Non-heartbeating organ donation: clinical process and fundamental issues.
This case report outlines the clinical process whereby a patient with severe traumatic brain injury became a non-heartbeating organ donor after a withdrawal-of-care decision. This process raises a series of ethical questions regarding decision-making on grounds of futility, the role of the next of kin, informed consent, the accommodation of manoeuvres directed towards organ retrieval at maximal viability, and the timing and determination of death. Although many aspects of the process can be accommodated within fundamental ethical principles and a broad interpretation of the concept of the 'best interests', the variance with established law requires authoritative clarification if a need for transplantable organs is to be responded to without compromising the reputation of practitioners involved in this area of care. Therefore, this recruitment strategy warrants wide public and professional debate to achieve longer-term sustainability and ensure the protection of all parties.
Bell
M D D
MD
The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK. dominic.bell@leedsth.nhs.uk
D000328:Adult; D001926:Brain Death; D001930:Brain Injuries / Q000000981:diagnostic imaging; D002102:Cadaver; D004739:England; D026690:Ethics, Clinical; D006801:Humans; D008297:Male; D018447:Medical Futility / Q000941:ethics; D020458:Third-Party Consent; D014019:Tissue Donors / Q000941:ethics* / Q000331:legislation & jurisprudence; D020858:Tissue and Organ Harvesting / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000379:methods; D009927:Tissue and Organ Procurement / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000379:methods; D014057:Tomography, X-Ray Computed