循環停止死亡後器官捐贈之倫理與法律議題

The Ethical Legal Issues in Organ Donation after Circulatory Death

黃馨葆(Sin-Bao Huang) ； 蔡甫昌(Daniel Fu-Chang Tsai)

《台灣醫學》 23卷4期 (2019/07) Pp. 413-424

https://doi.org/10.6320/FJM.201907_23(4).0001

摘要

本文探討循環停止死亡後器官捐贈（organ donation after circulatory death，DCD）所涉醫學倫理與法律問題，首先介紹DCD之定義與發展歷史、概覽國內外死亡判定之法規政策、探討臨床實務之倫理考量及溝通，最後對我國指引之現狀提出反省與展望。作者指出DCD是當代屍體器官捐贈（cadaveric organ donation）越來越重要之來源及先進國家發展趨勢，我國在2017年建立國家政策之後應盡力宣導推廣以幫助更多有捐贈意願之國民，能於身後實踐大愛器捐胸懷以嘉惠龐大等候器官移植之病人。

關鍵字

循環停止死亡後器官捐贈 ； 心臟死器官移植 ； 無心跳器官捐贈

並列摘要

This paper explores the ethical-legal issues concerning organ donation after circulatory death (DCD). The definition and history of DCD, the laws and policies for determination of death, and the ethical legal consideration and communication in DCD clinical practice are introduced and explored. Reflection on the current Taiwanese DCD guidelines and suggestion for future DCD practice are proposed. The authors argue that DCD plays an increasingly important role in the cadaveric organ donation, which is also a contemporary international trend. After Taiwan has established the National guideline and policy of DCD, continuous efforts for promoting DCD should be made so as to realize and respect the wishes for organ donation of our citizens, as well as to bring tremendous health welfare to the patients on the endless organ transplantation waiting list.

並列關鍵字

DCD ； donation after circulatory death ； donation after cardiac death ； non-heart beating donation ； NHBD

參考文獻

Manara AR, Murphy PG, O'Callaghan G: Donation after circulatory death. Br J Anaesth 2012;108(S1):i108-21.

Thuong M, Ruiz A, Evrard P, et al: New classification of donation after circulatory death donors definitions and terminology. Transpl Int 2016;29:749-59.

Jericho BG: Organ donation after circulatory death: ethical issues and international practices. Anesth Analg 2019;128:280-5.

Boucek MM, Mashburn C, Dunn SM, et al: Pediatric heart transplantation after declaration of cardiocirculatory death. N Engl J Med 2008;359:709-14.

Gries CJ, White DB, Truog RD, et al: An official American Thoracic Society/ International Society for Heart and Lung Transplantation/ Society of Critical Care Medicine/Association of Organ and Procurement Organizations/United Network of Organ Sharing Statement: ethical and policy considerations in organ donation after circulatory determination of death. Am J Respir Crit Care Med 2013;188:103-9.