Uncontrolled Donation After Circulatory Determination of Death: A Systematic Ethical Analysis.
Journal article

Uncontrolled Donation After Circulatory Determination of Death: A Systematic Ethical Analysis.

  • Dalle Ave AL 1 Ethics Unit, University Hospital of Lausanne, Lausanne, Switzerland.
  • Bernat JL 3 Neurology Department, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
  • 2017-03-16
Published in:
  • Journal of intensive care medicine. - 2018
English Uncontrolled donation after circulatory determination of death (uDCDD) refers to organ donation after a refractory cardiac arrest. We analyzed ethical issues raised by the uDCDD protocols of France, Madrid, and New York City. We recommend: (1) Termination of resuscitation (TOR) guidelines need refinement, particularly the minimal duration of resuscitation efforts before considering TOR; (2) Before enrolling in an uDCDD protocol, physicians must ascertain that additional resuscitation efforts would be ineffective; (3) Inclusion in an uDCDD protocol should not be made in the outpatient setting to avoid error and conflicts of interest; (4) The patient's condition should be reassessed at the hospital and reversible causes treated; (5) A no-touch period of at least 10 minutes should be respected to avoid the risk of autoresuscitation; (6) Once death has been determined, no procedure that may resume brain circulation should be used, including cardiopulmonary resuscitation, artificial ventilation, and extracorporeal membrane oxygenation; (7) Specific consent is required prior to entry into an uDCDD protocol; (8) Family members should be informed about the goals, risks, and benefits of planned uDCDD procedures; and (9) Public information on uDCDD is desirable because it promotes public trust and confidence in the organ donation system.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/261362
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