Este artigo tem como objetivo propor uma análise comparativa da maneira como a concepção de jogo se expressa nas obras de Górgias e Wittgenstein. No Elogio de Helena, Górgias desenvolve sua retórica como um artifício persuasivo, no qual o jogo é a própria essência da linguagem. Já Wittgenstein, em suas Investigações Filosóficas, desvela a teoria dos “Jogos de Linguagem”, com suas regras e significados. Ao cruzar esses dois horizontes, nosso propósito é evidenciar as possíveis aproximações entre o pensamento de ambos (...) os filósofos e, além disso, ressaltar a compreensão partilhada por eles acerca da dimensão lúdica da linguagem, uma vez que cada um, à sua maneira, sustenta que as palavras são dinâmicas: elas brincam e, sobretudo, significam. (shrink)

A noção de comportamento se faz importante em Wittgenstein, principalmente relacionada a argumentação da linguagem privada e o seguir regras. O Behaviorismo propõe, justamente, o comportamento, que é desenvolvido posteriormente, como objeto de estudo em uma espécie de revolução da ciência psicológica para que esta ganhasse o estatuto de ciência. Partindo de noções de comportamento distintas em Wittgenstein, no behaviorismo metodológico e no comportamentalismo, o presente ensaio tem quatro objetivos: 1) apresentar uma noção de comportamento em Wittgenstein; 2) apresentar a (...) noção de comportamento para o behaviorismo metodológico; 3) apresentar a noção de comportamento para o comportamentalismo; 4) se a noção de comportamento do comportamentalismo estaria ou não sujeita às críticas de Wittgenstein. Para tanto, inicialmente, apresentaremos brevemente o que ficou conhecido como o Argumento da Linguagem privada nas IF e em seguida serão apresentadas as concepções de comportamento. (shrink)

The DAP (Death Associated Protein) kinase family is a novel subfamily of pro-apoptotic serine/threonine kinases. All five DAP kinase family members identified to date are ubiquitously expressed in various tissues and are capable of inducing apoptosis. The sequence homology of the five kinases is largely restricted to the N-terminal kinase domain. In contrast, the adjacent C-terminal regions are very diverse and link individual family members to specific signal transduction pathways. There is increasing evidence that DAP kinase family members are involved (...) in both extrinsic and intrinsic pathways of apoptosis and may play a role in tumor progression. This review will focus on structural composition and subcellular localization of DAP kinase family members and on signal transduction pathways leading to their activation. Potential mechanisms of DAP kinase family-mediated apoptosis will be discussed. BioEssays 23:352–358, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

This paper examines the influence on product innovation of factors based on a company’s transformation and exploitation of knowledge gathered from its intra-organizational relationships. Specifically, this paper analyses the influence of intra-organizational social capital on realized absorptive capacity. Moreover, it analyses the mediating role of RACAP on the relationship between internal SC and product innovation. Based on a sample of companies from the Spanish biotechnological and pharmaceutical industries, two hypotheses were tested using a structural equations model and the partial least (...) squares technique. The results support both hypotheses, suggesting that the development of strong and tightly knit links based on a common understanding and trust among company members lead the firm to develop dynamic capabilities for transforming and exploiting knowledge acquired externally, which fosters innovation based on new product development. Research limitations, implications and future research are also discussed by the authors of the paper. (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

Background Obstetric violence is a widespread form of institutional abuse that violates women’s sexual and reproductive rights during childbirth. Although informed consent is a fundamental ethical, legal, and human right requiring adequate information and active participation, it is frequently absent or incomplete, even in non-emergency obstetric care. Aim To identify which clinical practices, according to their context (emergency or routine) and the presence or absence of informed consent, are associated with higher perceptions of obstetric violence. Additionally, it is to assess (...) the influence of professional treatment on these perceptions. Research design Cross-sectional observational study. Participants and research context: 2,367 women who gave birth in Spanish public hospitals. Perceptions of obstetric violence and quality of care were measured using the Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (CARE-MQ) and the Quality from the Patient’s Perspective–Intrapartal Questionnaire (QPP-I). Ethical Considerations The study was approved by the Clinical Research Ethics Committee of Reina Sofía University Hospital of Córdoba and by the ethics committees of Ciudad Real University Hospital and Mancha-Centro Hospital. Findings Clinical practices performed without informed consent or adequate information were significantly associated with higher CARE-MQ scores (p <.001). Procedures such as episiotomy and oxytocin administration, when carried out outside emergency situations, had a particularly strong impact on perceptions of abuse. Negative evaluations of professional treatment were also significantly associated with higher CARE-MQ scores (p <.001). Midwives received the highest ratings among healthcare professionals. Conclusion The absence of informed consent is a key determinant of women’s perceptions of obstetric violence, regardless of clinical context. Identifying procedures with low consent rates and highlighting the protective role of respectful professional behavior, particularly midwife-led care, provides actionable targets to improve maternity services. Strengthening communication, ethical training, and midwife-led models is essential to promote respectful maternity care and safeguard women’s rights during childbirth. (shrink)

