Organ donation and ethics 0.0 / 5 ? MedicineEthicsUniversityAll boards Created by: zCreated on: 04-03-16 16:22 Issues with donation need to undertake interventions that do not benefit pt (only donor) e.g. bloods, ventilation, cannulation, time and place of withdrawal of treatment answer: in best interests of pt if it is their wish to donate family veto patient has joined ODR and is known to want to donate, family can refuse consent 1 of 4 Increasing donation and approach ways to increase donation incentivise donation coerce donation force donatrion remove barriers to donatin approach MDT must discuss approach pt must be identified as potential donor and elicit statu son organ donor register (ODR) only approach family once they understand that death has occurred/is inevitable use positive language, open ended qus, avoid being apologetic or coercion 2 of 4 Diagnosis and confirmation of death legal responsibilty of a medical practitioner death= irreversible loss of capacity for consciousness + irreversible loss of capacity to breathe neurological, somatic and circulatory criteria must demonstrate loss of capacity for consciousness absence of pupillary response to light absence of corneal light absence of motor response to supre-orbital pressure demonstration of loss of capacity to breathe in CR arrest: 5 min observation of maintained CR arrest in coma: 5 minut apnoea test to demonstrate no spontaneous respiratory effort 3 of 4 Criteria for death neurological criteria established aetiology capable of causing structural damage to brain which has led to irreversible loss of capacity for consciousness and breathing exclusion of reversible conditions capable of mimicking or confoundong the diagnosis of death by these criteria clinical examination of the patient which demostrate profound coma, apnoea and absent brainstem reflexes somatic criteria pallor mortis livor mortis (bruising colour on lowest areas of body) algor mortis (coldness of death) rigor mortis decomposition circulatory criteria clear intention not to attempt/continue CPR observation period (5 minutes) to confirm cont apnoea, absent circ and unconsc prohibition of intervention at any time that might restore cerebral blood flow by any means 4 of 4
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