title: How many organs should one patient receive? The ethics of transplantation in the medical school.
abstract: BACKGROUND
  Interest in the humanities in the medical school is growing; while several medical schools, mainly of Anglo-Saxon background, have developed dedicated courses, the experience in Italy is limited.
  
  
  METHODS
  Since the academic year 2000 to 2001, a discussion of ethical problems was implemented in the nephrology course (fourth year of the Medical School of Torino, Italy; overall 6 years). In 2002 to 2003, a case entitled "Retransplantation of Multiple Organs (Prog Transplant 2002)" was discussed in 2 hours of small-group tutorial teaching: a boy received a renal graft at age 5, failed at age 7 due to recurrent glomerulonephritis, required a heart-kidney graft at age 11, and a second heart-kidney graft at 17. Student opinions were gathered by anonymous semistructured questionnaires at the beginning of the lessons as a basis for discussion.
  
  
  RESULTS
  Following the lessons all students returned the questionnaires (n = 104). In the absence of competition for allocation, retransplantation was approved by 76.2%, unacceptable for 1% (22.9% uncertain-blank). With a waiting list of 10 patients, the opinions changed: 32.4% approved transplantation, 6.7% didn't approve it, 60.9% were uncertain. A theoretical categorization into deontological or utilitaristic approaches favored the first (41.9% vs 26.7%), with a high prevalence of blank-uncertain (31.5%); 21.9% of the students would change their opinion was that study head of the Transplant Department.
  
  
  CONCLUSIONS
  Ethical aspects of the medical profession have been discussed with interest by medical school students; the high prevalence of uncertain answers and requests to develop specific tools underline the importance of this educational approach.
authors.affiliation: Cattedra di Nefrologia, Dipartimento di Medicina Interna, Università di Torino, Torino, Italy. gbpiccoli@yahoo.it
authors.forename: G B
authors.initials: GB
authors.lastname: Piccoli
authors.forename: G
authors.initials: G
authors.lastname: Soragna
authors.forename: S
authors.initials: S
authors.lastname: Putaggio
authors.forename: M
authors.initials: M
authors.lastname: Burdese
authors.forename: P
authors.initials: P
authors.lastname: Longo
authors.forename: D
authors.initials: D
authors.lastname: Rinaldi
authors.forename: D
authors.initials: D
authors.lastname: Bergamo
authors.forename: E
authors.initials: E
authors.lastname: Mezza
authors.forename: V
authors.initials: V
authors.lastname: Consiglio
authors.forename: C
authors.initials: C
authors.lastname: Novaresio
authors.forename: M
authors.initials: M
authors.lastname: Gai
authors.forename: D
authors.initials: D
authors.lastname: Motta
authors.forename: B
authors.initials: B
authors.lastname: Malfi
authors.forename: F
authors.initials: F
authors.lastname: Giacchino
authors.forename: A
authors.initials: A
authors.lastname: Jeantet
authors.forename: G P
authors.initials: GP
authors.lastname: Segoloni
mesh_terms: D006801:Humans; D007558:Italy; D016030:Kidney Transplantation / Q000941:ethics*; D012577:Schools, Medical; D013663:Teaching / Q000379:methods; D019737:Transplants / Q000941:ethics*