Elective Ventilation of Potential Organ Donors -- an Ethical Debate
Willatts, Sheila M.
Sells, Robert A.
Jones, Michael A.
BMJ (British Medical Journal). 1995 Mar 18; 310(6981): 714-718.
Elective ventilation describes the procedure of transferring selected patients dying from rapidly progressive intracranial haemorrhage from general medical wards to intensive care units for a brief period of ventilation before confirmation of brain stem death and harvesting of organs. This approach in Exeter has led to a rate of kidney retrieval and transplant higher than has been achieved elsewhere in the United Kingdom, with a stabilisation of numbers of patients on dialysis. Recently doubt has been cast on the legality of our practice of elective ventilation on the grounds that relatives are not permitted to consent to treatment of an incompetent person when that treatment is not in the patient's best interests. We are thus faced with the dilemma of a protocol that is ethical, practical, and operates for the greater good but which may be illegal. This article explores various objections to the protocol and calls for public, medical, and legal debate on the issues.
Attitudes; Brain; Brain Death; Common Good; Consent; Death; Determination of Death; Donors; Family Members; Guidelines; Health; Hospitals; Injuries; Intensive Care Units; Intention; Kidneys; Legal Aspects; Morality; Organ Donation; Organ Donors; Patient Transfer; Patients; Program Descriptions; Risks and Benefits; Relatives; Terminally Ill; Third Party Consent; Tissue Donation; Ventilators;
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