I-White House ithatha umgomo wokulinda uhlu lomlingo
Njengamanje, kunabantu abangaphezu kuka-120,000 baseMelika abadinga ukuguqulwa komzimba. Kulinganiselwa ukuthi abantu abangu-22 bafa usuku ngalunye ngenkathi balinde isitho. Njengezinye izingxenye eziningi zomhlaba, i-United States ibhekene nokuntuleka okunamandla kwezitho zokufakelwa kabusha. Ngakho-ke, ukwandisa inani leminikelo yombutho kuye kwaba yinto ebaluleke kakhulu emhlabeni.
Ngo-2016, ukuphathwa kuka-Obama kwamemezela izinhlelo ezintsha ezingahambi nje kuphela ekuhloleni kweminikelo yombutho kodwa futhi zinikeze usizo kubantu abanikeza izitho, noma abaxhasi abaphilayo .
Kulesi sihloko, sizobheka ngokucophelela lezi zinhlelo zokukhulisa ukutholakala komzimba kanye nezintshisekelo ezintsha ezinikezwa abantu abazinikela eminikelweni yomzimba kwamanye amazwe afana ne-Israyeli.
Amazwi ambalwa mayelana nokufakelwa kwe-Organ
Ukufakelwa kwezakhi zomzimba kwaba yinkambiso eyingozi futhi yokuhlola. Kodwa-ke, ngokuthuthuka kwezokwelapha, siye sakwazi ukufakelwa izitho ngempumelelo kubantu abaphethwe isifo segciwane, lapho isigungu sigcina ukusebenza ngokuphelele. Uma isitho esibalulekile, njengezinso, isibindi, inhliziyo noma amaphaphu eyeka ukusebenza, ukufa kulandela.
Nasi uhlu lwama-organ transplants ekuhlehlisweni kwemvamisa:
- Izinso
- Isibindi
- Inhliziyo
- Amapulazi
- I-Pancreas
- Amathumbu
Okuphawulayo, izicubu, njenge-cornea, amathambo, isikhumba, ama-fascia, imithanjeni ye-sphenoid ne-valves yenhliziyo, ingafakwa futhi.
Zombili ukufakelwa kwezinso zezinso nezingenasici kungatholakala ku-donor ophilayo. Ezinye izitho, njengenhliziyo namaphaphu, zivela kumnikeli osanda kufakwa.
Ngokuqondile, umuntu angaphila ngezinso ezilodwa nje futhi ngaleyo ndlela anikeze enye. Ngaphezu kwalokho, umuntu onesibindi esinempilo anganikeza ingxenye yesibindi sakhe nesibindi sizovuselela. Abantu abanikeza izitho ngenkathi bephila kuthiwa abaxhasi abaphilayo .
Iminikelo yenyama ngokuvamile ivela ezigulini ezibhedlela futhi zifa ngenxa yokushaya noma ukulimala.
I-Joint Commission, eyagunyaza futhi iqinisekisa izikhungo zokunakekelwa kwezempilo ezweni lonke, idinga ukuthi odokotela emnyangweni wezimo eziphuthumayo baxhumane nesezinhlaka zokuthola izinhlaka mayelana nokufa okuvela emnyangweni ophuthumayo. Ngamanye amazwi, ama-ejensi anjalo okuthengwa ngamalungu kumele aziswe ngokusemandleni ukuthi kungenzeka ukuthi izitho zitholakalayo zokufakelwa.
Imvume yomndeni iyisithiyo esikhulu kunazo zonke ekuthengeni kwezitho zokufakelwa. Ngokujwayelekile, uma umndeni ekuqaleni uphendula kahle umqondo weminikelo, khona-ke amathuba okuba umnikelo uzokwenzeka kangcono. Ngaphezu kwalokho, uma oshonile ebonise okuthandwa ngumnikelo wesigungu ngokuvuma nokubhalisa noMnyango Wezimoto (DMV), khona-ke amalungu omndeni angase avume futhi.
Uma umndeni ungavumelani nezifiso zomuntu oshonile ukunikela izitho, izazi eziqeqeshiwe zentengo yokuthengwa komzimba ezinolwazi kuloluhlobo oluthile lokuxazulula izingxabano zibizwa kulo. Labachwepheshe bayazi ngemithetho kahulumeni mayelana nokunikezwa komzimba nokuthengwa kwempahla futhi kungenza kube lula ukwenza izinqumo.
Uma uhlela ukunikela ngezitho zakho futhi ubhalisiwe ukwenza kanjalo, kuwumqondo omuhle ukwazisa amanye amalungu omndeni oseduze wale njongo.
