Strange Harvest. Lesley A. Sharp
Читать онлайн книгу.
if [donor kin] want to see the apnea test. They have a right to this! Otherwise, you're asking them to take on faith that this breathing thing is dead. Docs—I wish, please tell them to say dead.…I know one donor mom who was told she couldn't be there for the apnea test—she snuck in [anyway] and she was so glad she did. Then she believed [her son] was dead.
Variability and Trust
As reflected in Dr. Lazarre's statement, brain death criteria are more streamlined in emergency rooms, ICUs, and trauma centers when their directors enthusiastically support organ donation. The presence of large transplant centers in such cities as Pittsburgh, Cleveland, San Francisco, Dallas, New York City, and Rochester, Minnesota, for instance, as well as long-standing and large-scale OPO operations, also inevitably shapes brain death protocols. Individual OPOs frequently assist smaller hospitals in forging in-house policies for brain death declaration; at the very least they initiate the declaration process by observing individual patients and assessing their medical status. Based on their readings, OPO staff may then request that proper neurological tests be performed. The varying level of engagement and willingness on the part of hospital staff to work with OPOs ultimately shapes the time lag between the two physicians' assessments, as well as the urgency with which additional confirmatory tests might be applied.
The manner in which OPO counselors approach families is driven in part by a widespread paternalistic assumption that kin do not want, nor do they need, to know the specific details of brain failure (or, for that matter, organ procurement). Such knowledge is understood as too difficult to comprehend, too traumatic, or too cruel to describe to kin in the throes of grief. Also, too much knowledge might threaten the opportunity to acquire consent. As noted earlier, OPO coordinators generally prefer that a neurologist speak first to the family, but he or she should then withdraw so that a counselor can work directly with kin. Dr. Lazarre, who is highly supportive of organ donation, put it thus: “[They say], ‘your job is to [try to] save the patient and diagnose brain death and ours is [to talk about] donation.’ But they have this really patronizing attitude—they're afraid we're going to fuck up [the process]. But it's like the eight-hundred-pound gorilla—look, the family knows—they're already thinking about donation—and it helps them to see some good come out of the tragedy [of the death] and so, I say, I just want to let them know that I support this, that I support organ donation.”
Конец ознакомительного фрагмента.
Текст предоставлен ООО «ЛитРес».
Прочитайте эту книгу целиком, купив полную легальную версию на ЛитРес.
Безопасно оплатить книгу можно банковской картой Visa, MasterCard, Maestro, со счета мобильного телефона, с платежного терминала, в салоне МТС или Связной, через PayPal, WebMoney, Яндекс.Деньги, QIWI Кошелек, бонусными картами или другим удобным Вам способом.