Department of Surgery, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
Prog Cardiovasc Dis. 2012 Nov-Dec;55(3):282-9. doi: 10.1016/j.pcad.2012.08.005.
We discuss ethical issues of organ transplantation including the stewardship tension between physicians' duty to do everything possible for their patients and their duty to serve society by encouraging organ donation. We emphasize consideration of the role of the principles of justice, utility and equity in the just distribution of transplantable organ as scarce resources. We then consider ethical issues of determining death of the organ donor including the remaining controversies in brain death determination and the new controversies raised by circulatory death determination. We need uniformity in standards of death determination, agreement on the duration of asystole before death is declared, and consensus on the allowable circulatory interventions on the newly declared organ donor that are intended to improve organ function. We discuss the importance of maintaining the dead donor rule, despite the argument of some scholars to abandon it.
我们讨论器官移植的伦理问题，包括医生既要为患者竭尽全力，又要通过鼓励器官捐献为社会服务的责任冲突。我们强调考虑公正、效用和公平原则在稀缺资源的可移植器官公正分配中的作用。然后，我们考虑确定器官捐献者死亡的伦理问题，包括脑死亡判断中的剩余争议和循环死亡判断中提出的新争议。我们需要在死亡判断标准方面保持统一，就死亡宣告前心脏停搏的持续时间达成一致，并就新宣布的器官捐献者可进行的旨在改善器官功能的循环干预措施达成共识。我们讨论了尽管一些学者主张放弃这一原则，但维护死体器官捐献规则的重要性。