Four types of self-standards (ideal, ought, undesired, and forbidden selves) were analyzed in the context of self-assessed health of older adults. We focused on the relationships between self-discrepancies (perceived actualization of self-standards) and affect, as well as the content of self-descriptions of standards. Participants (116 Polish older adults) completed: Self Standards’ Measure (SSM), PANAS-X and 7 items from the WHOQOL-BREF. First, we found that self-assessed health moderates the effects of self-discrepancies on affect. The ideal and ought self-discrepancies predicted affect when (...) health was assessed as good. Conversely, the undesired and forbidden self-discrepancies predicted affect when health was assessed as poor. Second, health-related content was more typical for the ideal than for the ought standards. Third, older adults who assessed their health better had fewer health-related standards. The results are discussed with reference to control theory of approach and avoidance. (shrink)

This comprehensive anthology offers over 40 readings that are critical to the understanding of anthropological theory and the development of anthropology as an academic discipline. The fourth edition maintains a strong focus on the "four-field" roots of the discipline in North America but has been reorganized with a new section on twenty-first-century theory, including coverage of postcolonial and public anthropology. New key terms and introductions accompany each reading and a revamped glossary makes the book more student-friendly. Used on its own, (...) or together with the overview text A History of Anthropological Theory, Fourth Edition, this anthology offers a flexible and unrivaled introduction to anthropological theory that reflects not only the history but also the changing nature of the discipline today. For additional resources, visit the "Teaching Theory" page at www.utpteachingculture.com. (shrink)

Las micotoxinas son metabolitos fúngicos secunda­rios que pueden ejercer un efecto tóxico tanto en el hombre como en los animales debido, principalmente, a su exposición a través de los alimentos. La presencia de estos compuestos ha sido demostrada en una amplia variedad de materias primas, alimentos y piensos, en los que lo habitual es encontrar de for­ma frecuente una contaminación múltiple por diferentes mico­toxinas, en pequeñas cantidades, lo que puede generar efectos tóxicos subcrónicos, así como bioacumulación. Este artículo revisa los (...) principales elementos que configuran la problemática de las micotoxinas para el hombre y los animales, y aborda los retos de futuro que se plantean en el estudio de las micotoxinas, entre los que destacan el efecto que el cambio climático puede tener sobre el patrón de contaminación por micotoxinas en los alimentos, el descubrimiento creciente de nuevas micotoxinas en formas modificadas, la evaluación de la coexistencia de estas to­xinas y otros contaminantes, y las formas para detectar e intentar eliminar estos compuestos tóxicos de los alimentos. (shrink)

This paper defends an ‘opt-out’ scheme for organ procurement, by distinguishing this system from ‘presumed consent’ (which the author regards as an erroneous justification of it). It, first, stresses the moral importance of increasing the supply of organs and argues that making donation easier need not conflict with altruism. It then goes on to explore one way that donation can be increased, namely by adopting an opt-out system, in which cadaveric organs are used unless the deceased (or their (...) family) registered an objection. Such policies are often labelled ‘presumed consent’, but it is argued that critics are right to be sceptical of this idea—consent is shown to be an action, rather than a mental attitude, and thus not something that can be presumed. Either someone has consented or they have not, whatever their attitude to the use of their organs. Thankfully, an opt-out scheme need not rest on the presumption of consent. Actual consent can be given implicitly, by one's actions, so it is argued that the failure to register an objection (given certain background conditions) should itself be taken as sign of consent. Therefore, it is permissible to use the organs of someone who did not opt out, because they have—by their silence—actually consented. (shrink)

