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Title: Conflicts of interest in the context of end of life care for potential organ donors in Australia.
Austin Authors: 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 I ;Radford, Samuel T ;Turner, Andrew J;Martin, Dominique
Affiliation: Australian National University, Medical School, University of Canberra, Faculty of Health, Intensive Care Unit, Canberra Hospital, Canberra, Australia
Department of Critical Care Medicine, Royal Hobart Hospital, Hobart, Australia
School of Medicine, Faculty of Health, Deakin University. Geelong, Australia
Cairns and Hinterland Hospital and Health Service, James Cook University School of Medicine and Dentistry, Cairns, Australia
University of Sydney, Children's Hospital at Westmead, Sydney, Australia
Australian National University, Medical School, University of Technology Sydney, ImPaCCT, Department of Palliative Care, Canberra Hospital, Canberra, Australia
Intensive Care Unit, Royal Melbourne Hospital, Melbourne, Australia
Intensive Care Unit, the Northern Hospital, Epping, Australia
Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia
Department of Intensive Care, Royal Adelaide Hospital, Adelaide, Australia
University of Queensland, Brisbane, Australia
Intensive Care Service, Royal Prince Alfred Hospital, Sydney, Australia
Intensive Care
Intensive Care Unit, Austin Health, Faculty of Medicine, Dentistry and Health Science, Melbourne University, Y, Australia
Issue Date: Oct-2020
Date: 2020-07-04
Publication information: Journal of Critical Care 2020; 59: 166-171
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.
DOI: 10.1016/j.jcrc.2020.06.016
Journal: Journal of Critical Care
PubMed URL: 32674003
Type: Journal Article
Subjects: Conflict of interest
Donation physician
Dual roles
End of life
Organ donation
Palliative care
Appears in Collections:Journal articles

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