Ukwenza kanjalo kuzosiza ukuxazulula ukudideka nokuwa phakathi kwamalungu omndeni uma kwenzeka ushona futhi uqiniseke ukuthi izifiso zakho ziyahlonishwa.
Ukuthuthukisa Amanani Okutshala Ngokwemvelo
Nakuba amaphesenti angama-95 kubo bonke abaseMelika asekela ngeminikelo yendikimba, amaphesenti angu-50 kuphela aseMelika abhaliswa ukuba abe ngabanikeli bomzimba. Ngokubambisana namayunivesithi ahlukahlukene, izibhedlela, izinkampani, izisekelo kanye nezinhlangano zokugqugquzela isiguli, uhulumeni wesifundazwe uhlose ukuvimbela lokhu kuphazamiseka.
Kuzozonke, u-$ 200 million uzonikezwa imizamo yokucwaninga egxile ekucwaningeni nasekuthuthukisweni okubandakanya ukufakelwa komzimba.
Ngo-2016, ukuphathwa kuka-Obama kwabikezela ukuthi le mizamo izokwandisa inani leminikelo engaba ngu-2 000 ngonyaka.
Nazi ezinye izinhlelo ezenziwa ngu-Obama Administration ukuthuthukisa nokwandisa iminikelo yomzimba e-United States kanye nokunciphisa uhlu lokulinda lomzimba:
- Ukwandisa Ukuphumelela Emkhakheni Kazwelonke. I-United Network ye-Organ Sharing (i-UNOS), i-Organ Procurement Network kanye neTransplant Network, ihlela ukukhulisa ukusebenza kahle ohlelweni lokuthengwa komzimba nokuguqula. I-UNOS ihlela futhi ukwenza idatha nebuchwepheshe obusha ukuze kutholakale izikhungo nabacwaningi.
- Ukubamba Amandla Omphakathi Wezokuxhumana. I-Facebook, iTinder, i-Twitter, i-ORGANIZE nezinye izinhlangano eziningana zithuthukisa amathuluzi amasha ukuze unike amandla abanikeli abangakwazi ukubhalisa kalula. Lezi zinhlangano nazo zisebenzisa imithombo yezokuxhumana ukuze zisakaze imikhankaso yokuvikela umphakathi eyenzelwe abantu abasha. I-ORGANIZE ayiyona inzuzo eyadala ukubhalisa kokuqala okuphakathi. Njengamanje, wonke umbuso unomlando wokubhalisa umzimba. Kodwa-ke, lapho abantu behamba, isimo sabo somnikelo wesigungu silahlekile ngesikhathi sokugubha. I-ORGANIZE ilungisa le nkinga ngokubhalisa okuphakathi kwayo ekhona ozimele ngokubhalisa kombuso-ukubhalisa okuyinhloko ukuthi noma iyiphi inhlangano yokuthengwa komzimba ingasebenzisa ukucinga abaxhasi.
- I-Organic and Tissue Biofabrication. UMnyango Wezokuvikela (DOD) unikezela u-$ 160 million wemali yomphakathi-yangasese ukudala i-Advanced Tissue Biofabrication Manufacturing Innovation Institute. Lesi sikhungo sizohlakulela ubuchwepheshe bokukhiqiza obuzokwenza ukulungiswa nokuguqulwa kwamaseli namathishu. Lolu buchwepheshe lungase lusetshenziswe ngelinye ilanga ukudala izitho zokufakelwa. Ngaphezu kwalokho, i-DOD iphinde ibeke imali engu- $ 7 million emiklomelo yamabhizinisi amancane azama ukuthuthukisa isilondolozi somzimba nesishukela.
- Izifo Zezinso XPRIZE . I-American Society of Nephrology ibeka i $ 7 million yokuqala ukuthuthukisa isifo sezinso i-XPRIZE. Ngokusho kwewebhusayithi yayo, i-XPRIZE "imincintiswano eqondile yokuklonyeliswa emklomelo owenza umkhawulo walokho okungenzeka-ukushintsha umhlaba ube ngcono."
- Ukuthuthukisa Imiphumela Ye-Transplantation Yezingulube. I-Cystic Fibrosis Foundation izoxhasa imali eyizigidi eziyizigidi ezingu-15 ukuya ekucwaningweni okuthuthukisa imiphumela emva kokufakelwa kwamaphaphu
- Izinkokhelo Zamazinso. UWalter Reed Bethesda ukwakhiwa "ohlelweni lwezempi," oluhlanganisa imindeni yezempi ekhonzayo ngeziguli eWalter Reed abadinga izinso futhi kunzima ukufanisa. Encwadini ehlobene, izikhungo ezingaphezu kwezingu-30 zisebenzisana ukwabelana ngemininingwane kanye nemikhuba emihle yokuguqula izinso kumamukeli onzima.
