Contribution of the ethics committee of the French society of intensive care medicine to a scenario for the implementation of organ donation after Maastricht III-type cardiac death in France

Abstract

French regulation allows organ donation after cardiac death. Type III-Maastrich classification refers to cardiac arrest occurring after the withdrawal of life-sustaining treatments. The possibility of organ donation in such circumstances is currently discussed by the French authorities. This article describes the ethical scenario that should be considered as the frame for this procedure. Akey-point is the respect of the dying person, requiring no change in the patient’s and proxies’ care while aiming possible organ donation. The dead donor rule implies that organ donation should not cause or hasten death. Amajor ethical issue is the transition between the discussion with proxies about withdrawal of life-sustaining treatments and the announcement of the possibility of organ donation after death. This point should be better addressed by a combined interview of proxies with the medical team caring for the patient and the transplant coordinators. Implementation of non-heart-beating donation is discussed in this article, including the location where life-sustaining treatments should be withdrawn (intensive care unit versus operating theatre).