Background Advocates for a regulated system to facilitate kidney donation between unrelated donor-recipient pairs argue that monetary compensation encourages people to donate vital organs that save the lives of patients with end-stage organ failure. Scholars support compensating donors as a form of reciprocity. This study aims to assess the compensation system for the unrelated kidney donation program in the Islamic Republic of Iran, with a particular focus on the implications of Islam on organ donation and organ sales. (...) Methods This study reviews secondary documents for philosophical argumentation and ethical analysis of human organ donation and sale for transplantation. Results and discussion According to Islamic law, organ donation is an act of _sadaqatul jariyah,_ and individuals are permitted to donate organs with the intention of saving lives. The commercialization of humans as organ sellers and buyers is contrary to the Islamic legal maxim _eethaar_, undermining donors of ‘selfless’ or ‘altruistic’ motivations. Such an act should be considered immoral, and the practice should not be introduced into other countries for the sake of protecting human dignity, integrity, solidarity, and respect. I, therefore, argue that Iran’s unrelated kidney donation program not only disregards the position of the Islamic religion with respect to the provision or receipt of monetary benefits for human kidneys for transplantation but that it also misinterprets the Islamic legal proscription of the sale of human organs. I also argue that the implementation of Iran’s unrelated kidney donor transplantation program is unethical and immoral in that potential donors and recipients engage in a bargaining process akin to that which sellers and buyers regularly face in regulated commodity exchange markets. Conversely, I suggest that a modest fixed monetary remuneration as a gift be provided to a donor as a reward for their altruistic organ donation, which is permissible by Islamic scholars. This may remove the need to bargain for increased or decreased values of payment in exchange for the organ, as well as the transactional nature of ‘buyer and seller’, ensuring the philosophy of ‘donor and recipient’ is maintained. Conclusions Offering a fixed modest monetary incentive to organ donors would serve to increase organ supply while protecting donors’ health and reducing human suffering without legalizing the human organ trade. (shrink)

Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria, there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these (...) issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients. (shrink)

In recent years much research has been undertaken regarding the feasibility of the human uterine transplant as a treatment for absolute uterine factor infertility. Should it reach clinical application this procedure would allow such individuals what is often a much-desired opportunity to become not only social mothers, or genetic and social mothers but mothers in a social, genetic and gestational sense. Like many experimental transplantation procedures such as face, hand, corneal and larynx transplants, UTx as a therapeutic option falls firmly (...) into the camp of the quality of life transplant, undertaken with the aim, not to save a life, but to enrich one. However, unlike most of these novel procedures – where one would be unlikely to find a willing living donor or an ethics committee that would sanction such a donation – the organs to be transplanted in UTx are potentially available from both living and deceased donors. In this article, in the light of the recent nine-case research trial in Sweden which used uteri obtained from living donors, and the assertions on the part of a number of other research teams currently preparing trials that they will only be using deceased donors, I explore the question of whether, in the case of UTx, there exist compelling moral reasons to prefer the use of deceased donors despite the benefits that may be associated with the use of organs obtained from the living. (shrink)

The stipulation of living organ transplantation policy and practice in Bangladesh is family-oriented, with relatives being the only people legally eligible to donate organs. There have been very few transplantations of bone marrows, liver lobes, and kidneys from related-living donors in Bangladesh. The major question addressed in this study is why Bangladesh is not getting adequate organs for transplantation. In this study, I examin the stipulations of the policy and practice of living organ donation through the lens of 32 (...) key stakeholders including physicians and nurses, a health administrator, organ donors and recipients, and their family members, as they can shed light on the realities and problems of organ donation for transplantation in Bangladesh. My ethnography reveals that the family members are always encouraged to donate organs for transplantation, and saving the lives of relatives through organ donation is seen as a moral obligation. Many view saving the life of a relative by donating one’s organs as equivalent to saving one’s own life. An assessment of the dynamics of biomedicine, religion, and culture leads to the conclusion that the family-oriented organ donation policy and practice have been widely endorsed and accepted in Bangladesh, and Islamic ethical principles and collective family ethos undergird that policy and practice. However, the unavailability of medical resources, lack of post-operative coverage for organ donors, religious misconceptions and unawareness of the general public, and the absence of posthumously donated vital organs for transplantation are perceived to be the most common barriers to a successful living donor-recipient pair organ transplantation. By overcoming these obstacles, Bangladesh can develop a successful living donor-recipient pair organ transplantation program that will ensure improved healthcare outcomes, promote altruism and solidarity among Bangladeshi families, and protect the poor from having their organs sold to wealthy patients. (shrink)

