HEAL UoS

Posts Tagged ‘organ donation’

Prof Hazel Biggs debates ‘ranking’ patients for organ donation

In 2013, Organ donation on July 11, 2013 at 1:38 pm

This morning, on BBC Radio 4’s Today programme, Prof Hazel Biggs debated the ethics of ‘ranking’ patients for organ donation with Prof Bobbie Farsides of Sussex University.

A key question under consideration in the media this week (see also the Jeremy Vine show on Radio 2 this lunchtime, circa 1pm) is whether patients in need of organs – who themselves are on the organ donation register – should be ‘ranked’ higher than those who are not when a suitable organ becomes available; ie a form of prioritising patients according to their willingness to be an organ donor, as opposed to solely considering clinical needs.

Hazel spoke broadly in favour of this approach as a means (among other factors) to incentivise people to join the organ donor list, thereby producing more organs for donation; and raised questions around fairness and equity – ie, people needing organs who were not willing (as opposed to unable) to donate their own to others.

The programme can be accessed here.

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JME Editor’s Choice: John Coggon on Elective Ventilation

In 2013, Death and dying, Public Ethics on February 21, 2013 at 7:27 am

The latest issue of the Journal of Medical Ethics (JME) is a special issue focused on ‘Elective Ventilation’. John Coggon’s paper – which he delivered as a HEAL seminar last year – has been selected as the Editor’s Choice, hence it is open access and can be read in full here.

Abstract This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: ‘basic elective ventilation’; ‘epistemically complex elective ventilation’; ‘practically complex elective ventilation’; and ‘epistemically and practically complex elective ventilation’. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

Jonathan Montgomery’s paper on ‘Public Ethics’ is published

In Public Ethics on January 11, 2013 at 5:32 pm

Jonathan Montgomery’s paper on the nature of ‘ public ethics’ has now been published in the Cambridge Quarterly of Health Care Ethics. Based on a presentation at a seminar on organ donation at the University of Keele, it reflects on the processes by which the Organ Donation Taskforce reached its conclusion not to propose a ‘presumed consent’ model for organ donation. It draws on the Jonathan’s experience as a member of that Taskforce and of other bodies charged with exploring ‘public ethics’, including the working party of the Nuffield Council on Bioethics on Public Health Ethics.

Jonathan argues that ‘public’ ethics is a much more contingent process than academic work and needs to (a) take into account contemporary policy debates, (b) be expressed in terms that are sufficiently close to the prevailing professional discourse to have a reasonable hope of reception, (c) assess how positions will be represented in the media and what behavioural changes will follow in the actual political context, (d) create workable compromise formulations, from which people can reason even if they reach them by different arguments.

Critiques of ‘public ethics’ need to take these features into account. He discusses the way in which a key concept in the Nuffield Council’s Public Health: Ethical Issues report, ‘stewardship’, has been examined and criticised by academics (including fellow HEAL member John Coggon in both his seminal book What Makes Health Public? and articles in the Journal of Medical Ethics and the Northern Ireland Legal Quarterly). Jonathan contends that the approach taken in the report is both explicable and defensible when seen as an exercise in public ethics, even though it may be more difficult to defend as an academic position. Criticism needs also to be sensitive to the fact that pronouncements on ‘public ethics’ are an exercise in persuasion whose audience is not academics. This may excuse the use of familiar but imperfect paradigms for analysis and a degree of compromise between committee members. It does not justify incoherent arguments.

Jonathan goes on to argue that there are some specific issues which present a greater challenge for ‘public ethics’ than for personal academic contributions. He suggests that greater attention must be paid to the difficulties for ‘public ethics’ of dealing with public opinion and seeks to explain how the Organ Donation Taskforce took into account public views it thought were based on flawed assumptions. He examines how bodies charged with considering ‘public ethics’ should address controversies where lay and professional understandings of what counts as evidence diverge. He also considers the implications of the contingencies of the socio-political contexts for ‘public ethics’ for analysis based on comparative work (both over time and between countries). This is a commonly used approach, but fraught with difficulties.

John Coggon on Elective Ventilation for Organ Donation: Law, Policy, and Public Ethics

In 2012, Human tissue on December 5, 2012 at 7:59 am

Our most recent HEAL event was a fascinating seminar with John Coggon speaking on Elective Ventilation for Organ Donation: Law, Policy, and Public Ethics. His paper drew on an article accepted by the Journal of Medical Ethics (forthcoming); abstract kindly provided below.

 

Abstract This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: ‘basic elective ventilation’; ‘epistemically complex elective ventilation’; ‘practically complex elective ventilation’; and ‘epistemically and practically complex elective ventilation’. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

Today’s HEAL meeting: John Coggon

In 2012, Meetings on November 22, 2012 at 10:36 am

Today at 3pm, Thursday 22 November, John Coggon will see speaking on ‘Elective Ventilation for Organ Donation’, in room 2055/4(Law). All welcome.

This week’s meeting!

In 2012, Human tissue, Meetings on January 24, 2012 at 8:26 am

News of our first 2012 event: Friday, 27 January, at 11am in the staff club, Highfield campus – Hazel, Jonathan and I will be meeting to discuss the Welsh Assembly’s White Paper on a proposed opt-out system for organ donation in Wales. English & Welsh versions of this document and further details about the consultation can be found http://wales.gov.uk/consultations/healthsocialcare/organ/?lang=en

The consultation contains 9 questions, broadly about operational issues of such a system (eg. factors to be taken into account in determining whether someone ‘lives in Wales’, safeguards for those lacking capacity, age restrictions and possible equality impact), and closes on 31 January 2012.

Anyone who would like to join us for this discussion is most welcome.