{"id":111256,"date":"2026-07-22T00:11:58","date_gmt":"2026-07-21T22:11:58","guid":{"rendered":"https:\/\/www.infokuryr.cz\/n\/?p=111256"},"modified":"2026-07-21T11:33:33","modified_gmt":"2026-07-21T09:33:33","slug":"lekari-nyni-prosazuji-smrt-darovanim-organu","status":"publish","type":"post","link":"https:\/\/www.infokuryr.cz\/n\/2026\/07\/22\/lekari-nyni-prosazuji-smrt-darovanim-organu\/","title":{"rendered":"L\u00e9ka\u0159i nyn\u00ed prosazuj\u00ed smrt darov\u00e1n\u00edm org\u00e1n\u016f"},"content":{"rendered":"
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\u010cl\u00e1nek v \u010dasopise \u201eNew England Journal of Medicine\u201c tvrd\u00ed, \u017ee etick\u00e9 zam\u011b\u0159en\u00ed p\u0159i darov\u00e1n\u00ed org\u00e1n\u016f by se m\u011blo p\u0159esunout od okam\u017eiku smrti k \u201erespektov\u00e1n\u00ed\u201c rozhodnut\u00ed pacienta b\u00fdt usmrcen za \u00fa\u010delem odebr\u00e1n\u00ed org\u00e1nu.<\/span><\/p>\n

\u010cl\u00e1nek z 8. \u010dervence v \u010dasopise\u00a0<\/span>New<\/span><\/a>\u00a0England Journal of Medicine navrhuje p\u0159\u00edm\u00e9 zab\u00edjen\u00ed lid\u00ed prost\u0159ednictv\u00edm darov\u00e1n\u00ed org\u00e1n\u016f.<\/span><\/p>\n

V \u010dl\u00e1nku \u201eKontextualizace pravidla o mrtv\u00e9m d\u00e1rci v \u00e9\u0159e dobrovoln\u00e9 eutanazie\u201c Dr. Robert Truog a jeho kolegov\u00e9 vysv\u011btluj\u00ed, \u017ee \u2013 jeliko\u017e jsme ji\u017e p\u0159edefinovali smrt pro n\u00e1\u0161 sou\u010dasn\u00fd syst\u00e9m odb\u011bru org\u00e1n\u016f \u2013 povolen\u00ed explicitn\u00ed smrti prost\u0159ednictv\u00edm darov\u00e1n\u00ed org\u00e1n\u016f je jednodu\u0161e dal\u0161\u00edm logick\u00fdm krokem.<\/span><\/p>\n

Argument autor\u016f se zab\u00fdv\u00e1 \u201epravidlem mrtv\u00e9ho d\u00e1rce\u201c (DDR), etick\u00fdm principem, kter\u00fd stanov\u00ed, \u017ee pacienti mus\u00ed p\u0159ed darov\u00e1n\u00edm org\u00e1n\u016f zem\u0159eli a \u017ee zdravotnick\u00fd person\u00e1l nesm\u00ed zp\u016fsobit smrt odebr\u00e1n\u00edm org\u00e1n\u016f. Toto pravidlo m\u00e1 za c\u00edl udr\u017eet d\u016fv\u011bru ve\u0159ejnosti v n\u00e1\u0161 syst\u00e9m d\u00e1rcovstv\u00ed org\u00e1n\u016f.<\/span><\/p>\n

Ale podle Truoga a jeho koleg\u016f se \u201epravidlo mrtv\u00e9ho d\u00e1rce\u201c ji\u017e stalo flexibiln\u00edm:<\/span><\/p>\n

A\u010dkoli je NDR pova\u017eov\u00e1na za \u201eetick\u00fd pil\u00ed\u0159\u201c transplanta\u010dn\u00ed medic\u00edny, funguje m\u00e9n\u011b jako mor\u00e1ln\u00ed absolutno a sp\u00ed\u0161e jako mor\u00e1ln\u00ed kotva, jej\u00ed\u017e aplikace vy\u017eaduje neust\u00e1lou interpretaci a adaptaci.<\/span><\/em><\/p>\n

Auto\u0159i uv\u00e1d\u011bj\u00ed p\u0159\u00edklad \u201emozkov\u00e9 smrti\u201c a vysv\u011btluj\u00ed, \u017ee a\u010dkoli mozkov\u00e1 smrt nen\u00ed skute\u010dnou biologickou smrt\u00ed, slou\u017e\u00ed jako p\u0159\u00edklad toho, jak m\u016f\u017eeme definici smrti p\u0159izp\u016fsobit na\u0161im pot\u0159eb\u00e1m:<\/span><\/p>\n

