title: Extra corporeal membrane oxygenation support: ethical dilemmas.
abstract: The vast expansion of patients treated with of extra corporeal membrane oxygenation (ECMO) emerge novel ethical questions about the use of this new technology. In regard the indications, duration of support and timing of withdrawal of support, these questions sometimes create disagreement among surrogates, between health care team and surrogates, and even disagreement among health care team, these disagreements occurs because of the extreme emergency of support initiation, the ambiguity of the outcome as well as lack of clarity on the intended treatment direction, whether it is ineffective, bridge to recovery or bridge to lifetime mechanical support or transplant. In this article we discuss these questions through patients' scenarios.
authors.affiliation: Palliative Care Division, University of Massachusetts Medical School, Berkshire Medical Center, Pittsfield, MA, USA.
authors.forename: Tony
authors.initials: T
authors.lastname: Makdisi
authors.affiliation: Division of Cardiothoracic Surgery, Tampa General Hospital, Tampa, FL, USA.
authors.forename: George
authors.initials: G
authors.lastname: Makdisi
keywords: Extra corporeal membrane oxygenation (ECMO); ethics; extracorporeal support; mechanical circulatory support (MCS); multidisciplinary