Education and debate

An Ethical Debate: Elective ventilation of potential organ donors

^a Royal Devon and Exeter Hospital, Exeter EX2 5DW

Correspondence to: Mr Riad.London SW4 0LF Julia Neuberger. Intensive Therapy Unit, Bristol Royal Infirmary, Bristol BS2 8HW Sheila M Willatts, consultant in charge. Renal Transplant Unit, Royal Liverpool University Hospital, Liverpool Robert A Sells, director. Faculty of Law, University of Liverpool, PO Box 147, Liverpool L69 3BX Michael A Jones, professor of law. Three Serjeants Inn, London EC4Y 1BQ Robert Francis, Queen's Counsel.

Elective ventilation describes the procedure of transferring selected patients dying from rapidly progressive intracranial haemorrhage from general medical wards to intensive care units for a brief period of ventilation before confirmation of brain stem death and harvesting of organs. This approach in Exeter has led to a rate of kidney retrieval and transplant higher than has been achieved elsewhere in the United Kingdom, with a stabilisation of numbers on patients on dialysis. Recently doubt has been cast on the legality of our practice of elective ventilation on the grounds that relatives are not permitted to consent to treatment of an incompetent person when that treatment is not in the patient's best interests. We are thus faced with the dilemma of a protocol that is ethical, practical, and operates for the greater good but which may be illegal. This article . . . [Full text of this article]

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Elective ventilation is cost effective and humane

Hany Riad, Anthony Nicholls, and Charles Collins
BMJ 1995 311: 1370. [Extract] [Full Text]

Elective ventilation of potential organ donors

Peter G M Wallace
BMJ 1995 311: 121. [Extract] [Full Text]

Intensive care units have good reasons not to do it

Alex Manara and Claire Jewkes
BMJ 1995 311: 121-122. [Extract] [Full Text]

Written protocols do not solve difficulties

M S Nielsen
BMJ 1995 311: 122. [Extract] [Full Text]

This article has been cited by other articles:

• McNally, S J, Harrison, E M, Wigmore, S J (2005). Ethical considerations in the application of preconditioning to solid organ transplantation. J. Med. Ethics 31: 631-634 [Abstract] [Full text]  
• Wight, J., Jakubovic, M., Walters, S., Maheswaran, R., White, P., Lennon, V. (2004). Variation in cadaveric organ donor rates in the UK. Nephrol Dial Transplant 19: 963-968 [Abstract] [Full text]  
• Bell, M D D (2003). Non-heart beating organ donation: old procurement strategy--new ethical problems. J. Med. Ethics 29: 176-181 [Abstract] [Full text]  
• Elliot, J. (2003). Brain death. Trauma 5: 23-42 [Abstract]  
• Branthwaite, M A (2001). Ethical problems in respiratory care: the role of the law. Thorax 56: 78-81 [Full text]  
• Davidson, N. (1998). Credit cards could be used to indicate availability of cadaver organs for transplantation. BMJ 317: 478a-478 [Full text]  
• Riad, H., Nicholls, A., Collins, C. (1995). Elective ventilation is cost effective and humane. BMJ 311: 1370a-1370 [Full text]  
• Nielsen, M S (1995). Written protocols do not solve difficulties. BMJ 311: 122-122 [Full text]  
• Wallace, P. G M (1995). Elective ventilation of potential organ donors. BMJ 311: 121c-121 [Full text]  
• Manara, A., Jewkes, C. (1995). Intensive care units have good reasons not to do it. BMJ 311: 121d-122 [Full text]  
• Searle, J. (1995). Protocol balanced ethical principles. BMJ 311: 122a-122 [Full text]