Elective ventilation

Although the number of donors can be substantially increased by transferring patients with lethal cerebrovascular accidents and incipient brainstem death to the intensive care unit for elective mechanical ventilation until brainstem death is confirmed ( Fe§§L§t..ML 1.99.0), this practice raises a number of legal and ethical issues and is associated with a variety of practical difficulties. Some have suggested that the acceptance of elective ventilation for organ donation, a procedure from which the patient cannot benefit, represents the first step along a particularly dangerous road. The legality of elective ventilation is also questionable, and currently this practice is proscribed in the United Kingdom. Many have also been concerned that elective ventilation would place unacceptable demands on limited facilities and might affect staff morale adversely. Perhaps more worrying is the suggestion that the procedure could produce significant numbers of patients in a persistent vegetative state, although experience to date suggests that such an outcome is unlikely provided that a strict protocol is used.

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