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脑死亡争议:对其发生率和管理的全面审查
Erica Andrist1,2,3, Andrew Kiragu4, Matthew P Kirschen5,6,7
1Division of Pediatric Critical Care Medicine, C.S. Mott Children's Hospital, Ann Arbor, MI.
Critical care medicine
|November 27, 2025
概括
临床医生面临的挑战是家庭对脑死亡/神经学标准死亡 (BD/DNC) 声明的分歧. 需要更多的指导和一致的定义,以有效地管理这些有争议的案件.
科学领域:
- 医学伦理 医学伦理
- 神经学 神经学
- 法律医学 法律医学
背景情况:
- 家庭对脑死亡/通过神经学标准死亡 (BD/DNC) 声明的质疑带来了重大的伦理和临床挑战.
- 了解临床医生的经验和制定有效的策略来导航这些有争议的案件对于患者护理和家庭支持至关重要.
研究的目的:
- 描述临床医生的经验与家庭对BD/DNC的质疑.
- 为了整理导航争议BD/DNC案件的策略.
主要方法:
- 在多个数据库 (PubMed,EMBASE,PsychInfo,Scopus,CINAHL,Web of Science) 进行了全面的系统文献搜索,更新至2025年1月.
- 采用了范围审查方法,包括选10577份摘要,以确定26份符合条件的出版物,详细介绍了有争议的BD/DNC案件的经验,临床/法律方面或专业指南.
- 数据提取是使用Covidence进行的,重点是经验研究和专业协会在2014年之后发布的指南,不包括虚构或不涉及的评论和涉及孕妇患者的病例.
主要成果:
- 确定了26个出版物,其中20个来自美国,详细说明了BD/DNC质疑的各种情况,从家庭请求到漫长的诉讼.
- 咨询了包括息治疗,伦理学,社会工作和法律顾问在内的多学科团队,尽管他们的实用性很少详细.
- 临床医生和医院人员表示,需要具体的机构和法律指导来解决案件质疑问题.
结论:
- 临床医生经常遇到家庭对BD/DNC声明的质疑,这凸显了当前管理策略中的差距.
- 灵活和详细的管理方法是必要的,但缺乏数据和一致的术语阻碍了开发最佳反应.
- 需要进一步的多学科和参与性研究,以建立一致的定义,并传播有效的策略来管理有争议的BD/DNC案件.
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