https://doi.org/10.4081/mem.2015.6

La consulenza etica nella pratica clinica dei trapianti

V. 64 N. 6 (2015)
Pubblicato: agosto 1, 2016
Consulenza etica etica, donazione d’organo, trapianto d’organo, assegnazione degli organi / Ethics consultation, organ donation, organ transplantion, organ allocation
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Autori

Giuseppe Piccolo
giuseppe.piccolo@policlinico.mi.it
Medico, Direttore ff UOC Coordinamento Trapianti - Centro di Riferimento per i Trapianti della Regione Lombardia-Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico- Milano, Italy.
Nella medicina dei trapianti l'etica del rapporto medico-paziente si estende in modo peculiare a più soggetti "deboli": i soggetti in lista d'attesa, i familiari dei donatori deceduti, i donatori viventi. L'applicazione coerente e sistematica dei principi etici dei trapianti rappresenta forse l'elemento più critico di tutto il sistema donazione-trapianto. In Italia, il processo donazione-trapianto, sia da donatore cadavere, sia da donatore vivente, sta vivendo un'evoluzione, regionale e nazionale, che tocca le modalità di applicazione di principi fondanti quali l'equità di accesso alle cure ed il rispetto dell'autodeterminazione dei soggetti coinvolti nella donazione e nel trapianto. Nell'esperienza della Comunità dei Trapianti del NITp (Nord Italia Transplant), il coinvolgimento degli esperti di etica ha portato alla "Carta dei Principi", modello positivo di connubio tra etica e trapianti. Il ricorso alla consulenza etica viene oggi visto, in prospettiva, come un valore aggiunto che assicura l'indipendenza di valutazione di un parte terza rispetto ad alcune scelte critiche della rete regionale e nazionale trapianti nei confronti dei "pazienti" e dei loro familiari.
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In transplant medicine, ethics of doctor-patient relationship extends particularly to more "weak" subjects: subjects on the waiting list, the families of deceased donors, living donors. The consistent and systematic application of the ethical principles of transplantation is perhaps the most critical element of the whole system donation-transplantation. In Italy, the cadaveric donation- transplantation process, both from cadaveric and living donor, is undergoing an evolution, at regional and national levels, touching on detailed rules for the application of principles such as equality of access to care and respect for the self-determination of stakeholders. In the experience of the NITp's transplant community, the involvement of Ethics experts led to the "Chart of principles", a good match between ethics and clinical transplants. Ethics consultation is seen, ultimately, as an added value that ensures the independence of evaluation by a third party in the light of some critical choices of regional and national transplant network towards the "patients" and their family members.

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Piccolo, G. (2016). La consulenza etica nella pratica clinica dei trapianti. Medicina E Morale, 64(6). https://doi.org/10.4081/mem.2015.6

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