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Ethical and Legal Deliberation on Organ Donation after Circulatory Death in Taiwan—
Open the Dialogues and Repair the Social Trust
|Advisor:||蔡甫昌(Daniel Fu-Chang Tsai)|
organ donation,donation after circulatory death,donation after brain death,ethics,law,Human Organ Transplant Act,
|Publication Year :||2016|
Historically, the development of organ donation began with donation after circulatory death (DCD), followed by donation after brain death (DBD). Many countries reestablished DCD protocol due to the increasing gap between vital organs demand and supply in recent years. DCD became a focus of debates in the 2014 Taipei City mayor election. However, many criticisms of DCD were not intended for rational discussion and dialogue and have hurt the trust for organ donation in the society. The goals of this thesis are to invite a rational dialogue and repair the damaged social trust.
The thesis emphasizes the following:
First, to clarify the definition and content of DCD. The necessity to apply DCD in Taiwan was explored, considering history, supply and demand, and global trends.
Second, to facilitate mutual dialogue in the society, the methods to implement inquiry and registry of the willingness for organ donation in the general public were discussed.
Third, to fulfill the principle of respect for autonomy, additional options in the organ donation registration form were suggested. For example, would the patient accept death determination based on circulatory death criteria, kinds of organ the patient wish to donate, and would the patient accept interventions intended to improve organ quality in end-of-life care.
Fourth, to explore the ethical issues arising from DCD, including the determination of death, how to avoid conflict of interests, and antemortem and postmortem interventions.
Fifth, to explore if the practice of DCD is legal under current Taiwanese laws. Relevant U.K. and U.S.A. laws were compared to clarify the concepts.
Finally, I argue that the implementation of DCD needs comprehensive laws and ethical norms, and Taiwanese society already possesses such potential for the introduction and practice of DCD now. We should make sure, however, that DCD be established on an open and transparent basis and performed in a stepwise and orderly way. Under the premise of respect for autonomy, further mutual dialogue is needed to rebuild social trust.
|Appears in Collections:||醫學教育暨生醫倫理學科所|
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