Skip to main content
SpringerLink
Log in

Remapping the organ donation ethical climate: a care ethics consideration

  • Scientific Contribution
  • Published:
Medicine, Health Care and Philosophy Aims and scope Submit manuscript

Abstract

Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ shortage challenge, ranging from offering incentives to donors, addressing family refusals to donations and instituting presumed consent laws. Presumed consent as the favoured approach has not been universally effective in increasing actual transplants despite its appeal. Few considerations have been given to the broader ethical climate influencing the organ donation debate. This paper examines the ethical climate surrounding organ donation and identifies the challenges existing within such environments. It explores care ethics and its application to the donation system, demonstrating how it can influence the organ donation phases. The conclusion drawn from the analysis is that a caring ethical climate in the pre, during and post-transplant system respects donor autonomy, addresses family reluctance to agree to donation, facilitates the needs of the donee and creates an environment that promotes non-maleficence for all stakeholders.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abouna, G.M. 2008. Organ shortage crisis: Problems and possible solutions. Transplantation Proceedings 40 (1): 34–38.

    Article  Google Scholar 

  • Adanir, T., I. Erdogan, G. Hunerli, G. Unveren, H. Dasci, H.Y. Cetin, I. Ozsan, and U. Aydin. 2014. The effect of psychological support for the relatives of intensive care unit patients on cadaveric organ donation rate. Transplantation Proceedings 46: 3249–3252.

    Article  Google Scholar 

  • Albertsen, Andreas. 2018. Deemed consent: Assessing the new opt-out approach to organ procurement in Wales. Journal of Medical Ethics 44: 314–318.

    Article  Google Scholar 

  • Anker, Ashley E., Jessica E. Akey, and Thomas Hugh Feeley. 2013. Providing social support in a persuasive context: Forms of social support reported by organ procurement coordinators. Health Communication 28 (8): 835–845.

    Article  Google Scholar 

  • Arnaud, Anke, and Marshall Schminke. 2012. The ethical climate and context of organizations: A comprehensive model organization. Science 23 (6): 1767–1780.

    Google Scholar 

  • Bartholdson, Cecilia, Margareta af Sandeberg, Kim Lutzén, Klas Blomgren, and Pernilla Pergert. 2016. Healthcare professionals’ perceptions of the ethical climate in paediatric cancer care. Nursing Ethics 23 (8): 877–888.

    Article  Google Scholar 

  • Berntzen, Helene, and Ida Torunn Bjørk. 2014. Experiences of donor families after consenting to organ donation: A qualitative study. Intensive & Critical Care Nursing 30: 266–274.

    Article  Google Scholar 

  • Bilgel, Fırat. 2013. The effectiveness of transplant legislation, procedures and management: Cross-country evidence. Health Policy 110: 229–242.

    Article  Google Scholar 

  • Blok, G.A., J. van Dalen, K.J. Jager, M. Ryan, R.M. Wijnen, C. Wight, J.M. Morton, M. Morley, and B. Cohen. 1999. The European Donor Hospital Education Programme (EDHEP): Addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation. Transplant International 12 (3): 161–167.

    Article  Google Scholar 

  • Bocci, M.G., C. D’Alò, R. Barelli, S. Inguscio, A. Prestifilippo, S. Di Paolo, S. Lochi, M. Fanfarillo, D.L. Grieco, R. Maviglia, A. Caricato, G. Mistraletti, S. Pulitanò, M. Antonelli, and C. Sandroni. 2016. Taking care of relationships in the intensive care unit: Positive impact on family consent for organ donation. Transplantation Proceedings 48: 3245–3250.

    Article  Google Scholar 

  • Burks, Derek J., and Amy M. Kobus. 2012. The legacy of altruism in health care: The promotion of empathy, prosociality and humanism. Medical Education 46: 317–325.

    Article  Google Scholar 

  • Caplan, Arthur. 2016. Finding a solution to the organ shortage. CMAJ 188 (16): 1182–1183.

