Book contents
- Clinical Ethics in Anesthesiology
- Clinical Ethics in Anesthesiology
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- 1 Consent and refusal
- 2 End-of-life issues
- 15 The principle of double effect in palliative care: euthanasia by another name?
- 16 Surgical interventions near the end of life: “therapeutic trials”
- 17 Withholding and withdrawing life support in the intensive care unit
- 18 Discontinuing pacemakers, ventricular assist devices, and implanted cardioverter-defibrillators in end-of-life care
- 19 Brain death
- 20 Ethical issues in organ donation after cardiac death
- 21 Revising the Uniform Anatomical Gift Act – the role of physicians in shaping legislation
- 22 Physician aid-in-dying and euthanasia
- 3 Pain management
- 4 Research and publication
- 5 Practice issues
- 6 Anesthesiologists, the state, and society
- Index
20 - Ethical issues in organ donation after cardiac death
from 2 - End-of-life issues
Published online by Cambridge University Press: 05 March 2012
Book contents
- Clinical Ethics in Anesthesiology
- Clinical Ethics in Anesthesiology
- Copyright page
- Dedication
- Contents
- Contributors
- Foreword
- Preface
- 1 Consent and refusal
- 2 End-of-life issues
- 15 The principle of double effect in palliative care: euthanasia by another name?
- 16 Surgical interventions near the end of life: “therapeutic trials”
- 17 Withholding and withdrawing life support in the intensive care unit
- 18 Discontinuing pacemakers, ventricular assist devices, and implanted cardioverter-defibrillators in end-of-life care
- 19 Brain death
- 20 Ethical issues in organ donation after cardiac death
- 21 Revising the Uniform Anatomical Gift Act – the role of physicians in shaping legislation
- 22 Physician aid-in-dying and euthanasia
- 3 Pain management
- 4 Research and publication
- 5 Practice issues
- 6 Anesthesiologists, the state, and society
- Index
Summary
The transplantation program in the US is an altruistic program based on the premise that organ donation is a gift, and relying on ethical principles of autonomy, respect for persons (beneficence, nonmaleficence), and justice. Organ donation after cardiac death (DCD) is controversial because it combines two ethically complex events: withdrawal of life-supportive therapies as part of end-of-life care of the dying patient, and the altruistic gift of organ donation. Firewalls should separate the three key decisions involved in DCD: the decision to forgo resuscitation, the decision to withdraw life-sustaining therapies, and the decision to donate organs after death. The dead donor rule presents ethical problems for expansions of DCD, and some legislative and practice changes to counteract these limitations may have presented even greater ethical problems than the dead donor rule itself. Resolving conflicts in the DCD process may require revisiting the dead donor rule.
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- Clinical Ethics in AnesthesiologyA Case-Based Textbook, pp. 114 - 122Publisher: Cambridge University PressPrint publication year: 2010