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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
ECMO-assisted CPR (E-CPR)
cardiopulmonary resuscitation (CPR)
extracorporeal membrane oxygenation (ECMO)
out-of-hospital cardiac arrest (OHCA)
uncontrolled donation after circulatory determination of death (uDCDD)
Blood Circulation
Cardiopulmonary Resuscitation
Clinical Decision-Making
Clinical Protocols
Conflict of Interest
Death
Ethical Analysis
Family
France
Health Education
Heart Arrest
Humans
Informed Consent
New York City
Spain
Terminology as Topic
Tissue and Organ Procurement
Withholding Treatment
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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