Ethical considerations

Although they have never been tested in law, the recommendations of the C.O..nfe.r.e.n.C.e Of...,RO.y.a! CoUeges.. ..i19Z6), or similar guidelines elsewhere in the world, are believed by most practising clinicians to be a correct and ethical means of diagnosing brain death. Therefore death can be declared once death of the brainstem has been confirmed, and most would argue that mechanical ventilation should then be discontinued as soon as possible. This should not be viewed as withdrawing support to allow a patient to die, but rather as ceasing a futile intervention in a patient who is already dead. Therefore it is clear that, even if transplantation therapy did not exist, the ability to diagnose brain death with confidence contributes to the humane practice of intensive care, and most clinicians find the decision to discontinue ventilating a brain-dead patient relatively straightforward. The only situation in which it might be considered inappropriate to discontinue ventilating a brainstem-dead patient is when she is pregnant. In some such cases it has proved possible to support the mother for up to 3 months to permit growth of the fetus until delivery by Cesarean section can be performed safely.

Sleep Apnea

Sleep Apnea

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