Organismal death, the dead-donor rule and the ethics of vital organ procurement
- PMID: 29921617
- DOI: 10.1136/medethics-2018-104796
Organismal death, the dead-donor rule and the ethics of vital organ procurement
Abstract
Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death-namely, that death is equivalent to total brain failure-and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller's argument and suggest that it may be necessary to look for alternative biological markers that reliably indicate the death of a human being. We reject the suggestion that we should abandon the dead-donor criteria for organ donation. Rather than weaken the ethical standards for vital organ procurement, it may be necessary to make them more demanding. The aim of this paper is not to justify the dead donor rule. Rather, we aim to explore the perspective of those who agree with critiques of the whole brain and cardiopulmonary definitions of death but yet disagree with the proposal that we should abandon the dead-donor rule. We will consider what those who want to retain the dead-donor rule must argue in light of Nair-Collins and Miller's critique.
Keywords: death; definition/determination of death; donation/procurement of organs/tissues; euthanasia; vital organ donation.
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Conflict of interest statement
Competing interests: None declared.
Comment in
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An unquestioned assumption in the debate on the dead donor rule.J Med Ethics. 2018 Dec;44(12):872-873. doi: 10.1136/medethics-2018-104979. Epub 2018 Aug 13. J Med Ethics. 2018. PMID: 30104201 No abstract available.
Comment on
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Do the 'brain dead' merely appear to be alive?J Med Ethics. 2017 Nov;43(11):747-753. doi: 10.1136/medethics-2016-103867. Epub 2017 Aug 28. J Med Ethics. 2017. PMID: 28848063 Free PMC article.
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