Navzdory filozofick\u00fdm a biologick\u00fdm nejistot\u00e1m byla mozkov\u00e1 smrt za\u010dlen\u011bna do legislativy a l\u00e9ka\u0159sk\u00e9 praxe s p\u0159ijet\u00edm Z\u00e1kona o jednotn\u00e9m ur\u010dov\u00e1n\u00ed smrti v roce 1981, kter\u00fd definoval smrt jako nevratn\u00e9 ukon\u010den\u00ed v\u0161ech mozkov\u00fdch funkc\u00ed. Hromad\u00edc\u00ed se klinick\u00e9 zku\u0161enosti v\u0161ak odhalily nesrovnalosti v tomto integrativn\u00edm konceptu mozkov\u00e9 smrti. Dr. Allan Shewmon hl\u00e1sil \u010detn\u00e9 p\u0159\u00edpady pokra\u010duj\u00edc\u00edho biologick\u00e9ho p\u0159e\u017eit\u00ed po ur\u010den\u00ed mozkov\u00e9 smrti. Tito pacienti byli schopni r\u016fst, vst\u0159eb\u00e1vat \u017eiviny a vylu\u010dovat odpadn\u00ed produkty, zotavit se z infekc\u00ed a zran\u011bn\u00ed a dokonce i nosit plod a\u017e do term\u00ednu. Uprost\u0159ed t\u00e9to nejistoty pokra\u010dovalo d\u00e1rcovstv\u00ed org\u00e1n\u016f, co\u017e odhalilo hlub\u0161\u00ed koncep\u010dn\u00ed posun. NDR posunula ur\u010dov\u00e1n\u00ed smrti od \u010dist\u011b biologick\u00fdch krit\u00e9ri\u00ed sm\u011brem k dodr\u017eov\u00e1n\u00ed diagnostick\u00fdch krit\u00e9ri\u00ed vyjmenovan\u00fdch a potvrzen\u00fdch defini\u010dn\u00ed autoritou. \u201ePo\u017eadavek smrti\u201c a d\u016fv\u011bra v syst\u00e9m d\u00e1rcovstv\u00ed org\u00e1n\u016f nebyly poru\u0161eny, kdy\u017e byl nov\u00fd koncept smrti p\u0159ijat v r\u00e1mci soci\u00e1ln\u00edch a pr\u00e1vn\u00edch norem. Takov\u00e1 kontextualizace u\u010dinila z NDR flexibiln\u00ed mor\u00e1ln\u00ed z\u00e1ruku, kter\u00e1 zachovala povinnost neodeb\u00edrat org\u00e1ny \u017eiv\u00fdm lidem, a to i v p\u0159\u00edpad\u011b, \u017ee byl samotn\u00fd v\u00fdznam \u201esmrti\u201c redefinov\u00e1n.<\/span><\/em><\/p>\n

Kdy\u017e jste se registroval\/a jako d\u00e1rce org\u00e1n\u016f, bylo v\u00e1m \u0159e\u010deno, \u017ee samotn\u00e1 definice smrti byla p\u0159edefinov\u00e1na? V\u011bt\u0161ina lid\u00ed, kte\u0159\u00ed se registruj\u00ed jako d\u00e1rci org\u00e1n\u016f, si mysl\u00ed, \u017ee p\u0159i darov\u00e1n\u00ed org\u00e1n\u016f budou studen\u00ed, \u0161ed\u00ed a ztuhl\u00ed, ale nikdy to tak nen\u00ed. Bez krevn\u00edho ob\u011bhu se org\u00e1ny velmi rychle stanou nevhodn\u00fdmi pro transplantaci: mrtvoly nemohou darovat \u017eivotaschopn\u00e9 org\u00e1ny. Lid\u00e9 v hlubok\u00e9m k\u00f3matu (s tlukouc\u00edm srdcem) byli proto p\u0159edefinov\u00e1ni jako \u201emozkov\u011b mrtv\u00ed\u201c, co\u017e znamen\u00e1, \u017ee org\u00e1ny odpov\u011bdn\u00e9 za definici je pova\u017eovaly za \u201edostate\u010dn\u011b mrtv\u00e9\u201c na to, aby se stali d\u00e1rci org\u00e1n\u016f.<\/p>\n

