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Fin de vie programmée et don d'organes : enjeux individuels, communautaires et prudentiels

Abstract : Organ transplantation saves lives of many persons who otherwise would die from end-stage organ disease. In the past decades the need for transplants has grown faster than the number of available organs. This increasing requirement for donated organs has led to a renewed interest in donation after circulatory determination of death (DCDD). In some countries including France, terminally ill patients who die of cardiac arrest after a planned withdrawal of life support may be considered as organ donors (controlled DCDD). Before 2005 French rules were not designed for such practices. With regard to patients in final stage of incurable diseases, the law number 2005-370 of April 22, 2005 authorizes the withholding or withdrawal of treatments when they appear "useless, disproportionate or having no other effect than solely the artificial preservation of life". Advocates of the controlled DCDD argue that the end-of-life care plan should incorporate the patient's wishes concerning organ donation and the public interest of transplantation. Until 2014, most French medical academics regarded the perceived conflict of interest that would arise for clinicians treating potential donors as a major ethical question. As the French program started at the end of 2014 in a few pilot sites, we thus examine the practical, legal and ethical issues that arise in considering controlled DCDD, including determination of the donor's overall benefit, debates relating to the diagnosis and time of death, and factors determining how life-sustaining treatment is to be withdrawn.
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https://tel.archives-ouvertes.fr/tel-01617124
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  • HAL Id : tel-01617124, version 1

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Olivier Lesieur. Fin de vie programmée et don d'organes : enjeux individuels, communautaires et prudentiels. Ethique. Université Sorbonne Paris Cité, 2015. Français. ⟨NNT : 2015USPCB127⟩. ⟨tel-01617124⟩

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