- I-Transplants Engaphakathi ye-HIV. I-Johns Hopkins University kanye neNational Institute of Zigciwane kanye nezifo ezithathelwanayo zidala ucwaningo oluningi oluzocwaninga ngeminikelo yomzimba phakathi kwabantu abanegciwane lesandulela ngculaza kanye nemigomo yokusebenzisa i-donor-donor pool.
Ukunikezwa kwe-Organ Donation Incentivized
E-Israyeli, abantu abambalwa abantu banikela izitho. Ukuze kulwa nalesi sici sokuntuleka komhlaka, ngo-Mashi 31, 2008, iphalamende lase-Israyeli ladlulisela umthetho obeka phambili umnikelo womzimba kumaqembu alandelayo abantu:
- Abantu abhalisa njengabaxhasi bomzimba ngokusayina ikhadi lomnikelo
- Izihlobo ze-First-degree zezibonelelo zabasebenzi abafile
- Abanikeli bokuphila
Umthetho okhuthaza ukunikezwa komzimba futhi ngaleyo ndlela unikeze phambili okungekho emthethweni ukukhetha abantu yiyona ndlela entsha yenkinga yokuntuleka komzimba. Ngaphambi kokuba u-Israyeli adlulisele umthetho wokugqugquzela umnikelo womzimba, yiSingapore kuphela owayenqume umthetho onjalo ohlinzekela phambili ngokusekelwe kwesimo sokubhaliswa komzimba. Encwadini elandelanayo, eminyakeni kusukela u-Israyeli esedlulisa umthetho onjalo, iSilikhi nayo yenze umthetho wokubeka phambili amalungu omndeni wabanikeli bomzimba oshonile.
Kwathatha iminyaka emine ukuthi lo mthetho omusha uvuselele umnikelo womzimba ukuze usebenze. Phakathi nalesi sikhathi, izinqubomgomo zokwabiwa kanye nezinhlelo zokukhishwa kwempahla zanyatheliswa nguhulumeni wase-Israel. Ngaphezu kwalokho, phakathi nale nkathi yesikhashana, uhulumeni wase-Israel wabambelela ekugqugquzelweni ekupheleni kwemikhankaso yemfundo mayelana nale nqubomgomo entsha yokunikezwa komzimba.
Ngo-Ephreli 1, 2012, lo mthetho omusha uqale ukusebenza. Abantu ababhalisele ukuba babe ngabanikeli bomzimba ngaphambi kwalolu suku bafanelekile ukuthola isimo somamukeli wesikhungo kuqala kusukela kulolu suku. Abantu abhalisiwe ngemuva kwalolu suku kwakudingeka balinde iminyaka emithathu ukuze bathole kuqala. Le nkathi yokulinda iminyaka emithathu yenzelwe ukudambisa abantu ukuba bangene ngemvume ukuze babe umhlinzeki womzimba kuphela ngemuva kokuthi bathole ukuthi banesimo esingafuna ukufakelwa komzimba.
Esihlokweni se-2016 eshicilelwe eMnothweni WezeMpilo , Stoler kanye nosebenza nabo basebenzise idatha yokubhalisa ngomzimba-nhlangano ukuze babone ingxenye ukuthi ngabe inqubomgomo entsha yokuvuselela iminikelo yombutho yasebenza. Ngokusho abalobi balolu cwaningo:
- Inqubomgomo entsha ebeka phambili kubanikezeli bezinhlaka ababhalisiwe basebenze futhi "kakhulu" kwanda izinombolo zokubhaliswa komzimba.
- Abantu abaningi ababhalisiwe ngaphambi kokuba umthetho uqale ukusebenza ngo-Ephreli 1, 2012, okuyinto enengqondo ngoba abantu ababhalisile ngemuva kwalolu suku kwadingeka balinde iminyaka emithathu ukuze bathole isimo sokuqala.
- Imikhankaso yokuqwashisa emphakathini ehlose ukwethula le nqubomgomo yokubhaliswa kwabanikeli bezinhlaka ezikhuthazayo.
- Ukwenza kube lula ukubhalisa ngokusebenzisa ucingo noma izindlela ze-intanethi kwandise futhi iminikelo yomzimba.
Imiphumela yalolu cwaningo iyakhuthaza mayelana nokuphumelela kokuhlinzekela izibonelelo kubanikeli bezinhlaka ezibhalisiwe. Noma kunjalo, lolu cwaningo lunokulinganiselwa kwalo. Imiphumela yalolu cwaningo ibonisa kuphela ubudlelwane phakathi kokumiswa kwalo mgomo kanye nokubhaliswa komuntu owenzela amalungu. Ngamanye amazwi, abukho ubudlelwane obuqondile obubangela-kanye-nomphumela phakathi kokumiswa kwenqubomgomo enjalo nokunyuka kokubhaliswa kwabanikeli bomzimba.
