Ethics in extracorporeal life support: a narrative review

Alexandra Schou, Jesper Mølgaard, Lars Willy Andersen, Søren Holm, Marc Sørensen


During 50 years of extracorporeal life support (ECLS), this highly invasive technology has left a considerable imprint on modern medicine, and it still confronts researchers, clinicians and policymakers with multifarious ethical challenges. After half a century of academic discussion about the ethics of ECLS, it seems appropriate to review the state of the argument and the trends in it. Through a comprehensive literature search on PubMed, we identified three ethical discourses: (1) trials and evidence accompanying the use of ECLS, (2) ECLS allocation, decision-making and limiting care, and (3) death on ECLS and ECLS in organ donation. All included articles were carefully reviewed, arguments extracted and grouped into the three discourses. This article provides a narrative synthesis of these arguments, evaluates the opportunities for mediation and substantiates the necessity of a shared decision-making approach at the limits of medical care.

Original languageEnglish
Article number256
JournalCritical care (London, England)
Issue number1
Pages (from-to)256
Publication statusPublished - 21 Jul 2021


  • Ethics, Medical
  • Extracorporeal Membrane Oxygenation/history
  • History, 20th Century
  • Humans
  • Respiratory Insufficiency/physiopathology
  • Risk Factors


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