Nair-Collins Michael, Green Sydney R, Sutin Angelina R
Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA.
J Med Ethics. 2015 Apr;41(4):297-302. doi: 10.1136/medethics-2014-102229. Epub 2014 Sep 26.
Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the 'dead donor rule', which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma.
脑死亡器官捐献者是可移植器官的主要来源。然而，脑死亡是否等同于生物死亡存在争议。因此，脑死亡时的器官摘除是否符合“死亡供体规则”尚不清楚，该规则规定器官摘除不得导致死亡。我们的目的是评估公众对于明确描述为导致处于不可逆呼吸暂停昏迷状态的供体死亡的器官摘除的看法。我们对美国公众进行了一项横断面网络调查（n = 1096）。问卷领域包括对一个描述为导致处于不可逆昏迷状态的患者死亡的器官摘除假设情景的看法，以及衡量死后器官捐献意愿的项目。约71%的样本同意在所述情景下患者捐献器官应属合法，67%的样本同意他们在类似情况下愿意捐献器官。在同意死后愿意捐献器官的85%的样本中，76%同意他们会在器官摘除导致死亡的不可逆昏迷情景下捐献。在一个明确描述为违反死亡供体规则的情景中，公众似乎支持器官捐献。此外，大多数（但并非全部）在器官摘除描述为在死后进行时会同意捐献的人，在器官摘除描述为导致不可逆昏迷状态下的死亡时也会同意捐献。
