PubMed · 2714964
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J W Ross. Ethics committees. Why cases sometimes go wrong.. https://pubmed.ncbi.nlm.nih.gov/2714964/
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It is a widely accepted claim that scientific practice contains value judgments, i.e. decisions made on the basis of values. This paper clarifies the concepts involved in this claim and explains its implications for risk assessment. It is explained why values are necessarily a part of science and of risk assessment. A certain type of values that contribute to the aim of science, so-called epistemic values, are identified as rationally justified as basis for judgment in science. It is argued that the aims of pure science and risk assessment differ in some aspects and that consequently pure science's epistemic values are not sufficient for risk assessment. I suggest how the epistemic values may be supplemented in order to align better with the aim of risk assessment. It is concluded that since risk assessment is no less value-laden than pure science, it is important (a) that risk assessors become aware of what values they are (often implicitly) relying on, (b) that the values are justifiable, and (c) that transparency is ensured, i.e. that the values and value-based assumptions applied in particular risk assessments are explicitly acknowledged.
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To meet the constantly growing demand for organs for transplantation the use of living related and unrelated donors continues to increase. Transplant units with a living-donor programme often provide written information to their potential kidney donors. We saw a need to assess the contents of these brochures. Written information for potential live kidney donors was requested from different Transplant units throughout the world. We obtained and analysed 16 different brochures from 14 countries. The general approach ranged from persuasive to almost deterring. Sixteen main themes were identified in the information material. Eight of those were considered paramount, namely voluntarism, medical suitability, short-term donor risks, long-term donor risks, risk of graft loss, outcome with and without a living donor, postoperative course, and financial conditions. Five brochures covered all these crucial matters. When mentioned, examples and interpretations of donor risks were very dissimilar. Furthermore, the conditions for donation were obviously very different in the various countries. This review points at essential issues to be included in the written information for living kidney donors. All transplant units with a living-donor programme should provide such information, thus enabling the potential donor to make a thorough decision.