Patient's last wish: organ donation after euthanasia. What conditions should be met to fulfill it?

Q2 Medicine
S Marinelli, L De Paola, G Montanari Vergallo
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Abstract

Abstract: Organ donation after euthanasia (ODE) is a complex procedure involving the patient, the family, and the medical staff. Most organ donations occur from patients declared brain dead, and healthcare professionals rely on surrogate decisions, or the possible expression of ante-mortem will. Organ donation from deceased individuals is thus feasible under rigorous conditions, while direct donation after euthana-sia is not possible. The scientific community has not reached a shared conclusion. It is also difficult to quantify the number of patients who would be medically eligible to donate organs after euthanasia. In keep-ing with the core the principle of self-determination, any decision to undergo euthanasia (with or without organ donation) must be voluntary and not influenced by external pressures. For this reason, the physician should avoid informing the patient about the possibility of donating their organs before their request for euthanasia is evaluated. Just as noteworthy is the issue of healthcare providers' conscientious objec-tion and the receiving patient's right to know whether the transplanted organs come from a subject who underwent euthanasia. Finally, the patient who requests to end their life does so primarily because they are tormented by unbearable suffering and often expresses, as a last wish, the desire to exercise their free will regarding their own body. Organ donation after euthanasia would therefore seem to reinforce patient autonomy and self-esteem, thus giving a different meaning to their inevitable death, which is useful in saving the lives of others.

病人的遗愿:安乐死后的器官捐赠。实现这一愿望需要满足哪些条件?
摘要:安乐死后的器官捐献(ODE)是一项复杂的程序,涉及病人、家属和医务人员。大多数器官捐献发生在被宣布脑死亡的病人身上,医护人员依赖于代理决定或可能的生前意愿表达。因此,在严格的条件下,从死者身上捐献器官是可行的,而在安乐死后直接捐献器官则是不可能的。科学界尚未达成一致结论。此外,也很难量化安乐死后在医学上有资格捐献器官的病人数量。根据自决原则的核心,任何安乐死(无论是否捐赠器官)的决定都必须是自愿的,不受外界压力的影响。因此,在对病人的安乐死请求进行评估之前,医生应避免告知病人捐赠器官的可能性。同样值得注意的是医疗服务提供者的良心反对问题,以及接受器官的病人是否有权知道移植的器官是否来自安乐死对象。最后,要求结束自己生命的病人主要是因为他们被难以忍受的痛苦折磨着,而且作为最后的愿望,他们往往表达了对自己的身体行使自由意志的愿望。因此,安乐死后的器官捐赠似乎加强了病人的自主权和自尊,从而为他们不可避免的死亡赋予了不同的意义,这对挽救他人的生命是有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Clinica Terapeutica
Clinica Terapeutica PHARMACOLOGY & PHARMACY-
CiteScore
2.50
自引率
0.00%
发文量
124
审稿时长
6-12 weeks
期刊介绍: La Clinica Terapeutica è una rivista di Clinica e Terapia in Medicina e Chirurgia, fondata nel 1951 dal Prof. Mariano Messini (1901-1980), Direttore dell''Istituto di Idrologia Medica dell''Università di Roma “La Sapienza”. La rivista è pubblicata come “periodico bimestrale” dalla Società Editrice Universo, casa editrice fondata nel 1945 dal Comm. Luigi Pellino. La Clinica Terapeutica è indicizzata su MEDLINE, INDEX MEDICUS, EMBASE/Excerpta Medica.
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