This book challenges conventional medical ethics by exposing the inconsistency between the reality of end-of-life practices and established ethical justifications of them.
Core Topics in Neuroanesthesia and Neurointensive Care is an authoritative and practical clinical text that offers clear diagnostic and management guidance for a wide range of neuroanesthesia and neurocritical care problems. With coverage of every aspect of the discipline by outstanding world experts, this should be the first book to which practitioners turn for easily accessible and definitive advice. Initial sections cover relevant anatomy, physiology and pharmacology, intraoperative and critical care monitoring and neuroimaging. These are followed by detailed sections covering all aspects of neuroanesthesia and neurointensive care in both adult and pediatric patients. The final chapter discusses ethical and legal issues. Each chapter delivers a state-of-the art review of clinical practice, including outcome data when available. Enhanced throughout with numerous clinical photographs and line drawings, this practical and accessible text is key reading for trainee and consultant anesthetists and critical care specialists.
Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic ‘storm’, that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.
Rates of organ donation lag far behind the increasing need. At the start of 2006, more than 90,000 people were waiting to receive a solid organ (kidney, liver, lung, pancreas, heart, or intestine). Organ Donation examines a wide range of proposals to increase organ donation, including policies that presume consent for donation as well as the use of financial incentives such as direct payments, coverage of funeral expenses, and charitable contributions. This book urges federal agencies, nonprofit groups, and others to boost opportunities for people to record their decisions to donate, strengthen efforts to educate the public about the benefits of organ donation, and continue to improve donation systems. Organ Donation also supports initiatives to increase donations from people whose deaths are the result of irreversible cardiac failure. This book emphasizes that all members of society have a stake in an adequate supply of organs for patients in need, because each individual is a potential recipient as well as a potential donor.
The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.
This book offers valuable guidance to neurointensivists, other neurocritical care staff, and those desiring to develop a neurocritical care unit via a thorough discussion of neurological emergencies and neurocritical care unit organization. This comprehensive volume begins with a review of acute neurological emergencies as managed clinically in the neurocritical care unit. Topics include acute cerebrovascular, neurological, and neurosurgical disorders. The unique aspect of this book is its description of the organization of the neurocritical care unit. We focus on how other services in the hospital interact with and assist neurocritical care operations, telemedicine/telestroke, and neurocritical care personnel and their roles. A review of expected outcomes of neurocritical care conditions is also included. Neurointensivists, neurocritical care unit staff leadership, hospital administrators, and those interested in developing a neurocritical care unit will find Neurointensive Care Unit: Clinical Practice and Organization to be an invaluable guide.
The book provides an excellent review of all the clinical aspects of neuroanesthesia in children, including neurosurgeries during fetal state to neonatal, infancy, toddler, and school-going age groups. To provide optimal anesthetic care in children undergoing neurosurgery, the care provider must have adequate knowledge on the developing brain and spinal cord, and the effect of anesthetics on the neuronal tissue, and the inherent issues pertaining to neurologic lesions. This book covers the diagnostic, imaging, surgical as well as anesthetic managements of all the neurosurgical problems in children. The chapters include a wide range of topics from basic neurophysiology to general concerns for pediatric neuroanesthesia, including fluid management, blood transfusion, temperature regulation, and surgical positioning, as well as specific issues such as anesthesia for brain tumor surgery, hydrocephalus, neural tube defects, cerebrovascular surgeries such as aneurysmal surgery, arteriovenous malformations (AVMs), Moyamoya disease, and vein of Galen malformation, functional neurosurgery, epilepsy surgery, neuroendoscopy, craniovertebral junction anomalies, spinal surgeries, neurotrauma, and brain abscess with congenital heart diseases. Interesting topics like neuroanesthesia in remote locations, regional anesthesia during neurosurgery, and anesthesia for children with neuromuscular disease are also discussed. Moreover, the book elaborates on advanced neuroanesthesia techniques during fetal neurosurgery and craniopagus separation surgery; and the postoperative intensive care management aspects in each chapter. It is supplemented with figures depicting surgical procedures and positioning, neuroimages, tables and illustrations for easy understanding. This book caters to neuroanesthesiologists, pediatric anesthesiologists, residents, and fellows of anesthesia or neuroanesthesia, practicing anesthesiologists, pediatric neurointensivists, nurse anesthetists, neurosurgeons, and pediatric neurosurgeons. It also serves as a reference book for the DM (neuroanesthesiology and neurocritical care), DNB-SS (neuroanesthesiology), and MD (anesthesiology) curriculums apart from anesthesia residency and pediatric anesthesia/ neurosurgery fellowship programs offered at various Institutions worldwide.
This text provides an overview of the processes of brain death, exploring the concepts and historical approach of human death, clinical examinations of brain-dead patients, ancillary tests in coma and brain death, bioethical discussions of brain death and its relationship with some consciousness disturbances, and the legal considerations of human death. Unlike other, narrow-focus reference this book encompasses a wide spectrum of issues including medical, legal, bioethical and historical aspects.
New technologies and medical treatments have complicated questions such as how to determine the moment when someone has died. The result is a failure to establish consensus on the definition of death and the criteria by which the moment of death is determined. This creates confusion and disagreement not only among medical, legal, and insurance professionals but also within families faced with difficult decisions concerning their loved ones. Distinguished bioethicists Robert M. Veatch and Lainie F. Ross argue that the definition of death is not a scientific question but a social one rooted in religious, philosophical, and social beliefs. Drawing on history and recent court cases, the authors detail three potential definitions of death -- the whole-brain concept; the circulatory, or somatic, concept; and the higher-brain concept. Because no one definition of death commands majority support, it creates a major public policy problem. The authors cede that society needs a default definition to proceed in certain cases, like those involving organ transplantation. But they also argue the decision-making process must give individuals the space to choose among plausible definitions of death according to personal beliefs. Taken in part from the authors' latest edition of their groundbreaking work on transplantation ethics, Defining Death is an indispensable guide for professionals in medicine, law, insurance, public policy, theology, and philosophy as well as lay people trying to decide when they want to be treated as dead.
These questions and others are thoughtfully probed in this collection of essays, which features articles from theologians, philosophers, physicians, biomedical ethicists, and an attorney.