Journal of law and medicine
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Organ procurement is possible under statutes defining death as either irreversible cessation of all functions of the brain or irreversible cessation of the circulation, thus fulfilling the "dead donor rule". However, present practice does not conform strictly to these conditions. Clinical guidelines for the diagnosis of whole-brain death are equated, with coma, to absence of brain-stem reflexes which essentially means the absence of spontaneous respiration which is clinically interpreted as "dead enough" or "as good as dead" for the purpose. ⋯ State and national ethical guidelines on this practice conflict and it appears proscribed under State guardianship legislation which requires actions in the best interests of the donor, not the recipient. Considerations should be given to organ procurement in situations where the donor is dying or in which survival is impossible. Simple abandonment of the "dead donor rule", however, is not feasible since organ procurement would be the direct cause of death.
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A doctor who is treating a patient in an Australian hospital may make a pre-emptive decision not to attempt to resuscitate that patient in the event of the patient's sudden demise. This decision is commonly referred to as a not-for-resuscitation (NFR) order. This article examines what resuscitation is, and what it means to withhold attempts at resuscitation from a patient. The medical, legal and ethical doctrines relating to death and dying are synthesised into a set of robust guidelines for making NFR decisions.
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This column considers some of the imperatives and barriers which may impact on a medical practitioner who apologises to a patient following an adverse event in New South Wales. It also considers the inclusion of the apology provisions in ss 67-69 of the Civil Liability Act 2002 (NSW) and the extent to which those provisions may protect apologising practitioners from liability.