Conflicts of interest in the context of end of life care for potential organ donors in Australia

van Haren, Frank M.P., Carter, Angus, Cavazzoni, Elena, Chapman, Michael, D'Costa, Rohit L., Jones, Sarah L., McGee, Andrew, Moodie, Stewart, Nunnink, Leo, O'Leary, Michael, Opdam, Helen, Radford, Sam, Turner, Andrew J., and Martin, Dominique (2020) Conflicts of interest in the context of end of life care for potential organ donors in Australia. Journal of Critical Care, 59. pp. 166-171.

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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.

Item ID: 66175
Item Type: Article (Research - C1)
ISSN: 1557-8615
Keywords: Conflict of interest, Organ donation, Ethics, Donation physician, End of life, Palliative care, Dual roles
Copyright Information: © 2020 Elsevier Inc. All rights reserved
Date Deposited: 25 Nov 2020 08:16
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3299 Other biomedical and clinical sciences > 329999 Other biomedical and clinical sciences not elsewhere classified @ 100%
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