An Ethical Framework for Donation After Circulatory Death was published by UKDEC in December 2011. It discusses the key ethical issues that arise in considering controlled donation after circulatory death, and was developed from a draft published for consultation in January 2011.
The ethical guidance is a working document, aimed primarily at doctors and other healthcare workers who are responsible for various aspects of organ donation and transplantation, rather than the lay public.
As a result, it has been structured along the patient pathway in such a way as to provide logical and sequential advice to those involved in the clinical care of donors and recipients. Nevertheless UKDEC acknowledges that it will be more widely read and has therefore tried to write the document in a readable and understandable form for those less familiar with some of the clinical concepts discussed.
The document sets out two guiding principles behind the work of the UK Donation Ethics Committee:
Where donation is likely to be a possibility, full consideration should be given to the matter when caring for a dying patient; and
If it has been established that further life-sustaining treatment is not of overall benefit to the patient, and it has been further established that donation would be consistent with the patient's wishes, values and beliefs, consideration of donation should become an integral part of that patient's care plan in their last days and hours.
The Framework is then divided into three parts:
Part One, discusses the principal ethical issues that are relevant to donation after circulatory death, including determination of the potential donor's best interests, and issues relating to the diagnosis and confirmation of death;
Part Two, sets the principal ethical issues in the context of the patient pathway, and sets out recommendations for current practice in more detail. We discuss how, at each stage in the end of life care pathway, decisions can be made and care provided in accordance with the ethical framework.
Part Three, outlines some areas where UKDEC believes that further consideration and development would be helpful, either by UKDEC or other relevant organisations.
The Executive Summary and full Ethical Framework can be downloaded from the Reports and Guidance section of this website.