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发帖数: 1 | 1 History is full of ironies, and the 50-year legacy of the Harvard report is
no exception. From one perspective, the report laid the foundation for laws
that have both saved and improved the lives of hundreds of thousands of
patients through organ and tissue donation. Conversely, decades of attempts
to find a conceptual justification for linking this diagnosis to the death
of the patient remain incomplete. | z****e
发帖数: 1 | 2 When The Ad Hoc Committee of Harvard Medical School to Examine the
Definition of Brain Death began meeting in 1967, I was a graduate student,
with committee member Ralph Potter and committee chair Henry Beecher as my
mentors. The question of when to stop life support on a severely compromised
patient was not clearly differentiated from the question of when someone
was dead. A serious clinical problem arose when physicians realized that a
patient's condition was hopeless but life support perpetuated body function.
Thus, the committee stated that its first purpose was to deal with the
burdens on patients and families as well as on hospitals and on patients
needing hospital beds occupied by comatose patients. They intuited the
strategy of “defining” these patients as dead, thus legitimating treatment
stoppage. They noted that this would also serve a second purpose. Although
the dead donor rule had not yet been clearly articulated, they claimed that
defining patients as dead would also address controversy over obtaining
organs for transplant. My mentors’ discussions related to my interest in
the intersection between questions primarily of medical fact (When has a
human brain irreversibly ceased functioning?) and nonmedical questions of
social policy (Should we treat individuals with dead brains and beating
hearts as dead humans?). It quickly became clear that most committee members
did not appreciate the interplay of these questions. |
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