http://www.cleveland.com/healthfit/index.ssf/2013/11/cleveland_clinic_creates_transplant_ethics_fellowship_only_one_currently_operating_in_us.htmlCleveland Clinic creates Transplant Ethics Fellowship; only one currently operating in U.S.
By Angela Townsend
The Cleveland Clinic has created its first fellowship in the focused on ethical issues involved in organ transplantation, one that the hospital hopes will serve as a template for other centers across the country.
Dr. David Shafran, a pediatric nephrology fellow at University Hospitals Rainbow Babies and Children's Hospital who received a master’s degree in bioethics from Case Western Reserve University, has been chosen as the first fellow of the Clinic's Transplant Ethics Fellowship.
Former U.S. Treasury Secretary Robert Rubin, and his wife, Judith, provided a donation to help start the fellowship, which officials hope will be sustained in the future with an endowment.
With all of the ethical challenges surrounding transplant medicine – Which patients should be at the top of the wait list? How to handle someone who wants to donate a kidney or part of a liver to a stranger? – the timing was right, said Dr. Eric Kodish, a pediatric hematologist-oncologist and director of the Clinic’s Center for Ethics, Humanities and Spiritual Care.
“It seemed to us that there were enough issues specific to transplant medicine and ethics,” he said. “Organ shortages, allocation issues and informed consent policies for living donors are among the many ethical issues that confront the transplant field.”
Each year for the past seven years, the Cleveland Fellowship in Advanced Bioethics has chosen two people for two-year fellowships.
That program has served as the platform upon which the new fellowship – which also will be a two-year stint -- is based, Kodish said. Those chosen to be fellows in the future may come from the fields of law and philosophy in addition to medicine, he said.
Dr. Kathryn Weise is director of both fellowship programs. Weise and Shafran are developing a curriculum that will familiarize fellows with the core ethical issues surrounding organ transplantation and provide opportunity for independent research.
Given the scarcity of donated organs -- more than 120,000 people currently are awaiting organ transplants in the United States; this year, just over 19,000 transplants have been conducted through the end of August – questions of distributive justice and the role of technology in transplants are ongoing discussions, Kodish said.
Of the more than 350 clinical ethics consults at the Clinic that occurred in 2012 to handle ethical issues that arose during the course of patient care, 50 of them were transplant ethics consults, Kodish said.
The chance to return to the world of bioethics -- Shafran took lots of philosophy classes as an undergraduate at the University of Michigan, where he majored in Greek classical literature -- made the new fellowship a big draw. Halfway through his fellowship at UH Rainbow, he will work at both centers simultaneously.
"Like any other medical field that advances rapidly, transplant medicine is becoming a mainstream treatment," said Shafran, who hopes that other physicians use him as a resource when it comes to matters of transplant and bioethics.
"Keeping the conversation current, with regard to ethical issues, is extremely important.
"There are many things we are capable of doing," he said. The question becomes "whether or not we should be doing them."
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