It has traditionally been assumed that organ donation must be altruistic, though the necessity of altruistic motivations has recently been questioned. Few, however, have questioned whether altruism is always a good motive. This paper considers the possibility that excessive altruism, or self-abnegation, may be intrinsically bad. How this may be so is illustrated with reference to Tom Hurka’s account of the value of attitudes, which suggests that disproportionate love of one’s own good—either excessive or deficient—is intrinsically bad. Whether or (...) not we accept the details of this account, recognising that altruistic motivations may be intrinsically bad has important implications for organ procurement. One possible response is to say that we should take further measures to ensure that donors have good motives—that they are altruistic is no longer enough. An alternative is to say that, since altruistic donation need not be intrinsically good, we have less reason to object to other motivations. (shrink)

Children created through mitochondrial replacement techniques (MRTs) are commonly presented as possessing 50% of their mother’s nuclear DNA, 50% of their father’s nuclear DNA and the mitochondrial DNA of an egg donor. This lab-engineered genetic composition has prompted two questions: Do children who are the product of an MRT procedure have three genetic parents? And, do MRT egg donors have parental responsibilities for the children created? In this paper, I address the second question and in doing so I also address (...) the first one. First, I present a brief account of mitochondrial diseases and MRTs. Second, I examine how MRTs affect the numerical identity of eggs and zygotes. Third, I investigate two genetic accounts of parenthood and MRT egg donation. Fourth, I explore three causal accounts of parenthood and MRT egg donation. My conclusion is that, under the appropriate circumstances, MRT egg donors are parentally responsible for the children created under genetic accounts of parenthood and under causal accounts of parenthood. (shrink)

Altruism has long been taken to be the guiding principle of ethical organ donation in the UK, and has been used as justification for rejecting or allowing certain types of donation. We argue that, despite this prominent role, altruism has been poorly defined in policy and position documents, and used confusingly and inconsistently. Looking at how the term has been used over recent years allows us to define ‘organ donation altruism’, and comparing this with accounts in the (...) philosophical literature highlights its theoretical shortcomings. The recent report from the Nuffield Council on Bioethics reaffirmed the importance of altruism in organ donation, and offered a clearer definition. This definition is, however, more permissive than that of altruism previously seen in UK policy, and as a result allows some donations that previously have been considered unacceptable. We argue that while altruistic motivation may be desirable, it is not necessary. (shrink)

Currently in the United Kingdom, anyone donating gametes has the status of an open-identity donor. This means that, at the age of 18, persons conceived with gametes donated since April 1, 2005 have a right to access certain pieces of identifying information about their donor. However, in early 2015, the UK Parliament approved new regulations that make mitochondrial donors anonymous. Both mitochondrial donation and gamete donation are similar in the basic sense that they involve the contribution of gamete (...) materials to create future persons. Given this similarity, this paper presumes that both types of donor should be treated the same and made open-identity under the law, unless there is a convincing argument for treating them differently. I argue that none of the existing arguments that have been made so far in favor of mitochondrial donor anonymity are convincing and mitochondrial donors should therefore be treated as open-identity donors under UK law. (shrink)

This paper focuses on voluntary consent in the context of living organ donation. Arguing against three dominant views, I claim that voluntariness must not be equated with willingness, that voluntariness does not require the exercise of relational moral agency, and that, in cases of third-party pressure, voluntariness critically depends on the role of the surgeon and the medical team, and not just on the pressure from other people. I therefore argue that an adequate account of voluntary consent cannot understand (...) voluntariness as a purely psychological concept, that it has to be consistent with people pursuing various different conceptions of the good and that it needs to make the interaction between the person giving consent and the person receiving consent central to its approach. (shrink)

