their memories demand that we not fall victim to the hubris of believing that there will not be emerging threats or new knowledge to be gained. Greatest respect can be paid to the people who died and to this tragic and complicated history not by maintaining outdated policies but by constantly reevaluating and implementing changes in line with what we do know and by advancing science in areas we do not fully understand. We must be committed to empirical rigor in the evaluation of the outcomes of any new policy changes, and in that way we can continue to ensure a safe blood supply for every person, of every community, who may need it.”
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