The COVID-19 pandemic and organ donation and transplantation: ethical issues

Ban Ibrahim; Rosanne Dawson; Jennifer A. Chandler; Aviva Goldberg; David Hartell; Laura Hornby; Christy Simpson; Matthew John Weiss; Lindsay C. Wilson; T. Murray Wilson; Marie Chantal Fortin

doi:10.1186/s12910-021-00711-6

The COVID-19 pandemic and organ donation and transplantation: ethical issues

Ban Ibrahim, Rosanne Dawson, Jennifer A. Chandler, Aviva Goldberg, David Hartell, Laura Hornby, Christy Simpson, Matthew John Weiss, Lindsay C. Wilson, T. Murray Wilson, Marie Chantal Fortin

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

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.

Original language	English
Article number	142
Journal	BMC Medical Ethics
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12910-021-00711-6
Publication status	Published - Dec 2021

Bibliographical note

Funding Information:
Special thanks to T. Murray Wilson, our patient partner, whose experiential knowledge was openly shared during the development of this manuscript. The authors would also like to acknowledge the information services support they received from Robin Featherstone, MLIS, who designed and executed the search strategy used to inform this work.

Publisher Copyright:
© 2021, The Author(s).

ASJC Scopus Subject Areas

Issues, ethics and legal aspects
Health(social science)
Health Policy

PubMed: MeSH publication types

Journal Article
Review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12910-021-00711-6

Cite this

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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.",

author = "Ban Ibrahim and Rosanne Dawson and Chandler, {Jennifer A.} and Aviva Goldberg and David Hartell and Laura Hornby and Christy Simpson and Weiss, {Matthew John} and Wilson, {Lindsay C.} and Wilson, {T. Murray} and Fortin, {Marie Chantal}",

note = "Funding Information: Special thanks to T. Murray Wilson, our patient partner, whose experiential knowledge was openly shared during the development of this manuscript. The authors would also like to acknowledge the information services support they received from Robin Featherstone, MLIS, who designed and executed the search strategy used to inform this work. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

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AU - Dawson, Rosanne

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AU - Hornby, Laura

AU - Simpson, Christy

AU - Weiss, Matthew John

AU - Wilson, Lindsay C.

AU - Wilson, T. Murray

AU - Fortin, Marie Chantal

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N2 - 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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The COVID-19 pandemic and organ donation and transplantation: ethical issues

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

UN SDGs

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