Ethical Issues in Critical Care and Cardiac Arrest: Clinical Research, Brain Death, and Organ Donation

2006 ◽  
Vol 26 (4) ◽  
pp. 452-459 ◽  
Author(s):  
Luke Donatelli ◽  
Romergryko Geocadin ◽  
Michael Williams
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Brain Death ◽  
Clinical Research ◽  
Organ Donation ◽  
Ethical Issues

Chinese Pediatric Organ Donation With Scheduled Cardiac Arrest After Brain Death: A Novel China Classification Beyond Maastricht

2015 ◽  
Vol 47 (10) ◽  
pp. 2836-2840 ◽  
Author(s):  
Z. Wu ◽  
X. Gao ◽  
F. Chen ◽  
X. Tao ◽  
J. Cai ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Death ◽  
Organ Donation

scholarly journals A narrative review of family members’ experience of organ donation request after brain death in the critical care setting

2019 ◽  
Vol 45 (3) ◽  
pp. 331-342 ◽  
Author(s):  
Nancy Kentish-Barnes ◽  
L. A. Siminoff ◽  
W. Walker ◽  
M. Urbanski ◽  
J. Charpentier ◽  
...  
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
Care Setting ◽  
Family Members ◽  
Narrative Review ◽  
Critical Care Setting

Readiness of critical care physicians and nurses to handle requests for organ donation

1998 ◽  
Vol 7 (1) ◽  
pp. 4-12 ◽  
Author(s):  
MJ Evanisko ◽  
CL Beasley ◽  
LE Brigham ◽  
C Capossela ◽  
GR Cosgrove ◽  
...  
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
The United States ◽  
Critical Care Nurses ◽  
Care Staff ◽  
Factual Knowledge ◽  
Donation Process ◽  
Nurses And Physicians ◽  
Effective Procedures

BACKGROUND: Critical care nurses and physicians usually care for those patients whose condition progresses to brain death and are also often responsible for requesting organ donation from the family of a brain-dead patient. We hypothesized that staff support, knowledge, and training levels would be significantly associated with organ donation rates. OBJECTIVE: To assess the readiness of critical care staff to successfully handle requests for organ donation. METHODS: A total of 1061 critical care staff from 28 hospitals in four separate regions of the United States completed a questionnaire that assessed (1) factual knowledge about organ donation, (2) understanding of brain death, (3) previous training in procedures for requesting donations, and (4) comfort levels with the donation process. RESULTS: Staff training in effective procedures for requesting organ donations was significantly correlated with hospitals' donation rates. Less than a third of respondents, however, had received training in explaining brain death to and requesting organ donation from a grieving family. In hospitals with high rates of organ donation, 52.9% of staff had received training; in hospitals with low rates of organ donation, 23.5% of staff had received training. Levels of factual knowledge about organ donation and brain death were unexpectedly low but were not significantly related to hospitals' rates of organ donation. CONCLUSIONS: Training of critical care nurses and physicians in effective procedures for requesting organ donation is significantly associated with higher rates of organ donation, yet two thirds of critical care staff report no relevant training. Consequently, critical care staff cannot be considered ready to effectively handle requests for organ donation.

An assessment of advance relatives approach for brain death organ donation

2017 ◽  
Vol 26 (2) ◽  
pp. 553-563
Author(s):  
Carine Michaut ◽  
Antoine Baumann ◽  
Hélène Gregoire ◽  
Corinne Laviale ◽  
Gérard Audibert ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Healthcare Professionals ◽  
Ethical Issues ◽  
Organ Procurement ◽  
Post Mortem ◽  
Potential Donor ◽  
Tissue Procurement ◽  
Study Population ◽  
Network Administrators

Background: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. Research design: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called ‘Prélor’. Participants: The study population comprised 460 physicians and nurses in the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Units and the Emergency Departments. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics and the Prélor Network administrators. Main findings: A slight majority of 53.5% of respondents had previously participated in an advance relatives approach: 83% of the physicians and 42% of the nurses. A majority of healthcare professionals (68%) think that the main justification for advance relatives approach is the comprehensive care of the dying patient and the research of his or her most likely opinion (74%). The misunderstanding of the related issues by relatives is an obstacle for 47% of healthcare professionals and 51% think that the answer given by the relatives regarding the most likely opinion of the person regarding post-mortem organ donation really corresponds to the person opinion in only 50% of the cases or less. Conclusion: Time given by advance approach should be employed to help and enable relatives to authentically bear the values and interests of the potential donor in the post-mortem organ donation discussion. Nurses’ attendance of advance relatives approach seems necessary to enable them to optimally support the families facing death and post-mortem organ donation issues.

scholarly journals A Survey on Doctors' Attitude towards Organ Donation in Brain Death Patient after Cardiac Arrest

2013 ◽  
Vol 16 (1) ◽  
pp. 117-123 ◽  
Author(s):  
최은아 ◽  
차원철 ◽  
Byung In Choe, Ph.D. ◽  
Min Seob Sim, M.D. ◽  
조익준 ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Death ◽  
Organ Donation

