Skip to main content
SpringerLink
Log in

Power of Legal Concepts to Increase Organ Quantity

  • Chapter
  • First Online:
Organ Transplantation in Times of Donor Shortage

Part of the book series: International Library of Ethics, Law, and the New Medicine ((LIME,volume 59))

Abstract

The legal preconditions for and limits of organ transplantation as well as the interpretation and implementation of these framework conditions in practice significantly affect the willingness to donate an organ and subsequently the quantity of organs available. When generating innovative concepts to increase the quantity of organs, the legal provisions of the individual countries cannot be disregarded. Therefore, where alterations to current systems are discussed, also legislative suggestions for modification have to be presented.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    See www.dso.de (still on the opt-in solution without information).

  2. 2.

    There you also can find data on other European countries.

  3. 3.

    For more details Schroth (2010b).

  4. 4.

    For details see 15.4.1.

  5. 5.

    It had already been ruled in the so-called Act on Hospitals and Sanatoria (Kranken- und Kuranstaltengesetz—KaKuG) and has been adopted without changes for the Act on Organ Transplantations (Organtransplantationsgesetz—Austrian OTPG) (§§ 5 et seq.), which has been enforced December 2012. See to the new act Heissenberger (2013).

  6. 6.

    Also known as “presumed consent”; for details see 15.4.1.

  7. 7.

    See infra 15.5.1.

  8. 8.

    In detail Schroth (2010a); see also the corresponding recommendations of the Austrian so-called Obersten Sanitätsrat. http://www.austrotransplant.at/download/Hirntod_2005.pdf.

  9. 9.

    It is to be questioned if in the case of the opt-out solution it can be referred to donors in the narrower sense.

  10. 10.

    See § 2 German Act on Transplantation (Transplantationsgesetz—German TPG).

  11. 11.

    Cf. Schroth (2005). The option of relatives consenting to an organ removal does not exist if a legally effective dissent of the potential organ donor exists. Every citizen who has reached the age of 14—and therefore the religious majority—is entitled to legally binding dissent to organ removal after his death. The legally binding permission to consent is obtained when reaching the age of 16. (§ 2 Paragraph 2 Sentence 3 German TPG).

  12. 12.

    See § 1a Paragraph 5 German TPG.

  13. 13.

    See § 19 Paragraph 2 German TPG.

  14. 14.

    See data source: www.dso.de.

  15. 15.

    In Europe, the opt-out solution is in force inter alia in Belgium, France, the Scandinavian countries, and, as has already been mentioned, in Spain. The regulation of the Austrian OTPG is applicable independently of the in Austria deceased potential organ donor’s nationality or residency. This results from Art. 49 of the Austrian Constitution, which stipulates the territorially validity of the Austrian legal provisions.

  16. 16.

    §§ 5 etseq. Austrian OTPG.

  17. 17.

    The dissent can also only apply to a specific organ.

  18. 18.

    Possibilities would include examination of personal belongings, especially clothing and wallet, or of the patient’s room. Cf. Bruckmüller and Schumann (2010); of the same opinion Radner et al. (2000).

  19. 19.

    § 7 Austrian OTPG.

  20. 20.

    Cf. Gesundheit Österreich GmbH.

  21. 21.

    Cf. Aigner (1994). On registration and query, see http://www.goeg.at/de/Widerspruchsregister.

  22. 22.

    On the legal situation and practice in detail, see Dujmovits (2013); Bruckmüller and Schumann (2010); Barta et al. (1999); Kopetzki (1988).

  23. 23.

    This is, however, attenuated by the relatives’ possibility to decide.

  24. 24.

    Autopsies were already legally defined for scientific purposes in 1749.

  25. 25.

    § 25 Austrian KaKuG.

  26. 26.

    Signs depicting this sentence can still be found in Austrian pathologies.

  27. 27.

    In 2012, an average of 3.6 organs was removed from every organ donor and transplanted. Gesundheit Österreich (2013).

  28. 28.

    Gesundheit Österreich (2013).

  29. 29.

    On recent data, see www.dso.de.

  30. 30.

    On the arguments pro and contra to the opt-out solution, see Gutmann (2006) with further references.

  31. 31.

    See e.g. the anthology Engel et al. (2007).

  32. 32.

    The Nobel Prize winner Kahneman’s research has to be mentioned as fundamental in this context, see e.g. Kahneman et al. (1982); Kahneman and Tversky (2000).

  33. 33.

    Such as, for example, the different models of post-mortem organ donation.

  34. 34.

    See Johnson and Goldstein (2003).

  35. 35.

    In Austria, an active act is not even necessary, as was also the case in the project.

  36. 36.

    See § 8 German TPG.

  37. 37.

    See § 8 Austrian OTPG.

  38. 38.

    See Schroth (2010c) with further references to the discussion.

  39. 39.

    The corresponding rules in the Austrian Criminal Code are §§ 83 et seq. (acts against limb) and § 90 (consent).

  40. 40.

    See discussion in Burgstaller and Schütz (2010) and Bruckmüller and Schumann (2010).

  41. 41.

    Interestingly—because of cultural and religious issues—there are no preferences in the EU directives 2010/45/EU of 7 July 2010 on standards of quality and safety of human organs. See Bruckmüller and Schumann (2010a).

  42. 42.

    It is questionable, whether the Austrian population is informed in a comprehensive way. Is it enough that there is information on the opt-out solution on corresponding homepages and references can frequently be found in newspaper articles, including daily newspapers for the general public?

  43. 43.

    § 11 Paragraph 4 German TPG.

References

  • Aigner G. 1994. Organentnahmen bei Verstorbenen zu Transplantationszwecken gemäß § 62 a KAG; Widerspruchsregister. RdM (Recht der Medizin), 119.

