TY - JOUR
T1 - Under the pretence of autonomy
T2 - Contradictions in the guidelines for human tissue donation
AU - Steinmann, Michael
PY - 2009
Y1 - 2009
N2 - The paper concerns the uncertainty in current propositions for the regulation of tissue donation. It focuses mainly on two statements issued in Germany. The scope of the paper is to give a systematic approach to ethical problems coming up in this field. Both statements try to maintain the idea of positive autonomy in regard to tissue donation, but their attempt eventually is forced to fail. Different procedures are proposed that most often are not practicable (because a truly "informed" consent is impossible, or because optional models tend to overwhelm donors). Blanket consent is also proposed, but this form of consent cannot be seen as an expression of self-determination. Under the pretence of autonomy, donors are left alone with the task to control scientific research and to have their personal and property rights respected. Following this rather weak position of autonomy, in one statement there is a clear tendency to place the intrinsic value of research over the autonomy of the donor. In order to avoid this conclusion, autonomy has to be more than individual decision making. It has to be embedded in social and institutional rules which support and protect individual choice. If the benefits of research are supposed to lead to a common good and to satisfy public interests, then research has to be controlled through public institutions. Autonomy does not exclude institutional support, as institutional support is the only way to take the autonomy of donors seriously.
AB - The paper concerns the uncertainty in current propositions for the regulation of tissue donation. It focuses mainly on two statements issued in Germany. The scope of the paper is to give a systematic approach to ethical problems coming up in this field. Both statements try to maintain the idea of positive autonomy in regard to tissue donation, but their attempt eventually is forced to fail. Different procedures are proposed that most often are not practicable (because a truly "informed" consent is impossible, or because optional models tend to overwhelm donors). Blanket consent is also proposed, but this form of consent cannot be seen as an expression of self-determination. Under the pretence of autonomy, donors are left alone with the task to control scientific research and to have their personal and property rights respected. Following this rather weak position of autonomy, in one statement there is a clear tendency to place the intrinsic value of research over the autonomy of the donor. In order to avoid this conclusion, autonomy has to be more than individual decision making. It has to be embedded in social and institutional rules which support and protect individual choice. If the benefits of research are supposed to lead to a common good and to satisfy public interests, then research has to be controlled through public institutions. Autonomy does not exclude institutional support, as institutional support is the only way to take the autonomy of donors seriously.
KW - Autonomy
KW - Benefit
KW - Biobanks
KW - Donation
KW - Global consent
KW - Informed consent
KW - Optional model
KW - Public institutions
KW - Tissue
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UR - http://www.scopus.com/inward/citedby.url?scp=67649664041&partnerID=8YFLogxK
U2 - 10.1007/s11019-009-9181-3
DO - 10.1007/s11019-009-9181-3
M3 - Article
C2 - 19219565
AN - SCOPUS:67649664041
SN - 1386-7423
VL - 12
SP - 281
EP - 289
JO - Medicine, Health Care and Philosophy
JF - Medicine, Health Care and Philosophy
IS - 3
ER -