[Non-therapeutic ventilation of potential donor is ethically acceptable. It allows time to consider for both the family and the personnel].
In the debate on organ donation it has been argued that all medical care of patients in intensive care units should be undertaken solely for the good of the patient and that it is wrong to initiate non-therapeutic ventilation in order that such a patient may later become an organ donor. We argue against this view. We think the ethically relevant instant is not the time of death but the point where the physicians deem it pointless to undertake curative measures. We envisage two cases for such non-therapeutic ventilation. One is when a patient is deemed to be in a terminal state (for example after having suffered significant intra-cranial bleeding), and there are no curative measures to be taken. In this case the patient is unconscious and the decision for ventilator treatment must be taken with short notice. Here we recommend that such patients are put on ventilators and the relatives are consulted afterwards. The other case is when a patient, already ventilated, is in a terminal state, unconscious, and the physicians deem that curative measures no longer can be taken. In this case we recommend that ventilation be continued. In both cases, such a policy might provide more organs for transplantation. It could benefit many and it will hurt no one.
Welin
Stellan
S
Linköpings universitet. stewe@tema.liu.se
Sanner
Margareta
M
Nydahl
Anders
A
D003657:Decision Making / Q000941:ethics; D005190:Family; D017408:Guidelines as Topic; D006801:Humans; D012121:Respiration, Artificial / Q000941:ethics*; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000941:ethics*