Ethics in extracorporeal life support: a narrative review

Critical Care

Jesper Mølgaard¹  Alexandra Schou²  Søren Holm³  Marc Sørensen⁴  Lars Willy Andersen⁴ 

[1] Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark;Department of Anaesthesiology and Intensive Care Medicine, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark;Department of Law, School of Social Sciences, Faculty of Humanities, University of Manchester, Williamson Building, Oxford Road, M13 9PL, Manchester, UK;Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark;

关键词: Extracorporeal life support;    Extracorporeal membrane oxygenation;    Ethics;   

DOI  :  10.1186/s13054-021-03689-0

来源: Springer

【 摘 要 】

During 50 years of extracorporeal life support (ECLS), this highly invasive technology has left a considerable imprint on modern medicine, and it still confronts researchers, clinicians and policymakers with multifarious ethical challenges.After half a century of academic discussion about the ethics of ECLS, it seems appropriate to review the state of the argument and the trends in it. Through a comprehensive literature search on PubMed, we identified three ethical discourses: (1) trials and evidence accompanying the use of ECLS, (2) ECLS allocation, decision-making and limiting care, and (3) death on ECLS and ECLS in organ donation. All included articles were carefully reviewed, arguments extracted and grouped into the three discourses. This article provides a narrative synthesis of these arguments, evaluates the opportunities for mediation and substantiates the necessity of a shared decision-making approach at the limits of medical care.

【 授权许可】

CC BY