ETHICAL PROBLEMS: Defining death

August 2004 
Volume 34  Number 8
Pages 10 - 10
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    Recently, I assisted with the care of a patient who became a “nonheartbeating” kidney donor. This patient had an advance directive specifying her wishes not to have her life prolonged artificially and consenting to organ donation. However, according to the transplant coordinator, this patient's electroencephalogram wasn't completely flat. When she was taken to the OR, she was intubated and ventilated and had a pulse. The transplant coordinator told me that she was given morphine as a “comfort measure,” then extubated. Death occurred within 60 minutes. The patient was then pronounced dead, and her kidneys were removed a few minutes later .

    As a patient advocate, I'm uneasy participating in this kind of procedure. Facilitating a patient's death for the purpose of organ procurement is foreign to me. What is a nonheartbeating donor, and ...

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