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The diagnosis of brain death has medical, legal and ethical aspects. While the main determinant is the medical approach of the physician in terms of ethics, legal situations are also effective in the process. Non-harm, beneficence, respect for autonomy and justice are the principles that are widely accepted and form the basis of medical ethics. Understanding these principles is a must in order to talk about the ethics of brain death and organ transplantation. In the process of diagnosis and management of brain death, the physician should convey the process to the relatives of the patients in a clear and understandable language and in accordance with the educational-cultural levels of the relatives of the patients. The fact that the concept of brain death is misunderstood in the society or lack of knowledge creates social ethical problems. Special training should be given to health professionals for brain death awareness and early diagnosis, and their ability to resolve ethical problems should be strengthened. Human resources are of great importance in the diagnosis of brain death and in the process of organ transplantation from a cadaver. Communication skills are the mainstay of interaction within the clinic. Organ transplant coordinators should run the process smoothly by creating a bridge between the physician responsible for the case and the intensive care physicians. Such an approach will reduce ethical issues and ensure a successful diagnosis and donation process.

Organ transplantation is the most important option for the treatment of end-stage diseases. However, there is a large difference between the number of patients on the waiting list and the number of transplants performed. The gradual increase in this difference creates ethical problems related to organ transplantation. Ethical problems and other limitations require organ transplantation to be controlled by legal regulations. In our country, organ transplantation practice is carried out under the supervision of the state. Organ Transplant Practice Regulation has been updated by being published in the Official Gazette dated 09.12.2022 and numbered 32008. Possible end-of-life decisions in brain death are stated in accordance with the conditions of our country. “In cases where brain death is diagnosed, the organ preservation protocols applied are terminated in the absence of family or legal guardian approval regarding organ donation. In case of organ donation by the family or legal guardian, the organ preservation protocols needed for donor care are continued during the period until the transplantation of the organ to the waiting patient”, and a solution has been presented to the intensive care physicians for the prognosis of the cases that donated or could not be donated.In the regulation in which the prerequisites of the brain death diagnostic criteria are specified, it is stated that the central body temperature should be ≥36 °C. With the new regulation, end-of-life decisions on brain death and changes made in relation to central body temperature have brought convenience in the diagnosis and follow- up process.

Fat embolism is a syndrome which is caused by oil particles introduce into the systemic circulation and consists of respiratory distress, altered consciousness and petechial rashes. It may occur following traumatic, surgical and non-traumatic clinical conditions. The most common occurrence develops following the long bone fractures within 24-72 hours. The clinical picture of syndrome may vary slightly condition as well as respiratory failure and coma. The diagnosis is done based on mostly clinical criteria. There is no specific laboratory and radiographic findings. The suggested supportive approaches in the treatment of this syndrome are early fixation of the fracture, maintenance of fluid and electrolyte balance and treatment of hypoxia. We aimed to present two cases of successful diagnosis and treatment process with fat embolism syndrome following multiple fractures due to in-vehicle traffic accidents. (Journal of the Turkish Society Intensive Care 2012; 10: 23-7)

In adults, the main causes of iron poisoning are intake suicide attempts and an overdose of iron during pregnancy. The severity of intoxication depends on the amount of iron. When serum iron level exceeds the iron binding capacity of the body, free radicals occurs, leading to lipid peroxidation and cellular membrane damage. In iron poisoning, especially the liver, heart, kidney, lung, and hematologic systems are affected negatively. Acute iron poisoning can cause serious complications resulting in death. Clinical, laboratory observation and early treatment are important. In this case report, we examined to approach the acute iron poisoning with the occasion of high-dose iron intake for suicide attempt. (Journal of the Turkish Society Intensive Care 2011; 9: 107-9)ntakeforsuicideattempt. (Journal of theTurkishSocietyIntensiveCare 2011; 9: 107-9)