Death and dying

2011 ◽  
Author(s):  
Carl Waldmann ◽  
Neil Soni ◽  
Andrew Rhodes
Keyword(s):  
Spinal Cord ◽  
Organ Donation ◽  
Cranial Nerve ◽  
Death And Dying ◽  
Organ Donor ◽  
Cerebral Hemispheres ◽  
Cardiorespiratory Control ◽  
Brainstem Death ◽  
Heart Beating ◽  
Reticular Activating System

Confirming death using neurological criteria (brainstem death) 530Withdrawing and withholding treatment 532The potential heart-beating organ donor 534Non-heart-beating organ donation 538The brainstem provides the anatomical link between the spinal cord and cerebral hemispheres relaying sensory and motor impulses between the periphery and higher cortical centres. It also contains cranial nerve nuclei, the reticular activating system and cardiorespiratory control centres, the destruction of which underlies the process of confirming death according to neurological criteria (brainstem death)....

Death and dying

2019 ◽  
pp. 579-589
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Donation ◽  
Death And Dying ◽  
Best Interests ◽  
Life Care ◽  
Determination Of Death ◽  
Brainstem Death ◽  
Donation After Brain Death

This chapter discusses death and dying, and includes discussion on confirming death using neurological criteria (brainstem death), withdrawing and withholding treatment, organ donation after brain death (DBD), and organ donation after circulatory determination of death (DCD). Death is common in the intensive care unit (ICU) and it is important to identify patients whose condition meets the criteria for brainstem death testing as well as patients where continued treatment is not considered to be in their overall best interests. Confirming death using neurological criteria allows the relatives to be presented with the certainty of a diagnosis of death whether organ donation is possible or not. Decisions to withraw treatment are common in the ICU and are associated with approximately 50% of all deaths in the ICU. The decision is made by the multidisciplinary team in consultation with the patient’s relatives and taking into account the patient’s values and preferences. In both situations the possibility of organ donation should be considered and explored, and, when it is a possibility, it should be routinely offered to the relatives as an end-of-life care option.

Non-Heart Beating Organ Donation: A Case Study

2005 ◽  
Vol 15 (11) ◽  
pp. 467-475
Author(s):  
John Stirling
Keyword(s):  
Organ Donation ◽  
Clinical Assessment ◽  
Clinical Management ◽  
Organ Donor ◽  
Potential Donor ◽  
Heart Beating ◽  
Donation Process ◽  
Donor Transplant

The aim of this case study is to discuss the clinical management of a non-heart beating organ donor. This case study will concentrate in particular on the clinical assessment of the potential donor patient undertaken by the donor transplant coordinator (DTC) and the donation process up to the time of transplantation. The author will also describe the differences between heart beating and non-heart beating donors and discuss how transplantation can benefit renal recipient patients.

scholarly journals Care of the Brain-Dead Organ Donor

2019 ◽  
Vol 06 (02) ◽  
pp. 167-178
Author(s):  
Julian W. R. Siah ◽  
Nazneen Sudhan ◽  
Dhuleep S. Wijayatilake
Keyword(s):  
Organ Donation ◽  
Key Management ◽  
Early Recognition ◽  
Management Strategies ◽  
Organ Donor ◽  
Level Of Evidence ◽  
Donor Management ◽  
Brainstem Death ◽  
Management Concepts ◽  
And Function

AbstractThere remains a worldwide shortage of organs for transplantation. If not properly cared for, the organs of patients who are brainstem dead will deteriorate, making them either unsuitable for transplantation or reducing the success rate of transplants. The Medline database was searched with no time limit in January 2019 for English publications using keywords “brainstem death physiology” and “organ donor care.” Full texts of all publications related to care of deceased donors after brainstem death (DBD) were reviewed. Those that were not relevant were excluded. An online search for publications and guidelines produced by international organizations relating to organ donation and care of the organ donor was also preformed, and the results were reviewed.Although there is a low level of evidence to support specific management strategies to optimize the care of potential DBD patients, there is reasonable consensus between different international guidelines on protocolized intensive care unit (ICU) management of potential DBD patients and donor resuscitation targets.Key management concepts include (1) early recognition of brainstem DBD and referral to organ donation services, (2) ICU-led multidisciplinary team (MDT) approach to donor management, (3) shift in ICU teams thinking from management of raised intracranial pressure (ICP) to maintaining organ perfusion and function, (4) early active donor management to normalize donor physiology, and (5) prevention, recognition, and treatment of complications of brainstem death.

