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Pages 325-340

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From page 325... ... See also Preferential access to providing excellent emergency and donated organs resuscitative care, 157 to immunosuppressive medications providing professional education, 157� following transplantation, 95 158 Accreditation, 99 providing public education, 157 American Board for Transplant Actual donors, 25 Certification, 99 Ad Council, 188 Association of Organ Procurement Adjusted patient survival rate, 59 Organizations, 99 Advance directives, 23, 115 Centers for Medicare & Medicaid Advanced cardiac life-support efforts, Services, 99 criteria for termination of, 132 Joint Commission on Accreditation of Adverse biopsy results, 47, 50 Healthcare Organizations, 99 Adverse selection problem, 256�257 Organ Procurement and Transplantation Advisory Committee on Transplantation Network, 99 (ACOT) Read the entire page →
From page 326... ... See Acceptable appeals also Organ Donation Breakthrough Collaboratives; Organ Arguments for and against preferred-access approaches, 254�258 Transplantation Breakthrough the adverse selection problem, 256�257 Collaborative; Transplantation breakthrough collaboratives the information problem, 256 the unfair allocation problem, 257�258 British Medical Association, 222n Arizona, 186, 302 Buying and selling of organs, 239�242 advantages of the gift model, 240�241 Arkansas, 194 Asian Americans, 65, 196 claims of a liberty right to sell organs, Asian-Pacific Islanders, 195 241�242 Assessment of DCDD strategies in the United States, 141�143 C DCDD cases reported by OPOs, 143 deceased donors, 142 California Transplant Donor Network, organs recovered from DCDD donors in 109 the U.S., 143 Candidates on the transplant waiting list, Assessment of presumed-consent policies, growth in numbers of, 2, 16 212�224 Cannulation, 133, 310. autonomy-based arguments, 218�219 Cardiac arrests, 138, 286�287, 308 chances of a presumed-consent policy Cardiac life-support efforts, criteria for being adopted in the U.S., 222�224 termination of advanced, 132 cost-effectiveness, 216 CDC. Read the entire page →
From page 327... ... See Donation after circulatory Collaboratives at the Washington Hospital Center, 314 determination of death Committee's charge, 77�78 Dead bodies, commodification of, 233�234, 248�249 Commodification, 233�234, 248�249, 255 Community coalitions, 8�9, 199�200 Dead donor rule, 112 Community education, at the Washington Death, defining controlled, 129�131 Deceased organ donation, 22�25 Hospital Center, 154, 313�314 Community grassroots efforts, and minority incentives for, 229�262 populations, 195�198 process of organ donation, 24 religion and, 66�67 Community Oversight Committee, 137, 308 Community recognition, 229, 253 Deceased organ donors, 51, 142 Competence trustworthiness, 111�112 eligible, actual, and additional, 25 increase in number of, 105 Confidentiality, of donor registrations, 183 Conflicts of interest, 148�149 numbers of, 28 Confucianism, and deceased organ Decedents' wishes, respect for, 87 "Decision: Donation" packet, 194 donation, 67 Consensus Conference on the Asystolic Decision making Trauma Donor, 305 surrogate, 116 training in, 117�119 Consensus Conference on Trauma Victims and Organ Donation, 308, 314 Decisions to donate. See Facilitation of Consent. Read the entire page →
From page 328... ... See Facilities and equipment honoring donor consent, 182�183 Equitability of access to transplantation, 95 informed choice, 182 Donor hospitals, 6, 168 of the healthcare system, 94 Donor registries, 185�187 ESRD. See End-stage renal disease Ethical considerations, 28�29, 143�154 confidentiality of, 183 Donor Sabbath, 187 for expanded-criteria organ donation, 165 Donor service areas, 21 Ethical considerations in living donation, 12�13, 263�279 Donors. Read the entire page →
From page 329... ... INDEX 329 living donor follow-up, 276 assessment of DCDD strategies in the next steps, 274�276 United States, 141�143 other ethical considerations, 270�274 background and issues, 128�140 recommendation concerning facilitating common criteria for termination of living donor follow-up, 13, 277 advanced cardiac life-support efforts, recommendation concerning protecting 132 living donors, 13, 276�277 demonstration projects, 160 relationships between living donors and determination of death, 128�131 recipients, 265�266 economic considerations, 159�160 risk-benefit ratios, 268�270 encouraging and funding DCDD voluntary consent, 272�273 demonstration projects, 7, 168 Ethical issues pertinent to controlled DCDD expanded criteria for organ donation, myths and misperceptions about, 151 160�167 in the U.S., 145�150 general considerations, 131�133 Ethical issues pertinent to uncontrolled general ethical considerations, 143�154 DCDD, 150�154 implementing initiatives to increase rates informed consent, 153�154 of donation after circulatory myths and misperceptions about, 152 determination of death, 6�7, 168 resuscitation, 150�153 increasing research on organ quality and Ethnicity, 64�65. See