Archive for the ‘Ethics’ Tag

Academy of Royal Colleges – Diagnosis of Death

After a long process of consultation the Academy of Medical Royal Colleges have released the Code of Practise for the Diagnosis and Confirmation of Death. Always a topic likely to cause controversy – see previous posts! The document can be downloaded from the blue box, or here. I’m sure there will be plenty of comments, I’ll be posting my own shortly…….

Organ donation after Cardiac death

Pediatric Heart Transplantation after Declaration of Cardiocirculatory Death. Bouchek, M et al. New England Journal of Medicine. 2008: Volume 359:709-714.

A report in the NEJM describes a paediatric non-heart beating donor programme for cardiac transplants. This has not been done previously as the ischemic time between cessation of cardiac output and declaration of death has thought to be too great. The program shortened this time to 1.25 mins, justified as being longer than the 60 seconds maximum reported time for auto-resuscitation. Arterial cannulae were placed prior to death to allow rapid infusion of heparin and cooling solutions. There are 3 editorials to accompany the article debating the ethical questions that the program raises. Bernat and Veatch argue that the program makes explicit the conflict within non-heart beating donation, i.e. it may require either additional treatment of the donor, or require a change the definition of death. Continue reading