活體器官捐贈者社會心理評估經驗初探-以醫務社工為例

為了確保活體器官捐贈者的安全，將捐贈手術風險降至最低，必須在手術之前為活體器官捐贈者進行周全的評估。醫務社工在活體器官捐贈者社會評估過程中回應活體器官捐贈者權益的維護與及器官受贈者對生存機會的期待，同時也面對法律問題、倫理抉擇、團隊關係的考驗。本研究關注在醫務社工對活體器官移植進行心理社會評估的必要性。本研究使用質性研究方法，訪談12名醫務社工。分析醫務社工在活體器官者社會心理評估的實務經驗以及和移植醫療團隊合作經驗。研究發現，活體器官捐贈者社會心理評估應包括捐贈者基本資料、社會評估、心理評估、醫學認知評估、總體評估結果和建議五個部分。醫務社工在社會心理評估的過程中審慎蒐集相關資訊，以了解其社會風險並落實知情同意。醫務社工進行社會心理評估是為了降低風險與減少傷害，保護捐贈者的權利。在社會心理評估過程中醫務社工發揮了作為活體器官捐贈者的資源連結者、使能者、倡導者和教育者的作用。綜言之，活體器官捐贈者社會心理評估是維護捐贈者健康權益、避免脅迫利誘情況發生的關鍵。如何維護良好的評估品質、確保捐贈者權益是值得持續深究的議題。

The purpose of this study is to point out the necessity of psychosocial assessment of living organ donors in medical social work practice. To ensure the safety of living organ donors and to minimize the operative risks on donors, a comprehensive evaluation must be performed before surgery. Medical social workers need to cope with both the protection of the rights of living organ donors and the survival concerns of organ recipients. Thus, facing challenges from legal aspects, ethical issues, and interactions among members of the organ transplant team. This study recruited 12 medical social workers , through in depth interview, we collected information from their experience of the psychosocial assessment and their interactions among members of the team. We used qualitative research method to analyze the information. The results of the study showed that the psychosocial assessment of living organ donors should include five aspects : basic information of donors, social assessment, psychological assessment, medical cognitive assessment, overall assessment and recommendations. Through the psychosocial assessment, medical social workers clarify donors’ social risks and implement the informed consents to protect donors’ rights. The medical social workers serve as donors’ resource counselors, enablers, advocates, and educators. In conclusion, the psychosocial assessment of living organ donors is crucial to safeguard donors’ health rights and prevent coercion and inducement. How to maintain high quality psychosocial assessment in order to protect donors’ rights is an important issue and need further studies.