    Article  Google Scholar 

  • Chouhan, P., and H. Draper. 2003. Modified mandated choice for organ procurement. Journal of Medical Ethics 29 (3): 157–162.

    Article  Google Scholar 

  • Cloconi, Constantina, Evridiki Papastavrou, and Andreas Charalambous. 2018. Cancer nurses’ perceptions of ethical climate in Greece and Cyprus. Nursing Ethics 26: 1–17. https://doi.org/10.1177/0969733018769358.

    Article  Google Scholar 

  • Coppen, Remco, Roland D. Friele, Jouke van der Zee, and Sjef K. Gevers. 2010. The potential of legislation on organ donation to increase the supply of donor organs. Health Policy 98: 164–170.

    Article  Google Scholar 

  • Cronin, Antonia J., and John Harris. 2010. Authorisation, altruism and compulsion in the organ donation debate. Journal of Medical Ethics 36 (10): 627–631.

    Article  Google Scholar 

  • de Casterlé, Bernadette Dierckx, Sofie T.L. Verhaeghe, Marijke C. Kars, Annemarie Coolbrandt, Marleen Stevens, Maaike Stubbe, Nathalie Deweirdt, Jeroen Vincke, and Maria Grypdonck. 2011. Researching lived experience in health care: Significance for care ethics. Nursing Ethics 18 (2): 232–242.

    Article  Google Scholar 

  • de Groot, Jack, Maria van Hoek, Cornelia Hoedemaekers, Andries Hoitsma, Wim Smeets, Myrra Vernooij-Dassen, and Evert van Leeuwen. 2015. Decision making on organ donation: The dilemmas of relatives of potential brain dead donors. BMC Medical Ethics 16: 64.

    Article  Google Scholar 

  • de Lago, María. 2011. Organ donation rates in Spain for British residents are higher than in UK. BMJ 343: d4948. https://doi.org/10.1136/bmj.d4948.

    Article  Google Scholar 

  • English, V., and A. Sommerville. 2003. Presumed consent for transplantation: A dead issue after Alder Hey? Journal of Medical Ethics 29: 147–152.

    Article  Google Scholar 

  • Farsides, Bobbie. 2011. Negotiating change: Organ donation in the United Kingdom. In Organ shortage: Ethics, law and pragmatism, ed. Anne-Maree Farrell, David Price, and Muireann Quigley, 215–226. Cambridge, UK: Cambridge University Press.

    Chapter  Google Scholar 

  • Farsides, Bobbie. 2012. Respecting wishes and avoiding conflict: Understanding the ethical basis for organ donation and retrieval. British Journal of Anaesthesia 108 (S1): i73–i79.

    Article  Google Scholar 

  • Fernandes, Marli Elisa Nascimento, Zélia Zilda Lourenço de Camargo Bittencourt, and Ilka de Fátima Santana Ferreira Boin. 2015. Experiencing organ donation: Feelings of relatives after consent. Revista latino-americana de enfermagem 23 (5): 895–901.

    Article  Google Scholar 

  • Forsberg, Anna, Anne Flodén, Annette Lennerling, Veronika Karlsson, Madeleine Nilssong, and Isabell Fridhe. 2014. The core of after death care in relation to organ donation—A grounded theory study. Intensive & Critical Care Nursing 30: 275–282.

    Article  Google Scholar 

  • Gilligan, Carol. 1982, 1993. In a different voice: Psychological theory and women’s development. Cambridge, MA: Harvard University Press.

  • Gilligan, Conor, Robert William, Sanson Fisher, and Heidi Turon. 2012. The organ donation conundrum. Progress in Transplantation 22: 312–316.

    Article  Google Scholar 

  • Guttman, Nurit, Gil Siegal, Naama Appel, and Gitit Bar-On. 2016. Should altruism, solidarity, or reciprocity be used as prosocial appeals? Contrasting conceptions of members of the general public and medical professionals regarding promoting organ donation. Journal of Communication 66: 909–936.

    Article  Google Scholar 

  • Haddow, Gillian. 2005. Death, embodiment and organ transplantation: The phenomenology of death, embodiment and organ transplantation. Sociology of Health & Illness 27 (1): 92–113.

