Conflicts of interest in the context of end of life care for potential organ donors in Australia |
| |
| Affiliation: | 1. Department of Physiology and Pharmacology, Section of Perioperative Medicine and Intensive Care, Karolinska Institutet, Stockholm, Sweden;2. János Szentágothai Research Centre, University of Pécs, Pécs, Hungary;3. Division of Surgery and Clinical Neuroscience, Department of Physical Medicine and Rehabilitation, Oslo University Hospital and University of Oslo, Oslo, Norway;4. Department of Neurosurgery, University Hospital Northern Norway, Tromso, Norway;5. Department of Physical Medicine and Rehabilitation, University Hospital Northern Norway, Tromso, Norway;6. Trauma Surgery, Medical University Vienna, Vienna, Austria;7. Department of Anesthesiology & Intensive Care, University Hospital Nancy, Nancy, France;8. Raymond Poincare hospital, Hopitaux de Paris, Paris, France;9. Department of Anesthesiology & Intensive Care, S Raffaele University Hospital, Milan, Italy;10. Department of Neurosurgery, Radboud University Medical Center, Nijmegen, the Netherlands;11. Department of Neurosurgery, University of Szeged, Szeged, Hungary;12. International Projects Management, ARTTIC, Munchen, Germany;13. Department of Neurology, Neurological Intensive Care Unit, Medical University of Innsbruck, Innsbruck, Austria;14. Department of Neurosurgery & Anesthesia & intensive care medicine, Karolinska University Hospital, Stockholm, Sweden;15. NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK;16. Anesthesie-Réanimation, Hopitaux de Paris, Paris, France;17. Department of Anesthesia & ICU, AOU Città della Salute e della Scienza di Torino - Orthopedic and Trauma Center, Torino, Italy;18. Department of Neurology, Odense University Hospital, Odense, Denmark;19. BehaviourWorks Australia, Monash Sustainability Institute, Monash University, Victoria, Australia;20. Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia;21. Quesgen Systems Inc, Burlingame, CA, USA;22. Australian & New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia;23. Department of Surgery and Perioperative Science, Umeå University, Umeå, Sweden;24. Department of Neurosurgery, Medical School, Hungary and Neurotrauma Research Group, János Szentágothai Research Centre, University of Pécs, Hungary;25. Department of Medical Psychology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany;26. Brain Physics Lab, Division of Neurosurgery, Dept of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK;27. Neuro ICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy;28. ANZIC Research Centre, Monash University, Department of Epidemiology and Preventive Medicine, Melbourne, Victoria, Australia;29. Department of Neurosurgery, Hospital of Cruces, Bilbao, Spain;30. NeuroIntensive Care, Niguarda Hospital, Milan, Italy;31. School of Medicine and Surgery, Università Milano Bicocca, Milano, Italy;32. NeuroIntensive Care, ASST di Monza, Monza, Italy;33. Department of Public Health, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands;34. Department of Anaesthesiology, University Hospital of Aachen, Aachen, Germany;35. Department of Anesthesia & Neurointensive Care, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK;36. School of Public Health & PM, Monash University and The Alfred Hospital, Melbourne, Victoria, Australia;37. Radiology/MRI department, MRC Cognition and Brain Sciences Unit, Cambridge, UK;38. Institute of Medical Psychology and Medical Sociology, Universitätsmedizin Göttingen, Göttingen, Germany;39. Oxford University Hospitals NHS Trust, Oxford, UK;40. Intensive Care Unit, CHU Poitiers, Potiers, France;41. University of Manchester NIHR Biomedical Research Centre, Critical Care Directorate, Salford Royal Hospital NHS Foundation Trust, Salford, UK;42. Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK;43. Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium;44. Department of Anesthesia & Intensive Care, Maggiore Della Carità Hospital, Novara, Italy;45. Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium;46. Department of Neurosurgery, Clinical centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia;47. Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK;48. Center for Stroke Research Berlin, Charité, Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany;49. Intensive Care Unit, CHR Citadelle, Liège, Belgium;50. Department of Anaesthesiology and Intensive Therapy, University of Pécs, Pécs, Hungary;51. Departments of Neurology, Clinical Neurophysiology and Neuroanesthesiology, Region Hovedstaden Rigshospitalet, Copenhagen, Denmark;52. National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand;53. Department of Neurology, Erasmus MC, Rotterdam, the Netherlands;54. Department of Anesthesiology and Intensive care, University Hospital Northern Norway, Tromso, Norway;55. Department of Neurosurgery, Hadassah-hebrew University Medical center, Jerusalem, Israel;56. Fundación Instituto Valenciano de Neurorrehabilitación (FIVAN), Valencia, Spain;57. Department of Neurosurgery, Shanghai Renji hospital, Shanghai Jiaotong University/school