how dead is 'dead enough' asks the cbc
TRANSCRIPT
1/30/2015 How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics
http://impactethics.ca/2014/03/31/how-dead-is-dead-enough-asks-the-cbc/ 1/6
IMPACTETHICS
Making a Difference in Bioethics
Search this site...
SUBSCRI BE BY EMAI L
Enter your email address
HOW DEAD IS ‘DEAD
ENOUGH’, ASKS THE CBC
ABOUT SUBMIT A POST DISCLAIMER
1/30/2015 How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics
http://impactethics.ca/2014/03/31/how-dead-is-dead-enough-asks-the-cbc/ 2/6
Follow Impact Ethics
SUBSCRI BE BY RSS
FEED
FOLLOW US ON
TWI TTER
The Global Heal th Impact
Index by Hassoun and
Bhimani wp.me/p38o3S-wU
Impact Ethics
@ImpactEthics
Expand
Everything you wanted to
know about mitochondria l
mutations but were afra id to
ask buff.ly/18zO4Oc
Impact Ethics
@ImpactEthics
Show Summary
4h
23h
Tweets Follow
Tweet to @ImpactEthics
TOPI CS
Assisted Reproduction
(31)
Canadian Bioethics (19)
CIHR (6)
Clinical Ethics (43)
Community (1)
Death & Assisted Dying
(26)
March 31, 2014 · by impact ethics · in Clinical Ethics, Organ
Donation · 2 Comments
Sarah Chapple defends organ and tissue donation after cardiac
death for patients who are critically ill and dependent on
mechanical ventilation, but who do not meet the requirements for
neurological death.
_____________________________________________
The CBC program “The Fifth Estate” recently aired an episode
titled “Dead Enough” that explores issues regarding the
declaration of death in critical care units and the state of organ
transplant in Canada. As a critical care social worker, I have
worked with dozens of families faced with the situation of losing
their loved one to a critical illness or sudden traumatic death.
Organ donation can be a way of finding something good in a tragic
situation, as described by the family of Sarah Beth Therien, the
first DCD (donation after cardiac death) donor in Canada.
From my perspective, the portrayal of the consent process for
organ donation in this program is highly problematic and left the
viewer with an impression of physicians waiting in the wings ready
to swoop in and remove organs from patients who still might
recover from their injuries if given enough time. The comments
from the families of Shane Becker and Brandice Thompson may
lead the public to believe that families are being coerced into
consenting to organ donation. Although miraculous recoveries can
occur, these are extremely infrequent.
It is unethical to approach a family and attempt to coerce consent
to organ donation if there is any hope of recovery. In cases of
brain (neurologically determined) death, families would not be
approached regarding organ donation until a determination of
death has already been made by two physicians. The discussion
would only occur prior to this, if a family requested such
information after being informed that the prognosis was
1/30/2015 How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics
http://impactethics.ca/2014/03/31/how-dead-is-dead-enough-asks-the-cbc/ 3/6
Disability (2)
Environmental Ethics (3)
Fertility Preservation (4)
Health Research (16)
Impact Ethics (26)
International Healthcare
(3)
Law & Policy (53)
Medical Tourism (4)
Mental Health (3)
Neuroethics (5)
Organ Donation (12)
Paediatric (2)
Public Health (21)
Reproduction (20)
Research Ethics (32)
Science and Technology
(1)
Science Funding (6)
Sex Selection (4)
Sexual Health (2)
Uncategorized (2)
BI OETHI CS FORUM
Have a Miscarriage and
Go to Jail? Potential
Consequences of
Personhood
extremely poor. A referral would then be made to the provincial
transplant coordinator to check if the patient was a registered
donor. It should also be noted that if, at any time, a family
requested that the process be stopped, their wishes would always
be respected without question.
It is important to distinguish between brain death and cardiac
death, as many consider death to have occurred only once
respiration ceases and the heart stops beating. Brain death is
defined as the irreversible loss of consciousness and all functions
of the brain stem including the capacity to breathe. A patient
determined to be brain dead is clinically and legally dead, and an
evaluation for brain death is often considered in patients who
experience a massive head trauma with irreversible brain injury.
There is a nation-wide criterion for the testing, determination and
diagnosis of brain death in Canada that was published by the
Canadian Congress of Neurological Sciences in 1986.
