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Ethical Issues in Live Donor Kidney Transplant: Views of Medical and Nursing Staff

机译:活体捐赠者肾脏移植中的伦理问题:医护人员的观点

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Objectives: The ongoing development of live donor kidney transplant has generated many ethical dilemmas. It is important to be aware of the attitudes of transplant professionals involved in this practice. Materials and Methods: An anonymous and confidential questionnaire was sent to 236 members of the medical and nursing staff of the West London Renal and Transplant Centre, to assess their views on the ethics of the current practice of live donor kidney transplant. Results: Of the 236 questionnaires, 108 (45.8%) were returned. Respondents considered live donor kidney transplant ethically acceptable between blood relatives (100%), nonblood relatives and friends (92.6%), and strangers (47.2%). Most respondents were willing to donate a kidney to a blood relative (92.6%) or a nonblood relative or friend (81.5%), and 12.0% were willing to donate to a stranger. Considering themselves as potential recipients if they had end-stage renal disease, most would accept a kidney from a blood relative (91.7%) or nonblood relative or friend (85.2%), while 44.5% would accept a kidney from a stranger. The highest number of respondents (43.5%) believed that the recipient should approach the potential donor. About one-third believed there should be no financial reward, not even compensation for expenses, for donors; 8% favored direct financial rewards for donors known to recipients, and 18% favored rewards for donors not known to recipients. Slightly more than half were in favor of accepting donors with mild to moderate medical problems. Conclusions: Live related and unrelated kidney donation are considered ethically acceptable procedures, and non-directed donation is gaining support among transplant professionals. A substantial minority favored direct financial rewards for donors, especially in the case of non-directed donation.
机译:目标:活体供体肾脏移植的不断发展产生了许多道德困境。重要的是要意识到参与该实践的移植专业人员的态度。资料和方法:向西伦敦肾脏和移植中心的236名医疗和护理人员发送了匿名和保密的问卷,以评估他们对当前活体肾脏移植实践的道德观念的看法。结果:236份问卷中,有108份(45.8%)被返回。受访者认为,在血亲(100%),非血亲和朋友(92.6%)和陌生人(47.2%)之间进行活体供体肾脏移植在伦理上是可以接受的。大多数受访者愿意向有血缘关系的亲戚(92.6%)或非血亲或朋友(81.5%)捐赠肾脏,还有12.0%的人愿意向陌生人捐赠肾脏。如果将自己视为患有晚期肾脏疾病的潜在接受者,则大多数人会接受来自血亲的肾脏(91.7%)或非血缘亲戚或朋友的肾脏(85.2%),而44.5%会接受陌生人的肾脏。最多的受访者(43.5%)认为,接受者应接近潜在的捐赠者。约有三分之一的人认为,捐助者不应获得经济报酬,甚至不应该赔偿费用。 8%的人倾向于接受受赠人不知情的捐赠人的直接财务奖励,18%的人倾向于接受受赠人不知情的捐赠人的奖励。略多于一半的人赞成接受患有轻度至中度医疗问题的捐助者。结论:与生命有关和无关的肾脏捐赠在伦理上被认为是可以接受的程序,无定向捐赠正在获得移植专业人员的支持。极少数人赞成直接向捐赠者提供经济奖励,特别是在非直接捐赠的情况下。

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