Procon ethics debate Should mechanical ventilation be continued to allow for progression to brain death so that organs can be donated 英文参考文献.docVIP

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Procon ethics debate Should mechanical ventilation be continued to allow for progression to brain death so that organs can be donated 英文参考文献.doc

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Procon ethics debate Should mechanical ventilation be continued to allow for progression to brain death so that organs can be donated 英文参考文献

Available online /content/6/5/399 Commentary Pro/con ethics debate: Should mechanical ventilation be continued to allow for progression to brain death so that organs can be donated? Michael Parker1 and Sam D Shemie2 1University Lecturer in Medical Ethics, The Ethox Centre, University of Oxford, UK 2Department of Critical Care Medicine, Hospital for Sick Children, University of Toronto, and Montreal Children’s Hospital, McGill University, Canada Correspondence: Critical Care Editorial Office, editorial@ Published online: 15 August 2002 Critical Care 2002, 6:399-402 This article is online at /content/6/5/399 ? 2002 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract Organ transplants continue to redefine medical frontiers. Unfortunately, current demand for organs far surpasses availability, waiting lists are long and many people die before the organ they desperately need becomes available. One proposed way to increase organ availability is to admit patients to the ICU with severe neurological injuries, for a trial of therapy. If the injury is irretrievable, discussions would then focus on extending ventilation for potential brain death/organ donation if a prior wish to donate is known or if the substitute decision maker consents. The following debate discusses the ethical dilemmas of waiting for brain death. Keywords brain death, ethics, organ procurement, transplant The scenario The patient is a previously healthy 17-year-old boy who was Given the severity of hypoxic ischaemic brain injury and the patient’s dismal prognosis, the family was counselled to withdraw mechanical support. They requested organ donation but were informed that he was not eligible as he did not fulfil brain death criteria in view of the presence of spontaneous respiratory efforts. They agreed to withdrawal of support. The patient died 10 min after withdrawal of mechanical ventilation. transferred by air ambulance from a regional commun