Examination of prognostication, end-of-life decision-making and organ donation after cardiocirculatory death in severely brain-injured pediatric patients

Renseignements sur le financement
Canadian Institutes of Health Research
  • Type de subvention: Bourse salariale nouveau chercheur - Annonce de priorités : santé de la reproduction et de l'enfant
  • Années: 2010/11 à 2013/14
  • Financement total: $195,000
Mots clés
Chercheur(e) principal(e)
  • Racine, Eric
    Institut de recherches cliniques de Montréal
Collaborateur(s)

Aucun chercheur n’a été trouvé.

Partenaires

Aucune organisation partenaire n’a été touvée.

Sommaire du projet

Independently of patient characteristics, physician characteristics such as specialty and subspecialty, age, experience, religion and practice setting have been shown to influence end-of-life care in the intensive care unit (ICU). This variability creates challenges for the rigorous and systematic approach needed with the recent acceptance in Canada of organ donation after cardiocirculatory death (DCD). Within end-of-life decision-making and DCD, establishing a sound prognosis is medically crucial but often extremely challenging. This vexing problem is less well documented and defined in the literature for the severely brain-injured population and for the pediatric population. However, prognostication is fundamental in the care of severely brain-injured pediatric patients given that patient preferences are often indirectly articulated by a proxy decision-maker, that severe brain injury can lead to life-long impairments and that emerging practices of DCD directly touch brain-injured patients and their families. Aims: Examining prognostication in end-of-life decision-making in the pediatric DCD context With Canadian DCD practices emerging, there is a need for a clear assessment of physician prognostication and variability in the severely brain-injured pediatric population. This study will: 1.Identify prognostication practices and assess quantitative variability based on physician characteristics regarding end-of-life decision-making for severely brain-injured pediatric patients in the context of DCD; 2. Identify and define qualitative variability in language used by physicians for prognostication and end-of-life decision-making for severely brain-injured pediatric patients in the context of DCD; 3. Make recommendations on ethical prognostication and DCD for severely brain-injured pediatric patients based on the results of this research, literature reviews and an interdisciplinary workshop.

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