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Public preferences for the allocation of donor organs for transplantation: Focus group discussions

BACKGROUND: Deceased donor organs are scarce resources because of a large supply‐and‐demand mismatch. This scarcity leads to an ethical dilemma, forcing priority‐setting of how these organs should be allocated and whom to leave behind. OBJECTIVE: To explore public preferences for the allocation of d...

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Autores principales: Oedingen, Carina, Bartling, Tim, Dierks, Marie‐Luise, Mühlbacher, Axel C., Schrem, Harald, Krauth, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321724/
https://www.ncbi.nlm.nih.gov/pubmed/32189453
http://dx.doi.org/10.1111/hex.13047
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author Oedingen, Carina
Bartling, Tim
Dierks, Marie‐Luise
Mühlbacher, Axel C.
Schrem, Harald
Krauth, Christian
author_facet Oedingen, Carina
Bartling, Tim
Dierks, Marie‐Luise
Mühlbacher, Axel C.
Schrem, Harald
Krauth, Christian
author_sort Oedingen, Carina
collection PubMed
description BACKGROUND: Deceased donor organs are scarce resources because of a large supply‐and‐demand mismatch. This scarcity leads to an ethical dilemma, forcing priority‐setting of how these organs should be allocated and whom to leave behind. OBJECTIVE: To explore public preferences for the allocation of donor organs in regard to ethical aspects of distributive justice. METHODS: Focus groups were facilitated between November and December 2018 at Hannover Medical School. Participants were recruited locally. Transcripts were assessed with content analysis using the deductive framework method. All identified and discussed criteria were grouped according to the principles of distributive justice and reported following the COREQ statement. RESULTS: Six focus groups with 31 participants were conducted. Overall, no group made a final decision of how to allocate donor organ; however, we observed that not only a single criterion/principle but rather a combination of criteria/principles is relevant. Therefore, the public wants to allocate organs to save as many lives as possible by both maximizing success for and also giving priority to urgent patients considering the best compatibility. Age, waiting time, reciprocity and healthy lifestyles should be used as additional criteria, while sex, financial status and family responsibility should not, based on aspects of equality. CONCLUSIONS: All participants recognized the dilemma that prioritizing one patient might cause another one to die. They discussed mainly the unclear trade‐offs between effectiveness/benefit and medical urgency and did not establish an agreement about their importance. The results suggest a need of preference studies to elucidate public preferences in organ allocation.
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spelling pubmed-73217242020-06-30 Public preferences for the allocation of donor organs for transplantation: Focus group discussions Oedingen, Carina Bartling, Tim Dierks, Marie‐Luise Mühlbacher, Axel C. Schrem, Harald Krauth, Christian Health Expect Original Research Papers BACKGROUND: Deceased donor organs are scarce resources because of a large supply‐and‐demand mismatch. This scarcity leads to an ethical dilemma, forcing priority‐setting of how these organs should be allocated and whom to leave behind. OBJECTIVE: To explore public preferences for the allocation of donor organs in regard to ethical aspects of distributive justice. METHODS: Focus groups were facilitated between November and December 2018 at Hannover Medical School. Participants were recruited locally. Transcripts were assessed with content analysis using the deductive framework method. All identified and discussed criteria were grouped according to the principles of distributive justice and reported following the COREQ statement. RESULTS: Six focus groups with 31 participants were conducted. Overall, no group made a final decision of how to allocate donor organ; however, we observed that not only a single criterion/principle but rather a combination of criteria/principles is relevant. Therefore, the public wants to allocate organs to save as many lives as possible by both maximizing success for and also giving priority to urgent patients considering the best compatibility. Age, waiting time, reciprocity and healthy lifestyles should be used as additional criteria, while sex, financial status and family responsibility should not, based on aspects of equality. CONCLUSIONS: All participants recognized the dilemma that prioritizing one patient might cause another one to die. They discussed mainly the unclear trade‐offs between effectiveness/benefit and medical urgency and did not establish an agreement about their importance. The results suggest a need of preference studies to elucidate public preferences in organ allocation. John Wiley and Sons Inc. 2020-03-18 2020-06 /pmc/articles/PMC7321724/ /pubmed/32189453 http://dx.doi.org/10.1111/hex.13047 Text en © 2020 The Authors Health Expectations published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Oedingen, Carina
Bartling, Tim
Dierks, Marie‐Luise
Mühlbacher, Axel C.
Schrem, Harald
Krauth, Christian
Public preferences for the allocation of donor organs for transplantation: Focus group discussions
title Public preferences for the allocation of donor organs for transplantation: Focus group discussions
title_full Public preferences for the allocation of donor organs for transplantation: Focus group discussions
title_fullStr Public preferences for the allocation of donor organs for transplantation: Focus group discussions
title_full_unstemmed Public preferences for the allocation of donor organs for transplantation: Focus group discussions
title_short Public preferences for the allocation of donor organs for transplantation: Focus group discussions
title_sort public preferences for the allocation of donor organs for transplantation: focus group discussions
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7321724/
https://www.ncbi.nlm.nih.gov/pubmed/32189453
http://dx.doi.org/10.1111/hex.13047
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