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  1. Article ; Online: Be an ethicist not a stranger! : The critical patient stuck between the right to evidence-based medicine, informed consent, and social duty. Are we still "Strangers at the bedside"?

    Accogli, Agnese / Vergano, Marco

    Journal of anesthesia, analgesia and critical care

    2023  Volume 3, Issue 1, Page(s) 26

    Language English
    Publishing date 2023-08-04
    Publishing country England
    Document type Editorial
    ISSN 2731-3786
    ISSN (online) 2731-3786
    DOI 10.1186/s44158-023-00110-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Intensive care admission aiming at organ donation. Con.

    Vergano, Marco / Jung, Christian / Metaxa, Victoria

    Intensive care medicine

    2024  Volume 50, Issue 3, Page(s) 440–442

    MeSH term(s) Humans ; Tissue and Organ Procurement ; Critical Care ; Organ Transplantation ; Intensive Care Units ; Tissue Donors
    Language English
    Publishing date 2024-01-25
    Publishing country United States
    Document type Editorial
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-024-07326-6
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    Zs.A 1089: Show issues Location:
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  3. Article ; Online: From the pandemic to a war: a call for solidarity with all healthcare workers.

    Montomoli, Jonathan / Vergano, Marco / Semeraro, Federico / Bignami, Elena Giovanna

    Intensive care medicine

    2024  

    Language English
    Publishing date 2024-04-15
    Publishing country United States
    Document type Letter
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-024-07391-x
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  4. Article ; Online: Brain death as a moral definition and an act of love: the tale of Moon, Nehviel and Fate.

    Zamperetti, Nereo / Vergano, Marco / Latronico, Nicola

    Journal of neurosurgical sciences

    2022  Volume 67, Issue 2, Page(s) 230–235

    Abstract: The vital status of people with a destroyed brain is one of the most discussed topics in medical literature. According to the current legal narrative, people whose brain is destroyed are dead. Nevertheless, a clear biological rationale to support with ... ...

    Abstract The vital status of people with a destroyed brain is one of the most discussed topics in medical literature. According to the current legal narrative, people whose brain is destroyed are dead. Nevertheless, a clear biological rationale to support with certainty such a narrative is still lacking. The purported rationale of the "the brain as the central integrator of the body" has proven to be biologically untenable. Persons with a destroyed brain can be maintained viable for long periods of time, showing clear signs of good biological integration. This fact stirs up a continuous seething of heated discussions among scholars, and generates uncertainty among lay people, loss of trust towards the medical community, and highly controversial cases in the media. To try to settle this unresolved situation, we propose a moral narrative, according to which people whose brain is destroyed should be considered as dead. Defining those people as biologically dead is impossible. Their clinical condition is neither life nor death; it is something in between, an artifice created by modern medicine. Yet, we can well state that the irreversible loss of all brain functions is a clinically and scientifically useful point of no return in the process of dying which can guide sound decisions. Through a personal reinterpretation of the myth of Orpheus and Eurydice, we would like to show that the choice to consider people with a destroyed brain as dead is a sound moral decision and an act of love.
    MeSH term(s) Humans ; Brain ; Brain Death/diagnosis ; Love ; Morals ; Ethics
    Language English
    Publishing date 2022-11-03
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 193139-8
    ISSN 1827-1855 ; 0390-5616 ; 0026-4881
    ISSN (online) 1827-1855
    ISSN 0390-5616 ; 0026-4881
    DOI 10.23736/S0390-5616.22.05946-X
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  5. Article ; Online: Beneficence and equity

    Craxi Lucia / Vergano Marco

    how the covid-19 pandemic exposed our weaknesses in Italy

    2020  

    Abstract: How did Italy face the issue of allocating beds in Intensive Care Units and ventilators during the COVID-19 outbreak? At the beginning of the epidemic, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care issued recommendations ... ...

    Abstract How did Italy face the issue of allocating beds in Intensive Care Units and ventilators during the COVID-19 outbreak? At the beginning of the epidemic, the Italian Society of Anesthesia Analgesia Resuscitation and Intensive Care issued recommendations that sparked a heated debate. Later, the National Bioethics Committee, the ethical advisory board of the Government, has issued a document, which recognizes that the only admissible criterion to employ in a "pandemic emergency triage" is a clinical criterion. The document actually doesn’t address some core ethical issues, leaving many unanswered questions.
    Keywords COVID 19 ; Allocation ; Bioethics ; Public Health ; Italy ; Settore MED/02 - Storia Della Medicina ; Settore MED/41 - Anestesiologia ; covid19
    Language English
    Publisher British Medical Journal Publishing Group
    Publishing country it
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: An ethical algorithm for rationing life-sustaining treatment during the COVID-19 pandemic.

    Savulescu, Julian / Vergano, Marco / Craxì, Lucia / Wilkinson, Dominic

    British journal of anaesthesia

    2020  Volume 125, Issue 3, Page(s) 253–258

    MeSH term(s) Algorithms ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/mortality ; Coronavirus Infections/therapy ; Decision Making ; Humans ; Pandemics ; Personal Autonomy ; Pneumonia, Viral/mortality ; Pneumonia, Viral/therapy ; Quality of Life ; Resource Allocation ; SARS-CoV-2 ; Triage
    Keywords covid19
    Language English
    Publishing date 2020-06-02
    Publishing country England
    Document type Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2020.05.028
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  7. Article ; Online: Rapid Response

    Veatch, Robert M. / Vergano, Marco

    Is it not wrong to prioritise younger patients with Covid-19?

    2020  

    Keywords COVID-19 virus ; Bioethics ; Coronavirus infections ; Communicable diseases -- prevention ; Epidemics -- prevention & control ; Medical ethics ; covid19
    Publishing date 2020-04-30
    Publishing country us
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Medical assistance in dying: just an ethical or legal issue?

