hce_cmu
108年
英文
第 42 題
📖 題組：
The discovery of a recent research published in Nature shows that although electrophysiological monitoring could not detect any neural activity that reflects consciousness in mammalian brains, it did pick up cellular functions hours after death. In this study, researchers obtained dead pigs from a state-run slaughterhouse; they then connected 32 dead pigs to an artificial perfusion system called BrainEx. The brains of these pigs were removed from the skulls. As a result, these dead pigs would not have the ability to perceive the environment and experience sensations such as pain. But, incredibly, BrainEx—a computerized system utilized to control the blood flow, temperature, and perfusion, was capable of restoring circulation to major arteries and small blood vessels in pig brains. Notably, a drug used to enhance the blood flow in people’s brain also successfully dilated pig blood vessels. Electrodes inserted into pig brain tissues even detected activities between and among cells. Findings of this research raise challenges to a long-standing assumption that brains will be irrevocably damaged soon after blood stops circulation. Importantly, the discovery of this research exacerbates the tug-of-war between the effort to salvage a person’s life and the endeavors to remove and implant the organs in another body. Typically, practitioners use various rules of thumb, such as “declare death after 30 minutes of unsuccessful resuscitative efforts”, as the reference point for death determination and for switching from life-saving effort to “organ-saving” effort (for transplantation purposes). But the aforementioned rules of thumb have not been clear-cut. In most countries, most organs for transplant have been extracted from people who have been pronounced brain dead; however, recently, more and more people who are declared dead after their heart and lungs have stopped working (circulatory death) are also eligible for organ donation. Apparently, the standards for death determination and organ transplantation are still not unequivocally accepted by clinicians. The debate on life and death will continue. Despite the lack of consensus, the transplant community, scientists, and medical professionals and other stakeholders generally agree that indisputable, unambiguous transplantation guidelines that can help protect the interests of individuals for whom recovery is a possibility and the interests of potential organ recipients are warranted. Such transplantation guidelines will help medical professionals to make indisputable decisions on the timing to switch from saving someone’s life to saving their organs for the benefit of another person. In any case, this decision on “life and death” should not come down to a moral decision. In addition, medical professionals should also make joint effort to optimize the resuscitation technology. If such a technology gets improved, people who are pronounced brain dead may become candidates for brain resuscitation, rather than candidates for organ transportation. In this regard, it would be harder for families to accept that further resuscitative intervention performed on their love ones is futile. In our view, as the science of brain resuscitation progresses, the decisions to revive patients from unconsciousness or apparent death might increasingly become more reasonable; and the decisions to give up resuscitation in favor of transplanting organs might seem less so.
The discovery of a recent research published in Nature shows that although electrophysiological monitoring could not detect any neural activity that reflects consciousness in mammalian brains, it did pick up cellular functions hours after death. In this study, researchers obtained dead pigs from a state-run slaughterhouse; they then connected 32 dead pigs to an artificial perfusion system called BrainEx. The brains of these pigs were removed from the skulls. As a result, these dead pigs would not have the ability to perceive the environment and experience sensations such as pain. But, incredibly, BrainEx—a computerized system utilized to control the blood flow, temperature, and perfusion, was capable of restoring circulation to major arteries and small blood vessels in pig brains. Notably, a drug used to enhance the blood flow in people’s brain also successfully dilated pig blood vessels. Electrodes inserted into pig brain tissues even detected activities between and among cells. Findings of this research raise challenges to a long-standing assumption that brains will be irrevocably damaged soon after blood stops circulation. Importantly, the discovery of this research exacerbates the tug-of-war between the effort to salvage a person’s life and the endeavors to remove and implant the organs in another body. Typically, practitioners use various rules of thumb, such as “declare death after 30 minutes of unsuccessful resuscitative efforts”, as the reference point for death determination and for switching from life-saving effort to “organ-saving” effort (for transplantation purposes). But the aforementioned rules of thumb have not been clear-cut. In most countries, most organs for transplant have been extracted from people who have been pronounced brain dead; however, recently, more and more people who are declared dead after their heart and lungs have stopped working (circulatory death) are also eligible for organ donation. Apparently, the standards for death determination and organ transplantation are still not unequivocally accepted by clinicians. The debate on life and death will continue. Despite the lack of consensus, the transplant community, scientists, and medical professionals and other stakeholders generally agree that indisputable, unambiguous transplantation guidelines that can help protect the interests of individuals for whom recovery is a possibility and the interests of potential organ recipients are warranted. Such transplantation guidelines will help medical professionals to make indisputable decisions on the timing to switch from saving someone’s life to saving their organs for the benefit of another person. In any case, this decision on “life and death” should not come down to a moral decision. In addition, medical professionals should also make joint effort to optimize the resuscitation technology. If such a technology gets improved, people who are pronounced brain dead may become candidates for brain resuscitation, rather than candidates for organ transportation. In this regard, it would be harder for families to accept that further resuscitative intervention performed on their love ones is futile. In our view, as the science of brain resuscitation progresses, the decisions to revive patients from unconsciousness or apparent death might increasingly become more reasonable; and the decisions to give up resuscitation in favor of transplanting organs might seem less so.
According to the article, which of the following statements is NOT true?
- A The “circulatory death” has not been regarded as an appropriate death determination option.
- B Family members and clinicians might still not have the consensus on “the” right timing to stop resuscitative efforts.
- C Electrophysiological evidence has established that human beings stop having consciousness after death.
- D Medical professionals generally agree that decisions for death determination should not be a moral issue.
- E The transplant community and medical professionals agree that there is a need to establish an organ transplantation protocol.
思路引導 VIP
請重新閱讀文章第二段中後半部，特別是提到關於心肺停止運作（heart and lungs have stopped working）的人群。作者描述這些人目前在器官捐贈的流程中是被如何看待的？文中提到的「越來越多（more and more）」這個趨勢，對於該判定方式的地位有什麼樣的暗示呢？
🤖
AI 詳解
AI 專屬家教
恭喜你精準地鎖定了正確答案！這題需要對長篇且具學術深度的文章進行細節檢索，你能從密集的倫理與技術討論中撥開雲霧，代表你的閱讀洞察力非常敏銳。
關於「循環死」的實務現狀
文中第二段明確提到，雖然死亡判定的標準在臨床上仍未達成完全一致的共識，但近年來已有越來越多因心肺停止運作（即「循環死」，circulatory death）而被宣告死亡的人，被納入器官捐贈的合格對象（eligible for organ donation）。這說明在目前的醫療實務中，「循環死」已經被視為一種死亡判定的選項。因此，選項 (A) 主張它「尚未被視為適當的死亡判定選項」顯然與文中的事實描述相悖，這正是它被選為「非正確敘述」的原因。
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