To Translate Legal, Ethical and Societal Considerations Regarding Transplantation
Current Canadian organ allocation policy is built around notions of fairness and equity. However, policies around the world are increasingly embracing evidence-based outcome measures and the use of precision medicine tools for donor-recipient matching in order to maximize utility related to graft survival. This reality has the potential to create a tension between the goals of precision medicine and the legal obligations of healthcare providers and the healthcare system. For example, how will physicians balance their obligations to advocate for patients that fall outside (or on) the margins of precision medicine-determined allocation criteria? And, will this conflict significantly delay, slow or prevent the adoption of Precision Medicine-informed organ allocation in favour of current clinical practices? We will conduct a systematic and conceptual analysis of relevant case law, legislation, professional norms, legal theory, etc. to assess how existing norms and obligations may play out when donor-recipient matching tools are used to inform clinicians’ and patients’ decisions concerning acceptance or refusal of organs, deceased donor organ allocation policies, and living donor organ donation. This work will inform the integration of precision medicine into future allocation policies by clarifying legal and ethical obligations.