\u010cl\u00e1nek v New England Journal of Medicine se tak\u00e9 zab\u00fdv\u00e1 skute\u010dnost\u00ed, \u017ee d\u00e1rci org\u00e1n\u016f po z\u00e1stav\u011b srdce (DCD) tak\u00e9 nespl\u0148uj\u00ed z\u00e1konn\u00e1 krit\u00e9ria pro smrt v USA, kter\u00e1 vy\u017eaduj\u00ed nevratnou ztr\u00e1tu ob\u011bhov\u00fdch a d\u00fdchac\u00edch funkc\u00ed.<\/span><\/p>\n

Debata o tom, zda jsou postupy s odlo\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (DCD) skute\u010dn\u011b v souladu s konceptem smrti (DDR), pokra\u010duje, zejm\u00e9na proto, \u017ee trvalost nemus\u00ed b\u00fdt nutn\u011b synonymem pro nevratnost. V DCD ke smrti nedoch\u00e1z\u00ed proto, \u017ee by resuscitace nebyla mo\u017en\u00e1, ale proto, \u017ee je z\u00e1m\u011brn\u011b zadr\u017eov\u00e1na \u2013 v souladu s pacientov\u00fdmi hodnotami \u2013 a t\u00edm vede pacienta ke smrti na cest\u011b pova\u017eovan\u00e9 za \u201enevratnou\u201c, proto\u017ee ji nelze zvr\u00e1tit. Tento posun od biologick\u00e9ho k procedur\u00e1ln\u00edmu ch\u00e1p\u00e1n\u00ed smrti DDR p\u0159ekontextualizoval a srovnal ji sp\u00ed\u0161e s obecn\u00fdmi soci\u00e1ln\u00edmi a etick\u00fdmi pojmy ne\u017e s empirickou kone\u010dnost\u00ed. … Ani zde DDR nep\u0159etrv\u00e1v\u00e1 jako nem\u011bnn\u00e1 hranice, ale jako mor\u00e1ln\u00ed r\u00e1mec, jeho\u017e etick\u00e1 s\u00edla je udr\u017eov\u00e1na kontextualizac\u00ed.<\/span><\/em><\/p>\n

Byl(a) jste informov\u00e1n(a) o tomto posunu od biologick\u00e9 k procedur\u00e1ln\u00ed definici smrti, kdy\u017e jste se registroval(a) jako d\u00e1rce org\u00e1n\u016f? \u017de i kdy\u017e va\u0161e smrt nebude spl\u0148ovat pr\u00e1vn\u00ed standardy z\u00e1kona o jednotn\u00e9m ur\u010dov\u00e1n\u00ed \u00famrt\u00ed, budete pova\u017eov\u00e1n(a) za \u201edostate\u010dn\u011b mrtv\u00e9ho\u201c na to, abyste se stal(a) d\u00e1rcem org\u00e1n\u016f prost\u0159ednictv\u00edm \u201ekontextualizace\u201c?<\/span><\/p>\n

Auto\u0159i \u010dl\u00e1nku tak\u00e9 poukazuj\u00ed na to, \u017ee d\u00e1rci org\u00e1n\u016f stejn\u011b v\u0161ichni zem\u0159ou, tak\u017ee p\u0159esn\u00fd \u010das \u00famrt\u00ed je irelevantn\u00ed:<\/span><\/p>\n

V p\u0159\u00edpadech \u00famrt\u00ed v d\u016fsledku darov\u00e1n\u00ed org\u00e1n\u016f nen\u00ed souhlas, zku\u0161enosti a v\u00fdsledek pacienta ovlivn\u011bno t\u00edm, zda k \u00famrt\u00ed dojde kr\u00e1tce p\u0159ed odb\u011brem org\u00e1nu nebo b\u011bhem n\u011bj. Etick\u00e9 zam\u011b\u0159en\u00ed by se proto m\u011blo p\u0159esunout od ur\u010den\u00ed p\u0159esn\u00e9ho okam\u017eiku biologick\u00e9 smrti k respektov\u00e1n\u00ed autonomn\u00edch rozhodnut\u00ed pacient\u016f, a z\u00e1rove\u0148 by se m\u011blo zajistit robustn\u00ed z\u00e1ruky proti n\u00e1tlaku a vyko\u0159is\u0165ov\u00e1n\u00ed a prosazovat transparentn\u00ed a ve\u0159ejn\u011b odpov\u011bdn\u00fd proces.<\/span><\/em><\/p>\n

