Ethical, psychosocial, and public policy implications of procuring organs from non-heart-beating cadaver donors

Article Abstract:

Increasing the transplantation of organs from non-heart-beating cadaver donors (NHBCDs) could save lives but raises many ethical and practical issues. Most organs for transplantation come from patients who have been declared brain dead. They are called heart-beating cadaver donors because their hearts are still beating when the organs are removed. Before the acceptance of brain death in the 1970s, NHBCDs were the primary source of transplanted organs. Because of the time interval between declaration of death and removal and preservation of the organs, organs from NHBCDs may become irreversibly damaged. Two recent developments, however, make NHBCDs a more viable source of organs. Kidneys can now be cooled and preserved in the body immediately after death. The other option is to procure organs from patients who decide to forgo treatment such as mechanical ventilation. The Pittsburgh Protocol, which addresses some of the ethical issues raised, stresses that decisions about patient care and treatment must be made separately from any about organ donation.

Ethical aspects, Transplantation of organs, tissues, etc., Organ transplantation, Tissue transplantation, Transplantation

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Conflicts Regarding Decisions to Limit Treatment: A Differential Diagnosis

Article Abstract:

A discussion of the potential sources of conflict between doctors and the families of terminally ill patients is presented. Many families may want doctors to do everything to keep the patient alive, whereas the doctor may believe any treatment would be futile. It may be helpful to consider all the possible causes of conflict in the same way that doctors consider all the possible causes of a particular set of symptoms.

Analysis, Physician and patient, Physician-patient relations, Terminal care, Refusal to treat (Medicine)

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Factors Influencing Families' Consent for Donation of Solid Organs for Transplantation

Article Abstract:

People who wish to donate their organs upon their death should make sure their family members and their doctor know their wishes. In a study of 420 deceased patients who were eligible to donate organs, only 238 of the families did so.

Research

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