How many organs should one patient receive? the ethics of transplantation in the medical school

• DOI: 10.1016/j.transproceed.2004.02.064
• Publication Date: 2004-04-24T09:18:25Z
• Authors: G.B Piccoli; G Soragna; S Putaggio; M Burdese; P Longo; D Rinaldi; D Bergamo; E Mezza; V Consiglio; C Novaresio; M Gai; D Motta; B Malfi; F Giacchino; A Jeantet; G.P Segoloni
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Italy; Teaching; 4. Education; Humans; Transplants; Kidney Transplantation; Schools, Medical; 3. Good health

Interest in the humanities in the medical school is growing; while several medical schools, mainly of Anglo-Saxon background, have developed dedicated courses, the experience in Italy is limited.Since the academic year 2000 to 2001, a discussion of ethical problems was implemented in the nephrology course (fourth year of the Medical School of Torino, Italy; overall 6 years). In 2002 to 2003, a case entitled "Retransplantation of Multiple Organs (Prog Transplant 2002)" was discussed in 2 hours of small-group tutorial teaching: a boy received a renal graft at age 5, failed at age 7 due to recurrent glomerulonephritis, required a heart-kidney graft at age 11, and a second heart-kidney graft at 17. Student opinions were gathered by anonymous semistructured questionnaires at the beginning of the lessons as a basis for discussion.Following the lessons all students returned the questionnaires (n = 104). In the absence of competition for allocation, retransplantation was approved by 76.2%, unacceptable for 1% (22.9% uncertain-blank). With a waiting list of 10 patients, the opinions changed: 32.4% approved transplantation, 6.7% didn't approve it, 60.9% were uncertain. A theoretical categorization into deontological or utilitaristic approaches favored the first (41.9% vs 26.7%), with a high prevalence of blank-uncertain (31.5%); 21.9% of the students would change their opinion was that study head of the Transplant Department.Ethical aspects of the medical profession have been discussed with interest by medical school students; the high prevalence of uncertain answers and requests to develop specific tools underline the importance of this educational approach.