Procon ethics debate is nonheart-beating organ donation ethically acceptable 英文参考文献.docVIP

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Procon ethics debate is nonheart-beating organ donation ethically acceptable 英文参考文献.doc

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Procon ethics debate is nonheart-beating organ donation ethically acceptable 英文参考文献

Critical Care June 2002 Vol 6 No 3 Whetstine et al. Commentary Pro/con ethics debate: is nonheart-beating organ donation ethically acceptable? Leslie Whetstine1, Kerry Bowman2 and Laura Hawryluck3 1PhD Student, Duquesne University, Pittsburgh, Pennsylvania, USA 2Bioethicist, University of Toronto, Joint Centre for Bioethics, Ontario, Canada 3Assistant Professor, Critical Care Medicine, University Health Network, and Member, Joint Center for Bioethics, University of Toronto, Canada Correspondence: Critical Care Forum Editorial Office, editorial@ Published online: 26 April 2002 Critical Care 2002, 6:192-195 ? 2002 BioMed Central Ltd (Print ISSN 1364-8535; Online ISSN 1466-609X) Abstract This pro/con debate explores the ethical issues surrounding nonheart-beating organ donation (NHBD), a source of considerable controversy. It is estimated that NHBD can increase the number of organs available for transplant by 25% at a time of great need. However, should NHBD be ethically acceptable? In support of NHBD, it may be acceptable practice if there is a separation of the rationale to withdraw life support/to withhold cardiopulmonary resuscitation from the decision to recover organs, if no conflicts of interest exist, if a waiting time precluding spontaneous return of circulation is included, and if NHBD conforms to a standardized protocol. Against NHBD, there are questions regarding the ambiguity and cultural perspectives of death, regarding whether a separation of rationale between withdrawal and donation is sufficient to preclude conflicts of interest, and regarding whether variable protocols arise that subordinate the patient to the goal of donation. Such concerns suggest NHBD may damage the trust in patient–physician relationships and may adversely affect organ donation rates. Keywords bioethics, critical care, death, nonheart-beating organ donation, organ donation Introduction Laura Hawryluck NHBD is currently a source of con