Death determination, organ donation and the importance of the Dead Donor Rule following withdrawal of life‐sustaining treatment: A survey of community opinions

2021 ◽  
Author(s):  
Michael J O’Leary ◽  
George Skowronski ◽  
Christine Critchley ◽  
Lisa O’Reilly ◽  
Cynthia Forlini ◽  
...  
Keyword(s):  
Organ Donation ◽  
Rule Following ◽  
Dead Donor Rule ◽  
Life Sustaining Treatment ◽  
The Dead ◽  
Death Determination

Double-Effect Donation Disputed

2021 ◽  
pp. 002436392110381
Author(s):  
Thomas A. Cavanaugh
Keyword(s):  
Organ Donation ◽  
Healthy Individual ◽  
Living Donor ◽  
Double Effect ◽  
Vital Organ ◽  
Dead Donor Rule ◽  
Knowing That ◽  
The Dead ◽  
Living Person ◽  
Do So

In “Double Effect Donation,” Camosy and Vukov argue that “there are circumstances in which it is morally permissible for a healthy individual to donate their organs even though their death is a foreseeable outcome”. They propose that a living donor could ethically donate an entire, singular, vital organ while knowing that this act would result in death. In reply, I argue that it is not ethical for a living person to donate an entire, singular, vital organ. Moreover, mutatis mutandis, it is not ethical for surgeons and others to perform such a deadly operation. For to do so is “intentionally to cause the death of the donor in disposing of his organs”. Such an act violates the dead donor rule which holds that an entire, singular, vital organ may be taken only from a corpse. Contrary to Camosy and Vukov’s claims, double-effect reasoning does not endorse such organ donation.

scholarly journals Abandoning the dead donor rule? A national survey of public views on death and organ donation

2014 ◽  
Vol 41 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Michael Nair-Collins ◽  
Sydney R Green ◽  
Angelina R Sutin
Keyword(s):  
Organ Donation ◽  
National Survey ◽  
Dead Donor Rule ◽  
The Dead ◽  
Public Views

Ambiguity, death determination, and the dead donor rule

2018 ◽  
Vol 13 (4) ◽  
pp. 165-171
Author(s):  
Will Lyon
Keyword(s):  
Brain Death ◽  
Organ Transplant ◽  
Organ Donors ◽  
Guiding Principle ◽  
Definition Of Death ◽  
Dead Donor Rule ◽  
Transplant Ethics ◽  
The Dead ◽  
Definition Of ◽  
Death Determination

The dead donor rule states that organ donors must be declared dead before any vital organs are removed. Recently, scholars and physicians have argued for the abandonment of the dead donor rule, based on the rule’s supposed connection with the concept of brain death, which they view as a conceptually unreliable definition of death. In this essay, I distinguish between methods of death determination and the question of whether or not the dead donor rule should be a guiding principle of organ transplant ethics. In principle, the dead donor rule does not rely on any one definition of death, but only prohibits the taking of vital organs before a patient is declared dead. In light of this distinction, I argue that even if the dead donor rule is tied to brain death in practice, conceptual disagreement about brain death does not provide grounds for rejection of this rule. I then present evidence in support of the consistency and reliability of the diagnosis of brain death. I show that, when performed carefully and under specific clinical circumstances, the diagnosis of brain death is considered by most neurologists to be reliable. Finally, I argue that, without the dead donor rule, organ transplantation programs would become susceptible to violations of the ethical principle of respect for persons.

Organ Donation After Circulatory Death and Before Death: Ethical Questions and Nursing Implications

2019 ◽  
Vol 20 (3) ◽  
pp. 163-173 ◽  
Author(s):  
Lila de Tantillo ◽  
Juan M. González ◽  
Johis Ortega
Keyword(s):  
United States ◽  
Health Care ◽  
Organ Donation ◽  
Brain Function ◽  
The United States ◽  
Health Care Facilities ◽  
Donation After Circulatory Death ◽  
Dead Donor Rule ◽  
The Dead ◽  
Circulatory Death

Scientific advances have enabled thousands of individuals to extend their lives through organ donation. Yet, shortfalls of available organs persist, and individuals in the United States die daily before they receive what might have been lifesaving organs. For years, the legal foundation of organ donation in the United States has been known as the Dead Donor Rule, requiring death to be defined for organ donation purposes by either a cardiac standard (termination of the heartbeat) or a neurological one (cessation of all brain function). In this context, one solution used by an increasing number of health care facilities since 2006 is donation after circulatory death, generally defined as when care is withdrawn from individuals who have known residual brain function. Despite its increased use, donation after circulatory death remains ethically controversial. In addition, some ethicists have advocated forgoing the Dead Donor Rule altogether and allowing donation before or near death in certain circumstances. However, nurses and other health professionals must carefully consider the practical and ethical implications of broadening the Dead Donor Rule—as may be already occurring—or removing it entirely. Such changes could harm both the integrity of the health care system as well as efforts to secure organ donation commitments from the public and are outweighed by the moral and pragmatic cost. Nurses should be prepared to confront the challenge posed by the ongoing scarcity of organs and advocate for ethical alternatives including research on effective care pathways and education regarding organ donation.

Difficulties of Determining Death

2020 ◽  
pp. 155-176
Author(s):  
James F. Childress
Keyword(s):  
Organ Donation ◽  
Vital Organ ◽  
Determination Of Death ◽  
Life And Death ◽  
Ethical Implications ◽  
Legal Fiction ◽  
Dead Donor Rule ◽  
Deceased Organ Donation ◽  
The Dead

This chapter considers what we should do with the “dead donor rule” in transplantation in light of controversies about different ways of determining death. The system of voluntary deceased organ donation depends on public trust, based in part on adherence to the “Dead Donor Rule” (DDR). However, this rule presupposes that the line between life and death can be reliably drawn for purposes of removing vital organs for transplantation. Different but serious conceptual, scientific, and ethical questions surround deceased donation after neurological determination of death and after circulatory determination of death in either controlled or uncontrolled forms. This chapter examines the ethical implications of different approaches to the DDR and asks which public policy should be adopted: (1) abandon the DDR and move to living vital organ donation; (2) retain the DDR but view the determination of death as a legal fiction; (3) retain the DDR but expand individual/familial choices of conceptions of and criteria for determining death; or (4) retain and strengthen the DDR and ethically improve its operation. This chapter argues for the fourth option and for improving the process of individual and familial informed consent to deceased organ donation.

Organ donation after cardiac death: Are we willing to abandon the dead-donor rule?

2007 ◽  
Vol 8 (5) ◽  
pp. 507-509 ◽  
Author(s):  
Martha A. Q. Curley ◽  
David K. Urion ◽  
Tamara Vesel ◽  
Charlotte H. Harrison ◽  
Peter C. Laussen
Keyword(s):  
Organ Donation ◽  
Cardiac Death ◽  
Donation After Cardiac Death ◽  
Dead Donor Rule ◽  
The Dead
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