    Google Scholar 

  • Barta, H., G. Kalchschmid, C. Kopetzki, and E. Dujmovits. 1999. Rechtspolitische Aspekte des Transplantationsrechts. Wien: Hanz

    Google Scholar 

  • Bruckmüller, K., and S. Schumann. 2010. Die Heilbehandlung im österreichischen Strafrecht. In Handbuch des Medizinstrafrechts, ed. C. Roxin and U. Schroth. 4th ed., 847. Stuttgart: Boorberg.

    Google Scholar 

  • Bruckmüller, K., and S. Schumann. 2010a. Organmangel und Organspende—Europarechtliche Rechtsetzung und nationaler Anpassungsbedarf, Jahrbuch Gesundheitsrecht. Wien: NWV Verlag.

    Google Scholar 

  • Burgstaller H., and H., Schütz. 2010. In Wiener Kommentar zum Strafgesetzbuch. 2nd ed., ed. Ratz Höpfel. Wien: Manz Verlag.

    Google Scholar 

  • Deutsche Stiftung Organtransplantation, Statistiken. www.dso.de.

  • Dujmovits, J. 2013. Organtransplantation. In Handbuch Medizinrecht für die Praxis (Loseblattsammlung), ed. Kletečka Aigner and M. Kletečka-Pulker, et al. Wien: Manz Verlag.

    Google Scholar 

  • Engel, C., M. Englerth, J. Lüdemann, and I. Spiecker., eds. 2007. Recht und Verhalten: Beiträge zu Behavioral Law and Economics. 1st ed. Tübingen: Mohr Siebeck.

    Google Scholar 

  • Gesundheit Österreich GmbH—Geschäftsbereich ÖBIG. 2013. ÖBIG-Transplant. Jahresbericht 2012, 2013.

    Google Scholar 

  • Gutmann, T. 2006. Für ein neues Transplantationsgesetz. Eine Bestandsaufnahme des Novellierungsbedarfs im Recht der Transplantationsmedizin, 155. Berlin: Springer.

    Google Scholar 

  • Heissenberger W. 2013. Das Bundesgesetz über die Transplantation menschlicher Organe und dessen wesentliche Neuerungen. RdM (Recht der Medizin), 50. Wien: Manz Verlag.

    Google Scholar 

  • Johnson, E. J., and D. Goldstein. 2003. Do defaults save lives? Science 302:1338.

    Article  Google Scholar 

  • Kahneman, D., and A. Tversky. 2000. Choices, values and frames. Cambridge: Cambridge University Press.

    Google Scholar 

  • Kahneman, D., P. Slovic, and A. Tversky. 1982. Judgement under uncertainty: Heuristics and biases. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Kopetzki, C. 1988. Organgewinnung zu Zwecken der Transplantation: Eine systematische Analyse des geltenden Rechts. New York: Springer.

    Book  Google Scholar 

  • Radner, A., A. Haslinger, and P. Reinberg. 2000. Krankenanstaltenrecht. 1st ed. Austria: Trauner Verlag.

    Google Scholar 

  • Schroth, U. 2005. § 16 Richtlinien zum Stand der Erkenntnisse der med. Wissenschaft. In Transplantationsgesetz. Kommentar, ed. U. Schroth, P. König, T. Gutmann, and F. Oduncu. München: C.H. Beck.

    Google Scholar 

  • Schroth, U. 2010a. Die postmortale Organ- und Gewebespende. In Handbuch des Medizinstrafrechts, ed. Schroth Roxin, 4th ed., 448. Stuttgart: Boorberg.

    Google Scholar 

  • Schroth, U. 2010b. Kritische Einführung in die Rechtslage der postmortalen Organtransplantation sowie der Lebendorgantransplantation in Deutschland. In Recht am Krankenbett—Zur Kommerzialisierung des Gesundheitssystems, ed. Dochow Duttge and Weber Waschkewitz, 3. Göttingen: Universitätsverlag Göttingen.

    Google Scholar 

  • Schroth, U. 2010c. Die strafrechtlichen Grenzen der Organlebendspende. In Handbuch des Medizinstrafrechts, ed. Schroth Roxin, 4th ed., 466. Stuttgart: Boorberg.

    Google Scholar 

  • Schroth, U. 2012. Postmortale Transplantation und Autonomie. Zur Debatte 2:36.

    Google Scholar 

  • Schroth, U. 2013. Die strafrechtliche Beurteilung der Manipulation bei der Leberallokation. NStZ (Neue Zeitschrift für Strafrecht) 437.

    Google Scholar 

  • Thaler, R. H., and C. R. Sunstein. 2009. Nudge—Wie man kluge Entscheidungen anstößt. 2nd ed., 244. Berlin: Econ.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Law, LMU Munich, Munich, Germany and Faculty of Law, JKU Linz, Linz, Austria

    Karin Bruckmüller

  2. Faculty of Law, LMU Munich, Munich, Germany

    Ulrich Schroth

Authors
  1. Karin Bruckmüller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulrich Schroth
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karin Bruckmüller .

Editor information

Editors and Affiliations

  1. Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany

    Ralf J. Jox

  2. Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany

    Galia Assadi

  3. Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-University Munich, Munich, Germany

    Georg Marckmann

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Bruckmüller, K., Schroth, U. (2016). Power of Legal Concepts to Increase Organ Quantity. In: Jox, R., Assadi, G., Marckmann, G. (eds) Organ Transplantation in Times of Donor Shortage. International Library of Ethics, Law, and the New Medicine, vol 59. Springer, Cham. https://doi.org/10.1007/978-3-319-16441-0_15

Download citation

Publish with us

Policies and ethics

Search

Navigation