Donatelli Luke A, Geocadin Romergryko G, Williams Michael A
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Semin Neurol. 2006 Sep;26(4):452-9. doi: 10.1055/s-2006-948326.
Cardiac arrest results in global hypoxic-ischemic brain injury from which there is a range of possible neurological outcomes. In most cases, patients may require a surrogate to make decisions regarding end-of-life care, including the withdrawal of life-sustaining therapies. This article reviews ethical considerations that arise in the clinical care of patients following cardiac arrest, including decisions to continue or withdraw life-sustaining therapies; brain death determination; and organ donation in the context of brain death and cardiac death (so-called non-heart-beating donation). This article also discusses ethical concerns pertaining to the design and conduct of resuscitation research that is necessary for the development of effective therapies to prevent anoxic brain injury or promote neurological recovery.
心脏骤停会导致全脑缺氧缺血性脑损伤，由此可能产生一系列不同的神经学转归。在大多数情况下，患者可能需要代理人来做出有关临终护理的决定，包括撤除维持生命的治疗措施。本文回顾了心脏骤停患者临床护理中出现的伦理考量，包括继续或撤除维持生命治疗的决定、脑死亡判定，以及在脑死亡和心脏死亡背景下的器官捐献（即所谓的非心脏跳动捐献）。本文还讨论了与复苏研究的设计和实施相关的伦理问题，而复苏研究对于开发预防缺氧性脑损伤或促进神经功能恢复的有效治疗方法是必不可少的。
