{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T10:10:31Z","timestamp":1790503831086,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Ethics"],"accepted":{"date-parts":[[2013,1,3]]},"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:p>The chronic worldwide lack of organs for transplantation and the continuing improvement of strategies for <jats:italic>in situ<\/jats:italic> organ preservation have led to renewed interest in elective non-therapeutic ventilation of potential organ donors. Two types of situation may be eligible for elective intensive care: patients definitely evolving towards brain death and patients suitable as controlled non-heart beating organ donors after life-supporting therapies have been assessed as futile and withdrawn. Assessment of the ethical acceptability and the risks of these strategies is essential. We here offer such an ethical assessment using the four principles of medical ethics of Beauchamp and Childress applying them in their broadest sense so as to include patients and their families, their caregivers, other potential recipients of intensive care, and indeed society as a whole. The main ethical problems emerging are the definition of beneficence for the potential organ donor, the dilemma between the duty to respect a dying patient's autonomy and the duty not to harm him\/her, and the possible psychological and social harm for families, caregivers other potential recipients of therapeutic intensive care, and society more generally. Caution is expressed about the ethical acceptability of elective non-therapeutic ventilation, along with some proposals for precautionary measures to be taken if it is to be implemented.<\/jats:p>","DOI":"10.1136\/medethics-2012-100990","type":"journal-article","created":{"date-parts":[[2013,1,26]],"date-time":"2013-01-26T20:18:36Z","timestamp":1359231516000},"page":"139-142","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":29,"title":["Elective non-therapeutic intensive care and the four principles of medical ethics"],"prefix":"10.1136","volume":"39","author":[{"given":"Antoine","family":"Baumann","sequence":"first","affiliation":[{"name":"Anesth\u00e9sie R\u00e9animation Chirurgicale, Centre Hospitalier Universitaire de Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Audibert","sequence":"additional","affiliation":[{"name":"Anesth\u00e9sie R\u00e9animation Chirurgicale, Centre Hospitalier Universitaire de Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Guibet Lafaye","sequence":"additional","affiliation":[{"name":"Centre Maurice Halbwachs, CNRS, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Puybasset","sequence":"additional","affiliation":[{"name":"Neuro Anesth\u00e9sie R\u00e9animation, Centre Hospitalier Universitaire Piti\u00e9-Salp\u00e9tri\u00e8re, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul-Michel","family":"Mertes","sequence":"additional","affiliation":[{"name":"Anesth\u00e9sie R\u00e9animation Chirurgicale, Centre Hospitalier Universitaire de Nancy, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9rique","family":"Claudot","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine l\u00e9gale et de Droit de la Sant\u00e9, Facult\u00e9 de M\u00e9decine, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,1,26]]},"reference":[{"key":"2025092414241025000_39.3.139.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.302.6784.1053"},{"key":"2025092414241025000_39.3.139.2","doi-asserted-by":"publisher","DOI":"10.1136\/jme.22.2.72"},{"key":"2025092414241025000_39.3.139.3","doi-asserted-by":"publisher","DOI":"10.1136\/jme.23.3.170"},{"key":"2025092414241025000_39.3.139.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70060-1"},{"key":"2025092414241025000_39.3.139.5","first-page":"2893","article-title":"Categories of non-heart-beating donors","volume":"27","author":"Kootstra","year":"1995","journal-title":"Transplant Proc"},{"key":"2025092414241025000_39.3.139.6","first-page":"93","article-title":"Kidney and liver transplants from donors after cardiac death: initial experience at the London Health Sciences Centre","volume":"53","author":"Hernandez-Alejandro","year":"2010","journal-title":"Can J Surg"},{"key":"2025092414241025000_39.3.139.7","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2007.021568"},{"key":"2025092414241025000_39.3.139.8","unstructured":"Identification of potential donors of organs for transplantation, Health service guideline 41, NHS Executive: Acute Services Policy Unit, 1994."