Ethical concept of clinical transplant coordinators in living donor liver transplantation

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  • Shuda Akihiro
    Analytical Health Science, Graduated School of Health Care Sciences, Tokyo Medical and Dental University:Department of Nursing Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University

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  • 生体肝移植に関わるクリニカル移植コーディネーターの倫理的概念
  • セイタイ カン イショク ニ カカワル クリニカル イショク コーディネーター ノ リンリテキ ガイネン

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Abstract

The purposes of this study were (1) to elucidate ethical problems that clinical transplant coordinators (CTCs) face routinely and (2) to explore and delineate ethical concepts for nursing practice developed from their "ideals" in such situations. An interview was conducted in 11 CTCs from 7 institutions. Ethical problems were elucidated which were classified into six categories based on 84 episodes: "no guarantee of donor's autonomy," "no preservation of dignity," "inability to balance beneficence and nonmaleficence," "variability of responsibilities," "inability to fulfill their responsibilities," and "incompatibility with own values." Further analysis was performed for 138 "ideals" of CTCs in such situations. As a result, eight ethical concepts were revealed: "respect for the intention," "communication of facts as they are," "support of decisions based on the values of the donor," "respect as a human being," "fulfillment of responsibilities toward the subjects," "demonstration of professional expertise by cooperating with professionals in other fields," "emphasis on the process for impartial and fair progression," and "sympathy and understanding toward the subject."

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