Non-heart-beating donors (individuals whose deaths are determined by cessation of heart and respiratory function rather than loss of whole brain function) could potentially be of major importance in reducing the gap between the demand for and available supply of organs for transplantation. Prompted by questions concerning the medical management of such donors--specifically, whether interventions undertaken to enhance the supply and quality of potentially transplantable organs (i.e. the use of anticoagulants and vasodilators) were in the best interests of the donor patient--the U.S. Department of Health and Human Services asked the Institute of Medicine to examine from scientific and ethical points of view "alternative medical approaches that can be used to maximize the availability of organs from [a] donor [in an end-of-life situation] without violating prevailing ethical norms...." This book examines transplantation supply and demand, historical and modern conceptions of non-heart-beating donors, and organ procurement organizations and transplant program policies, and contains recommendations concerning the principles and ethical issues surrounding the topic. Table of Contents <ul>
<li>Front Matter</li>
<li>Executive Summary</li>
<li>1 Introduction</li>
<li>2 Transplantation Supply and Demand</li>
<li>3 Background</li>
<li>4 The Modern Non-Heart-Beating Donor</li>
<li>5 Survey of Organ Procurement Organization and Transplant Program Policies</li>
<li>6 Analysis, Findings, and Recommendations</li>
<li>References</li>
<li>Appendix A</li>
<li>Appendix B</li>
<li>Appendix C</li>
</ul>

Non-Heart-Beating Organ Transplantation: Medical and Ethical Issues in Procurement

Politics & Social Sciences

INSTITUTE OF MEDICINE

Herdman, Roger

Potts, John T.

Philosophy

National Academies Press

The VA National Formulary generated controversy, which motivated congressional scrutiny and a directive to the VA to commission this report reviewing the experience with the National Formulary and formulary system. This Institute of Medicine committee was pleased to assist the Congress with this review, in part because the committee saw in the VHA example an opportunity to understand and anticipate problems that all publicly funded programs are likely to encounter in this new age of pharmaceuticals. The Congress asked the committee to review the restrictiveness of the National Formulary, its impact on the costs and quality of care in the VHA, and how it compared to formularies and drug management practices in the private sector and in other public programs, especially Medicaid. Detailed in the pages that follow, the committee's findings and conclusions on these questions are, the committee believes, highly instructive, though not always in the ways that we anticipated. Table of ContentsFront MatterExecutive SummaryIntroductionIs the VA National Formulary Overly Restrictive and Does it Prevent Physicians from Meeting the Health Care Needs of Veterans?What are the Potential Costs to VA Health Care Associated with the National Formulary for Drugs?What are the Effects of the National Formulary and Related Policies on Quality of Care?How Does the VA National Formulary Compare with Private Insurance Formularies for Drugs and Devices and with Other Government Formularies?The VA National Formulary and Veterans Health CareReferencesAcronymsAppendix A: Interim Report of the Committee on VA Pharmacy Formulary Analysis to the Department of Veterans Affairs and the Congress of the United StatesAppendix B: Academy of Managed Care Pharmacy's Managed Care Formulary and Pharmacy Benefit Design SurveyAppendix C: Additional Cost InformationAppendix D: GlossaryAppendix E: Drug Classes and Drug IndexAppendix F: Committee Biographies

Description And Analysis of the Va National Formulary

Medical Books

Blumenthal, David

Administration & Medicine Economics

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