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Monash Bioethics Review

, Volume 37, Issue 3–4, pp 111–135 | Cite as

Ethical issues associated with solid organ transplantation and substance use: a scoping review

  • Lauren Notini
  • Denitsa Vasileva
  • Ani Orchanian-Cheff
  • Daniel Z. BuchmanEmail author
Original Article

Abstract

While solid organ transplantation for patients with substance use issues has attracted ethical discussion, a typology of the ethics themes has not been articulated in the literature. We conducted a scoping review of peer-reviewed literature on solid organ transplantation and substance use published between January 1997 and April 2016. We aimed to identify and develop a typology of the main ethical themes discussed in this literature and to identify gaps worthy of future research. Seventy articles met inclusion criteria and underwent inductive content analysis. Four main ethical themes were identified: (1) personal responsibility; (2) utility; (3) moral character; and (4) fairness. Each theme had multiple sub-themes and there was substantial overlap between themes. This scoping review identified a disproportionate emphasis in the literature regarding personal responsibility, which was referenced by each of the other themes, and a narrow focus on alcohol and liver. We recommend future research further investigate these connections between ethical themes and focus on ethical issues associated with transplants from organ groups other than liver for patients who use substances other than alcohol.

Keywords

Bioethics Organ transplantation Personal responsibility Scoping review Substance use 

Notes

Author contributions

Participated in the research design: DZB, LN, AO-C. Participated in the writing of the paper: LN, DZB, DV, AO-C. Participated in the performance of the research: LN, DV, DZB, AO-C. Participated in the data analysis: LN, DV, DZB.

Funding

Funding was provided by State Government of Victoria (Operational Infrastructure Program), University of Toronto (Fellowship in Clinical and Organizational Bioethics) and University Health Network (Salary Support).

Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose.

Supplementary material

40592_2019_100_MOESM1_ESM.docx (27 kb)
Appendix 1: Search strategies used for Medline and Medline in-process segments. Supplementary material 1 (DOCX 27 kb)
40592_2019_100_MOESM2_ESM.docx (29 kb)
Appendix 2: List of articles meeting inclusion criteria. Supplementary material 2 (DOCX 28 kb)

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Copyright information

© Monash University 2019

Authors and Affiliations

  1. 1.Joint Centre for BioethicsUniversity of TorontoTorontoCanada
  2. 2.Melbourne Law SchoolThe University of MelbourneCarltonAustralia
  3. 3.Biomedical Ethics Research GroupMurdoch Children’s Research InstituteParkvilleAustralia
  4. 4.University Health NetworkTorontoCanada
  5. 5.Library and Information ServicesUniversity Health NetworkTorontoCanada
  6. 6.Bioethics Department, Toronto Western HospitalUniversity Health NetworkTorontoCanada
  7. 7.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  8. 8.Krembil Research InstituteTorontoCanada

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