Kenneth Prager is Professor of Clinical Medicine, Director of Clinical Ethics, and Chairman of the Medical Ethics Committee at Columbia University Medical Center.
He recently made an outstanding presentation at the MacLean Center for Clinical Medical Ethics: “ECMO as a Bridge to Nowhere: Ethically Challenging and Poignant Cases from the Technological Edge.”
Prager addresses decision making when ECMO proves to be neither a bridge to transplant (e.g. because the patient gets de-listed) nor a bridge to recovery. One particularly interesting tool is a “goals notification document” that advises the surrogate (and may even ask them to acknowledge) that the team “will stop” ECMO in such situations.