Brain death as a prerequisite for post-mortem organ donation

1999 ◽  
Vol 13 (2) ◽  
pp. 113-116
Author(s):  
H. Angstwurm
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Post Mortem

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.

Non-therapeutic intensive care for organ donation

2014 ◽  
Vol 23 (2) ◽  
pp. 191-202 ◽  
Author(s):  
Stéphanie Camut ◽  
Antoine Baumann ◽  
Véronique Dubois ◽  
Xavier Ducrocq ◽  
Gérard Audibert
Keyword(s):  
Intensive Care ◽  
Brain Death ◽  
Organ Donation ◽  
Healthcare Professionals ◽  
University Hospital ◽  
Individual Autonomy ◽  
Post Mortem ◽  
Multiple Choice Questions ◽  
Presumed Consent ◽  
Family Approach

Background and Purpose: Providing non-therapeutic intensive care for some patients in hopeless condition after cerebrovascular stroke in order to protect their organs for possible post-mortem organ donation after brain death is an effective but ethically tricky strategy to increase organ grafting. Finding out the feelings and opinion of the involved healthcare professionals and assessing the training needs before implementing such a strategy is critical to avoid backlash even in a presumed consent system. Participants and methods: A single-centre opinion survey of healthcare professionals was conducted in 2013 in the potentially involved wards of a French University Hospital: the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Unit and the Emergency Department. A questionnaire with multiple-choice questions and one open-ended question was made available in the different wards between February and May 2013. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics. Results: Of a total of 340 healthcare professionals, 51% filled the form. Only 21.8% received a specific education on brain death, and only 18% on potential donor’s family approach and support. Most healthcare professionals (93%) think that non-therapeutic intensive care is the continuity of patient’s care. But more than 75% of respondents think that the advance patient’s consent and the consent of the family must be obtained despite the presumed consent rule regarding post-mortem organ donation in France. Conclusion: The acceptance by healthcare professionals of non-therapeutic intensive care for brain death organ donation seems fairly good, despite a suboptimal education regarding brain death, non-therapeutic intensive care and families’ support. But they ask to require previously expressed patient’s consent and family’s approval. So, it seems that non-therapeutic intensive care should only remain an ethically sound mean of empowerment of organ donors and their families to make post-mortem donation happen as a full respect of individual autonomy.

Double Effect Donation

2021 ◽  
Vol 88 (2) ◽  
pp. 149-162
Author(s):  
Charles C. Camosy ◽  
Joseph Vukov
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Human Life ◽  
Double Effect ◽  
Natural Death

Double Effect Donation claims it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. The reason this act is permissible is that it does not aim at one’s own death but rather at saving the lives of others and because saving the lives of others constitutes a proportionately serious reason for engaging in a behavior in which one foresees one’s death as the outcome. Double Effect Donation, we argue, opens a novel position in debates surrounding brain death and organ donation and does so without compromising the sacredness and fundamental equality of human life. Summary: Recent cases and discussion have raised questions about whether brain death criteria successfully capture natural death. These questions are especially troubling since vital organs are often retrieved from individuals declared dead by brain death criteria. We therefore seem to be left with a choice: either salvage brain death criteria or else abandon current organ donation practices. In this article, we present a different way forward. In particular, we defend a view we call Double Effect Donation, according to which it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. Double Effect Donation, we argue, is not merely compatible with but grows out of a view that acknowledges the sacredness and fundamental equality of human life.

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

ETHICAL DEBATE OVER ORGAN DONATION IN THE CONTEXT OF BRAIN DEATH

Bioethics ◽  
2010 ◽  
Vol 24 (2) ◽  
pp. 54-60 ◽  
Author(s):  
MARY JIANG BRESNAHAN ◽  
KEVIN MAHLER
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Ethical Debate

Organ Donation After Brain Death After Long-Term Left Ventricular Mechanical Support

2008 ◽  
Vol 27 (7) ◽  
pp. 815-816 ◽  
Author(s):  
Michael S. Firstenberg ◽  
Louis B. Louis ◽  
Chittoor B. Sai-Sudhakar ◽  
Benjamin C. Sun
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Left Ventricular ◽  
Mechanical Support ◽  
Donation After Brain Death

Comparison of 1 vs 2 Brain Death Examinations on Time to Death Pronouncement and Organ Donation

Neurology ◽  
2021 ◽  
Vol 96 (10) ◽  
pp. e1453-e1461
Author(s):  
Panayiotis N. Varelas ◽  
Mohammed Rehman ◽  
Chandan Mehta ◽  
Lisa Louchart ◽  
Lonni Schultz ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Brain Function ◽  
Brain Injuries ◽  
Organ Procurement ◽  
Tertiary Hospital ◽  
Consent Rate ◽  
Organ Procurement Organization ◽  
Time To Death ◽  
Elapsed Time

ObjectiveTo fill the evidence gap on the value of a single brain death (SBD) or dual brain death (DBD) examination by providing data on irreversibility of brain function, organ donation consent, and transplantation.MethodsTwelve-year tertiary hospital and organ procurement organization data on brain death (BD) were combined and outcomes, including consent rate for organ donation and organs recovered and transplanted after SBD and DBD, were compared after multiple adjustments for covariates.ResultsA total of 266 patients were declared BD, 122 after SBD and 144 after DBD. Time from event to BD declaration was longer by an average of 20.9 hours after DBD (p = 0.003). Seventy-five (73%) families of patients with SBD and 86 (72%) with DBD consented for organ donation (p = 0.79). The number of BD examinations was not a predictor for consent. No patient regained brain function during the periods following BD. Patients with SBD were more likely to have at least 1 lung transplanted (p = 0.031). The number of organs transplanted was associated with the number of examinations (β coefficient [95% confidence interval] −0.5 [−0.97 to −0.02]; p = 0.044), along with age (for 5-year increase, −0.36 [−0.43 to −0.29]; p < 0.001) and PaO2 level (for 10 mm Hg increase, 0.026 [0.008–0.044]; p = 0.005) and decreased as the elapsed time to BD declaration increased (p = 0.019).ConclusionsA single neurologic examination to determine BD is sufficient in patients with nonanoxic catastrophic brain injuries. A second examination is without additional yield in this group and its delay reduces the number of organs transplanted.

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