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Ethical challenges of adult ECMO
Open accessAbstract
The use of extracorporeal membrane oxygenation (ECMO) is expanding rapidly, and as more centres streamline their management policies, the bioethics literature on ECMO has been highlighting the ethical challenges of using an expensive, resource-intensive technology including its eligibility, duration of support, cost-effectiveness and societal repercussions. The absence of high-quality studies on long-term outcomes of ECMO survivors leads to multiple ethical problems involving patient autonomy, beneficence and clinical wisdom pertaining to its initiation, maintenance and termination. This article reviews some of the ethical challenges that affect decision-making during ECMO therapy and suggests an ethical framework that may help the treating team deal with such conundrums, when the patient does not recover despite being on ECMO.
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“Nonetheless, ECMO presents major challenges: initiation requires precise timing within a narrow therapeutic window, and complications such as bleeding, thrombosis, and infection remain common7,8.”
From Decisional conflict among Chinese family caregivers prior to ECMO initiation: a cross-sectional study (2025) · cites this paper as [8]
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Research works printed but not linked: 20
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Cited by
Xiao, S., Liu, H., Tang, L., Xiong, Q., Jiang, R., & Hong, D. (2025) · Scientific Reports · doi:10.1038/s41598-025-28709-9 · Cited by 1
Metadata
- Authors
- Ramanathan, K.
- Affiliations
- Bond University (AU)
- Corresponding author
- Ramanathan, Kollengode
- Venue
- Indian Journal of Thoracic and Cardiovascular Surgery
- Published
- 2020-02-17
- Volume
- 37
- Issue
- S2
- Pages
- 303-308
- ISSN
- 0970-9134 (ISSN-L)
- 0973-7723
- PMC
- PMC8062656
- OpenAlex
- W3007895549
- Cited by
- 13
- References
- 0
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 2 · 2022: 1 · 2021: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Indian Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Ethics and Legal Issues in Pediatric Healthcare
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Mechanical Circulatory Support Devices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Keywords
- extracorporeal membrane oxygenation, adult ECMO, bioethics, patient autonomy, beneficence, withdrawal of life-sustaining treatment, cost-effectiveness, resource allocation, ethical decision-making framework
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