The Ethics of Donation after Cardiac Death

The Ethics of Donation after Cardiac Death

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Course

Tutor’s Name

23rd October, 2010

Outline

Introduction

Gives an explanation of cardiac arrest and how it is done in the clinical practice. It gives an overview of the removal and preservation of the donated organs.

Organ Preservation

Antemortem drug administration reduces the risk of the organ being damaged just before as well as after potential donor’s death.

Ethical issues

These are issues arising during donation of organs after cardiac arrest.

Consent

This is a formal registration which allow for organ donation. It is given by the patient or family members.

Effects on the Donor

This examines the effects of antemortem interventions to the patient.

Death Uncertainty

Taking the patient to the operating theater before death could jeopardize his or her health and cause death.

Treatment Processes

Effects of administration of heparin, antibiotics, steroids and femoral vessels cannulation

Conclusion

The medical practice is geared to improve the health of patients although it may interact with the social welfare of others.

Introduction

Donation after Cardiac Death is an emerging practice where organs are harvested immediately the patient undergoes a cardiac arrest and resuscitation is inapplicable. Under ideal conditions, it is legally identified. The theoretic criterion points that just a few patients whom the physicians pronounce dead are truly dead by criteria that are theoretically rigorous (Mike, 2005).

Organ cryopreservation through advancing technology has allowed reversible organ function especially for kidney and mammalian brain. The electrophysiological and metabolic activity preservation enables those who are terminally ill to pursue cure. Legal death is based on cardiac death in situations that resuscitation is inapplicable (Mike, 2005).

Organ Preservation

After cardiac death, the organs which are procured are at a great risk of damage due to thrombic insults and warm ischaemia. These organs have great incidence of having delayed graft function as compared to those procured when brain death occurs. The practice involves antemortem drug administration to reduce risk of the organ being damaged just before as well as after potential donor’s death. Surgery is done immediately the patient is pronounced dead in the operating theatre where time observance is crucial (Bernadette & Wendy, 2007).

Ethical issues

Consent

To demonstrate respect for individuals, consent is necessary. When there lacks formal registration giving consent to give a donation, in most cases family members can offer grounds to donations. Mostly, it is not distinguished whether the donation after cardiac death or after brain death. This may be assumed that people’s consent may be donation after brain death. Ethically valid consent must be given and informed without any coercion. Without ante-mortem or explicit interventions, it becomes unclear whether the consent is given to organ removal before death in the operating theater (Mitch, 2008).

For an appendicectomy, consent excludes procedures such as appendix removal, incision by surgeon, suture techniques, and antibiotics. There is consent to all steps facilitating the appendix removal. For organ removal, consent for donation involves all reasonable procedures for successful operation to give organs that are viable. The consent to donation should be ethically sufficient for donations to occur after cardiac death as well as any required ante-mortem intervention (Bernadette & Wendy, 2007).

Effects on the Donor

Avoiding harm is another ethical consideration. This brings the question whether the patient is harmed by the ante mortem interventions or not. The interventions are heparin administration, operating theatre removal, antibiotics, steroids and femoral vessels cannulation.

Death Uncertainty

When the patient is taken to the theater before death, he or she may get disturbed or else the family members. This may jeopardize the medical care of the patient. It inevitably causes disruption although it is unclear whether its death in the intensive care unit or that of the operating room.

Treatment Processes

No evidence is associated with bleeding after heparin administration which results to death. Related harms are unlikely since patients who have active bleeding are not considered for donation. Administration of heparin can be through intravenous lines which interfere with none of the members of the family at the bedside. Antibiotics and steroids administration might be likewise cause no harm. Femoral vessels cannulation is physically invasive and may cause disruptions to the family since they have to move away for the process to continue. The cannulas are removed if the patient does not proceed for donation (Bernadette & Wendy, 2007).

Conclusion

Donations after Cardiac arrest trigger many ethical as well as legal issues. These issues revolve around the need for medical advancements in alleviation of human suffering versus considerations of social issues that revolve around religion and humane side of medicine.

Reference

Bernadette, R. Wendy A. Rogers. (2007). Organ donation after cardiac death: legal and ethical justifications for ante-mortem interventions. , SA. Flinders University, Adelaide: Department of Medical Education,

Mitch, K. (2008) Donation after Cardiac Death: ‘Is mostly dead slightly alive?’ Las Vegas Nevada.

Mike Darwin. (2005). Critical Care Donation after Cardiac Death. Alcor

Bibliography:

Anish B. & Marek A. M. (2010). Handbook of Neurocritical Care (2 Ed.) New York, Springer

National Academy of Sciences (NAS). (2006). Organ Donation. United States of America

Raymond, J. D. (2010). Practical Decision Making in Health Care Ethics, Cases and Concepts (3 Ed). Washington, D.C. Georgetown University Press.

Susan J., W. & Katherine D. (2009). Essentials of Nursing Law and Ethics. U.S.A, Jones

and Bartlet Publishers

Vincent, J. (2010). 2010 Year Book of Intensive Care and Emergency Medicine. Germany,

Springer.

Wayne, S. & John, B. (2001). Advances in Bioethics ‘The Ethics of Organ Transplantation’: Netherlands, Elsevier Science Ltd.