Transparentnost? V sou\u010dasn\u00e9 dob\u011b d\u00e1rci org\u00e1n\u016f nedost\u00e1vaj\u00ed absolutn\u011b \u017e\u00e1dn\u00e9 informace o tom, jak je jejich smrt ur\u010dena p\u0159ed darov\u00e1n\u00edm org\u00e1n\u016f. \u017d\u00e1dn\u00fd d\u00e1rce org\u00e1n\u016f nikdy nedostane informace, kter\u00e9 by jak\u00fdkoli rozumn\u00fd \u010dlov\u011bk cht\u011bl zn\u00e1t, aby mohl d\u00e1t informovan\u00fd souhlas. Opravdu v\u011b\u0159\u00edme, \u017ee tento proces bude v budoucnu transparentn\u00ed a ve\u0159ejn\u011b ov\u011b\u0159iteln\u00fd?<\/span><\/p>\n

Dr. Truog a jeho kolegov\u00e9 tvrd\u00ed, \u017ee zp\u016fsob, jak\u00fdm ji\u017e nyn\u00ed redefinujeme smrt v kontextu darov\u00e1n\u00ed org\u00e1n\u016f, ospravedl\u0148uje jejich my\u0161lenku j\u00edt je\u0161t\u011b o krok d\u00e1l a povolit p\u0159\u00edm\u00e9 zabit\u00ed za \u00fa\u010delem odebr\u00e1n\u00ed org\u00e1n\u016f: \u201eI kdy\u017e smrt darov\u00e1n\u00edm org\u00e1n\u016f m\u016f\u017ee b\u00fdt vn\u00edm\u00e1na jako odchylka od NDR\u2026 interpretujeme ji jako soulad s historick\u00fdm vzorcem rekontextualizace.\u201c<\/span><\/p>\n

Vzhledem k tomu, \u017ee jsme v minulosti dok\u00e1zali p\u0159edefinovat \u017eiv\u00e9 lidi tak, \u017ee byli pova\u017eov\u00e1ni za mrtv\u00e9 a mohli se tak st\u00e1t d\u00e1rci org\u00e1n\u016f, m\u016f\u017eeme nyn\u00ed zjevn\u011b otev\u0159en\u011b volat po eutanazii prost\u0159ednictv\u00edm odebr\u00e1n\u00ed org\u00e1n\u016f. Tento proces se tak\u00e9 ozna\u010duje jako \u201ekluzk\u00fd svah\u201c.<\/span><\/p>\n

M\u00edsto toho, abychom tyto st\u00e1le se roz\u0161i\u0159uj\u00edc\u00ed definice smrti nad\u00e1le ospravedl\u0148ovali v z\u00e1jmu d\u00e1rcovstv\u00ed org\u00e1n\u016f, mus\u00edme se vr\u00e1tit k uzn\u00e1n\u00ed smrti jako biologick\u00e9 reality. A mus\u00edme naj\u00edt nov\u00e1, etick\u00e1 \u0159e\u0161en\u00ed pro lidi s org\u00e1nov\u00fdm selh\u00e1n\u00edm, kter\u00e1 nezahrnuj\u00ed zabit\u00ed.<\/span><\/p>\n

*<\/span><\/strong><\/p>\n

Dr. Heidi Klessig<\/strong> je anesteziolo\u017eka a specialistka na l\u00e9\u010dbu bolesti v d\u016fchodu, kter\u00e1 p\u00ed\u0161e a p\u0159edn\u00e1\u0161\u00ed o etick\u00fdch aspektech d\u00e1rcovstv\u00ed a transplantace org\u00e1n\u016f. Je autorkou knihy *Myln\u00e1 p\u0159edstava o mozkov\u00e9 smrti* a jej\u00ed d\u00edlo lze nal\u00e9zt na webov\u00fdch str\u00e1nk\u00e1ch respectforhumanlife.com.<\/span><\/p>\n<\/div>\n<\/div>\n

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Zdroj<\/span><\/a><\/span><\/h3>\n

 <\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

\u010cl\u00e1nek v \u010dasopise \u201eNew England Journal of Medicine\u201c tvrd\u00ed, \u017ee etick\u00e9 zam\u011b\u0159en\u00ed p\u0159i darov\u00e1n\u00ed org\u00e1n\u016f…<\/p>\n","protected":false},"author":2,"featured_media":111257,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[7],"tags":[677,2373,3575],"_links":{"self":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/111256"}],"collection":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/comments?post=111256"}],"version-history":[{"count":0,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/posts\/111256\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media\/111257"}],"wp:attachment":[{"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/media?parent=111256"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/categories?post=111256"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.infokuryr.cz\/n\/wp-json\/wp\/v2\/tags?post=111256"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}