DeVita Michael A, Vukmir Rade, Snyder James V, Graziano Cheryl
Kennedy Inst Ethics J. 1995 Mar;5(1):43-9. doi: 10.1353/ken.0.0021.
In the preceding commentary, Campbell and Weber raise two valid and important issues concerning non-heart-beating organ donation (NHBOD). First, because the procedure links withdrawal of life support and the potential for subsequent organ donation, the desire for organs may create a situation in which care of the dying individual has relatively less importance and the dying may receive suboptimal care. Second, even if concerns about care of the dying were dealt with adequately, there will not be enough non-heart-beating donors to significantly decrease the organ shortage that exists, making the procedure not worth the risk. We agree that attention to the important details of caring for the dying are, and must be, the primary concern of all health care workers caring for those individuals. Ensuring the patients' comfort, dignity, and autonomy, and providing for family and social support are the mainstays of this care. All policies for NHBOD should clearly support and mandate these concepts. Regarding the second concern, we agree that NHBOD is currently rare; however, evidence is increasing that this type of donation has great potential. Continued growth of the practice in this country will depend largely on public acceptance, which we believe will be directly influenced by whether the public perceives that care of the dying is not compromised by this procedure.
在前一篇评论中，坎贝尔和韦伯提出了两个关于非心脏跳动器官捐赠（NHBOD）的合理且重要的问题。首先，由于该程序将撤除生命支持与后续器官捐赠的可能性联系在一起，对器官的需求可能会造成一种情况，即对濒死个体的护理相对不那么重要，而且濒死者可能得不到最佳护理。其次，即使对濒死护理的担忧得到了充分解决，非心脏跳动捐赠者的数量也不足以显著缓解现有的器官短缺问题，这使得该程序不值得冒险。我们同意，关注濒死护理的重要细节是且必须是所有照顾这些个体的医护人员的首要关注点。确保患者的舒适、尊严和自主权，并提供家庭和社会支持是这种护理的支柱。所有关于非心脏跳动器官捐赠的政策都应明确支持并强制推行这些理念。关于第二个问题，我们同意目前非心脏跳动器官捐赠很少见；然而，越来越多的证据表明这种捐赠方式具有巨大潜力。在这个国家，这种做法的持续发展在很大程度上取决于公众的接受程度，我们认为公众的接受程度将直接受到公众是否认为该程序不会损害濒死护理的影响。