    Gristina, Giuseppe R / Vergano, Marco / Orsi, Luciano

    Recenti progressi in medicina

    2020  Volume 111, Issue 5, Page(s) 316–326

    Abstract: According to current vital statistics suicide appears as a growing public health problem in most Western countries. However, suicide is rarely discussed in scientific journals, possibly because of a persisting moral stigma. As a consequence, the diverse ... ...

    Abstract According to current vital statistics suicide appears as a growing public health problem in most Western countries. However, suicide is rarely discussed in scientific journals, possibly because of a persisting moral stigma. As a consequence, the diverse bases of suicidal behavior are little understood while the role of Chronic-Degenerative Terminal Diseases (CDTD) has been poorly investigated. In the present study, the topic of suicidality was addressed in a clinical, holistic, perspective in an attempt to clarify how, in some chronically ill patients, the decision to end their own life is taken independently from mental disorders, being conversely, the expression of a rational psychological pattern which copes with the burden of chronic illnesses to become an integral part of their clinical spectrum. An assisted suicide (AS) request should therefore be considered from a clinical point of view and not only as an ethical or legal issue, in fact a holistic evaluation of the patient's situation must be performed, conferring the decisions making process a further in-depth line of thinking. In this study we first examined the relationship between suicide and CDTD as reported in the medical literature; then we reviewed the psychological theories which allegedly explain suicidal behavior; finally we discussed the possible role of a full-fledged palliative care in preventing suicide and in managing death requests by CDTD patients.
    MeSH term(s) Euthanasia ; Humans ; Medical Assistance ; Palliative Care ; Suicide, Assisted/psychology
    Language English
    Publishing date 2020-05-21
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 138266-4
    ISSN 2038-1840 ; 0034-1193
    ISSN (online) 2038-1840
    ISSN 0034-1193
    DOI 10.1701/3366.33413
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    Zs.B 193: Show issues Location:
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  9. Article ; Online: Rationing in a Pandemic: Lessons from Italy.

    Craxì, Lucia / Vergano, Marco / Savulescu, Julian / Wilkinson, Dominic

    Asian bioethics review

    2020  Volume 12, Issue 3, Page(s) 325–330

    Abstract: In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts ... ...

    Abstract In late February and early March 2020, Italy became the European epicenter of the COVID-19 pandemic. Despite increasingly stringent containment measures enforced by the government, the health system faced an enormous pressure, and extraordinary efforts were made in order to increase overall hospital beds' availability and especially ICU capacity. Nevertheless, the hardest-hit hospitals in Northern Italy experienced a shortage of ICU beds and resources that led to hard allocating choices. At the beginning of March 2020, the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) issued recommendations aimed at supporting physicians in prioritizing patients when the number of critically ill patients overwhelm the capacity of ICUs. One motivating concern for the SIAARTI guidance was that, if no balanced and consistent allocation procedures were applied to prioritize patients, there would be a concrete risk for unfair choices, and that the prevalent "first come, first served" principle would lead to many avoidable deaths. Among the drivers of decision for admission to ICUs, age, comorbidities, and preexisting functional status were included. The recommendations were criticized as ageist and potentially discriminatory against elderly patients. Looking forward to the next steps, the Italian experience can be relevant to other parts of the world that are yet to see a significant surge of COVID-19: the need for transparent triage criteria and commonly shared values give the Italian recommendations even greater legitimacy.
    Keywords covid19
    Language English
    Publishing date 2020-06-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2602378-7
    ISSN 1793-9453 ; 1793-8759
    ISSN (online) 1793-9453
    ISSN 1793-8759
    DOI 10.1007/s41649-020-00127-1
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  10. Article ; Online: Transcranial Doppler and Color-Coded Doppler Use for Brain Death Determination in Adult Patients: A Pictorial Essay.

    Deana, Cristian / Biasucci, Daniele G / Aspide, Raffaele / Brasil, Sergio / Vergano, Marco / Leonardis, Francesca / Rica, Ermal / Cammarota, Gianmaria / Dauri, Mario / Vetrugno, Giuseppe / Longhini, Federico / Maggiore, Salvatore Maurizio / Rasulo, Frank / Vetrugno, Luigi

    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine

    2024  Volume 43, Issue 5, Page(s) 979–992

    Abstract: Transcranial Doppler (TCD) is a repeatable, at-the-bedside, helpful tool for confirming cerebral circulatory arrest (CCA). Despite its variable accuracy, TCD is increasingly used during brain death determination, and it is considered among the optional ... ...

    Abstract Transcranial Doppler (TCD) is a repeatable, at-the-bedside, helpful tool for confirming cerebral circulatory arrest (CCA). Despite its variable accuracy, TCD is increasingly used during brain death determination, and it is considered among the optional ancillary tests in several countries. Among its limitations, the need for skilled operators with appropriate knowledge of typical CCA patterns and the lack of adequate acoustic bone windows for intracranial arteries assessment are critical. The purpose of this review is to describe how to evaluate cerebral circulatory arrest in the intensive care unit with TCD and transcranial duplex color-coded doppler (TCCD).
    MeSH term(s) Adult ; Humans ; Brain Death/diagnostic imaging ; Brain ; Ultrasonography, Doppler, Transcranial ; Ultrasonography, Doppler, Color ; Arteries ; Cerebrovascular Circulation
    Language English
    Publishing date 2024-01-26
    Publishing country England
    Document type Review ; Case Reports
    ZDB-ID 604829-8
    ISSN 1550-9613 ; 0278-4297
    ISSN (online) 1550-9613
    ISSN 0278-4297
    DOI 10.1002/jum.16421
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