scholarly journals Ethical and Legal Implications of Elective Ventilation and Organ Transplantation: “Medicalization” of Dying versus Medical Mission

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Paola Frati ◽  
Vittorio Fineschi ◽  
Matteo Gulino ◽  
Gianluca Montanari Vergallo ◽  
Natale Mario Di Luca ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Donor ◽  
Legal Framework ◽  
Organ Donors ◽  
Organ Perfusion ◽  
Medical Mission ◽  
Legal Implications ◽  
Legal Context ◽  
Successful Transplantation ◽  
Italian Context

A critical controversy surrounds the type of allowable interventions to be carried out in patients who are potential organ donors, in an attempt to improve organ perfusion and successful transplantation. The main goal is to transplant an organ in conditions as close as possible to its physiological live state. “Elective ventilation” (EV), that is, the use of ventilation for the sole purpose of retrieving the organs of patients close to death, is an option which offsets the shortage of organ donation. We have analyzed the legal context of the dying process of the organ donor and the feasibility of EV in the Italian context. There is no legal framework regulating the practice of EV, neither is any real information given to the general public. A public debate has yet to be initiated. In the Italian cultural and legislative scenario, we believe that, under some circumstances (i.e., the expressed wishes of the patient, even in the form of advance directives), the use of EV does not violate the principle of beneficence. We believe that the crux of the matter lies in the need to explore the real determination and will of the patient and his/her orientation towards the specific aim of organ donation.

scholarly journals Hospital-based organ donation memorial ceremony: a grounded theory pilot study

2015 ◽  
Vol 4 (3) ◽  
pp. 1
Author(s):  
Charles Calhoun Reed ◽  
Elma I Fonseca ◽  
Regina I Reed ◽  
Stacy Foremski ◽  
Sara L Gill
Keyword(s):  
Grounded Theory ◽  
Pilot Study ◽  
Organ Donation ◽  
Organ Procurement ◽  
Social Process ◽  
Organ Donor ◽  
Hospital Staff ◽  
Tree Planting ◽  
Individual Level ◽  
Organ Procurement Organizations

Objective: Various types of organ donation memorials, to include tree planting, rose garden memorials, candle lighting, donor memorial wall events are conducted throughout the year primarily by organ procurement organizations (OPOs). Although the benefits of such events have not been explored there has been continued interest by hospital staff and administrators to host such events. The purpose of this grounded theory pilot study was to describe the process of healing that a hospital-based organ donation memorial ceremony creates at the individual level and organ donation awareness and advocacy at the community level.Methods: The researchers interviewed nine organ donor family members who were invited to attend a hospital-based organ donation memorial ceremony at one Level I Trauma Center located in South Texas.Results: A 4-stage social process, “makes the hole in the heart smaller”, was identified from the qualitative interview data. Participants journeyed through a four stage process to make the hole in their hearts smaller. The four stages are: choosing to attend, being able to connect, keeping the memory alive and knowing something good came from it. As participants moved between stages their meaning for attendance changed. Families shifted from personal grieving and needing support to supporting other donor families and in the process became advocates for organ donation.Conclusions: The findings from this study validate the benefits of hospital-based organ donation memorial ceremonies. Families reported these ceremonies support their decision to donate, while also providing a means of continued emotional support throughout their grief process. The memorial event provides a safe venue for organ donor families to connect and share with others who have had a similar experience, while acknowledging their loved ones gift of life. Hospital-based organ donation memorial ceremonies and the permanent memorial structure increase awareness of organ donation for the community of donor families, hospital visitors and hospital staff.

