关于捐赠配子子代知情权的伦理学思考

在配子捐赠中有一个重要但长期未能解决的问题，即是否应告知子代其受孕的真相，如是，那么应告知其有关捐赠者的多少资料。在这个问题上，父母、捐赠者和子代可能有各自不同的观点。不同的辅助生殖技术（ART）项目和精子库收集的捐赠者资料以及在什么情况下告知接受配子者和子代也有所不同。     

1986年国际移植学会捐献肾脏的标准

1.只有在找不到合适的尸体捐赠者,或有血缘关系的捐赠者时,才可接受无血缘关系者的捐赠。2.接受者(受植者)及相关医师应确认捐赠者系出于利他的动机。而且应有一社会公正人士出面证明捐赠者的“知情同意”不是在压力下签字的。也应向捐赠者保证,若切除后发生任何问题,均会给予援助。3.不能为了个人的利益,而向没有血缘关系者恳求,或利诱其捐出肾脏。4.捐赠者应已达法定年龄。5.活体无血缘关系之捐赠者应与有血缘关系之捐赠者一样,都应符合伦理、医学与心理方面的捐肾标准。6.接受者本人或家属,或支持捐赠的机构,不可付钱给捐赠者,以免误导器…     

848名职业院校医卫类学生器官捐赠态度和意愿的影响因素分析

目的：分析职业院校医卫类学生器官捐赠态度和意愿的影响因素，为在职业院校开展器官捐赠教育提供参考依据。方法：采用分层整群抽样法抽取衡阳市某职业院校医卫类学生，采用史丽珠《器官捐赠量表》进行问卷调查；用SPSS17．0软件统计848份有效问卷，分析848名医卫类学生器官捐赠态度和意愿现状及其影响因素。结果：在848名学生中，其器官捐赠态度总得分为（3．44±0．73）、器官捐赠意愿总得分为（2．00±0．59）；有55名学生愿意进行器官捐赠，且最愿意将器官捐赠给家人；愿意捐赠的器官前3位分别是捐赠眼角膜（30．5％）、捐赠肾（18．8％）、捐赠心（16．5％）。结论：职业院校医卫类学生的器官捐赠态度和意愿得分处于中等水平；器官捐赠呈正向态度，但捐赠意愿较低，应在学生中加强器官捐赠知识教育。     

关于捐赠配子子代知情权的伦理学思考

在配子捐赠中有一个重要但长期未能解决的问题,即是否应告知子代其受孕的真相,如是,那么应告知其有关捐赠者的多少资料。在这个问题上,父母、捐赠者和子代可能有各自不同的观点。不同的辅助生殖技术(ART)项目和精子库收集的捐赠者资料以及在什么情况下告知接受配子者和子代也有所不同。是否告知子代配子捐赠的事实一直存在争议。支持告知者认为,人类有权知道他们的生物学出生,不告知子代的出生侵犯其自主权。研究提示知道生物学出生对子代的个体发展是重要的,而保密会导致疑惑且损伤自尊心。支持者还认为告知是与子代坦诚交往的重要部分,…     

美国男子捐精成150个孩子父亲

捐赠精子在美国愈来愈普遍,亦令很多妇女成功怀孕,每年约有6万名婴儿出生。然而,据香港《文汇报》报道,有精子银行为了赚钱,允许同一捐赠者的精子诞下太多孩子,有一名捐赠者竟是150名孩子的父亲。拥有150名孩子的精子捐赠者虽然没被公开姓名,但     

鄂西北地区城市居民器官捐赠知识、态度与意愿调查

目的了解鄂西北地区城市居民器官捐赠知识、态度与意愿现状,为鄂西北地区开展器官捐赠宣传教育工作提供一定的参考。方法采用方便抽样方法,选取鄂西北地区1 192名城市居民进行问卷调查。结果鄂西北地区城市居民器官捐赠知识得分为6.82±1.76,器官捐赠态度得分为3.91±1.27,不认同器官捐赠价值得分为4.29±1.33,认同器官捐赠价值得分为3.99±1.31,阻碍器官捐赠原因得分为3.70±1.40,器官捐赠意愿得分为2.31±0.94。年龄、本人或亲友有无器官捐献经历;曾接受或学习过器官移植相关内容和器官捐赠知识、认同器官捐赠价值及不认同器官捐赠价值;阻碍器官捐赠原因,共同影响器官捐赠意愿。结论鄂西北地区城市居民器官捐赠知识得分较高,态度得分处于中等,而捐赠意愿较低,应加强器官捐赠相关知识的宣传教育,培养城市居民器官捐赠的正向态度,提升捐赠意愿。     