Organ and tissue donation after cardiac death (DCD) is an option
for patients who are critically ill and dependent on mechanical
ventilation, but who do not meet the requirements for
neurological death. These patients have usually experienced a
severe and irreversible brain injury with no long term prognosis
for recovery, as defined by the Trillium Gift of Life Network in
Ontario. Dr. Brian Goldman explains that organ donation after
1/30/2015 How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics
http://impactethics.ca/2014/03/31/how-dead-is-dead-enough-asks-the-cbc/ 4/6
Amendments
BI OPOLI TI CAL
TI MES
Obama Precision
Medicine Plan Would
Create Huge U.S.
Genetic Biobank
FEAR & LOATHI NG
I N BI OETHI CS
Cuckoo for cocoa puffs?
The surgical and
neoplastic role of cacao
extract in breakfast
cereals
HEALTHY DEBATE
Should hospital staff
satisfaction survey
results be public?
PRACTI CAL ETHI CS
New Book: The Ethics of
Embryonic Stem Cell
Research
ARCHI VES
January 2015
December 2014
cardiac death means that donation can take place within minutes
after the heart stops, precautions are put in place to ensure
cardiac death has taken place and that families are not
approached in haste. Critics of the DCD process express concern
that cardiac death may be reversible after five minutes. However
death, although potentially reversible through CPR, is still death
once circulation ceases.
A national, multidisciplinary, year-long discussion occurred in
Canada in 2005 to address the ethical issues associated with
organ donation after cardiac death. Offering organ donation is
viewed as an important part of end of life care, and research has
shown that organ donation has a beneficial effect on family
bereavement. A study from 2008, found that 97 percent of
respondents had no regrets about consenting to organ donation
and 94.5 percent said they were treated with compassion and
respect. There is, however, some room for improvement in these
conversations, as half of the respondents also felt confused about
brain death and may have felt rushed into making decisions.
Acting as the decision-maker for a loved one with a critical illness
is highly stressful, and can result in symptoms of acute stress.
Access to clear and consistent information and good
interpersonal relationships with the health care staff can help to
ease anxiety and stress, especially when the focus of care shifts
from life-saving interventions to comfort care and organ donation.
Providing families with clear information and encouraging them to
write down their questions for the medical team may assist with
recall and decrease stress.
Families need to be able to trust the medical team, have their
questions answered and be given time to consider options,
although the urgency of critical care treatment may not always
allow enough time for this t occur The focus in critical care is to
save lives, not prolong death, and for some families the potential
for organ donation can help them to cope with their grief over a
Follow
Follow “Impact
Ethics”
1/30/2015 How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics
http://impactethics.ca/2014/03/31/how-dead-is-dead-enough-asks-the-cbc/ 5/6
Re-posting IE blogs: Impact Ethics permits non-commercial
redistribution of commentaries, as long as the original
commentary is passed along unchanged and in whole, with credit
to the author and a link to the original Impact Ethics post. For
commercial reprints, please contact the blog manager at
Disclaimer
November 2014
October 2014
September 2014
August 2014
July 2014
June 2014
May 2014
April 2014
March 2014
February 2014
January 2014
December 2013
November 2013
October 2013
September 2013
August 2013
July 2013
June 2013
May 2013
April 2013
sudden loss.
_______________________________________________
Sarah Chapple is a Critical Care Social Worker in Vancouver and
an Instructor at the University of Victoria in the Faculty of Human
and Social Development @sarah_chapple
Share this:
Tags: brain death, cardiac death, organ donation
20
61
Related
Needed: Better
Guidelines for
Defining Death
In "Clinical Ethics"
Needed: More
Honesty About
Death Before
Donation
In "Clinical Ethics"
No Ethical Free
Lunch in Organ
Donation Policy
In "Clinical Ethics"
Ethics”
Get every new post delivered
to your Inbox.
Join 259 other followers
Enter your email address
Sign me up
Build a website with WordPress.com
1/30/2015 How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics
http://impactethics.ca/2014/03/31/how-dead-is-dead-enough-asks-the-cbc/ 6/6
Blog at WordPress.com.
The Origin Theme.
2 comments
M. Montgomery · May 10, 2014 - 1:09 am · Reply→
Insightful article. It is indeed a slippery slope between
life and death. It must be stressful to be in a situation
where a family knows their loved one will die. Organ
donation is a way to give life to someone else. I believe
this knowledge would lessen my own pain- knowing I
was helping someone else.
How Dead is ‘Dead Enough’, Asks the CBC | Impact Ethics | Philosophy of
Death · March 31, 2014 - 9:08 pm · Reply→
[…] http://impactethics.ca/2014/03/31/how-dead-is-
dead-enough-asks-the-cbc/ […]
Leave a Reply
← On Drug Addiction, Harm
Reduction and Governing In The Dark
Needed: Better Guidelines for
Defining Death →
Enter your comment here...