    Article  Google Scholar 

  • Haesen, Sophie, and David Shaw. 2018. Directing citizens to create advance directives. Swiss Medical Weekly 148: w124628. https://doi.org/10.4414/smw.2018.14628.

    Article  Google Scholar 

  • Hawkes, Nigel. 2018. “Muddy waters” surround evidence for opt-out system of organ donation, says surgeon. BMJ 360: k744. https://doi.org/10.1136/bmj.k744.

    Article  Google Scholar 

  • Held, Virginia. 2006. The ethics of care: Personal, political and global. New York: OUP.

    Google Scholar 

  • Henderson, Macey L., and Jed Adam Gross. 2017. Living organ donation and informed consent in the United States: Strategies to improve the process. The Journal of Law, Medicine & Ethics 45: 66–76.

    Article  Google Scholar 

  • Hobday, Mike. 2015. Time to debate an opt-out system for organ donation in England as well as the rest of the UK. BMJ 351: h6140. https://doi.org/10.1136/bmj.h6140.

    Article  Google Scholar 

  • Holmes, Cheryl L., Harry Miller, and Glenn Regehr. 2017. (Almost) forgetting to care: An unanticipated source of empathy loss in clerkship. Medical Education 51: 732–739.

    Article  Google Scholar 

  • Hulme, W., J. Allen, A.R. Manara, P.G. Murphy, D. Gardiner, and E. Poppitt. 2016. Factors influencing the family consent rate for organ donation in the UK. Anaesthesia 71: 1053–1063.

    Article  Google Scholar 

  • Isch, D.J. 2007. In defense of the reverence of all life: Heideggerean dissolution of the ethical challenges of organ donation after circulatory determination of death. Medicine, Health Care and Philosophy 10: 441–459.

    Article  Google Scholar 

  • Jacoby, Liva, Vicki Crosier, and Henry Pohl. 2006. Providing support to families considering the option of organ donation: An innovative training method. Progress in Transplantation 16: 247–252.

    Article  Google Scholar 

  • Kesselring, A., M. Kainz, and Alexander Kiss. 2007. Traumatic memories of relatives regarding brain death, request for organ donation and interactions with professionals in the ICU. American Journal of Transplantation 7: 211–217.

    Article  Google Scholar 

  • Kim, H.S., Y.S. Yoo, and O.H. Cho. 2014. Cho satisfaction with the organ donation process of brain dead donors’ families in Korea. Transplantation Proceedings 46: 3253–3256.

    Article  Google Scholar 

  • Kjell, AudOrøy, Erik Strømskag, and Eva Gjengedal. 2015. Do we treat individuals as patients or as potential donors? A phenomenological study of healthcare professionals’ experiences. Nursing Ethics 22 (2): 163–175.

    Article  Google Scholar 

  • Koskenvuori, Janika, Olivia Numminen, and Riitta Suhonen. 2017. Ethical climate in nursing environment: A scoping review. Nursing Ethics 26: 327–345.

    Article  Google Scholar 

  • Kuhse, Helga. 1997. Caring: Nurses, women and ethics. Oxford, UK: Blackwell Publishers.

    Google Scholar 

  • Kuntz, J.R.C., J.R. Kuntz, Detelin Elenkov, and Anna Nabirukhina. 2013. Characterizing ethical cases: A cross-cultural investigation of individual differences, organisational climate, and leadership on ethical decision-making. Journal of Business Ethics 113: 317–331.

    Article  Google Scholar 

  • Lamiani, Giulia, Lidia Borghi, and Piergiorgio Argentero. 2017. When healthcare professionals cannot do the right thing: A systematic review of moral distress and its correlates. Journal of Health Psychology 22 (1): 51–67.

    Article  Google Scholar 

  • Levitt, Mairi. 2015. Could the organ shortage ever be met? Life Sciences, Society and Policy 11: 6. https://doi.org/10.1186/s40504-015-0023-1.

