RESUMEN
Donation after death is the most important ethical principle to carry out organ donation after citizens’ death. The newly-revised <i>Regulations on Human Organ Donation and Transplantation</i> does not define death, and avoids the key question of “whether to recognize brain death”. Certain legal risks or damages to the rights and interests of donors may exist in organ donation. Death is an inevitable part of human life. It is necessary to establish specific criteria, which is also the only approach, to define death in any era. Death criteria are established based on the view of death, and restricted by the development level of productive forces and other social factors. The determination of death criteria hugely varies between China and the West. To standardize organ donation and transplantation and promote high-quality development of organ donation, medical staff must adhere to the principle of pure motivation, take informed consents as the premise, respect the donors' and their close relatives' rights to choose their own death criteria, strictly follow the death judgment procedures and operating norms, and ensure the scientificity, accuracy and fairness of death determination.
RESUMEN
In recent years, organ donation has developed rapidly in China, whereas the brain death criteria have not been confirmed by relevant legislation. In this article, the current legislation situation of brain death criteria at home and abroad, and the current criteria for determination of death for organ donation after citizen's death in China were introduced. The necessity of legislation of brain death criteria in China was discussed from the perspective of organ donation, and suggestions on the form and content of brain death criteria legislation were proposed based on the actual national conditions, aiming to provide reference for the legislation of brain death criteria.
RESUMEN
En la actualidad, los servicios de urgencias atienden pacientes con daño neurológicograve, especialmente por trauma craneoencefálico, en quienes durante la reanimacióninicial se logra la recuperación de la estabilidad hemodinámica, pero requieren intubacióntraqueal y soporte con ventilación mecánica, sin que con ello se logren recuperar lasfunciones cerebrales y de tallo, lo que lleva a la sospecha de muerte encefálica. No es útilque un paciente con alta probabilidad de certeza para este diagnóstico sea trasladado a unaunidad de cuidado intensivo, pero sí es necesario que los pacientes con este diagnóstico,potencialmente donantes de órganos, puedan ofrecer este último servicio altruista en suexistencia. Los médicos urgenciólogos deben hacer este diagnóstico cuando sea el casoy conocer el ámbito legal que lo rodea...
In currently, emergency services are faced with patients that have severe neurologicaldamage after traumatic brain injury, and especially in those that during the initial resuscitation is achieved hemodynamic stability,required intubation and mechanical ventilationsupport, and were unable to recovery functionalbrain, leading to the suspicion of brain death. Itis futile for those patients with a high probabilityof certainty of this diagnosis need to be hospitalizedto intensive care unit but, it is necessary forthose patients with a diagnosis of brain death,potential organ donor, can offer a last selflessservice in your existence. Emergency physiciansshould make this diagnosis when is appropriate,and know the legal field that surrounds it...
