Ethical guidelines on organ transplantation open for consultation

The National Health and Medical Research Council (NHMRC) has released a draft document to inform decisions around the allocation of organs for transplantation, following a joint request from the Organ and Tissue Authority (OTA) and the Transplantation Society of Australia and New Zealand (TSANZ).

Australia has one of the highest organ transplantation success rates in the world, but around 1500 Australians are awaiting a transplant at any one time, a number of whom die before an organ becomes available. NHMRC CEO Professor Warwick Anderson said because the demand for organs outstrips their availability, it is important that decisions around organ transplant eligibility and priority are made in ethical and transparent ways.

“There are many ways to determine why one person should receive an organ over another, rather than just one ‘right’ way,” Professor Anderson noted.

“Once finalised, these guidelines will provide an overarching framework to help decision-makers with the tough calls in ethically robust ways.”

The guidelines will thus inform ethical practice in assessing the eligibility of an individual for transplantation, assessing the suitability of donor organs for transplantation and allocating organs from deceased donors. The guidelines say there must be no discrimination against potential recipients on medically irrelevant grounds; instead, factors to be considered should include:

• the potential benefit to the individual,
• the length of time awaiting a transplant,
• the urgency of the need for a transplant,
• the likelihood that the recipient will be able to adhere to the necessary post-operative treatment and health advice.

The guidelines also cover the importance of discussing transplantation with potential recipients well before an organ becomes available, consent and the need to respect choices of potential recipients to refuse the offer of an organ. They employ a series of case studies to tease out some of these ethical quandaries and show how the principles can be used to shape decisions.

The development of the guidelines is being overseen by the Australian Health Ethics Committee (AHEC). In their final form, they will inform the next version of the organ-specific clinical protocols for organ transplantation from deceased donors, which will be developed by the TSANZ.

Professor Anderson said public consultation is a crucial part of the process in implementing the guidelines. Submissions can be made here by 5 pm AEDT, 6 March.