of medicine, Shanghai, China;58. Karolinska Institutet, INCF International Neuroinformatics Coordinating Facility, Stockholm, Sweden;59. Emergency Department, CHU, Liège, Belgium;60. Neurosurgery clinic, Pauls Stradins Clinical University Hospital, Riga, Latvia;61. Department of Computing, Imperial College London, London, UK;62. Department of Neurosurgery, Hospital Universitario 12 de Octubre, Madrid, Spain;63. Department of Anesthesia, Critical Care and Pain Medicine, Medical University of Vienna, Austria;64. College of Health and Medicine, Australian National University, Canberra, Australia;65. Department of Neurosurgery, Neurosciences Centre & JPN Apex trauma centre, All India Institute of Medical Sciences, New Delhi 110029, India;66. Department of Neurosurgery, Erasmus MC, Rotterdam, the Netherlands;67. Department of Neurosurgery, Oslo University Hospital, Oslo, Norway;68. Division of Psychology, University of Stirling, Stirling, UK;69. Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital & University of Cambridge, Cambridge, UK;70. Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands;71. Neurointensive Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK;72. Salford Royal Hospital NHS Foundation Trust Acute Research Delivery Team, Salford, UK;73. Department of Intensive Care, Department of Ethics and Philosophy of Medicine, Erasmus Medical Center, Rotterdam, the Netherlands;74. Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå, Sweden;75. Hungarian Brain Research Program - Grant No. KTIA_13_NAP-A-II/8, University of Pécs, Pécs, Hungary;76. Cyclotron Research Center, University of Liège, Liège, Belgium;77. Centre for Urgent and Emergency Care Research (CURE), Health Services Research Section, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK;78. Emergency Department, Salford Royal Hospital, Salford, UK;79. Institute of Research in Operative Medicine (IFOM), Witten/Herdecke University, Cologne, Germany;80. VP Global Project Management CNS, ICON, Paris, France;81. Department of Anesthesiology-Intensive Care, Lille University Hospital, Lille, France;82. Department of Neurosurgery, Rambam Medical Center, Haifa, Israel;83. Department of Anesthesiology & Intensive Care, University Hospitals Southhampton NHS Trust, Southhampton, UK;84. Cologne-Merheim Medical Center (CMMC), Department of Traumatology, Orthopedic Surgery and Sportmedicine, Witten/Herdecke University, Cologne, Germany;85. Intensive Care Unit, Southmead Hospital, Bristol, Bristol, UK;86. Department of Neurological Surgery, University of California, San Francisco, CA, USA;87. Department of Anesthesia & Intensive Care, M. Bufalini Hospital, Cesena, Italy;88. Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany;89. Department of Neurosurgery, The Walton centre NHS Foundation Trust, Liverpool, UK;90. Department of Medical Genetics, University of Pécs, Pécs, Hungary;91. Department of Neurosurgery, Emergency County Hospital Timisoara, Timisoara, Romania;92. School of Medical Sciences, Örebro University, Örebro, Sweden;93. Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland;94. Analytic and Translational Genetics Unit, Department of Medicine; Psychiatric & Neurodevelopmental Genetics Unit, Department of Psychiatry, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA;95. Program in Medical and Population Genetics, The Stanley Center for Psychiatric Research, The Broad Institute of MIT and Harvard, Cambridge, MA, USA;96. Department of Radiology, University of Antwerp, Edegem, Belgium;97. Department of Anesthesiology & Intensive Care, University Hospital of Grenoble, Grenoble, France;98. Department of Anesthesia & Intensive Care, Azienda Ospedaliera Università di Padova, Padova, Italy;99. Dept. of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands;100. Department of Neurosurgery, Helsinki University Central Hospital, Finland;101. Division of Clinical Neurosciences, Department of Neurosurgery and Turku Brain Injury Centre, Turku University Hospital and University of Turku, Turku, Finland;102. Department of Anesthesiology and Critical Care, Pitié -Salpêtrière Teaching Hospital, Hôpitaux de Paris and University Pierre et Marie Curie, Paris, France;103. Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d''Hebron Research Institute, Barcelona, Spain;104. Department of Neurosurgery, Kaunas University of technology and Vilnius University, Vilnius, Lithuania;105. Department of Neurosurgery, Rezekne Hospital, Latvia;106. Department of Anaesthesia, Critical Care & Pain Medicine NHS Lothian, University of Edinburg, Edinburgh, UK;107. MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK;108. Department of Physical Medicine and Rehabilitation, Oslo University Hospital/University of Oslo, Oslo, Norway;109. Division of Orthopedics, Oslo University Hospital, Oslo, Norway;110. Institue of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;111. Broad Institute, Cambridge MA, Harvard Medical School, Boston MA, Massachusetts General Hospital, Boston, MA, USA;112. National Trauma Research Institute, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia;113. Department of Neurosurgery, Odense University Hospital, Odense, Denmark;114. International Neurotrauma Research Organisation, Vienna, Austria;115. Klinik für Neurochirurgie, Klinikum Ludwigsburg, Ludwigsburg, Germany;116. Division of Biostatistics and Epidemiology, Department of Preventive Medicine, University of Debrecen, Debrecen, Hungary;117. Department Health and Prevention, University Greifswald, Greifswald, Germany;118. Department of Anaesthesiology and Intensive Care, AUVA Trauma Hospital, Salzburg, Austria;119. Department of Neurology, Elisabeth-TweeSteden Ziekenhuis, Tilburg, the Netherlands;120. Department of Neuroanesthesia and Neurointensive Care, Odense University Hospital, Odense, Denmark;121. Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, Trondheim, Norway;122. Department of Physical Medicine and Rehabilitation, St.Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;123. Department of Neurosurgery, University of Pécs, Pécs, Hungary;124. Division of Neuroscience Critical Care, John Hopkins University School of Medicine, Baltimore, USA;125. Department of Neuropathology, Queen Elizabeth University Hospital, University of Glasgow, Glasgow, UK;126. Dept. of Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands;127. Department of Pathophysiology and Transplantation, Milan University, Neuroscience ICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy;128. Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden;129. Cochrane Consumers and Communication Review Group, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia;130. Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland;131. Department of Neurosurgery, Kaunas University of Health Sciences, Kaunas, Lithuania;132. Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands;133. Department of Neurosurgery, Kings college London, London, UK;134. Neurologie, Neurochirurgie und Psychiatrie, Charité – Universitätsmedizin Berlin, Berlin, Germany;135. icoMetrix NV, Leuven, Belgium;137. Psychology Department, Antwerp University Hospital, Edegem, Belgium;138. Director of Neurocritical Care, University of California, Los Angeles, USA;139. Department of Neurosurgery, St.Olavs Hospital, Trondheim University Hospital, Trondheim, Norway;140. Department of Emergency Medicine, University of Florida, Gainesville, FL, USA;141. Department of Neurosurgery, Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany;142. VTT Technical Research Centre, Tampere, Finland;143. Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada;144. Dept. of Neurosurgery, Medical Center Haaglanden, The Hague, the Netherlands;1. University Neurosurgical Center Holland, LUMC, HMC & HAGA, Leiden & The Hague, the Netherlands;2. Department of Intensive Care, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands;3. Centre for Medical Decision Making, Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, Rotterdam, the Netherlands;4. School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy;5. San Gerardo Hospital, ASST, Monza, Italy;6. Department of Neurosurgery, Antwerp University Hospital, Edegem, Belgium;7. University of Antwerp, Antwerp, Belgium;8. Department of Anaesthesia, University of Cambridge, Cambridge, United Kingdom;9. Department of Physiopathology and Transplantation, Milan University, Milan, Italy;10. Neuro ICU Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy;11. Department of Medical Ethics and Philosophy of Medicine, Erasmus MC – University Medical Centre Rotterdam, Rotterdam, the Netherlands;1. 5/123 Hawker Street, Ridleyton, Adelaide 5008, Australia;2. School of Nursing and Midwifery, Flinders University, GPO Box 2100, Adelaide 5001, Australia |
| |
| Abstract: | End-of-life (EOL) care has become an integral part of intensive care medicine and includes the exploration of possibilities for deceased organ and tissue donation. Donation physicians are specialist doctors with expertise in EOL processes encompassing organ and tissue donation, who contribute significantly to improvements in organ and tissue donation services in many countries around the world. Donation physicians are usually also intensive care physicians, and thus they may be faced with the dual obligation of caring for dying patients and their families in the intensive care unit (ICU), whilst at the same time ensuring organ and tissue donation is considered according to best practice. This dual obligation poses specific ethical challenges that need to be carefully understood by clinicians, institutions and health care networks. These obligations are complementary and provide a unique skillset to care for dying patients and their families in the ICU.In this paper we review current controversies around EOL care in the ICU, including the use of palliative analgesia and sedation specifically with regards to withdrawal of cardiorespiratory support, the usefulness of the so-called doctrine of double effect to guide ethical decision-making, and the management of potential or perceived conflicts of interest in the context of dual professional roles. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