台湾同胞无偿捐赠的骨髓在浙江移植成功

在接受了台湾同胞无偿捐赠的骨髓移植后，浙江省首例非亲缘异基因骨髓移植病人范和志近日康复出院。目前，台湾同胞捐赠的骨髓在这位患者体内已完全成活，患者骨髓中的癌症细胞标记完全消失，骨髓的造血功能也已恢复正常。据介绍，异基因骨髓移值是治疗白血病等血液系统疾病的有效办法，但要找到相配的骨髓难度却很大。去年，浙江天台患者范和志因患白血病需进行该项移植。但其亲人中却无一人的骨髓能配型相合，在祖国大陆的骨髓捐赠者中也没有找到合适的骨髓。结果，台湾慈济骨髓捐赠中心在１７万位捐赠者中找到了唯一相配的骨髓。去年１１…     

器官捐赠现状及其影响因素

本文从器官捐赠知识、态度及意愿的研究现状和影响器官捐赠的主要因素两个方面加以综述。影响器官捐赠的主要因素有传统观念、脑死亡、组织协调和器官捐赠宣传教育。     

粤北地区医学生器官捐赠知识、态度和意愿调查

目的 调查粤北地区医学生对器官捐赠的知识、态度和意愿现状,分析影响其意愿的主要因素。方法 采用器官捐赠量表对1 820名在校医学生进行问卷调查。结果 医学生器官捐赠知识、态度及意愿得分分别为7.58±1.18、3.63±0.66、2.16±0.88。多元线性回归分析结果显示,阻碍器官捐赠原因得分和家人是否同意是影响捐赠意愿的两个主要因素,而家人不同意和法律制度不完善是医学生不愿意捐赠器官的两个主要原因。结论 粤北地区医学生器官捐赠意愿较低,学校与全社会应加强器官捐赠宣传教育,提高医学生的捐赠知识、态度和意愿水平。     

医生领带更易带病原

由于捐赠器官不足，心脏病人不得不长时间等待器官移植，病情严重者甚至因等待时间过长而濒临死亡。近日，随着首种临时性人造心脏获得美国食品和药物管理局的认可，这种新发明的人造心脏可以暂时弥补捐赠器官不足的空缺。     

Encouraging family discussion on the decision to donate organs: the role of the willingness to communicate scale

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.     

Encouraging Family Discussion on the Decision to Donate Organs: The Role of the Willingness to Communicate Scale

Family discussion of organ donation has been found to double rates of family consent regarding organ donation. Therefore, family discussion is an important communication process to study in the effort to get more people to become organ donors. This investigation concerns the willingness to communicate about organ donation and its relationship to other variables and processes related to family discussion of organ donation. Previous research on willingness to communicate examined the antecedent variables of knowledge, attitude toward organ donation, and altruism. This research found that being willing to communicate about organ donation with one's family is related to prior thought and intent to sign an organ donor card, to perceiving organ donation messages as credible, and to feeling relatively low anxiety after reading organ donation messages. One week after being presented with the messages, willingness to communicate was found to be positively associated with worrying about the lack of donors, engaging in family discussion about organ donation, and having an organ donor card witnessed. It was negatively related to feeling personally uneasy about organ donation during the past week.     

Marketing the concept of becoming a potential organ donor

Medical technology now enables thousands of people with terminal organ diseases to return to productive lives. Thousands more, however, will die because suitable donor organs are not currently available. Despite an early call for marketing approach to the problem of recruiting potential organ donors, little progress has been made to date. The author reviews the current literature on organ donation, discusses previous organ donation research conducted by a team he led, and makes suggestions for marketing the concept of becoming a potential organ donor.     

The Challenges of Social Marketing of Organ Donation: News and Entertainment Coverage of Donation and Transplantation

While great strides have been made in persuading the public to become potential organ donors, actual behavior has not yet caught up with the nearly universally favorable attitudes the public expresses toward donation. This paper explores the issue by situating the social marketing of organ donation against a broader backdrop of entertainment and news media coverage of organ donation. Organ donation storylines are featured on broadcast television in medical and legal dramas, soap operas, and other television serials approximately four times per month (not including most cable networks), and feature storylines that promote myths and fears of the organ donation process. National news and other non-fictionalized coverage of organ donation are even more common, with stories appearing over twenty times a month on average. These stories tend to be one-dimensional and highly sensationalized in their coverage. The marketing of organ donation for entertainment essentially creates a counter-campaign to organ donation, with greater resources and reach than social marketers have access to. Understanding the broader environmental context of organ donation messages highlights the issues faced by social marketing campaigns in persuading the public to become potential donors.     