    Article  Google Scholar 

  • Lin, Yen-Ko, Wei-Che Lee, Liang-Chi Kuo, Yuan-Chia Cheng, Chia-Ju Lin, Hsing-Lin Lin, Chao-Wen Chen, and Tsung-Ying Lin. 2013. Building an ethical environment improves patient privacy and satisfaction in the crowded emergency department: A quasi-experimental study. BMC Medical Ethics 14: 8. https://doi.org/10.1186/1472-6939-14-8.

    Article  Google Scholar 

  • Manyalich, Martí, Carlos A. Mestres, Chloe Ballesté, Gloria Páez, Ricard Valero, and María Paula Gómez. 2011. Organ procurement: Spanish transplant procurement management. Asian Cardiovascular & Thoracic Annals 19 (3/4): 268–278.

    Article  Google Scholar 

  • Manzari, Zahra Sadat, Eesa Mohammadi, Abbas Heydari, Hamid Reza Aghamohammadian Sharbaf, Mohammad Jafar Modabber Azizi, and Ebrahim Khaleghi. 2012. Exploring families’ experiences of an organ donation request after brain death. Nursing Ethics 19 (5): 654–665.

    Article  Google Scholar 

  • Martin, Kelly D., and John B. Cullen. 2006. Continuities and extensions of ethical climate theory: A meta-analytic review. Journal of Business Ethics 69: 175–194.

    Article  Google Scholar 

  • Martinsen, Elin. 2011. Harm in the absence of care: Towards a medical ethics that cares. Nursing Ethics 18 (2): 174–183.

    Article  Google Scholar 

  • Matesanz, R. 2003. Factors influencing the adaptation of the Spanish Model of organ donation. Transplant International 16: 736–741.

    Article  Google Scholar 

  • Matesanz, Rafael, Beatriz Domínguez-Gil, Elisabeth Coll, Gloria de la Rosa, and Rosario Marazuela. 2011. Spanish experience as a leading country: What kind of measures were taken? Transplant International 24: 333–343.

    Article  Google Scholar 

  • Matesanz, R., B. Domınguez-Gil, E. Coll, B. Mahıllo, and R. Marazuela. 2017. How Spain reached 40 deceased organ donors per million population. American Journal of Transplantation 17: 1447–1454.

    Article  Google Scholar 

  • McCartney, Margaret. 2017. When organ donation isn’t a donation. BMJ 356: j1028. https://doi.org/10.1136/bmj.j1028.

    Article  Google Scholar 

  • M’hamdi, Hafez Ismaili, Medard Hilhorst, Eric A.P. Steegers, and Inez de Beaufort. 2017. Nudge me, help my baby: On other-regarding nudges. Journal of Medical Ethics 43 (10): 702–706.

    Article  Google Scholar 

  • Morgan, Susan E., and Jenny K. Miller. 2002. Beyond the organ donor card: The effect of knowledge, attitudes, and values on willingness to communicate about organ donation to family members. Health Communication 14 (1): 121–134.

    Article  Google Scholar 

  • Morgan, Susan E., Tyler R. Harrison, Walid A. Afifi, Shawn D. Long, and Michael T. Stephenson. 2008. In their own words: The reasons why people will (not) sign an organ donor card. Health Communication 23 (1): 23–33.

    Article  Google Scholar 

  • Murphy, P.G., and M. Smith. 2012. Towards a framework for organ donation in the UK. British Journal of Anaesthesia 108 (S1): i56–i67.

    Article  Google Scholar 

  • NHSBT. 2014a. A strategy for delivering a revolution in public behaviour in relation to organ donation 23red for NHS Blood & Transplant March 2014.

  • NHSBT. 2014b. Taking organ transplantation to 2020: A detailed strategy NHSBT.

  • Navarro-Michel, Monica. 2011. Institutional organization and transplanting the ‘Spanish Model’. In Organ shortage: Ethics, law and pragmatism, ed. Anne-Maree Farrell, David Price, and Muireann Quigley, 151–170. Cambridge, UK: Cambridge University Press.

