Are Transplant Recipients Human Subjects When Research Is Conducted on Organ Donors?

• Published in: The Hastings Center report Vol. 47; no. 5; pp. 10 - 14
• Main Authors: HEFFERNAN, KATE GALLIN, GLAZIER, ALEXANDRA K.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.09.2017; Blackwell Publishing Ltd
• Subjects: Bioethics; Biomedical Research - legislation & jurisprudence; Biomedical Research - organization & administration; Blood & organ donations; Clinical trials; Clinical Trials as Topic - legislation & jurisprudence; Clinical Trials as Topic - organization & administration; Communication; Essays; Human subjects; Humans; Informed Consent; Medical research; Research Design; Research Subjects - legislation & jurisprudence; Tissue Donors - legislation & jurisprudence; Tissue Donors - psychology; Transplant Recipients - legislation & jurisprudence; Transplant Recipients - psychology; Transplants & implants
• DOI: 10.1002/hast.757
• ISSN: 0093-0334

Interventional research on deceased organ donors and donor organs prior to transplant holds the promise of reducing the number of patients who die waiting for an organ by expanding the pool of transplantable organs and improving transplant outcomes. However, one of the key challenges researchers face is an assumption that someone who receives an organ that was part of an interventional research protocol is always a human subject of that same study. The consequences of this assumption include the need for oversight by an institutional review board and for research‐level informed consent from transplant recipients, all within the complex practical realities of the organ donation and transplantation process in the United States. The current national focus on this issue provides an opportunity to think critically about the policy goals of the human subjects regulations and their application to the nascent field of deceased organ donor intervention research. We propose that for donor research where the transplant recipient does not fall under the definition of human subject, the clinical consent model—rather than the consent model used for human research subjects—best facilitates the policy objectives of balancing clinical innovation, transparency, and protection of patients in an ethically responsible and legally compliant manner.