},{"key":"2025092414241025000_39.3.139.9","doi-asserted-by":"publisher","DOI":"10.1136\/jme.29.3.176"},{"key":"2025092414241025000_39.3.139.10","unstructured":"Rodgers ME . The Law Commission's proposals on mental capacity and the legality of elective ventilation for transplantation purposes. Web Journal of Current Legal Issues in association with Blackstone Press Ltd., 1995."},{"key":"2025092414241025000_39.3.139.11","unstructured":"Beauchamp TL Childress JF . Principles of biomedical ethics, 6th edn. New York:Oxford University Press, 2008."},{"key":"2025092414241025000_39.3.139.12","unstructured":"Kant E . Second Section: Transition from Popular Moral Philosophy to the Metaphysic of Morals, Fundamental Principles of the Metaphysic of Morals, 1785, 95."},{"key":"2025092414241025000_39.3.139.13","doi-asserted-by":"publisher","DOI":"10.1136\/jme.21.3.179"},{"key":"2025092414241025000_39.3.139.14","first-page":"3","article-title":"(End of life non-therapeutic intensive care for organ preservation and donation: Legal and ethical issues.)","volume":"2012","author":"Baumann","year":"2012","journal-title":"Presse Med"},{"key":"2025092414241025000_39.3.139.15","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen106"},{"key":"2025092414241025000_39.3.139.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2012.04.018"},{"key":"2025092414241025000_39.3.139.17","doi-asserted-by":"publisher","DOI":"10.1177\/0885066609344955"},{"key":"2025092414241025000_39.3.139.18","first-page":"23","article-title":"The conflict between autonomy and beneficence in medical ethics: proposal for a resolution","volume":"3","author":"Pellegrino","year":"1987","journal-title":"J Contemp Health Law Policy"},{"key":"2025092414241025000_39.3.139.19","doi-asserted-by":"publisher","DOI":"10.1111\/1467-8519.00194"},{"key":"2025092414241025000_39.3.139.20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2010.02386.x"},{"key":"2025092414241025000_39.3.139.21","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1111\/j.1600-6143.2007.02087.x","article-title":"Donors after cardiac death: validation of identification criteria (DVIC) study for predictors of rapid death","volume":"8","author":"DeVita","year":"2008","journal-title":"Am J Transplant"},{"key":"2025092414241025000_39.3.139.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.annfar.2012.02.009"},{"key":"2025092414241025000_39.3.139.23","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1177\/152692480301300405","article-title":"Development of the University of Wisconsin donation after cardiac death evaluation tool","volume":"13","author":"Lewis","year":"2003","journal-title":"Prog Transplant"},{"key":"2025092414241025000_39.3.139.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2005.01150.x"},{"key":"2025092414241025000_39.3.139.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2010.05.007"},{"key":"2025092414241025000_39.3.139.26","doi-asserted-by":"crossref","first-page":"3441","DOI":"10.1016\/j.transproceed.2011.09.034","article-title":"End of life care in the operating room for non-heart-beating donors: organization at the University Hospital of Liege","volume":"43","author":"Joris","year":"2010","journal-title":"Transplant Proc"},{"key":"2025092414241025000_39.3.139.27","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/jhq009"},{"key":"2025092414241025000_39.3.139.28","doi-asserted-by":"publisher","DOI":"10.1186\/2110-5820-2-23"},{"key":"2025092414241025000_39.3.139.29","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(99)00515-1"}],"container-title":["Journal of Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/medethics-2012-100990","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T21:24:22Z","timestamp":1758749062000},"score":1,"resource":{"primary":{"URL":"https:\/\/jme.bmj.com\/lookup\/doi\/10.1136\/medethics-2012-100990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,26]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2013,2,18]]},"published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.1136\/medethics-2012-100990"],"URL":"https:\/\/doi.org\/10.1136\/medethics-2012-100990","relation":{},"ISSN":["0306-6800","1473-4257"],"issn-type":[{"value":"0306-6800","type":"print"},{"value":"1473-4257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,26]]}}}