There exists a serious shortage of organs for transplantation in China, more so than in most Western countries. Confucianism has been commonly used as the cultural and ethical reason to explain the reluctance of Chinese and other East-Asian people to donate organs for medical purposes. It is asserted that the Confucian emphasis on xiao (filial piety) requires individuals to ensure body intactness at death. However, based on the original texts of classical Confucianism and other primary materials, we refute this popular (...) view. We base our position on the related Confucian norms of filial piety and ren (humaneness, humanity or benevolence), the tension between differentiated love and universal love, and belief in the goodness of human nature. In light of this, we argue that the Confucian ethical outlook actually calls for organ donation at an individual level, and supports an opt-out (presumed consent) system at the level of social policy. Furthermore, because the popular view is based on a number of dominant but misleading modes of thinking about cultural differences, our revisionist account of Confucian moral duties regarding organ donation has implications for developing a more adequate transcultural and global bioethics. These will be discussed and expanded upon. (shrink)

In the Netherlands, consent from relatives is obligatory for post mortal donation. This study explored the perspectives of relatives regarding the request for consent for donation in cases without donor registration. A content analysis of narratives of 24 bereaved relatives of unregistered, eligible, brain-dead donors was performed. Relatives of unregistered, brain-dead patients usually refuse consent for donation, even if they harbour pro-donation attitudes themselves, or knew that the deceased favoured organ donation. Half of those who (...) refused consent for donation mentioned afterwards that it could have been an option. The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures. Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances. It is anticipated that the number of consenting families could be enlarged by examining the experience of decoupling and offering the possibility of consent for donation after circulatory death if families refuse consent for donation after brain-death. (shrink)

Arguments against directed altruistic living organ donation are too weak to justify a ban. Potential donors who want to specify the non-related person or group of persons to receive their donated kidney should be accepted. The arguments against, based on considerations of motivation, fairness and (non-)anonymity (e.g. those recently cited by an advisory report of the Dutch Health Council), are presented and discussed, as well as the Dutch Governments response. Whereas the Government argues that individuals have authority with regard (...) to the allocation of their organs, partial considerations have not been sufficiently explored. In addition, it is argued that partial relationships govern human life, are significant and should be valued highly. These relationships are at the core of accepted living kidney donation between relatives (family members, partners, friends). Respecting the particular act of living donation goes beyond respect for autonomy; it touches upon our personal and social identity. Donation, e.g. of a kidney, is not undertaken strictly for the benefit of the recipient, but also to meet the moral standards we wish to set for ourselves. This consideration, rooted in a view of moral identity, provides the basis for many forms of directed donation that are both partial and justified. If the importance of this is not recognized, social policies can be neither adequate nor effective. (shrink)

This article explores the options for establishing a legal framework for posthumous medical data donation (PMDD). This concept has not been discussed in legal scholarship to date at all. The paper is, therefore, a first legal study of PMDD, aiming to address the gap and shed light on the most significant legal issues that could affect this concept. The paper starts by looking at the protection of the deceased’s health records and medical data, finding that this protection in law (...) is more extensive than the general protection of the deceased’s personal data, or the protection of post-mortem privacy as a concept. The paper then investigates key issues around ownership and succession of personal data, including medical and health-related data, and how these could affect PMDD and its legal framework.The author then goes on to explore some parallels with organ donation to determine whether there are some lessons to be learned from this comparable regulatory framework. The paper concludes with the discussion around the need for a Code for posthumous medical data donation developed by the Digital Ethics Lab at the Oxford Internet Institute, and a more formal regime that would enable and facilitate this practice. Here, the author proposes key law reforms in the area of data protection and governance related to PMDD. These reforms would include amendments to the general data protection ideally, to ensure harmonisation and consistency across the EU, as well as between the general and sector-specific data protection laws and policies. These changes would contribute to legal and regulatory clarity and would help implement this important and valuable practice, which aims to facilitate research and advances in medical treatments and care. (shrink)

