The COVID-19 pandemic and organ donation and transplantation: ethical issues
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Date
2021-10-21
Authors
Ibrahim, Ban
Dawson, Rosanne
Chandler, Jennifer A.
Goldberg, Aviva
Hartell, David
Hornby, Laura
Simpson, Christy
Weiss, Matthew-John
Wilson, Lindsay C.
Wilson, T. M.
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Abstract
Abstract
Background
The COVID-19 pandemic has had a significant impact on the health system worldwide. The organ and tissue donation and transplantation (OTDT) system is no exception and has had to face ethical challenges related to the pandemic, such as risks of infection and resource allocation. In this setting, many Canadian transplant programs halted their activities during the first wave of the pandemic.
Method
To inform future ethical guidelines related to the COVID-19 pandemic or other public health emergencies of international concern, we conducted a literature review to summarize the ethical issues.
Results
This literature review identified three categories of ethical challenges. The first one describes the general ethical issues and challenges reported by OTDT organizations and transplantation programs, such as risks of COVID-19 transmission and infection to transplant recipients and healthcare professionals during the transplant process, risk of patient waitlist mortality or further resource strain where transplant procedures have been delayed or halted, and resource allocation. The second category describes ethical challenges related to informed consent in the context of uncertainty and virtual consent. Finally, the third category describes ethical issues related to organ allocation, such as social considerations in selecting transplant candidates.
Conclusion
This literature review highlights the salient ethical issues related to OTDT during the current COVID-19 pandemic. As medical and scientific knowledge about COVID-19 increases, the uncertainties related to this disease will decrease and the associated ethical issues will continue to evolve.
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Citation
BMC Medical Ethics. 2021 Oct 21;22(1):142