[Intervened death: from brain death to withholding or withdrawal of life-sustaining treatment].
The concept of intervened death accounts for all those situations in which the withholding or withdrawal of life-sustaining treatment constitutes a limit to therapeutic action associated to the occurrence of the traditional cardio-respiratory death. The 1968 Harvard Report advanced a new definition of death through the concept of complete cessation of global brain functions and, more than thirty years later, this process of intervention in its diagnosis may be seen as a continuum link to the need to procure organs for transplant purposes and the need to avoid long agonies in unrecoverable patients. During the last decade, the ethical admissibility of withdrawing ordinary and advanced life-sustaining therapy in cases that do not amount to brain death diagnosis--such as vegetative states and other irreversible clinical situations--and even the advances made for purposes of obtaining organs for transplant purposes in these situations (with the explicit authorization of the donor or his/her representative) allows a joint interpretation of these situations through the acceptance that limits may be established in medical assistance. Reflection on intervened death as an emerging phenomenon of our culture is mandatory so that society may get involved in an issue of its absolute and exclusive interest.
Gherardi
Carlos R
CR
División Terapia Intensiva, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina. acgherar@sinectis.com.ar
D001926:Brain Death / Q000175:diagnosis; D003657:Decision Making; D004992:Ethics, Medical; D006801:Humans; D018447:Medical Futility; D018458:Persistent Vegetative State / Q000175:diagnosis; D028761:Withholding Treatment