When successful solid organ transplantation was initiated almost 40 years ago, its current success rate was not anticipated. But continuous efforts were undertaken to overcome the two major obstacles to success: injury caused by interrupting nutrient supply to the organ and rejection of the implanted organ by normal host defense mechanisms. Solutions have resulted from technologic medical advances, but also from using organs from different sources. Each potential solution has raised ethical concerns and has variably resulted in societal acclaim, censure, (...) and apathy. Transplant surgery is now well accepted, and the list of transplant candidates has grown far quicker than the availability of organs. More than 30,000 patients were awaiting organs for transplantation at the end of March 1993. While most organs came from donors declared dead by brain criteria, the increasing shortage of donated organs has prompted a reexamination of prior restrictions of donor groups. Recently, organ procurement from donors with cardiac death has been reintroduced in the United States. This practice had been mostly abandoned by the U.S. and some, though not all, other countries. Transplantation has been more successful using organs procured from heart-beating, "brain dead" cadavers than organs from non-heart-beating cadavers. However, recent advances have led to success rates with organs from non-heart-beating donors that may portend large increases in organ donation and procurement from this source. (shrink)

This issue’s “Legal Briefing” column covers legal developments pertaining to organ donation and allocation. This topic has been the subject of recent articles in JCE. Organ donation and allocation have also recently been the subjects of significant public policy attention. In the past several months, legislatures and regulatory agencies across the United States and across the world have changed, or considered changing, the methods for procuring and distributing human organs for transplantation.Currently, in the U.S., more than 100,000 persons (...) are waiting for organ transplantation. In China, more than 1.5 million people are waiting. Given the chronic shortage of available organs (especially kidneys and livers) relative to demand, the primary focus of most legal developments has been on increasing the rate of donation. These and related developments are usefully divided into the following 12 topical categories: 1. Revised Uniform Anatomical Gift Act2. Presumed Consent and Opt-Out3. Mandated Choice4. Donation after Cardiac Death5. Payment and Compensation6. Donation by Prisoners7. Donor Registries8. Public Education9. Other Procurement Initiatives10. Lawsuits and Liability11. Trafficking and Tourism12. Allocation and Distribution. (shrink)

In their recent ‘The ethical case for non-directed postmortem sperm donation’, Hodson and Parker outline and defend the concept of voluntary non-directed postmortem sperm donation, the idea that men should be able to register their desire to donate their sperm after death for use by strangers since this would offer a potential means of increasing the quantity and heterogeneity of donor sperm. In this response, we raise some concerns about their proposal, focusing in particular on the fact that (...) current methodologies do not make for a reliable way of ensuring that sperm retrieved postmortem has a good chance of leading to conception, which is in turn likely to make potential recipients reluctant to use such sperm. These concerns add to the ethical doubts that attend aspects of the proposal, making the prospect of implementation of such a policy unlikely at best. (shrink)

This paper asks whether investigation into the ontology of the extended family can help us to think about and resolve questions concerning the nature of the family’s decision-making authority where organ donation is concerned. Here, “extended family” refers not to the multigenerational family all living at the same time, but to the family extended past its living boundaries to include the dead and the not yet living. How do non-existent members of the family figure into its ontology? Does an (...) answer to this question help to resolve questions about the distribution of authority within the extended family? (shrink)

Figuring out what pushes individuals to become organ donors has become the holy grail of social scientists interested in transplantations. In this paper I concentrate on solidarity as a determinant of organ donation and examine it through the history of organ donation in Israel. By following the history of transplantation policies since 1968 and examining them in relation to different types of solidarities, this paper leads to a nuanced understanding of the ties between solidarity and health policy. Attempts (...) to foster an all-encompassing consensus on the definition of brain death yielded the Transplantation and the Brain-Respiratory Death Laws of 2008. It was hoped that a wide “civic solidarity” would render Israel self-sufficient in its organ economy. However, the failure of the law led to the breakdown of civic solidarity in organ donation. As a result, initiatives such as the priority policy and non-directed living organ donations, developed out of a narrower conception of solidarity. Juxtaposing these initiatives sheds light on macro level processes for policy makers and suggests solidarity as a key bioethical concept to understand organ donation policies. (shrink)

The trend towards postponement of childbearing has seen increasing numbers of women turning towards oocyte banking for anticipated gamete exhaustion (AGE banking), which offers a realistic chance of achieving genetically connected offspring. However, there are concerns around the use of this technology, including social/ethical implications, low rate of utilisation and its cost-effectiveness. The same societal trends have also resulted in an increased demand and unmet need for donor oocytes, with many women choosing to travel overseas for treatment. This has its (...) own inherent social, medical, financial and psychological sequelae. We propose a possible pathway to address these dual realities. The donation of oocytes originally stored in the context of AGE banking, with appropriate compensatory mechanisms, would ameliorate AGE banking concerns, while simultaneously improving the supply of donor oocytes. This proposed arrangement will result in tangible benefits for prospective donors, recipients and society at large. (shrink)

