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Svæfingar við líffæraflutninga. Siðferðileg álitamál

Útdráttur

This dissertation seeks answers to the question “ What moral questions rise among nurse anesthetists when they provide anesthesia to a donor who has been clarified brain dead?” To be able to answer this question fully, material from academic resources was explored and a qualitative research among nurse anesthetists who have given anesthesia to an organ donor was undertaken. In the litterature review, attitutes toward death and how they have changed through the centuries were examined. Moreover, the evolution of research of the human body was covered as well as the history of organ transplantations. Exploring the litterature of organ transplantations, it became evident that the ethics of organ transplantations came afterwards the operations themselves and many ethical mistakes were made during the early days of organ transplantations. It is arguable when a person who has been declared braindead is considered deceased. My conclusion, which is based on the reading of academic resources and the findings of the study, is that if a person can never gain consciousness again and all mental life has vanished it does not change the fate of the individual whether he is considered deceased, dying or alive. The person will not be able to wake up again. On the other hand it matters from a legal and ethical point of view. Some have gone as far as saying that we are removing organs from a living human that will not gain consciousness again.
In the litterature review organ transplantation from non heartbeating donors where looked into. In those articles, very different opinions on this sensitive topic where introduced. Under those circumstances the time from which the person is declared dead until the transplantation begins must be very short. What matters concerning organ transplantation after cardiac arrest is whether it has been decided to bring the patient back to life and what kind of treatment he has been undergoing. Full treatment, full treatment but no resuscitation or is the person receiving palliative care. The time from cardiac arrest to organ removal is variable between countries. Shorter time benefits those waiting for organs while a longer time provides the patient with more security. Therefore a very clear and firm boundary which cannot be crossed is needed. In Iceland organ transplantation after cardiac arrest is very rare so there is no information on that in the study.
Furthermore, in the litterature review, facts about organ transplantation, reasons for organ donation and arrangement of priority in choosing candidates for organ transplantation are looked upon. The results from the study itself where the following themes: sorrow, respect, doubt, justification and solitude. The participants experienced sorrow because of the course of events that lead to the organ donation. Respect for the donor and the relatives and their suffering was a keystone. Doubt of whether being doing the right thing or not came to most minds but some considered it a necessity to examine things carefully. The justification for organ transplantation is that others can obtain a new life. It was essential for the participants to gain this acknowledgement by getting some information about the utiliation of the organs, how many patients had organ transplants from the individual they anesthetized. The solitude consisted in not being able to talk about their experience to other people. The nurse anesthetists talked to each other though. Solitude sometimes also consisted in feeling and seeing the donors body fade away and die without others seeming to notice. Regarding the research question“ What moral questions rise among nurse anesthetists when they provide anesthesia to a donor who has been clarified brain dead?”, the study revealed following:
Is it certain that the individual is brain dead and will never be able to gain consciousness again?
Is it justifiable to remove the organs?
In the light of these questions it is my belief that perhaps more education on organ transplantation is needed for nurse anesthetists. Further studies might then regularly observe how these nurses look at participating in these operations and wheter a choice should be given never to involve in organ transplantation.

Birting
11.3.2010


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