BIOETHICAL ISSUES TOWARD THE END OF HUMAN LIFE

• TRILLIONS OF CELLS

• VITAL ORGANS

• MAJOR CAUSES OF DEATH

• DISTINCTION BETWEEN ASSISTING OR SUBSTITUTING VITAL ORGANS

REVIEW:

BIOLOGICAL UNIT OF LIFE = CELL

LEVELS OF BIOLOGICAL ORGANIZATION (HIERARCHY OF LIFE):

CELLS -> TISSUES -> ORGANS -> SYSTEMS (ORGAN SYSTEMS) -> ORGANISM (INDIVIDUAL)

• VITAL ORGANS

VITAL ORGANS:

• BRAIN

• BRAIN STEM

• BOTH LUNGS

• HEART

• LIVER

• PANCREAS

• STOMACH

• SMALL INTESTINE

• LARGE INTESTINE

• BOTH KIDNEYS

• MAJOR CAUSES OF DEATH

% Primary Organ

1. Diseases of the heart 28.5 HEART

2. Malignant tumors 22.8 ANY VITAL ORGAN

3. Cerebrovascular diseases 6.7 BRAIN

4. Chronic lower respiratory diseases 5.1 LUNGS

5. Accidents (unintentional injuries) 4.4 ANY VITAL ORGAN

6. Diabetes mellitus (Type II Diabetes) 3 PANCREAS

7. Influenza and pneumonia 2.7 LUNGS

8. Alzheimer’s disease 2.4 BRAIN

9. Nephritis, nephrotic syndrome and nephrosis 1.7 KIDNEYS

10. Septicemia (blood poisoning) 1.4 BLOOD

11. Suicide 1.3 ANY VITAL ORGAN

12. Chronic liver disease and cirrhosis 1.1 LIVER

13. Primary hypertension and hypertensive renal disease 0.8 ANY VITAL ORGAN

14. Parkinson’s disease (tied) 0.7 BRAIN

15. Homicide (tied) 0.7 ANY VITAL ORGAN

All others 16.7 ANY VITAL ORGAN

100

(Source: CDC/NHS National Vital Statistics System)

15 Major Causes of Death (USA)

• DISTINCTION BETWEEN ASSISTING OR SUBSTITUTING VITAL ORGANS

DIALYSIS: SUBSTITUTES KIDNEYS

RESPIRATOR; ASSISTS IN PROVIDING OXYGEN

VENTILATOR; DEPENDS ON THE SETTINGS: ASSIST OR SUBSTITUTE BREATHING

RESPIRATORS: ASSIST BREATHING

(NOT VENTILATOR)

VENTILATOR: PERFUSION

WEANING PROCESS

VENT ~ 2-3 WEEKS BEFORE TRACHEOTOMY

EXTUBATION

TRACHEOTOMY

(TRACHEOSTOMY)

CARDIOPULMONARY RESUSCITATION (CPR):

• ASSISTS / SUBSTITUTES HEART

Defibrillation

Automated External Defibrillator (AED) Implantable Cardioverter Defibrillator (ICD) Wearable Cardioverter Defibrillator (WCD)

• treatment for cardiac dysrhythmias

• Ex. ventricular fibrillation (VF) and ventricular tachycardia (VT)

• delivers a dose of electric current to the heart

• VITAL ORGANS

• DISTINCTION BETWEEN ASSISTING OR SUBSTITUTING VITAL ORGANS

• ASSISTING VITAL ORGANS GENERALLY OBLIGATES BIOETHICALLY

• SUBSTITUTING VITAL ORGANS GENERALLY DOES NOT OBLIGATE

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