Ethical Concerns and Care Before Organ Donation

2019 ◽  
pp. 1012-1014
Author(s):  
Diane C. McLaughlin ◽  
Lauren K. Ng Tucker
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
Cardiac Death ◽  
Family Members ◽  
Organ Donor ◽  
Donation After Cardiac Death ◽  
Potential Organ Donor ◽  
Ethical Concerns

Organ donation usually proceeds smoothly and compassionately without raising any ethical concerns, and the involved family members are usually very satisfied. When concerns do arise, they typically involve 3 issues: consent for organ donation, critical care of the potential organ donor with brain death, and donation after cardiac death.

scholarly journals Knowledge and Attitude Regarding Organ Donation among Medical Students

2016 ◽  
Vol 14 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Vaishaly K. Bharambe ◽  
Hetal Rathod ◽  
Kalpana Angadi
Keyword(s):  
Medical Students ◽  
Brain Death ◽  
Organ Donation ◽  
Health Care Professionals ◽  
Ethical Issues ◽  
Organ Procurement ◽  
Organ Transplant ◽  
Medical College ◽  
Knowledge And Attitude ◽  
High Level

AbstractIntroduction. All over the world people on organ transplant waiting lists die due to shortage of donor organs. The success of organ donation program needs education of the population regarding organ donation for which healthcare professionals are most suitable. The present study was taken up to assess the knowledge and attitude of 1st, 2ndand 3rdyear medical students about organ donation. Methods. A specially designed self-administered questionnaire was distributed amongst all willing 1st, 2nd and 3rdyear medical students at our Medical College and later analyzed statistically. Results. A total of 157, 145 and 92 students from each year of medical education respectively gave their consent for participation in the study. Awareness regarding organ donation was found to be 98.7-100%, 69.4% claimed television as their source of information regarding organ donation and 46.7% stated that it is possible for patient to recover from brain death. The awareness regarding eye, liver, heart and kidney donations was found to be 92.4%, 87%, 87% and 97.8%, respectively. 87% of medical students were aware of need for legal supervision, and awareness regarding the existing laws was found to be 57.6%. Conclusion. Medical students had a high level of awareness and a positive attitude towards organ donation. However, knowledge regarding “brain-death”, organs and tissues donated, legislation and ethical issues was poor. A teaching intervention designed to specifically address these issues could help increase the confidence of the health-care professionals and may result finally in increased organ procurement rates.

Ethical Issues at the End of Life

2016 ◽  
Author(s):  
Alan R. Fleischman
Keyword(s):  
Pain Management ◽  
Brain Death ◽  
Organ Donation ◽  
End Of Life ◽  
Cardiac Death ◽  
Ethical Issues ◽  
Donation After Cardiac Death ◽  
Ethical Justification ◽  
Death Of A Child ◽  
At Home

This chapter deals with the difficult ethical issues associated with children who are dying. A recurring theme in the chapter is the role that children can play in planning their own care. The concept of brain death is examined and it is contrasted with cardiac death. The practice of organ donation after cardiac death is described and its ethical justification is questioned. . Several other controversial ethical issues are analyzed, including the distinction between withholding and withdrawing of treatment, withdrawing medically provided hydration and nutrition from infants who are not in the process of dying, whether pain management at the end of life hastens death and is therefore not permitted, and whether children should die in the hospital or at home. The chapter concludes with a description of how to support families after the death of a child.

scholarly journals Vaginal delivery in the 30+4 weeks of pregnancy and organ donation after brain death in early pregnancy

2019 ◽  
Vol 12 (9) ◽  
pp. e231601
Author(s):  
Ann Kristin Reinhold ◽  
Markus Kredel ◽  
Christian K Markus ◽  
Peter Kranke
Keyword(s):  
Critical Care ◽  
Brain Death ◽  
Organ Donation ◽  
Vaginal Delivery ◽  
Traffic Accident ◽  
Head Injuries ◽  
Ethical Challenges ◽  
Donation After Brain Death ◽  
Ethical And Legal Issues

A 28-year-old woman suffered a traffic accident resulting in severe head injuries with deleterious prognosis. Diagnostics further revealed a hitherto unknown pregnancy, at suspected week 9. Based on the patient’s wish to donate organs, brain death protocol confirmed irreversible loss of brain function. Yet, vital pregnancy rendered organ transplantation impossible. Multiple ethical and legal issues arose, from invalidation of established legal care after brain death to the delivery of a healthy child after trauma and long-term critical care. After medicolegal and ethical counselling, pregnancy was sustained, and the goal of organ donation postponed. Critical care focused on foetal homeostasis. At 30+4 weeks, a viable girl was born via assisted vaginal delivery. Postpartal organ donation resulted in heart, kidney and pancreas transplantation. The case emphasises the medical, legal and ethical challenges to combine two apparently diametrical goals: the successful full-term pregnancy and the fulfilment of a patient’s wish to donate organs.

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