The challenges of social marketing of organ donation: news and entertainment coverage of donation and transplantation

While great strides have been made in persuading the public to become potential organ donors, actual behavior has not yet caught up with the nearly universally favorable attitudes the public expresses toward donation. This paper explores the issue by situating the social marketing of organ donation against a broader backdrop of entertainment and news media coverage of organ donation. Organ donation storylines are featured on broadcast television in medical and legal dramas, soap operas, and other television serials approximately four times per month (not including most cable networks), and feature storylines that promote myths and fears of the organ donation process. National news and other non-fictionalized coverage of organ donation are even more common, with stories appearing over twenty times a month on average. These stories tend to be one-dimensional and highly sensationalized in their coverage. The marketing of organ donation for entertainment essentially creates a counter-campaign to organ donation, with greater resources and reach than social marketers have access to. Understanding the broader environmental context of organ donation messages highlights the issues faced by social marketing campaigns in persuading the public to become potential donors.     

Liver transplantation from a living donor

Recently the first three liver transplantations from living donors were performed in The Netherlands. The motivations to proceed with this new procedure were threefold; the existing shortage of post-mortem organ donors, the successful transplants reported in the literature and the supposedly better organ quality and favourable-logistics of the procedure. This new procedure is in line with a recent advisory report on organ donation from the National Health Council of The Netherlands. As long as there is a shortage of post-mortem donors, living donation is a necessary treatment for patients with otherwise fatal liver insufficiency. However this should not keep public and governmental organisations from its continuing efforts to promote post-mortem donation. These should also include a discussion regarding changes to the organ donation law.     

'New pathways to organ donation'; a recommendation of the Dutch Health Council

Despite recent efforts at improvement, the current status of postmortem organ donation in the Netherlands is a reason for serious concern. The waiting lists for all organ transplantations are increasing in length. The Dutch Health Council was asked by the Minister of Health to report on any available alternative sources of donor organs, focusing especially on donation from living donors and postmortem donors in whom the heart is no longer beating. Kidney donation by living relatives is a well-known procedure that has been performed since 1950. Since HLA-matching is now less important due to new immunosuppressive regimens, transplants from unrelated living volunteers are also possible with good results. Live donation from emotionally involved persons should be encouraged. In case of ABO incompatibility, donors could be exchanged via the organ exchange institution. Live donation of liver segments by an adult to benefit a child recipient is justified. In case of an adult recipient this should be performed only under exceptional circumstances. Live donation of lung lobes and segments of intestine is still in a developmental phase. Postmortem donation of kidneys and livers from donors in whom the heart is no longer beating should also be encouraged. Donation of the lungs and pancreas from these donors is still an experimental procedure.     

The impact of an organ donation registration information program for high school students in the Netherlands

In 1998, a new organ donor registration system was implemented in the Netherlands to increase the number of potential donors. A high school education program was developed to prepare adolescents to make an informed decision about organ donation. A post-test only randomised controlled trial was conducted in 39 high schools including 2868 students. Students within schools were randomly allocated to either attend the organ donation education program or not. The impact of the program on students' intention to register their organ donation preference (and determinants thereof) were analysed using multivariate multileveling modelling (MlwiN). The results show that students who were exposed to the education program had more favourable registration intentions (B = .40), were more often willing to be donors (OR = 1.45), and had greater knowledge about (B = 3.84) and more positive social outcome expectations (B = .09) and self-efficacy regarding organ donation registration (B=.22). Lastly, they experienced significantly less negative outcome expectations related to organ donation registration (B = -.15). Students' evaluation of the school-based education program was favourable. The present organ donation registration program proved to be effective in changing determinants of organ donation registration, and a large-scale implementation in the Dutch high school curriculum is planned.     

Donor registries,first-person consent legislation,and the supply of deceased organ donors

In this paper, we exploit the varied timing in state adoption of organ donor registries and first-person consent (FPC) legislation to examine corresponding changes in the supply of deceased organ donors. Results indicate that the establishment of a state organ donor registry leads to an increase in donation rates of approximately 8%, while the adoption of FPC legislation has no effect on the supply of organ donors. These results reinforce the need to encourage individuals to communicate their donation preferences, either explicitly via a registry or by discussing them with family.     

Organ donation process: perception by relatives of cadaverous donors

This study aimed to disclose how relatives of cadaverous donors perceive the organ donation process for transplantation. A phenomenological, qualitative research was carried out on the basis of the "situated-phenomenon structure". The statements revealed that, for the relatives of the donors, the process of donation begins with the patients' hospital admission and only ends when they are buried. Furthermore, it is considered bureaucratic, long, consuming and tiring. This situation results in suffering and stress, but there is no regret about the organ donation since, although the pain caused by the loss does not end, the donation initiative comforts and brings satisfaction.