Murphy P, Manara A, Bell D, Smith M
The General Infirmary, Leeds, UK.
Anaesthesia. 2008 May;63(5):526-30. doi: 10.1111/j.1365-2044.2007.05397.x.
While many intensive care clinicians in the UK continue to express significant concerns regarding controlled non-heart beating organ donation, others are involved in established programmes that make an increasingly significant contribution to the total number of cadaveric donations each year. The successful introduction of a controlled non-heart beating organ donation programme requires local resolution of any apparent ethicolegal obstacles to the process, with specific attention needing to be given to three areas: the potential conflict of interest between decision making over futility and any subsequent approach regarding organ donation; a belief that it may be unlawful to adjust in any way an end of life care pathway in order to allow donation to take place, and, finally, an uncertainty over how soon after cardiac death organ retrieval can begin. It is proposed that recent changes in legislation provide, through an emphasis on patient autonomy and best interests, a solid ethicolegal foundation for donation after cardiac death.
尽管英国许多重症监护临床医生仍对非心脏跳动控制下的器官捐献表达了重大担忧，但其他医生则参与了既定项目，这些项目每年对尸体捐献总数的贡献越来越大。成功引入非心脏跳动控制下的器官捐献项目需要当地解决该过程中任何明显的伦理法律障碍，尤其需要关注三个方面：关于医疗无效判定的决策与随后任何器官捐献方法之间潜在的利益冲突；认为为了实现捐献而以任何方式调整临终护理路径可能是非法的观点，以及最后，心脏死亡后多久可以开始器官获取的不确定性。有人提出，近期的立法变化通过强调患者自主权和最大利益，为心脏死亡后的捐献提供了坚实的伦理法律基础。
