New draft guidelines for choosing organ recipients

With demand for donor organs greatly outstripping availability, the NHMRC has released new draft guidelines it hopes will make decisions about choice of recipients and allocation easier.

The draft document, Ethical Guidelines for Organ Transplantation from Deceased Donors was released this week with the aim of providing a more comprehensive framework for fair and equitable decisions. It will now undergo a consultation process.

“Deciding how to allocate organs for transplantation is a complex process and raises a number of ethical issues and dilemmas," NHMRC chief executive professor Warwick Anderson said. "There are many ways to determine why one person should receive an organ over another, rather than just one ‘right’ way.”

The document states that race, religious belief, gender, marital status, sexuality and social or other status, as well as disability or age, should be entirely disregarded in making such decisions.

“Decisions regarding eligibility for organ transplantation must exclude arbitrary discrimination on medically irrelevant grounds and ensure that medically relevant factors are carefully assessed,” the document states.

According to the draft guidelines, the need for a transplant as a result of lifestyle choices, the ability to pay for treatment, refusal to participate in research and geographic location should also not be factors in organ allocation decisions. However, general health, including factors that will directly affect the likelihood of a poor outcome, such as degree of frailty and relevant medical conditions, are acceptable factors to weigh up, along with the relative severity of illness and urgency of need.

“Individuals assessed for eligibility for transplantation have the right to know whether or not they are considered suitable and, if they are evaluated as ineligible for transplantation, the basis for this determination,” the draft guide states.

The guidelines were developed at the request of the Organ and Tissue Authority and Transplantation Society of Australia and New Zealand (TSANZ). Once finalised, they will inform the next version of the organ-specific clinical protocols for transplantation from deceased donors, which the TSANZ will develop.

Submissions to the draft consultation process will be accepted via the NHMRC’s website or via post, until March 6.

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