Firstly, we need to form clear guidelines related to the diagnosis of brain death and subsequently guidelines related to the withdrawal of life support
in these patients.
While much of the medical, ethical, and legal debate centers around this two to five minute period, this comment explores the one-hour waiting period between withdrawal of life support
and cardiac arrest.
After approval from the Institutional Review Board, participants were mailed an author developed questionnaire, "Critical Care Nurses' Participation in the Withdrawal of Life Support
," which had 100% interrater reliability and addressed educational preparation for nurses regarding WDLS, support for nurses, nurses' roles and participation in family conferences, specific practices during WDLS, and demographics.
The rate of withdrawal of life support
in our study was only 4%, which is similar to the rates that have been observed in India (9), Lebanon (2) and Turkey (15).
But no mention of donation is made until withdrawal of life support
has been discussed with the family.
This paper presents a case study based discussion around the ethics of withdrawal of life support
They found that at least 25,000 cases annually consisted of the withdrawal of life support
(passive euthanasia), and of those, 27% were administered morphine in order to shorten life.
When the withdrawal of life support
is consensually decided by the attending physician and the family member or surrogate (particularly in the hospital setting of the ICU), consistent opportunity for DCD should now be available to all families or to honor the deceased donor's wishes.
Decisions regarding the withdrawal of life support
in desperately ill patients are always difficult, often heart-wrenching.
The decision to declare the patient 'suitable' to donate organs would be made either after, or even before, the withdrawal of life support
Because of the physical and mental traumas many of these children have faced, it is not unusual for the decisions to involve major surgery, orders not to resuscitate, or even withdrawal of life support
In a study exploring family needs during withdrawal of life support
in critically ill patients, Counsell and Guin (2002), found that even in extreme situations family members do not routinely anticipate death as an outcome.