Brainstem death and organ donation

Head Injury ◽  
2010 ◽  
pp. 151-159
Author(s):  
Martin B. Walker
Keyword(s):  
Organ Donation ◽  
Brainstem Death

scholarly journals Knowledge and Attitudes about Organ Donation among Patient Companion at a Tertiary Hopsital in Ethiopia

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Mahteme Bekele ◽  
Wubshet Jote ◽  
Tigist Workneh ◽  
Berhanu Worku
Keyword(s):  
Organ Donation ◽  
Medical Center ◽  
Negative Attitude ◽  
Organ Donor ◽  
Tertiary Hospital ◽  
Favorable Attitude ◽  
Good Knowledge ◽  
Donor Pool ◽  
Cross Sectional ◽  
Study Participants

BACKGROUND: Worldwide, the supply of organs continues to be much less than the demand. Many studies identify poor knowledge and negative attitude about organ donation for this. The purpose of this study was to assess knowledge and attitude towards organ donation and associated factors among people who accompany patient during hospital visit at tertiary hospital in Ethiopia.METHODS: A hospital-based cross-sectional study was conducted from March 1st to May 31, 2019, at a tertiary hospital and the only transplant center in Ethiopia. The patient companions were interviewed with structured questionnaires. Descriptive statistics were presented and factors associated with good knowledge and favorable attitude were assessed using Binary logistic regression.RESULTS: A total of 414 patient companion participated in the study. The mean age of the respondents was 35+13years, and 252(60.9%) were males. Forty-four (10.6%) of the study participants had good knowledge about organ donation. Male gender was significantly associated with improved knowledge (AOR=2.127 95% CI: 1.036, 4.368). A favorable attitude towards donation was found in 219(52.9%) of the study participants. Participants who had completed secondary education were more likely to have unfavorable attitude towards organ donation (AOR=0.498, 95% CI: 0.290, 0.857).CONCLUSION: Knowledge about organ donation was found to be poor, and attitudes towards organ donation were found to be unfavorable among patient companions at a major medical center in Ethiopia. Strategies focused on education of the general public and broad dissemination of information on the benefits of organ donation will be critical for improving the organ donor pool.

scholarly journals Knowledge and attitude of law, medicine, and mass-communication students towards deceased organ donation

2020 ◽  
Vol 8 (1) ◽  
pp. 22
Author(s):  
Pragya Paneru ◽  
Shyam S. Budhathoki ◽  
Samyog Uprety ◽  
Birendra K. Yadav ◽  
Rashmi Mulmi ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Failure ◽  
Organ Transplantation ◽  
Mass Communication ◽  
Organ Donor ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Deceased Organ Donation ◽  
Knowledge And Attitude

Background: With the global increase in the incidence organ failure and subsequent advancement in the medical technology, organ transplantation is growing as the best choice of treatment among the patients with various kinds of organ failure. However, the rate of deceased organ donation is relatively low in South-East Asia regions, including Nepal. This has created a mismatch between the demand and supply of organs for transplantation. World Health Organization encourages organ transplantation from a deceased organ donor as there is no risk to the donor. Thus, this paper aimed to assess knowledge and attitude of literate group specifically towards deceased organ donation.Methods: This was a cross-sectional study conducted among 299 students selected conveniently from medicine, law, and mass communication streams from 9 different colleges (3 colleges from each stream) of Kathmandu. Data was collected through a self-administered questionnaire. Knowledge level was classified into three different categories based on obtained scores and attitude was analyzed based on five-point Likert scale.Results: Almost half (48.8%) of the respondents while only 7% had high level of knowledge on the organ donation and transplantation. Similarly, 95% of the people had positive attitude towards organ donation. However, there was a weak correlation between knowledge and attitude of the respondents. None of the respondents carried an organ donation card.Conclusions: There is a need to plan robust strategies to educate people on organ donation so that they can make pragmatic decisions to register their names for deceased organ donation.

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