Controlled Donation After Circulatory Determination of Death

Journal of Intensive Care Medicine
Anne L Dalle Ave, David M Shaw

Abstract

Controlled donation after circulatory determination of death (cDCDD) concerns donation after withdrawal of life-sustaining therapy (W-LST). We examine the ethical issues raised by W-LST in the cDCDD context in the light of a review of cDCDD protocols and the ethical literature. Our analysis confirms that W-LST procedures vary considerably among cDCDD centers and that despite existing recommendations, the conflict of interest in the W-LST decision and process might be difficult to avoid, the process of W-LST might interfere with usual end-of-life care, and there is a risk of hastening death. In order to ensure that the practice of W-LST meets already well-established ethical recommendations, we suggest that W-LST should be managed in the ICU by an ICU physician who has been part of the W-LST decision. Recommending extubation for W-LST, when this is not necessarily the preferred procedure, is inconsistent with the recommendation to follow usual W-LST protocol. As the risk of conflicts of interest in the decision of W-LST and in the process of W-LST exists, this should be acknowledged and disclosed. Finally, when cDCDD programs interfere with W-LST and end-of-life care, this should be transparently disclosed to the family, and spe...Continue Reading

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Apr 22, 2017·The American Journal of Bioethics : AJOB·James L Bernat
Dec 1, 2017·Progress in Transplantation : Official Publication, North American Transplant Coordinators Organization ... [et Al.]·Anne L Dalle AveBernice Elger
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Nov 7, 2019·Journal of the Intensive Care Society·Dale GardinerAnne L Dalle Ave
Feb 10, 2021·Current Opinion in Anaesthesiology·Kenneth F PotterMohammed A Quader

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