Advance Directives, Do Not Resuscitate Orders, Hospice, Organ Transplantation and Physician Assisted Suicide
Advance care planning can take a number of forms including discussions with family members that are not formally documented, similar discussions with one’s physician, and directives for level of care during hospitalization such as do not resuscitate (DNR) orders. Organ transplantation has, in the span of less than 50 years, moved from a rare, highly publicized experimental procedure to a relatively common surgical procedure for conditions such as kidney failure. A difficult issue with harvesting and transplanting organs such as the heart, is that the donor, while maintaining some physiological activity, is considered to be in an irreversible state of death. As was evident in the description of ethical dilemmas in Israel, death has not been consistently defined. In addition, there are significant cultural differences as well as international variability in the use of advance directives, hospice, do not resuscitate orders, and the acceptability of physician-assisted death…
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