Dr Esha Bansal joins Ethics Talk to discuss her article, coauthored with Drs Saran Kunaprayoon and Linda P. Zhang: “Opportunities for Global Health Diplomacy in Transnational Robotic Telesurgery.”
Katrina A. Bramstedt, PhD and Francis L. Delmonico, MD
Transplant centers cannot regulate how people establish relationships, but when a donor-recipient pair comes together through Internet solicitation, the center must assess the donor’s motivations carefully.
Efforts to meet the demand for organs have long had disproportionate effects on members of particular races, not only because of disparate levels of need for transplants but because of the way our donation system works.
We must try to understand why there is such certainty about poor prognosis in severe brain-injury cases, when in fact many patients recover, albeit to a level of function most of us would not desire.
The United States government’s insistence that organs can only be procured through altruism, rather than being exchanged or purchased, contributes to the very exploitation of people of color in developing countries it sought to prevent.
We really can't promise both more transplants and better outcomes. The controversies over organ allocation really represent intellectual exhaustion in the face of a long series of inadequate policy responses to the decade-long trend of the kidney supply increasing only at the expense of organ quality and patient outcomes.
When a would-be living organ donor wants to accept risk in the name of altruism when there is little chance for benefit or significant chance for harm, physicians are justified in limiting that altruism.