Anna Smajdor’s proposal of whole body gestational donation (WBGD) states that female patients diagnosed as brain-dead should be considered for use as gestational donors. In this response, Smajdor’s proposal is rejected on four different accounts: (a) the debated acceptability of surrogacy despite women's autonomy, (b) the harm to dead women ́s interests, (c) the interests of the descendants, and (d) the symbolic value of the body and interests of relatives. The first part argues that WBGD rests on a particular (...) conception of the instrumentalization of bodies that cannot be circumvented simply by the patient’s consent and relinquished autonomy. The second part argues the importance of avoiding any harm to dead women’s interests. The third part identifies the importance of the interest of the foetus in the light of Procreative-Beneficence principle that Smajdor overlooks. And finally, the fourth part considers the symbolic value of the human body and the interest of relatives. The main goal of this commentary is not to show that WBGD cannot be implemented; rather, it is to show that there are not any good arguments in favour of doing so. (shrink)

This chapter introduces the background to organ donation and transplantation in mainland China. First, it briefly describes China’s current healthcare system and the development of organ transplantation. Then it introduces some important legislation and landmark policies regarding organ donation in recent years. Finally, it presents the organ donation operation system and its relevant features in mainland China.

We systematically examined the content of the websites of 46 agencies that buy and sell human eggs to understand how they market themselves to both donors and recipients. We found that these websites use marketing techniques that obscure the realities of egg donation, presenting egg donation as a mutually beneficial and fulfilling experience. Sites emphasize egg donors' emotional fulfillment and address recipients' anxieties by stressing the ability to find the perfect “fit” or “match”, suiting recipients’“preferences”/“desires”, and even designing/customizing (...) a child. Agencies attempt to create a sense of connection between the recipients and donors by reporting donors' personal characteristics — e.g., interests/hobbies, traits, mood/temperament, and self-reported childhood behavior/memories. Sites present donors as caring/generous and smart/successful/beautiful. These data, the first to examine several key aspects of egg donation agency websites, reveal critical aspects of how these companies communicate to prospective donors and recipients, raising several ethical concerns. Websites frame information in ways that may bias consumers, making emotional appeals that may distract from appropriate risk/benefit assessments and obscure the ethical challenges of egg donation. These data highlight needs for improved practices, adherence to guidelines, and consideration of enhanced guidelines or policy. (shrink)

In August 2000, Arthur Matas and his colleagues de scribed a protocol in which their institution began to accept as potential donors, individuals who came to the University of Minnesota hospital offering to donate a kidney to any patient on the waiting list. Matas and his colleagues refer to these donors as nondirected donors by which is meant that the donors are altruistic and that they give their organs to an unspecified pool of recipients with whom they have no emotional (...) relationship. This paper represents an ethical and policy critique of the nondirected donation protocol that was implemented at the University of Minnesota in August 1999. Specifically, I address the ethical questions: Whether altruistic living solid organ donations by strangers should be permitted? And if so, What are appropriate ethical guidelines for such donations? (shrink)

The family of a patient who is unconscious and respirator-dependent has made a decision to discontinue medical treatment. The patient had signed a donor card. The family wants to respect this decision, and agrees to non-heart-beating organ donation. Consequently, as the patient is weaned from the ventilator, he is prepped for organ explantation. Two minutes after the patient goes into cardiac arrest, he is declared dead and the transplant team arrives to begin organ procurement. At the time retrieval begins, (...) it is not certain that the patient's brain is dead or that cardiac function cannot be restored. Procurement follows uneventfully, and two transplantable kidneys are retrieved.Many people now consider such cases of non-heart-beating organ donation to be ethically permissible. However, widespread disagreement persists as to how such practices are to be justified and whether such practices are compatible with the Uniform Declaration of Death Act. In this paper, I argue that non-heart-beating organ donation can be ethically justified, that in the justified cases the patients are in fact dead, and that the early declarations of death required for such donation do comply with the UDDA. (shrink)