Résumé :
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[BDSP. Notice produite par INIST VCKNGR0x. Diffusion soumise à autorisation]. Context Understanding the consent process that organ procurement organizations (OPOs) use is crucial to improving the process and thereby reducing the number of individuals who die each year for want of an organ transplant. However, no data exist on OPOs'current consent practices. Objective To assess whose wishes OPOs follow when procuring solid organs from deceased individuals and whether advance directives and computerized registries might improve the consent process for solid organ procurement. Design, Setting, and Participants Telephone survey conducted from June to August 1999 of all 61 active OPOs. Main Outcome Measures Responses to the 49-question survey addressing consent practices in specific scenarios of deceased and next of kin wishes. Results Widespread divergence exists in OPOs'consent practices for cadaveric solid organ procurement. Regarding overall consent practices, 19 (31%) OPOs reported that they follow the deceased's wishes, 19 (31%) follow the next of kin's wishes, 13 (21%) procure organs if neither party objects, 8 (13%) procure organs if either party consents or neither objects, and 2 (3%) do not follow any of these 4 overall practices. These differences appear to be traceable to implicit ethical disagreements about whose wishes should be followed. A total of 29 (48%) OPOs reported having an official policy to address whether they follow the family's or deceased's wishes. (...)
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