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KMID : 1025620190220020129
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Korean Journal of Medical Ethics
2019 Volume.22 No. 2 p.129 ~ p.139
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Ethical Issues in the use of Extracorporeal Membrane Oxygenation Related to Brain Death and attitudes of organ harves
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Kim Do-Kyong
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Abstract
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Organ preserving extracorporeal membrane oxygenation (OP-ECMO) is used as a method of donor management in donation after brain determination of death (DBDD) or potential brain-death to acquire organs in a way that stabilize vital sign in hemodynamically unstable donors. Because it can cause physical and psychological harm to donors and their family members OP-ECMO for DBDD or potential brain death raises ethical issues. Donors who refuse life-sustaining treatment may not receive the end of life care they want, and family members may have difficulty in accepting the patient’s death because of the use of ECMO even after a brain-death declaration. In cases of a potential brain-death, a medical professional who initiates ECMO without informed consent betrays the patient, the family, and any third-party payers.
In light of scarce medical resources, the use of OP-ECMO should be carefully examined. To address the potential ethical issues related to ECMO use in organ donors, medical professionals should indicate that the purpose of organ donation is not merely to harvest organs but rather give to the gift of life and should approach donor-centered organ donation and the harvesting process with respect for donor.
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KEYWORD
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donation after brain determination of death, potential brain-death, extracorporeal membrane oxygenation, organ donation, gift for life
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