also individual racial enhanced organ viability, 7, 168 and ethnic groups learning from past experience and donors, transplants, and waiting list by, international models, 136�140 50 next steps for DCDD, 156�160 family decision making, 65 prior reports and recommendations, individual decision making, 64�65 133�136 Europe, 138�140, 305 recommendation concerning maintaining European Resuscitation Council, 153 opportunities for organ donation, 6� Eurotransplant International Foundation, 27 7, 167�168 Evaluation, 158 reexamination of uncontrolled DCDD, of HRSA's extramural research grants, 154�156 303�304 Expected donations, 107, 111, 216 of proposed changes, criteria for, 90�91 Explicit consent, 28 Evolution of the request process, 106�110 Extramural research program, 299�304 formulation of the request, 107 clinical interventions, 301 requesters, 108�110 grant summary, 301�303 timing of requests, 107�108 media-based interventions, 301 Excellence, in emergency and resuscitative overview of HRSA's extramural research care, 157 program, 299�303 Expanded criteria for organ donation, 160� social and behavioral interventions, 300� 167 301 ethical considerations for expanded criteria organ donation, 165 next steps for expanded criteria, 166�167 F organ quality, 166 organ screening, 167 Facilitation of individual and family targeted research needs, 166�167 decisions to donate, 7�9, 39, 175� 203 UNOS definition of expanded-criteria kidney donors, 162 additional opportunities to document Expansion of the population of potential donation decisions, 187 donor cards, 184�185 donors, 6�7, 39, 127�173 actions needed to increase rates of donor registries, 9, 185�187, 200 DCDD, 157�159 driver's license registration, 184 Read the entire page →
From page 330... ... See also integrating organ donation and end-of- Professional societies life care, 114�117 enhancing training for, 6, 120 for public education, 198�199 Heart and heart-lung, 57�59 regarding mandated choice, 180�181 adjusted patient survival rate, 59 sustaining continuous quality Hemodialysis, 53 improvement, 113�114 Hinduism, and deceased organ donation, 67 Florida, 206 Hispanics, 64, 195, 197, 301 Florida v. Powell, 206�207 History Formulation of requests, 107 clarifying criteria for determination of death, 18�19 Read the entire page →
From page 331... ... in, Illicit markets for bodies, 233 307�308 Immunosuppressive therapies, 51 Interdisciplinary healthcare teams, 112, 117 Improvement aims for the healthcare Interdisciplinary training, 118 system, 93�94 Intermountain Donor Services, 69 effectiveness, 94 International models, learning from, 136�140 efficiency, 94 International perspective, 26�29, 285 equitability, 94 comparing rates of organ donation, 27 patient centeredness, 94 ethical, social, and cultural issues, 28�29 safety, 93 numbers of deceased donors, 28 timeliness, 94 Intestine, 61�62 Incentives for deceased donation, 10�12, IOM. See Institute of Medicine 39, 229�262, 285 Iowa, 194 financial incentives within a donation Ireland, 27 framework, 247�252, 286 Irreversibility, controversy over, 145�146 history and context, 230�231 Islam, and deceased organ donation, 66 nonfinancial incentives, 253�258 payments as a token of gratitude, 252� 253 J preferential access to donated organs, 253�258 Japan, 29 recommendation concerning financial JCAHO. Read the entire page →
From page 332... ... , 305, Omnibus Budget Reconciliation Act, 19 313�315 Organ Donation and Recovery MedSTAR, 305�309, 311, 314 Improvement Act, 19 MELD. See Model for End-Stage Liver Uniform Anatomical Gift Act, 19 Disease Uniform Determination of Death Act, 19 Mental capacity issues, 219 Libertarian argument, 241 Mentoring, 158 Liberty right, to sell organs, claims of, 241� Minnesota, 194 242 Minority populations, 2 Life Gift, 109 community grassroots efforts and, 195� Life Point, 109 198 Life-support efforts, 30, 148 Misperceptions. Read the entire page →
From page 333... ... , postoperative, 35 19�20, 153, 231, 239, 265, 273 Motor vehicles departments, 9, 184, 185 National Survey of Organ Donation, 181� MOTTEP 182, 215, 224, 244 See National Minority Organ and Tissue Native Americans, 195 Transplant Education Program NCQA. See National Committee for MRI. Read the entire page →
From page 334... ... See Organ procurement by donor type, 48 organizations by ethnicity, 50 Opportunities for action, 13�14, 281�282 living donors, 51�52 to document donation decisions, 187 OPTN/UNOS waiting list, 47 to ensure donations, 158 transplants, 49�50 to increase organ donations, 14, 282 waiting list, 49�50 Opt-in approach, 154, 214�215, 280 waiting list additions, 48 Opt-out approach, 28, 210, 214 Organ exchange organizations, 26 OPTN. See Organ Procurement and Organ markets Transplantation Network buying and selling in, 239�242 OPTN/UNOS policy, 136�137, 161�164 demand side of, 236�239 waiting list under, 47 problems with a free market in, 231�239 Organ brokers, 238 supply side of, 232�236 Organ Donation and Recovery Organ Procurement and Transplantation Improvement Act, 19, 270 Network (OPTN) Read the entire page →
