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安乐死医疗辅助后器官捐献的实践与挑战:纳入 2021 年首次国际圆桌会议结果的范围综述。

Practice and challenges for organ donation after medical assistance in dying: A scoping review including the results of the first international roundtable in 2021.

机构信息

Anesthesiology/Intensive Care Department, Isala Hospitals, Zwolle, The Netherlands.

Family Medicine Centre Dalfsen, Zwolle, The Netherlands.

出版信息

Am J Transplant. 2022 Dec;22(12):2759-2780. doi: 10.1111/ajt.17198. Epub 2022 Oct 26.

Abstract

The procedure combining medical assistance in dying (MAiD) with donations after circulatory determination of death (DCDD) is known as organ donation after euthanasia (ODE). The first international roundtable on ODE was held during the 2021 WONCA family medicine conference as part of a scoping review. It aimed to document practice and related issues to advise patients, professionals, and policymakers, aiding the development of responsible guidelines and helping to navigate the issues. This was achieved through literature searches and national and international stakeholder meetings. Up to 2021, ODE was performed 286 times in Canada, the Netherlands, Spain, and Belgium, including eight cases of ODE from home (ODEH). MAiD was provided 17,217 times (2020) in the eight countries where ODE is permitted. As of 2021, 837 patients (up to 14% of recipients of DCDD donors) had received organs from ODE. ODE raises some important ethical concerns involving patient autonomy, the link between the request for MAiD and the request to donate organs and the increased burden placed on seriously ill MAiD patients.

摘要

将医疗辅助死亡(MAiD)与循环死亡判定后捐献(DCDD)相结合的程序被称为安乐死后器官捐献(ODE)。第一次国际 ODE 圆桌会议于 2021 年 WONCA 家庭医学会议期间举行,作为范围审查的一部分。它旨在记录实践和相关问题,为患者、专业人员和政策制定者提供建议,为制定负责任的准则提供帮助,并帮助解决问题。这是通过文献检索以及国家和国际利益相关者会议实现的。截至 2021 年,加拿大、荷兰、西班牙和比利时共进行了 286 次 ODE,包括 8 例在家进行的 ODE(ODEH)。在允许 ODE 的八个国家中,MAiD 提供了 17217 次(2020 年)。截至 2021 年,837 名患者(占 DCDD 供体受者的 14%)已接受 ODE 器官。ODE 引发了一些重要的伦理问题,涉及患者自主权、MAiD 请求与捐赠器官请求之间的联系,以及重病 MAiD 患者的负担增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0ea/10092544/57cad8c86b22/AJT-22-2759-g002.jpg

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