    Chapter  Google Scholar 

  • Noddings, Nel. 1984. Caring: A feminine approach to ethics & moral education. Berkeley, LA: University of California Press.

    Google Scholar 

  • Noyes, J., L. McLaughlin, K. Morgan, et al. 2019. Short-term impact of introducing a soft opt-out organ donation system in Wales: Before and after study. British Medical Journal Open 9: e025159. https://doi.org/10.1136/bmjopen-2018-025159.

    Article  Google Scholar 

  • Nuffield Council on Bioethics. http://nuffieldbioethics.org/news/2018/nuffield-council-bioethics-raises-concern-lack-evidence-support. Accessed 23 Feb 2018; http://nuffieldbioethics.org/news/2018/response-governments-plans-optout-system-organ-donation. Accessed 6 Aug 2018.

  • Numminen, Olivia, Helena Leino-Kilpi, Hannu Isoaho, and Riitta Meretoja. 2015. Ethical climate and nurse competence—Newly graduated nurses’ perceptions. Nursing Ethics 22 (8): 845–859.

    Article  Google Scholar 

  • Parsons, Jordan Alexander. 2018. Welsh 2013 deemed consent legislation falls short of expectations. Health Policy. https://doi.org/10.1016/j.healthpol.2018.07.019.

    Article  Google Scholar 

  • Pettersen, Tove. 2011. The ethics of care: Normative structures and empirical implications. Health Care Analysis 19: 51–64.

    Article  Google Scholar 

  • Pillay, Prinitha. 2015. Resuscitating an ethical climate in the health system: The role of healthcare workers. South African Medical Journal 105 (4): 277–278.

    Article  Google Scholar 

  • Price, David. 2011. Promoting organ donation: Challenges for the future. In Organ shortage: Ethics, law and pragmatism, ed. Anne-Maree Farrell, David Price, and Muireann Quigley, 245–268. Cambridge, UK: Cambridge University Press.

    Chapter  Google Scholar 

  • Quinn, Gwendolyn P., Devin Murphy, Christie Pratt, Teresita Mun˜oz-Antonia, Lucy Guerra, Matthew B. Schabath, Marino E. Leon, and Eric Haura. 2013. Altruism in terminal cancer patients and rapid tissue donation program: Does the theory apply? Medicine, Health Care and Philosophy 16: 857–864.

    Article  Google Scholar 

  • Ríos, Antonio, Laura Martínez-Alarcoń, Jose Sánchez, Nick Jarvis, Jose A. Garcia, Jose M. Rodríguez, Pascual Parrilla, and Pablo Ramírez. 2008. The quest for favourable subgroups to encourage living kidney donation in Spain. An attitudinal study among British and Irish citizens resident in south eastern Spain. Nephrology, Dialysis, Transplantation 23: 1720–1727.

    Article  Google Scholar 

  • Ríos, Antonio, Ana I. Lopez-Navas, Juan C. Navalon, Laura Martınez-Alarcon, Marco A. Ayala-Garcıa, Marıa J. Sebastian-Ruiz, Francisco Moya-Faz, Gregorio Garrido, Pablo Ramirez, and Pascual Parrilla. 2015. The Latin American population in Spain and organ donation. Attitude toward deceased organ donation and organ donation rates. Transplant International 28: 437–447.

    Article  Google Scholar 

  • Ríos, A., A.I. López-Navas, Á. Sánchez, M.A. Ayala, G. Garridof, M.J. Sebastián, L. Martínez-Alarco, G. Ramis, A.M. Hernández, P. Ramírez, and P. Parrilla. 2018. Factors that affect the attitudes of the Bolivian population in Spain with regard to organ donation for transplant. Transplantation Proceedings 50: 319–322.

    Article  Google Scholar 

  • Ríos, A., P. Cascales, L. Martínez, J. Sanchez, N. Jarvis, P. Parrilla, and P. Ramírez. 2007. Emigration from the British Isles to Southeastern Spain: A study of attitudes toward organ donation. American Journal of Transplantation 7: 2020–2030.

