Suchergebnisse

Suvremeni pogled na umiranje obilježen je nizom neizvjesnih i teških pitanja koja proizlaze iz kliničkoga konteksta, pravne i bioetičke domene donošenja teških egzistencijalnih odluka vezanih uz posljednje životne trenutke, a napose s obzirom na medicinske intervencije izbora "skrbi na kraju života". Taj korak zahtijeva punu racionalnost slobodne autonomije, koja u određenim trenucima može biti znatno narušena gubitkom fizičkih i/li mentalnih sposobnosti, uvjetovanih pojedinim bolestima. Stoga bi bolesnici trebali imati zakonodavnu mogućnost jasno priopćiti svoje želje u vezi sa zahtijevanim tretmanom ili njegovim distanazijskim povlačenjem u unaprijed pripremljenim smjernicama anticipiranih medicinskih odredbi bioloških oporuka za (ne)postupanje ili imenovanje surogatnog opunomoćenika kao zastupnika u (ne)izboru liječenja u slučaju ograničene sposobnosti odlučivanja. Potpisana biološka oporuka mogla bi uvelike pridonijeti pozitivno dostojanstvenijom modusu samodeterminiranog načina umiranja, poštujući "kulturu života", sukladnog onom koji je odabir autonomnih pacijentovih vrijednosti skrbi na kraju života, koji često mogu ući u koliziju iz heteronomne perspektive surogatnih odlučitelja. Biološkim bi se oporukama višestruko nadvladale i teškoće kliničkih dilema egzistencijalnih odluka: liječnicima bi se olakšao odabir skrbi u hitnim planovima zdravstvene njege u kriznim situacijama; pacijentima bi pružale jamstvo provedbe njihova samoodređenja; dok bi surogatne odlučitelje uvelike oslobodili pritiska odgovornosti. ; A contemporary view of death is characterized by a sequence of uncertain and difficult questions arising from the clinical context, out of the legal and bioethical domains of taking difficult existential decisions related to the last moments of human life. This step requires a full rationality of free autonomy, which can be significantly disturbed by the loss of mental ability, conditioned by certain illnesses in certain moments. Therefore, patients should have a legislative opportunity to clearly ...

Abstract During the past ten years, the efforts to improve and organize the national transplantation system in Croatia have resulted in a steadily growing donor rate, which reached its highest level in 2011, with 33.6 utilized donors per million population (p.m.p.). Nowadays, Croatia is one of the leading countries in the world according to deceased donation and transplantation rates. Between 2008 and 2011, the waiting list for kidney transplantation decreased by 37.2% (from 430 to 270 persons waiting for a transplant) and the median waiting time decreased from 46 to 24 months. The Croatian model has been internationally recognized as successful and there are plans for its implementation in other countries. We analyzed the key factors that contributed to the development of this successful model for organ donation and transplantation. These are primarily the appointment of hospital and national transplant coordinators, implementation of a new financial model with donor hospital reimbursement, public awareness campaign, international cooperation, adoption of new legislation, and implementation of a donor quality assurance program. The selection of key factors is based on the authors' opinions; we are open for further discussion and propose systematic research into the issue.