Public preferences for the allocation of donor organs for transplantation

Focus group discussions

Bibliographic Data

ID19506002
AuthorsCarina Oedingen (0000-0002-5070-284X, Institute for Epidemiology Social Medicine and Health Systems Research Hannover Medical School Hannover Germany, corresponding author), Tim Bartling (0000-0002-2867-8396, Institute for Epidemiology Social Medicine and Health Systems Research Hannover Medical School Hannover Germany), Marie-Luise Dierks (0000-0002-0225-6048, Medizinische Hochschule Hannover), Marie‐Luise Dierks (Institute for Epidemiology Social Medicine and Health Systems Research Hannover Medical School Hannover Germany), Axel C Mühlbacher (Institute of Health Economics and Health Care Management Hochschule Neubrandenburg Neubrandenburg Germany), Axel Mühlbacher (0000-0003-4402-9211, Duke University), Harald Schrem (0000-0002-5527-7555, Department of General, Visceral and Transplant Surgery Medical University Graz Graz Austria), Christian Krauth (0000-0003-0836-9737, Institute for Epidemiology Social Medicine and Health Systems Research Hannover Medical School Hannover Germany)
Year2020
Volume23
Issue3
Pages670-680
Publication date2020-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Expectations (JOURNAL)
Journal identifiersISSN: 1369-6513 • E-ISSN: 1369-7625
PublisherWiley (PUBLISHER • GB)
DOI10.1111/hex.13047
PMID32189453
OpenAlexW3011929133
LanguageEN
Citations received4
References cited30

BACKGROUND: Deceased donor organs are scarce resources because of a large supply-and-demand mismatch. This scarcity leads to an ethical dilemma, forcing priority-setting of how these organs should be allocated and whom to leave behind. OBJECTIVE: To explore public preferences for the allocation of donor organs in regard to ethical aspects of distributive justice. METHODS: Focus groups were facilitated between November and December 2018 at Hannover Medical School. Participants were recruited locally. Transcripts were assessed with content analysis using the deductive framework method. All identified and discussed criteria were grouped according to the principles of distributive justice and reported following the COREQ statement. RESULTS: Six focus groups with 31 participants were conducted. Overall, no group made a final decision of how to allocate donor organ; however, we observed that not only a single criterion/principle but rather a combination of criteria/principles is relevant. Therefore, the public wants to allocate organs to save as many lives as possible by both maximizing success for and also giving priority to urgent patients considering the best compatibility. Age, waiting time, reciprocity and healthy lifestyles should be used as additional criteria, while sex, financial status and family responsibility should not, based on aspects of equality. CONCLUSIONS: All participants recognized the dilemma that prioritizing one patient might cause another one to die. They discussed mainly the unclear trade-offs between effectiveness/benefit and medical urgency and did not establish an agreement about their importance. The results suggest a need of preference studies to elucidate public preferences in organ allocation

Actuarial science · Business · Dilemma · Distributive justice · Economic Justice · Economics · Focus group · Health care rationing · Microeconomics · Organ donation · Political science · Scarcity · Law · Medicine · Organ Donation and Transplantation · Organ Transplantation Techniques and Outcomes · Psychology · Renal Transplantation Outcomes and Treatments · Social Psychology · Marketing · Surgery · Transplantation