Case Study – ECMO and Ethics

Case Study – “ECMO? For How Long?” ECMO Extends Life and Poses Challenging Ethics Questions

Oximeter on a finger.By Ryan Pferdehirt, DBe and Tarris (Terry) Rosell, PhD, DMin, HEC-C

June 2024

Bioethics case study on ECMO and ethics.




Thad is a 44-year-old male patient suffering from multisystem organ failure including heart and lung failure. Thad remains in a minimally conscious state. He is in need of a heart transplant and has been waiting for two years on the donor recipient list but has continued to decline. He is now requiring ECMO in order to live. Thad lacks capacity and is totally bedbound. The patient’s family (wife and daughter) are insistent that all aggressive measures continue, in the hope that he will eventually receive a heart transplant. The hospital team understand the importance ECMO has in keeping Thad alive and giving hope to the family but are concerned about its continuation as they do not known when a heart transplant will become available. They request an ethics consult regarding how long they should continue to provide ECMO.

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