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Donation after cardiac death and the emergency department: ethical issues

Jeremy R Simon1, Raquel M Schears, Aasim I Padela

  • 1The Department of Medicine and Center for Bioethics, Columbia University, New York, NY.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|February 21, 2014
PubMed

Insights

Organ donation after cardiac death (DCD) is a growing option to combat organ shortages. This article examines operational and ethical challenges emergency physicians face with DCD procedures in emergency departments.

Area of Science:

  • Medical Ethics
  • Transplantation Medicine
  • Emergency Medicine

Background:

  • Organ donation after cardiac death (DCD) is increasingly utilized globally to address organ shortages.
  • DCD procedures differ from donation after brain death, presenting unique challenges.
  • Emergency departments (EDs) are becoming more involved in DCD processes.

Purpose of the Study:

  • To explore the operational considerations for emergency physicians (EPs) regarding DCD.
  • To examine the ethical issues surrounding DCD within the emergency department setting.
  • To provide guidance for EPs managing DCD cases.

Main Methods:

  • Review of current DCD protocols and guidelines.
  • Analysis of operational workflows in EDs for DCD.
  • Discussion of ethical dilemmas and case examples.

Main Results:

  • Identification of key operational challenges in EDs for DCD implementation.
  • Highlighting of ethical complexities, including consent and determination of death.
  • Emphasis on the need for specialized training for EPs.

Conclusions:

  • EDs play a critical role in the DCD process.
  • Clear protocols and ethical frameworks are essential for successful DCD.
  • Further education and policy development are needed to support EPs in DCD.

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