Treating the dead; how far ought medicine go to obtain transplantable organs?

Autor:	Bernstock JD; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Chalif JI; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Jha R; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Brown A; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Essayed WI; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States., Caplan A; Division of Medical Ethics, Grossman School of Medicine, New York University, New York, NY, United States., Peruzzi P; Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in transplantation [Front Transplant] 2023 Nov 17; Vol. 2, pp. 1297957. Date of Electronic Publication: 2023 Nov 17 (Print Publication: 2023).
DOI:	10.3389/frtra.2023.1297957
Abstrakt:	Under what circumstances, is it ethical to perform tumor surgery on a brain-dead individual? The neurosurgeons at Brigham and Women's Hospital were recently faced with such a question when asked to operate on a 28-year-old man who was pronounced brain-dead secondary to a severe brain-stem injury. His advanced directives clearly documented a desire for organ donation. During his transplant work-up, cranial imaging suggested a possible cerebellar mass of unknown etiology that was concerning for metastatic disease. Despite negative full body imaging, the neurosurgical team was asked to perform an open biopsy of the intracranial lesion to rule out occult systemic cancer. This case invites many nuanced questions related to the decisions surgeons and the broader medical community must make in the face of pursuing viable organs for the many in need. What is the moral standing and personhood eligibility of brain-dead individuals? What is the scope of medical interventions and procedures that surgeons are ethically bound to carry out? How ought the desire for increased medical intervention to try to save organs be balanced with practical limitations given limited medical resources? Competing Interests: JDB has an equity position in Treovir Inc. and is a member of the board of scientific advisors for Upfront Diagnostics, Centile Biosciences, and NeuroX1. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (© 2023 Bernstock, Chalif, Jha, Brown, Essayed, Caplan and Peruzzi.)
Databáze:	MEDLINE
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