Written protocols do not solve difficulties

BMJ 1995;311:122 (8 July)

Letters

Written protocols do not solve difficulties

EDITOR,--Much is made by the protagonists of interventionalventilation¹ of its approval by, among others, the BMA. Theassociation's guidance included the recommendation that, ineach unit, a comprehensive protocol should exist from whichno deviation should be permitted.² It is therefore worryingthat, in the study in Exeter on which the strategy is based,circumstances "made some deviation from the protocol necessary"in four of the nine patients admitted to intensive care.³ Ifthis was the case in the ideal circumstances of the centre thatpioneered the approach, considerable "bending of the rules"might well occur in less well organised hospitals.

Robert Francis proposes incorporating appropriately worded consentto interventional ventilation in the wording of the organ donorcard as a means of overcoming existing legal barriers.¹ He arguesthat, if competent patients can decline lifesaving treatment,why should they not be able to consent to such a non-therapeutic. . . [Full text of this article]

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An Ethical Debate: Elective ventilation of potential organ donors: Hany Riad and Anthony Nicholls
BMJ 1995 310: 714-715. [Extract] [Full Text]

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