It's been quite an emotional week for me at work this week. Along with lots of other trying cases, I was called to a major trauma in which young man had been involved in a serious accident and was rushed into theatre bleeding excessively. Despite our best efforts, he never regained consciousness. We sent him up to the Intensive care unit (ICU) on life-support and he was confirmed clinically dead later that evening.
Just to explain the difference between clinically dead and biologically dead, the latter is basically, when you die and there is no oxygen supplying your tissues and organs, so they begin to decay, whereas clinical death is when you're on life-support, your tissues and organs receive oxygen so continue to function as normal, but your brain has zero activity, so that if you were to be disconnected from life support, you would then be biologically dead (Edward-Morgan, Mikhail & Murray, 2004).
For our current assignment, we've been looking at doing a group report on the ethics involved with organ donation and various laws that we could change in order to increase donation rates.
What got me thinking ethics with this particular case was that although traumatic and an extremely sad and emotional time for all involved, this patient would have been an ideal candidate for organ donation, however, the question wasn't even raised with the family as they were Maori. My question then was, is it okay to immediately dismiss the idea of speaking to the family just because of their culture? Maybe this young man had at some point discussed it with someone in his family. Is it ethical to just assume that because someone is of a specific race or culture that they wouldn't be willing to donate?
I'll be looking further into this matter along with my current research. In the meantime, stay safe out on the roads this summer.
Edward-Morgan, G., Mikhail, M.S. & Murray, M.J. (2002). Clinical Anaesthesiology
(4th ed). New York: McGraw-Hill Medical Publishing Division
That sounds like a horrible day. I believe we should be asking all families, regardless of race or culture. What is it that they say about making assumptions? Something about it usually being wrong anyway.
ReplyDeleteIt reminds me of when I took a friend for a pap smear a few months ago and the dr said "are you sexually active?"
Friend "yes"
Dr "Birth control?"
Friend "no"
Dr "So you understand you will get pregnant right?"
Friend "Its unlikely as I am gay"
Dr "ah."
Anyway, back on point, I just don't think it would do any harm to ask the question, regardless of who you are asking.
What a traumatic time at work. I must say that it makes me angry that organ donation is not raised with Maori families, and then Maori are blamed for not donating. The belief that Maori do not donate because of their culture needs to be challenged. Many Maori actually donate. It is easier to blame culture than to blame the lack of willingness of health professionals to raise the topic with Maori. How can Maori donate if they are not given the option?
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