The ethics of elective (non-therapeutic) ventilation

Bioethics

Volumn 14, Issue 1, 2000, Pages 42-57

  Browne, Alister ^a   Gillett, Grant ^b   Tweeddale, Martin ^c  

^a UNIVERSITY OF BRITISH COLUMBIA   (Canada)

^b UNIVERSITY OF OTAGO   (New Zealand)

^c QUEEN ALEXANDRA HOSPITAL   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTIFICIAL VENTILATION; BRAIN DEATH; ETHICS; FAMILY COUNSELING; HUMAN; INFORMED CONSENT; MEDICAL ETHICS; ORGAN DONOR; ORGAN TRANSPLANTATION; REVIEW;

ANALYTICAL APPROACH; HEALTH CARE AND PUBLIC HEALTH; MORAL POLICY; PHILOSOPHICAL APPROACH; PROFESSIONAL PATIENT RELATIONSHIP; RISKS AND BENEFITS;

BRAIN DEATH; BRAIN INJURIES; ETHICAL THEORY; FAMILY; HUMANS; LIFE SUPPORT CARE; MORAL OBLIGATIONS; PERSISTENT VEGETATIVE STATE; PRESUMED CONSENT; RISK ASSESSMENT; THIRD-PARTY CONSENT; TISSUE AND ORGAN PROCUREMENT; TISSUE DONORS; VENTILATORS, MECHANICAL;

EID: 0033973267     PISSN: 02699702     EISSN: None     Source Type: Journal    
DOI: 10.1111/1467-8519.00179     Document Type: Article

References (22)

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2. Acute Services Policy Unit. Identification of potential donors of organs for transplantation. Health Services Guidelines (84)1, 1994. King's Fund Institute Report. A question of give and take: improving the supply of donor organs for transplantation. London: King's Fund Institute, Research Report 18, 1994: 64.
3. Law Commission Report. Mental incapacity. London: HMSO, Law Comm. No. 231, 1995: para. 6.26.
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7. Feest, T.G., Riad, H.N., Collins, C.H., Golly, M.G., Nicholls, A.J., Hamad, S.N. 'Protocol for increasing organ donation after cerebrovascular deaths in a district general hospital.' Lancet 1990; 335: 1135. Shaw, A.B. 'Non-therapeutic (elective) ventilation of potential organ donors: the ethical basis for changing the law.' Journal of Medical Ethics, 1996; 22: 73.
8. Shaw, A.B. Op cit.: 75.
9. Routh, G. 'Elective ventilation for organ donation - the case against.' Care of the Critically Ill 1992; 8: 61-2.
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11. Neuberger, J. 'Elective ventilation of potential organ donors. The lay view.' British Medical Journal 1995; 310: 716. Willatts, S.M. 'Elective ventilation of potential organ donors. Transplantation and interventional ventilation on the intensive therapy unit.' British Medical Journal 1995; 310: 716.
12. Neuberger, J. Op. cit.: 716.
13. Lynn, J. 'Are the patients who become organ donors under the Pittsburgh protocol for 'non-heart-beating donors' really dead?' Kennedy Institute of Ethics Journal 1993; 3: 168.
14. Singer, P. 'Famine, affluence, and morality.' Aiken, W., LaFollette, H., eds. World hunger and moral obligation. Englewood Cliffs, New Jersey: Prentice-Hall, 1977: 39.
15. For a critique of Singer see Arthur, J. 'Rights and the duty to bring aid.' In Aiken and LaFollette, Op. cit.: 37-48. Singer replies in a Postscript (Op. cit.: 35-6.), arguing that the idea, widely shared by moral philosophers, that impartiality is a requirement of morality forces anyone who accepts the principle that we have an obligation to prevent very bad things from happening if we can do so without thereby sacrificing anything of moral significance, to accept the principle that we have the same obligation as long as this does not require us to sacrifice anything of comparable moral significance. But, given the onerous burdens that this latter principle places on us, it is up to Singer to show that impartiality is in fact a requirement of morality. Until this is done, the verdict on Singer's view must be 'not proven'.
16. For a critique of Singer see Arthur, J. 'Rights and the duty to bring aid.' In Aiken and LaFollette, Op. cit.: 37-48. Singer replies in a Postscript (Op. cit.: 35-6.), arguing that the idea, widely shared by moral philosophers, that impartiality is a requirement of morality forces anyone who accepts the principle that we have an obligation to prevent very bad things from happening if we can do so without thereby sacrificing anything of moral significance, to accept the principle that we have the same obligation as long as this does not require us to sacrifice anything of comparable moral significance. But, given the onerous burdens that this latter principle places on us, it is up to Singer to show that impartiality is in fact a requirement of morality. Until this is done, the verdict on Singer's view must be 'not proven'.
17. For a critique of Singer see Arthur, J. 'Rights and the duty to bring aid.' In Aiken and LaFollette, Op. cit.: 37-48. Singer replies in a Postscript (Op. cit.: 35-6.), arguing that the idea, widely shared by moral philosophers, that impartiality is a requirement of morality forces anyone who accepts the principle that we have an obligation to prevent very bad things from happening if we can do so without thereby sacrificing anything of moral significance, to accept the principle that we have the same obligation as long as this does not require us to sacrifice anything of comparable moral significance. But, given the onerous burdens that this latter principle places on us, it is up to Singer to show that impartiality is in fact a requirement of morality. Until this is done, the verdict on Singer's view must be 'not proven'.
18. Mill, J.S. Utilitarianism. 1863: Ch. V, para. 13.
19. New, B., Solomon, M. Dingwall, R., McHale, J. A question of give and take. Improving the supply of donor organs for transplantation. King's Fund Institute: research report 18, 1994: 65.
20. Steinbock, B. Life before birth: the moral and legal status of embryos and fetuses. New York: Oxford University Press, 1992: 26.
21. There is a rich philosophic literature on whether the dead can be harmed. Presumably those who argue yes will hold that persons can be harmed by falling into a permanently insensate state, whereas those who argue no will hold that they cannot be. For a survey together with references see Price, D.P.T. 'Contemporary transplantation initiatives: where's the harm in them?' The Journal of Law, Medicine & Ethics 1996; 24: 140, 143-4.
22. We have profited from comments by John Fenwick, Rosalie Starzomski and Barrie Woodhurst.