Asunto(s)
Medicina de Emergencia , Medicina/normas , Muerte Encefálica/diagnósticoRESUMEN
A national sample survey of medical students about their perception and evaluation on medical study, career plan, and medical care system was conducted in December 1997 through January 1998. About 10% of all the medical students in 32 medical schools that had students from freshman to senior in November 1997 were systematically sampled for a questionnaire survey. Out of 1,386 students, 1,233(89.0%) had responded and 12 of them were excluded from the analysis because of incomplete response. This report is the third part of the study regarding students' view on merits and demerits of being physician, patients and diseases, medical practice, and medical care system. Respondents indicated that the merits of being a physician are humanitarian nature of work(30.0%) and autonomy of work(28.0%) and the demerits are too busy to enjoy peronal life(56.5%) and too much stress from work(41.2%). Social status of physicians was assessed by the students in four dimensions, i.e. social prestige, social influence, power, and income. Students were found to think that the current social status of physicians is lower than it should be ideally in all of four dimensions. Ninety percent of student agreed that physician is a noble occupation that deals with human life but only two-thirds of students agreed that physician is economically secured and socially well recognized occupation. Students regarded the medical insurance system as instigating increase of general hospital and withering of private clinics and hindering medical development by reducing investment capacity. Major problems in medical care system indicated by the students are irrational medical insurance system, concentration of physicians in large cities, and irrational health care delivery system. Medical students regarded the role of nurses as not merely assisting physicians(40.7%) but have to participate more actively in patient care(49.8%). Regarding medical study's effect on views of patients and diseases, 60.4% of them indicated that they became to view patients more as entities of diseases and this was a significant increase from 28.9% in 1983 study. For criteria of death, 73.5% agreed with brain-death. Regarding organ transplantation, 79.2% agreed to encourage it but only 46.9% agreed to encourage artificial fertilization in vitro. In case of accidental death, 73.5% agreed to donate their organs for transplantation. To a statement related with medical malpractice reading "Physicians should be treated generously for their mistakes in medical practice so long as the mistakes are not due to negligence", 71.6% of the students agreed to the statement. To another statement reading "Physicians should be thoroughly investigated and duly penalized for mistakes made by them in their medical practice", only 31.8% agreed to it. These findings suggested that medical students are well aware of the problems in the health care system and social status of physicians. Changes were noticed in the sense of responsibility for medical malpractice and physician's attitude toward patients since 1983 study.
Asunto(s)
Humanos , Encuestas y Cuestionarios , Atención a la Salud , Fertilización In Vitro , Hospitales Generales , Seguro , Inversiones en Salud , Mala Praxis , Ocupaciones , Trasplante de Órganos , Facultades de Medicina , Estudiantes de Medicina , TrasplantesRESUMEN
A national sample survey of medical students about their perception and evaluation on medical study, career plan, and medical care system was conducted in December 1997 through January 1998. About 10% of all the medical students in 32 medical schools that had students from freshman to senior in November 1997 were systematically sampled for a questionnaire survey. Out of 1,386 students, 1,233(89.0%) had responded and 12 of them were excluded from the analysis because of incomplete response. This report is the third part of the study regarding students' view on merits and demerits of being physician, patients and diseases, medical practice, and medical care system. Respondents indicated that the merits of being a physician are humanitarian nature of work(30.0%) and autonomy of work(28.0%) and the demerits are too busy to enjoy peronal life(56.5%) and too much stress from work(41.2%). Social status of physicians was assessed by the students in four dimensions, i.e. social prestige, social influence, power, and income. Students were found to think that the current social status of physicians is lower than it should be ideally in all of four dimensions. Ninety percent of student agreed that physician is a noble occupation that deals with human life but only two-thirds of students agreed that physician is economically secured and socially well recognized occupation. Students regarded the medical insurance system as instigating increase of general hospital and withering of private clinics and hindering medical development by reducing investment capacity. Major problems in medical care system indicated by the students are irrational medical insurance system, concentration of physicians in large cities, and irrational health care delivery system. Medical students regarded the role of nurses as not merely assisting physicians(40.7%) but have to participate more actively in patient care(49.8%). Regarding medical study's effect on views of patients and diseases, 60.4% of them indicated that they became to view patients more as entities of diseases and this was a significant increase from 28.9% in 1983 study. For criteria of death, 73.5% agreed with brain-death. Regarding organ transplantation, 79.2% agreed to encourage it but only 46.9% agreed to encourage artificial fertilization in vitro. In case of accidental death, 73.5% agreed to donate their organs for transplantation. To a statement related with medical malpractice reading "Physicians should be treated generously for their mistakes in medical practice so long as the mistakes are not due to negligence", 71.6% of the students agreed to the statement. To another statement reading "Physicians should be thoroughly investigated and duly penalized for mistakes made by them in their medical practice", only 31.8% agreed to it. These findings suggested that medical students are well aware of the problems in the health care system and social status of physicians. Changes were noticed in the sense of responsibility for medical malpractice and physician's attitude toward patients since 1983 study.