Ezinye izici, njengemikhankaso yemfundo yomphakathi kanye nokwanda okukhulu kokubhalisa (ngocingo noma nge-intanethi), kungase kubambe iqhaza ekwandeni komnikelo womzimba. Ngenxa yokuthi lolu cwaningo lubuyele emuva futhi lungenayo iqembu lokulawula, kunzima ukucacisa ngokuqondile umphumela ngamunye wale nqubomgomo entsha yokuvuselela izitho kumanani okunikela ngomzimba.
Ngokusho kochwepheshe abaphendula emiphumeleni yalolu cwaningo, ukuklanywa komthetho wakwa-Israyeli obeka kuqala abantu abhalise njengabaxhasi bomzimba kunamaphutha ambalwa. Ngokukodwa, isihlobo esilandelayo singasenqabela isifiso somnikeli wokubhalisa ukunikela izitho ngemuva kokufa komuntu. Ngaphandle kwalokho, "ukubhaliswa" okungekho emthethweni kungase kwenzeke lapho umuntu ebhalisa khona ukuba abe umhlinzeki womzimba ukuze athole kuqala lapho ephila kodwa eyala isihlobo sokuguqula lesi sinqumo ngemva kokufa. Ngokusho kwalabachwepheshe, indlela kuphela yokuvimbela ukuguqulwa kanye nokubhaliswa kwabanikazi bezinkolelo "zokukhohlakala" ukubukeza inqubomgomo yokwenza ukuze isihlobo sokuqala singakwazi ukufaka inqubo yokunikezwa komzimba futhi senqabe ukugunyaza umnikelo.
Isiphetho
Ngokusho kochwepheshe, ukugqugquzelwa komzimba ngokuvumelana nalokho okwenzeka ku-Israyeli kungenzeka ukuthi ngeke kusebenze kahle e-United States ngoba i-United States ihlukile ngezindlela eziningi ezivela kwa-Israyeli. Ngaphezu kwalokho, nakuba abaningi baseMelika bedinga izitho, i-United States isilinganiselwe "isitho esicebile" uma siqhathaniswa no-Israyeli.
Noma kunjalo, uma wena noma othandekayo njengamanje edinga isitho noma ulindele izidingo zesikhathi esizayo (okuhlala nokuhluleka kokusebenza komzimba), izinhlelo ezintsha ezenziwa nguhulumeni we-Obama kufanele zinikeze ithemba. Yize kungathatha isikhashana ukuthi lezi zinyathelo ziqalise ukusebenza, cishe zizokwakha ukutholakala komzimba e-United States ngokukhulisa amazinga omnikelo, ukuthuthukisa izimpahla nokususa ezinye "zokukhohlisa" njengezindleko nokulahlekelwa kwemali okuhlangenwe nakho kwabanikeli abaphilayo.
Ngombhalo wokugcina, uma unesithakazelo ekubeni ngumnikeli womzimba, sicela uqaphele ukuthi ngaphezu kokubhalisa njengomhlinzeki nge-DMV yakho yombuso ungabhalisa ku-intanethi kumasayithi afana ne-ORGANIZE ne-organdonor.gov, ephathwa nguMnyango wase-US Wezempilo Nemisebenzi Yabantu.
Imithombo:
I-Weaver L, i-Hobgood C. Isaziso Sokufa, kanye Nezimiso Zokuqala. Ku: Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM. ama-eds. Umuthi Ophuthumayo We-Tintinalli: Umhlahlandlela Wokufunda Ophelele, 8e . ENew York, NY: McGraw-Hill; 2016. http://accessmedicine.mhmedical.com.proxygw.wrlc.org/content.aspx?bookid=1658&Sectionid=109449064.
I-Goldberg DS, i-Trotter JD. Isipho Esiqhubekayo Ekunikezeni: Ukwandisa Amanani Ezinkokhelo Ngokunikeza Izinzuzo. I-American Journal of Transplantation 2016.
Ukunikezwa komzimba kuxhomeke ku-Trust [ukuhlelwa]. I-Lancet 2016.
U-Stoler A et al. Ukugqugquzela ukubhaliswa kwabanikazi be-Organ nge-Organ Allocation Priority. Umnotho wezeMpilo 2016; 387: 2575.
Ukulondoloza Ukuphila Nokunikeza Ithemba Ngokunciphisa Uhlu Lokulinda Umzimba. Whitehouse.gov.