题目内容
One of the principle obstacles to donation after circulatory death (DCD) development has been a concern about real and perceived conflicts of interests between providing care for a dying patient and facilitating donation before death has been established.
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Decisions regarding life-sustaining treatment should be made on their own merit, in consideration of organ donation.
Transplant physicians must be involved in the decision to withdrawal or withholding of life-sustaining treatment (WLST)or in death determination. This minimizes both real and perceived conflicts of interest for ICU staff between their therapeutic duty to the critically ill patient and their non-therapeutic relationship to potential organ transplant recipients.
Under the circumstances where the ICU may concurrently care for end-stage organ failure patients who are potential transplant recipients, physicians and caregivers who may be in conflict should not voluntarily withdraw from the care of a potential donor or the potential recipient.
Some families might perceive the request for donation to imply that the principal concern of the medical team is with the patient's organs rather than with the patient. It may be appropriate to delegate these discussions to representatives from an organ procurement organization or a program representative from the health care organization itself.
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