Decision-making processes of physicians after the organ donation scandal in Germany: the factorial survey

A dilemma is a situation in which two or more moral principles conflict with one another. The dilemma in transplantation medicine is a conflict between professional ethics, the patient's wishes and behavior, legal norms, and unwritten or formal rules of the organization. Such dilemma situations...

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Main Authors: Hermann, Dieter (Author) , Dannecker, Gerhard (Author) , Pohlmann, Markus (Author)
Format: Chapter/Article Conference Paper
Language:English
Published: 22 March 2023
In: Organizational crime
Year: 2023, Pages: 251-277
DOI:10.1007/978-3-658-38960-4_11
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/978-3-658-38960-4_11
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Author Notes:Dieter Hermann, Gerhard Dannecker & Markus Pohlmann

MARC

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520 |a A dilemma is a situation in which two or more moral principles conflict with one another. The dilemma in transplantation medicine is a conflict between professional ethics, the patient's wishes and behavior, legal norms, and unwritten or formal rules of the organization. Such dilemma situations may lead to delinquency such as the manipulation of data and the alteration of medication to influence the ranking of allocation of a donor organ in patients. With an empirical study, we looked to investigate conditions of delinquent actions (guideline violations) in dilemma situations. For this purpose, all 46 transplant centers in Germany have been contacted. Due to the small number of cases, randomly selected nephrologists were additionally surveyed. 40 transplant physicians and 37 nephrologists participated in the survey. The results show that transplant physicians are primarily guided by legal norms in a conflict between legal norms and organizational interests. In a conflict between legal norms and professional ethics, the patient's welfare and care are primary. The importance of informal norms of the organization is secondary. Transplant physicians and nephrologists differ especially in this point. One can assume that before the organ donation scandal happens, both groups practiced the same pattern of action and that this occurrence led transplant physicians to change their decision-making principles. 
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