    Article  Google Scholar 

  • Ríos, A., L. Martínez-Alarcón, J. Sánchez, A. López-Navas, G. Ramis, P. Ramírez, and P. Parrilla. 2010. Welsh citizens in South-Eastern Spain: A study of attitude toward organ donation. Transplantation Proceedings 42: 3116–3119.

    Article  Google Scholar 

  • Rodríguez-Arias, David, Linda Wright, and David Paredes. 2010. Success factors and ethical challenges of the Spanish Model of organ donation. Lancet 376: 1109–1112.

    Article  Google Scholar 

  • Rogers, W.A., S. de Lacey, and J.C. Avery. 2011. Donation after cardiac death: Community views about ‘decent’ intervals. American Journal of Transplantation 11: 583–590.

    Article  Google Scholar 

  • Roybal, Deb. 2017. What we say, what they hear: Perceptions of organizational values and ethical climate in the health care setting. Nurse Leader 15: 251–257.

    Article  Google Scholar 

  • Sadala, Maria Lúcia, Marisa Lorenc Araujo, Márcia Cercal, and Arthur Schelp. 2006. Caring for organ donors: The intensive care unit physicians’ view. Heart and Lung 35 (3): 190–197.

    Article  Google Scholar 

  • Sadler, Blair L., and Nicole Robins Sadler. 2015. Having conversations about organ donation. The Hastings Center Report 45 (5): 9. https://doi.org/10.1002/hast.485.

    Article  Google Scholar 

  • Sander-Staudt, Maureen. Care ethics (Internet encyclopedia of philosophy). https://www.iep.utm.edu/care-eth/. Accessed 10 Apr 2019.

  • Sanner, Margareta A. 2003. Transplant recipients’ conceptions of three key phenomena in transplantation: The organ donation, the organ donor, and the organ transplant. Clinical Transplantation 17: 391–400.

    Article  Google Scholar 

  • Saul, P. 2012. Why isn’t organ donation part of advance care planning? BMJ Supportive & Palliative Care 2: 173.

    Article  Google Scholar 

  • Saunders, John. 2010. Bodies, organs and saving lives: The alternatives. Clinical Medicine 10 (1): 26–29.

    Article  Google Scholar 

  • Sharif, A., and G. Moorlock. 2018. Influencing relatives to respect donor autonomy: Should we nudge families to consent to organ donation? Bioethics 32 (3): 155–163.

    Article  Google Scholar 

  • Shepherd, Lee, Ronan E. O’Carroll, and Eamonn Ferguson. 2014. An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: A panel study. BMC Medicine 12: 131.

    Article  Google Scholar 

  • Silén, Marit, Mia Svantesson, Sofia Kjellström, Birgitta Sidenvall, and Lennart Christensson. 2011. Moral distress and ethical climate in a Swedish nursing context: Perceptions and instrument usability. Journal of Clinical Nursing 20: 3483–3493.

    Article  Google Scholar 

  • Slote, Michael. 2007. The ethics of care and empathy. London: Routledge.

    Book  Google Scholar 

  • Smajdor, Anna, Andrea Stöckl, and Charlotte Salter. 2011. The limits of empathy: Problems in medical education and practice. Journal of Medical Ethics 37: 380–383. https://doi.org/10.1136/jme.2010.039628.

    Article  Google Scholar 

  • Sque, Magi, and Tracy Long-Sutehall. 2011. Bereavement, decision-making and the family in organ donation. In Organ shortage: Ethics, law and pragmatism, ed. Anne-Maree Farrell, David Price, and Muireann Quigley, 67–85. Cambridge, UK: Cambridge University Press.

    Chapter  Google Scholar 

  • Sque, Magi, Wendy Walker, and Tracy Long-Sutehall. 2014. Research with bereaved families: A framework for ethical decision-making. Nursing Ethics 21 (8): 946–955.

    Article  Google Scholar 

  • Sque, Magi, Wendy Walker, Tracy Long-Sutehall, Myfanwy Morgan, Gurch Randhawa, and Amanda Rodney. 2018. Bereaved donor families’ experiences of organ and tissue donation, and perceived influences on their decision making. Journal of Critical Care 45: 82–89.