From page 335... ... data set, 155 136 Precedent autonomy, 87 actions proposed by the National Preferential access to donated organs, 229, Conference on Donation after 253�258 Cardiac Death, 136�137 arguments against, 255�258 recommendations of Non-Heart-Beating arguments for, 254�255 Organ Transplantation, 134�135 Premortem interventions, 144 Process, of organ donation, 24, 236, 310� controversy over, 146�147 313 Preservation, 308. See also Cold Professional education, 157�158 preservation techniques; Kidney Professional societies, 6, 168 preservation Proposed changes, criteria for evaluating, 90�91 Read the entire page →
From page 336... ... See Donation rates; Expansion of the minority populations, 195�198 population of potential donors driver's license registration, 194 Reciprocity model, 12, 80�81, 254�255, 257 learning from other public health efforts, Recommendations, 119�120, 199�200, 189�192 226�227, 258�259, 276�277 media, 192�193 encouraging and funding DCDD next steps for public education, 198�199 demonstration projects, 7, 168 workplace efforts, 193 enhancing donor registries, 9, 200 youth, 194�195 enhancing training for healthcare Public health professionals, 6, 120 intervention strategies, 192 facilitating living donor follow-up, 13, learning from previous efforts, 189�192 277 Public opinion, 243�245 financial incentives, 12, 259 implementing initiatives to increase rates of donation after circulatory Q determination of death, 6�7, 168 increasing opportunities for people to Quality improvement record their decision to donate, 9, in health care, 102 200 sustaining continuous, 5, 113�114, 119 increasing public understanding of and and trust in the healthcare system, 69� support for organ donation, 8�9, 199 70 increasing research on innovative system Quantifying self-interest in organ donation, changes, 5, 120 293�297 increasing research on organ quality and assumptions, 294�296 enhanced organ viability, 7, 168 notation, 294 maintaining opportunities for organ risk of being placed on a waiting list, 297 donation, 7, 168 Question of whether payments would from Non-Heart-Beating Organ actually increase the organ supply, Transplantation, 134�135 242�245 preferential access, 12, 259 opinions of healthcare professionals, 245 protecting living donors, 13, 277 public opinion, 243�245 strengthening and integrating organ religious group opinion, 245 donation and quality end-of-life care Question of whether payments would be a practices, 6, 120 cost-effective policy, 245�247 sustaining continuous quality improvement initiatives, 5, 119 R systems approach, 4�6 terms, 4 Race. See Ethnicity; individual racial and Referrals, required, 101 ethnic groups Regional infrastructures, 159 Rapid Organ Recovery Program, 306, 313 Regulated commerce in organs, 99, 239�247 protocol for, 150 allowing buying and selling of organs, Rapid organ recovery program 239�242 transplantation services American Board for Transplant consent, 309�310 Certification, 99 design and methods for, 306�313 Association of Organ Procurement donor criteria, 306�307 Organizations, 99 Read the entire page →
From page 337... ... See Society of Critical Care regulation and accreditation, 99 Medicine Scientific Registry of Transplant Recipients (SRTR) , 31, 98, 299 T "Second Chance" Volunteers, 188 Self-interest, mutual, 221�222 Taoism, and deceased organ donation, 67 Self-interest in organ donation, quantifying, Targeted research needs, 166�167 293�297 Task Force on Organ Transplantation, 81, Selling. Read the entire page →
From page 338... ... efforts to increase organ donation, 31� Washington Hospital Center's rapid 33 organ recovery program, 305�315 funding the HRSA Division of Transplants, growth in numbers of, 2, 16 Transplantation, 32 Trends, 45�75 U.S. organ donation system organ donation statistics and trends, 45� context of the current, 95�101 62 required request and required referral, who donates -- individual and family 101 decisions, 62�71 systems of care -- an organizational Trustworthiness of a system, 3, 29, 79�84 perspective, 96�101 common stake in, 3 U.S. Read the entire page →
From page 339... ... See Washington Regional Transplant Consortium W Waiting lists. See Transplant waiting lists X Washington Hospital Center (WHC) Read the entire page →

From page 325...

... See also Preferential access to providing excellent emergency and donated organs resuscitative care, 157 to immunosuppressive medications providing professional education, 157� following transplantation, 95 158 Accreditation, 99 providing public education, 157 American Board for Transplant Actual donors, 25 Certification, 99 Ad Council, 188 Association of Organ Procurement Adjusted patient survival rate, 59 Organizations, 99 Advance directives, 23, 115 Centers for Medicare & Medicaid Advanced cardiac life-support efforts, Services, 99 criteria for termination of, 132 Joint Commission on Accreditation of Adverse biopsy results, 47, 50 Healthcare Organizations, 99 Adverse selection problem, 256�257 Organ Procurement and Transplantation Advisory Committee on Transplantation Network, 99 (ACOT)

Index Pages 325-340

Index
Pages 325-340