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Principles in Medical Ethics

Not all end of life decisions in the Intensive Care Unit and the discussions that go with them can rely on the clarity of a brain death diagnosis. Just under half of all deaths in Intensive Care Units involve non-beneficial treatment being withdrawn or withheld. In less well resourced countries limited access to ICU means these decisions as to when treatment is futile frequently occur earlier, outside of the ICU setting. In week 2 we will discuss end of life care and the ethical principles which help guide us in making difficult decisions in the ICU. What do we do when interventions may prolong suffering with no reasonable chance of recovery? We will see how the dead donor rule can be applied after circulatory arrest and that in certain patients it may be possible to honour their wish to be an organ donor. We will cover the different types of donation after circulatory arrest and go over the process of donation after circulatory death in detail. We will end the week by covering tissue donation and what happens to the body of the donor after the organ donor operation is complete.

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