    Article  Google Scholar 

  • Taylor, Lauren J., Anne Buffington, Joseph R. Scalea, Norman Fost, Kenneth D. Croes, Joshua D. Mezrich, and Margaret L. Schwarze. 2018. Harms of unsuccessful donation after circulatory death: An exploratory study. American Journal of Transplantation 18: 402–409.

    Article  Google Scholar 

  • Tenbrunsel, Ann E., Kristin Smith-Crowe, and Elizabeth E. Umphress. 2003. Building houses on rocks: The role of the ethical infrastructure in organizations. Social Justice Research 16 (3): 285–307.

    Article  Google Scholar 

  • The European Donor Hospital Education Programme (EDHEP): Addressing the training needs of doctors and nurses who break bad news, care for the bereaved, and request donation.

  • The Global Observatory on Donation and Transplantation WHO-ONT (Global Observatory on Donation and Transplantation, 2016) http://www.transplant-observatory.org/. Accessed 10 Apr 2019.

  • Tong, Rosemarie and Williams, Nancy, “Feminist Ethics”, The Stanford Encyclopedia of philosophy (Winter 2018 Edition), Edward N. Zalta (ed.). https://plato.stanford.edu/archives/win2018/entries/feminism-ethics/. Accessed 10 Apr 2019.

  • Tronto, Joan C. 1993. Moral Boundaries: A political argument for an ethic of care. New York: Routledge.

    Google Scholar 

  • van Dalen, Hendrik P., and Kène Henkens. 2014. Comparing the effects of defaults in organ donation systems. Social Science and Medicine 106: 137–142.

    Article  Google Scholar 

  • Van den Bulcke, B., R. Piers, H.I. Jensen, et al. 2018. Ethical decision-making climate in the ICU: Theoretical framework and validation of a self-assessment tool. BMJ Quality & Safety. https://doi.org/10.1136/bmjqs-2017-007390.

    Article  Google Scholar 

  • Verheijde, Joseph L., Mohamed Y. Rady, Joan L. McGregor, and Catherine Friederich-Murray. 2009. Enforcement of presumed-consent policy and willingness to donate organs as identified in the European Union Survey: The role of legislation in reinforcing ideology in pluralistic societies. Health Policy 90: 26–31.

    Article  Google Scholar 

  • Victor, Bart, and John B. Cullen. 1988. The organizational bases of ethical work climates. Administrative Science Quarterly 33 (1): 101–125.

    Article  Google Scholar 

  • Waldrop, Deborah P., Judith A. Tamburlin, Sanna J. Thompson, and Mark Simon. 2004. Life and death decisions: Using school-based health education to facilitate family discussion about organ and tissue donation. Death Studies 28 (7): 643–657.

    Article  Google Scholar 

  • Walker, Wendy, and Magi Sque. 2016. Balancing hope and despair at the end of life: The contribution of organ and tissue donation. Journal of Critical Care 32: 73–78.

    Article  Google Scholar 

  • Walker, Wendy, Andrew Broderick, and Magi Sque. 2013. Factors influencing bereaved families’ decisions about organ donation: An integrative literature review. Western Journal of Nursing Research 35 (10): 1339–1359.

    Article  Google Scholar 

  • Wispelaere, Jurgen De, and Lindsay Stirton. 2010. Advance commitment: An alternative approach to the family veto problem in organ procurement. Journal of Medical Ethics 36: 180–183.

    Article  Google Scholar 

  • Wu, Xiaoliang, and Qiang Fang. 2013. Financial compensation for deceased organ donation in China. Journal of Medical Ethics 39 (6): 378–379.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Huddersfield, Huddersfield, UK

    Hui Yun Chan

Authors
  1. Hui Yun Chan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hui Yun Chan.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chan, H.Y. Remapping the organ donation ethical climate: a care ethics consideration. Med Health Care and Philos 23, 295–308 (2020). https://doi.org/10.1007/s11019-019-09934-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11019-019-09934-2

Keywords

Search

Navigation